Clinical features of paediatric pulmonary hypertension : a registry study

NARCIS (Netherlands)

Berger, Rolf M. F.; Beghetti, Maurice; Humpl, Tilman; Raskob, Gary E.; Ivy, D. Dunbar; Jing, Zhi-Cheng; Bonnet, Damien; Schulze-Neick, Ingram; Barst, Robyn J.

2012-01-01

Background Paediatric pulmonary hypertension, is an important cause of morbidity and mortality, and is insufficiently characterised in children. The Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension (TOPP) registry is a global, prospective study designed to provide information about

Are thiazides effective on hypertensive vertigo? A preliminary study.

Science.gov (United States)

Eryaman, Esra; Gökcan, Gökçen; Parmaksız, Ergün; Acar, Nurhan Ozdemir; Ozlüoğlu, Levent Naci

2012-01-01

In this study, we aimed to investigate whether the symptoms of vertigo related to hypertension resulted from endolymphatic hydrops and the efficacy of the thiazides in the treatment. A total of 24 vertigo patients without peripheric or central vestibular pathologies or hyperlipidemia were included. The study group comprised 15 patients with hypertension, including nine with regulated non-insulin-dependent diabetes mellitus (DM). The control group comprised nine patients without hypertension or DM. The patients in the study group received hydrochlorothiazide treatment. The European Evaluation of Vertigo Scale (EEVS) and Vertigo Handicap Questionnaire (VHQ), puretone audiometry, tympanometry, electronystagmography (ENG) for nystagmus tests, oculomotor tests, and caloric test were carried out initially and at three weeks for both groups. The results of the study group were compared to those of the control group. There was a statistically significant decrease in the scores of EEVS and VHQ at three weeks in the study group, compared to the baseline scores (for both groups p≤0.01). Our study results showed that thiazides alleviated vertigo symptoms in hypertensive patients, as measured by qualitative methods (i.e. EEVS, VHQ), but not with quantitative measurements (i.e. ENG).

Studies on arterial stiffness and wave reflections in hypertension.

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Safar, Michel E; Levy, Bernard I

2015-01-01

Patho-physiological and pharmacological studies have consistently noticed that, with the exception of subjects with end-stage renal disease, total intravascular blood volume is not increased in patients with chronic hypertension. Because the mean circulatory pressure is enhanced in such subjects, it was postulated that the compliance of the cardiovascular system could be abnormally low in this particular population. This simple observation has influenced a great part of our experimental and clinical research directed toward subjects with hypertension and their relationship with the compliance of the vascular system. These works started between 1970 and 1980 by methodological investigations and validations followed by analysis of clinical situations that showed that venous and mostly arterial stiffness were significantly increased in hypertensive patients independently of blood pressure level. During the same time, we assessed the role of endothelium on the large arterial wall mechanical properties in normotensive and hypertensive rats. Thereafter more specific directions have been developed, affecting large arteries structure and function and arterial wall remodeling, including their consequences on central and peripheral hemodynamics. In parallel, epidemiological studies identified the pulsatile hemodynamic parameters as major independent predictors of cardiovascular risks. The consequences of these alterations on clinical pharmacology and therapeutics in hypertension are analyzed in detail. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Barriers to treatment and control of hypertension among hypertensive participants: A community based cross-sectional mixed method study in municipalities of Kathmandu, Nepal

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Surya Devkota

2016-08-01

Full Text Available AbstractIntroduction: Despite the established evidence on benefits of controlling raised blood pressure and development of several guidelines on detection and management of hypertension, people often have untreated or uncontrolled hypertension. In this context, we undertook this study to identify the barriers existing in hypertension treatment and control in the municipalities of Kathmandu district in Nepal. Methods: This was a community based, cross-sectional mixed method study conducted in the municipalities of Kathmandu district in Nepal between January and July 2015. Among 587 randomly selected participants, the aware hypertensive participants were further assessed for the treatment and control of hypertension. For qualitative component, 20 participants having uncontrolled hypertension took part in two focused group discussions and two cardiac physicians participated in in-depth interviews.Results: Out of 587 participants screened, 191 (32.5% were identified as hypertensive. Among 191 hypertensive participants, 118 (61.8% were aware of their problem. Of the 118 aware hypertensive participants, 93 (78.8% were taking medicines, and among those treated, 46 (49.6% had controlled hypertension. Proportions of participants taking anti-hypertensive medications varied significantly with age groups, ethnicity, occupation and income. Hypertension control was significantly associated with use of combination therapy, adherence to medication, follow-up care, counseling by healthcare providers and waiting time in hospital. Being worried that the medicine needs to be taken life-long, perceived side effects of drugs, non-adherence to medication, lost to follow-up, inadequate counseling from physician, and lack of national guidelines for hypertension treatment were the most commonly cited barriers for treatment and control of hypertension in qualitative component of the research.Conclusion: Large proportion of the hypertensive population has the untreated and

Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study.

Science.gov (United States)

Behrens, Ida; Basit, Saima; Melbye, Mads; Lykke, Jacob A; Wohlfahrt, Jan; Bundgaard, Henning; Thilaganathan, Baskaran; Boyd, Heather A

2017-07-12

Objectives  To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time. Design  Nationwide register based cohort study. Setting  Denmark. Populations  482 972 primiparous women with a first live birth or stillbirth between 1995 and 2012 (cumulative incidence analyses), and 1 025 118 women with at least one live birth or stillbirth between 1978 and 2012 (Cox regression analyses). Main outcome measures  10 year cumulative incidences of post-pregnancy hypertension requiring treatment with prescription drugs, and hazard ratios estimated using Cox regression. Results  Of women with a hypertensive disorder of pregnancy in a first pregnancy in their 20s, 14% developed hypertension in the first decade post partum, compared with 4% of women with normotensive first pregnancies in their 20s. The corresponding percentages for women with a first pregnancy in their 40s were 32% and 11%, respectively. In the year after delivery, women with a hypertensive disorder of pregnancy had 12-fold to 25-fold higher rates of hypertension than did women with a normotensive pregnancy. Rates in women with a hypertensive disorder of pregnancy were threefold to 10-fold higher 1-10 years post partum and remained twice as high even 20 or more years later. Conclusions  The risk of hypertension associated with hypertensive disorders of pregnancy is high immediately after an affected pregnancy and persists for more than 20 years. Up to one third of women with a hypertensive disorder of pregnancy may develop hypertension within a decade of an affected pregnancy, indicating that cardiovascular disease prevention in these women should include blood pressure monitoring initiated soon after pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Neurocognitive disorder in hypertensive patients. Heart-Brain Study.

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Vicario, A; Cerezo, G H; Del Sueldo, M; Zilberman, J; Pawluk, S M; Lódolo, N; De Cerchio, A E; Ruffa, R M; Plunkett, R; Giuliano, M E; Forcada, P; Hauad, S; Flores, R

2018-02-15

The relation between hypertension and cognitive impairment is an undisputable fact. The aims of this study were to determine the prevalence of cognitive impairment in hypertensive patients, to identify the most affected cognitive domain, and to observe the association with different parameters of hypertension and other vascular risk factors. A multicentre study was carried out, and 1281 hypertensive patients of both genders and ≥21 years of age were included. Data on the following parameters were obtained: cognitive status (Minimal Cognitive Examination), behavioural status (Hospital Anxiety and Depression Scale), blood pressure, anthropometry, and biochemical profile. The average age was 60.2±13.5 years (71% female), and the educational level was 9.9±5.1 years. Global cognitive impairment was seen in 22.1%, executive dysfunction in 36.2%, and semantic memory impairment in 48.9%. Cognitive impairment was higher in males (36.8% vs. 30.06%) within both the 70-79-year-old and the ≥80-year-old (50% vs. 40%) age groups. Abnormal Clock Drawing Test results were related to high pulse pressure (p24), 29.4% presented executive dysfunction, and 41.5% semantic memory impairment. Cognitive impairment was higher in hypertensive patients than in the general population. Executive functions and semantic memory were the most affected cognitive domains. High systolic blood pressure and pulse pressure were associated with abnormal results in cognitive tests. Copyright © 2018 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

[Microalbuminuria in diabetic and hypertensive patients: a study of 979 patients].

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Roberto Robles, Nicolás; Velasco, Joaquín; Mena, Cándido; Angulo, Enrique; Garrote, Timotea

2006-11-25

Microalbuminuria is a known complication of diabetes mellitus but it is also a cardiovascular risk factor commonly present among hypertensive (non diabetic) population. The prevalence of microalbuminuria is variable and it has been never estimated in our region. The aim of this study has been to determine the prevalence of microalbuminuria in hypertensive (non diabetic) and diabetic population in Extremadura (Spain). The study included diabetic patients and non-diabetic hypertensive ones randomly selected. Microalbuminuria was measured in every patient using albumin/creatinin reactive stick in fasting first morning urine. Whenever possible microalbuminuria was confirmed in laboratory by microalbuminuria/creatinina coefficient in first morning urine samples. A total of 979 patients (mean age [SD], 67.9 [10.8] years; 409 men and 570 women, 505 diabetics) were studied. The presence of microalbuminuria was found in 12.4% of hypertensive patients and in 21.4% of diabetic patients (p < 0.001). Hypertensives and normotensive diabetics showed a similar prevalence of microalbuminuria (13.3%, not significant), but it tripled in hypertensive diabetics (33.8; p < 0.01). Glicemic control was not different for microalbuminuric diabetic patients and non microalbuminuric ones. The patients receiving rennin-angiotensin axis blocking drugs do not showed less prevalence of microalbuminuria (hypertensives 10.5%, diabetics 23.5%). Microalbuminuria was confirmed in 65.4% of patients. The prevalence of microalbuminuria in Extremadura seems to be high either in diabetics or non diabetic hypertensive patients. The finding of microalbuminuria in diabetics patients correlates with hypertension but do not with glicemic control. The prevalence of microalbuminuria is high in spite of using rennin-angiotensin axis blocking drugs.

Hypertension control in industrial employees: findings from SHIMSCO study

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Alireza Khosravi

2012-03-01

Full Text Available Background: Hypertension prevention and control are among the most important public health priorities. We evaluated the impacts of a workplace intervention project "Stop Hypertension in Mobarakeh Steel Company" (SHIMSCO on controlling hypertension in industrial workers. Methods: The study was carried out in Mobarakeh Steel Company in Isfahan among 7286 male workers and employees. All individuals were evaluated for the presence of hypertension (HTN. According to examinations, 500 subjects with  systolic blood pressure (SBP ≥ 140 mmHg, and/or diastolic blood pressure (DBP ≥ 90 mmHg, and/or those using antihypertensive medications were confirmed to have HTN and thus included in this study. They were questioned for sociodemographic characteristics, past medical history and medication use. They received an educational program including healthy lifestyle and self-care recommendations of HTN management and control as well as training for accurate blood pressure measurement and home monitoring for two years. SBP, DBP, weight, height and routine lab tests were measured for all hypertensive subjects before and after the interventions. Paired t-test, generalized estimation equation (GEE and ordinary linear regression (OLR were used for statistical analysis in SPSS. Results: The comparison of SBP and DBP before and after the educational program showed significant reductions in both parameters (-7.97 ± 14.72 and -2.66 ± 9.96 mmHg, respectively. However, a greater decrease was detected in case of DBP. GEE showed SBP and DBP to decrease about -0.115 and -0.054 mmHg/month. OLR also revealed reductions of 4.88 and 2.57 mmHg respectively in SBP and DBP upon adding each antihypertensive drug. Conclusion: SHIMSCO, a 3-year interventional project in workplaces, was effective in reducing SBP and DBP among hypertensive employees and workers. We conclude that implementing simple educational programs in worksites can improve the management and control of

Hypertension, risk factors and coronary artery stenosis: A case-control study.

Science.gov (United States)

Sedaghat, Zahra; Zibaeenejad, Mohammadjavad; Fararouei, Mohammad

2018-04-25

Although hypertension is introduced as a major risk factor for cardiovascular diseases (CVDs), our knowledge about the nature of the association is hindered. The aim of this study was to assess the concurrent associations of several factors including serologic, anthropometric and coronary artery stenosis (CAS) with blood pressure. This is a case-control study on 163 hypertensive patients (SBP > 140 mmHg or DBP > 80 mmHg) and 227 healthy participants. All participants underwent angiography due to classic symptoms of CVDs. Controlling for other study variables, significant associations between CAS (OR yes/no = 1.99, 95%CI: 1.18-3.34 P = 0.006), BMI (kg/m 2 ) (OR = 1.08, 95%CI: 1.03-1.14, P = 0.002) and age (year) (OR = 1.03, 95%CI = 1.005-1.05, p = 0.01) with hypertension were found. However, according to the results of the stratified analysis, no such associations were found among those with significant CAS. BMI and age were the only significant predictors of hypertension among participants with no CAS. Abdominal obesity was not remained in the final model regardless of the presence or absence of stenosis. As expected, stenosis itself was significantly associated with hypertension. This study suggested that BMI and age are the most powerful predictors of hypertension among those without CAS. As the result, it can be concluded that CAS alters the association between several factors and hypertension.

Neonatal hypertension – a long-term pilot follow-up study

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Chaudhari T

2013-06-01

Full Text Available Tejasvi Chaudhari,1 Michael C Falk,2,3 Rajeev Jyoti,2,4 Susan Arney,5 Wendy Burton,5 Alison L Kent1,2 1Department of Neonatology, Canberra Hospital, Woden, ACT, Australia; 2Australian National University Medical School, Canberra, ACT, Australia; 3Department of Nephrology, 4Medical Imaging Department, 5Centre for Newborn Care, Canberra Hospital, Woden, ACT, Australia Background: Neonatal hypertension occurs in up to 3% of neonates, more commonly in those admitted to neonatal intensive care. The aims of this study were to review renal function and renal volumes in children who had a history of neonatal hypertension. Methods: Children with a history of neonatal hypertension from January 2001 to December 2008 were included in the study during 2011. Blood pressure, weight, height, and body mass index were recorded. Renal ultrasound with 3D volume, urine for electrolytes, albumin, ß2 microglobulin, and blood for electrolytes, urea, creatinine, calcium, phosphate, renin, and aldosterone were collected depending on parental consent. Results: Of the 41 neonates with neonatal hypertension, eleven (27% were included in the study (six died; 24 moved interstate or declined involvement. One child (9% was still on antihypertensive medication and one was found to be hypertensive on review. This child had small volume kidneys and albuminuria. Three out of nine renal volume measurements were low (33% and two out of eleven had renal scarring (18%. The six available renin/aldosterone results were normal. Conclusion: This study suggests there are long-term renal and blood pressure implications for neonates with hypertension and ongoing surveillance of blood pressure and renal function should be performed throughout childhood and into early adulthood. Keywords: neonate, hypertension, renal ultrasound, 3D

Magnesium supplement in pregnancy-induced hypertension. A clinicopathological study

DEFF Research Database (Denmark)

Rudnicki, M; Junge, Jette; Frølich, A

1990-01-01

The placenta and the umbilical cord obtained from 18 women with pregnancy-induced hypertension were investigated by light microscopy. The umbilical artery was studied by electron microscopy. 10 placentae and umbilical cords from normal pregnancies served as controls. The study was performed...... fibrosis or intervillous fibrin. Ultrastructurally, the endothelial cells of the umbilical arteries from women with pregnancy-induced hypertension showed a significant increase in the amount of dilated endoplasmic reticulum and basal laminae thickness when all 18 cases were compared with the controls....... There was no significant difference when the magnesium group, the placebo group and the control group were compared separately. The present study suggests that magnesium supplement has a beneficial effect on fetal growth in pregnancy-induced hypertension. With regard to the light and electron microscopic changes we were...

Leptin, not adiponectin, predicts hypertension in the Copenhagen City Heart Study

DEFF Research Database (Denmark)

Asferg, Camilla Lundegaard; Møgelvang, Rasmus; Flyvbjerg, Allan

2010-01-01

of hypertension have been directly compared. The objective of this study was to investigate the relationships between plasma levels of leptin and adiponectin and new-onset hypertension in the Copenhagen City Heart Study (CCHS). METHODS: In a prospective study design, we examined new-onset hypertension in 620...... blood pressure (DBP) > or = 90 mm Hg, or use of antihypertensive medication. Using logistic regression analysis, adjusting for age, sex, estimated glomerular filtration rate, triglycerides, high-density lipoprotein cholesterol (HDL-C), fibrinogen, and glucose, and with leptin and adiponectin included...

The CHIPS Randomized Controlled Trial (Control of Hypertension in Pregnancy Study): Is Severe Hypertension Just an Elevated Blood Pressure?

Science.gov (United States)

Magee, Laura A; von Dadelszen, Peter; Singer, Joel; Lee, Terry; Rey, Evelyne; Ross, Susan; Asztalos, Elizabeth; Murphy, Kellie E; Menzies, Jennifer; Sanchez, Johanna; Gafni, Amiram; Helewa, Michael; Hutton, Eileen; Koren, Gideon; Lee, Shoo K; Logan, Alexander G; Ganzevoort, Wessel; Welch, Ross; Thornton, Jim G; Moutquin, Jean-Marie

2016-11-01

To determine whether clinical outcomes differed by occurrence of severe hypertension in the international CHIPS trial (Control of Hypertension in Pregnancy Study), adjusting for the interventions of "less tight" (target diastolic blood pressure [dBP] 100 mm Hg) versus "tight" control (target dBP 85 mm Hg). In this post-hoc analysis of CHIPS data from 987 women with nonsevere nonproteinuric preexisting or gestational hypertension, mixed effects logistic regression was used to compare the following outcomes according to occurrence of severe hypertension, adjusting for allocated group and the influence of baseline factors: CHIPS primary (perinatal loss or high-level neonatal care for >48 hours) and secondary outcomes (serious maternal complications), birth weight hypertension that was associated with all outcomes examined except for maternal readmission (P=0.20): CHIPS primary outcome, birth weight hypertension and serious maternal complications was seen only in less tight control (P=0.02). Adjustment for preeclampsia (464, 47.3%) did not negate the relationship between severe hypertension and the CHIPS primary outcome (Phypertension is a risk marker for adverse maternal and perinatal outcomes, independent of BP control or preeclampsia co-occurrence. URL: http://pre-empt.cfri.ca/. Unique identifier: ISRCTN 71416914. URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01192412. © 2016 The Authors.

Cervical spondylosis and hypertension: a clinical study of 2 cases.

Science.gov (United States)

Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

2015-03-01

Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis.

A review of population-based studies on hypertension in Ghana ...

African Journals Online (AJOL)

Background: Hypertension is becoming a common health problem worldwide with increasing life expectancy and increasing prevalence of risk factors. Epidemiological data on hypertension in Ghana is necessary to guide policy and develop effective interventions. Methods: A review of population-based studies on ...

The CHIPS Randomized Controlled Trial (Control of Hypertension in Pregnancy Study): Is Severe Hypertension Just an Elevated Blood Pressure?

NARCIS (Netherlands)

Magee, Laura A.; von Dadelszen, Peter; Singer, Joel; Lee, Terry; Rey, Evelyne; Ross, Susan; Asztalos, Elizabeth; Murphy, Kellie E.; Menzies, Jennifer; Sanchez, Johanna; Gafni, Amiram; Helewa, Michael; Hutton, Eileen; Koren, Gideon; Lee, Shoo K.; Logan, Alexander G.; Ganzevoort, Wessel; Welch, Ross; Thornton, Jim G.; Moutquin, Jean-Marie

2016-01-01

To determine whether clinical outcomes differed by occurrence of severe hypertension in the international CHIPS trial (Control of Hypertension in Pregnancy Study), adjusting for the interventions of less tight (target diastolic blood pressure [dBP] 100 mmHg) versus tight control (target dBP 85

Breakfast cereals and risk of hypertension in the Physicians’ Health Study I

Science.gov (United States)

Kochar, Jinesh; Gaziano, J. Michael; Djoussé, Luc

2012-01-01

Summary Background and aims Hypertension is a major public health problem. While many dietary factors affect the risk of developing hypertension, limited data are available on the association between consumption of breakfast cereal and incident hypertension. We examined the association between breakfast cereal consumption and the risk of hypertension. Methods We prospectively analyzed data from 13,368 male participants of the Physicians’ Health Study I. Consumption of breakfast cereals was estimated using an abbreviated food frequency questionnaire and incident hypertension was ascertained through yearly follow-up questionnaires. Results The average age of study participants was 52.4 ±8.9 years (range 39.7-85.9) during the initial assessment of cereal intake (1981-1983). During a mean follow up of 16.3 years, 7,267 cases of hypertension occurred. The crude incidence rates of hypertension were 36.7, 34.0, 31.7, and 29.6 cases/1,000 person-years for people reporting breakfast cereal intake of 0, ≤ 1, 2-6, and ≥ 7 servings/week, respectively. In a Cox regression model adjusting for age, smoking, body mass index, alcohol consumption, fruit and vegetable consumption, physical activity, and history of diabetes mellitus, hazard ratios (95% CI) for hypertension were 1.0 (reference), 0.93 (0.88-0.99), 0.88 (0.83-0.94), and 0.81 (0.75-0.86) from the lowest to the highest category of cereal consumption, respectively (p for trend cereals and was observed in lean as well as overweight or obese participants. Conclusions The results of this longitudinal cohort study suggest that whole grain breakfast cereal consumption confers a lower risk of hypertension in middle-aged adult males PMID:21868140

Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at Jimma University Teaching and Specialized Hospital: cross-sectional study

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Tesfaye B

2017-03-01

Full Text Available Bekele Tesfaye,1 Dessalegn Haile,1 Benalfew Lake,1 Tefera Belachew,2 Temamen Tesfaye,3 Habtamu Abera4 1Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, 2Department of Population and Family Health, 3Department of Nursing and Midwifery, College of Health Science, Jimma University, Jimma, 4Department of Nursing and Midwifery, College of Health Sciences, School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Hypertension, including poorly controlled blood pressure, is the major global health problem that affects one billion people worldwide. Limited studies have been conducted on prevalence of uncontrolled hypertension and associated factors among adult hypertensive patients in Ethiopia.Objective: The aim of this study was to determine the prevalence of uncontrolled hypertension and associated factors among adult hypertensive patients at Jimma University Teaching and Specialized Hospital.Methods: Institution-based cross-sectional study was conducted at the chronic illness clinic of Jimma University Specialized and Teaching hospital from March 09 to April 13, 2016. A total of 345 hypertensive patients were selected using systematic sampling technique. Data were collected using structured questionnaire through face-to-face exit interview and chart review. Data were analyzed using Statistical Package for the Social Sciences (SPSS version 20.0 software. The bivariate and multivariable analysis was done to identify factors of uncontrolled hypertension.Results: More than half, 52.7%, of the patients had uncontrolled hypertension. Lack of awareness of hypertension-related complications (adjusted odds ratio [AOR]=2.140, 95% confidence interval [CI]=1.272–3.600, p=0.004, nonadherent to smoking abstinence (AOR=3.935, 95% CI=1.065–14.535, p=0.004, nonadherent to alcohol abstinence (AOR=2.477, 95% CI=1.074–5.711, p=033, Khat (Catha edulis chewing (AOR=2.518, 95% CI=1.250–5

Definition and management of hypertension among Haitian immigrants: a qualitative study.

Science.gov (United States)

Sanon, Marie-Anne; Mohammed, Selina A; McCullagh, Marjorie C

2014-08-01

Hypertension is a major health concern among Haitian immigrants, one of the largest Caribbean immigrant groups in the United States. Yet, little is known about how Hatian immigrants define and manage hypertension. For this qualitative study, face-to-face semi-structured interviews were conducted with 31 Haitian immigrants in Miami Dade County, Florida. Results indicated that most Haitian immigrants used the Haitian Creole word tansyon to represent hypertension. Tansyon was considered as either a normal condition of the human body or a maladi (illness). Both traditional biomedical and alternative approaches were used to manage hypertension. The findings show that how Haitian immigrants defined hypertension shaped their beliefs about its occurrence and the resulting management strategies used. Those who believed tansyon was a normal body condition did not take any management measures. Awareness and understanding of Haitian immigrants' beliefs about and approaches to hypertension management can enhance culturally sensitive care and improve health outcomes.

Perceptions on hypertension among migrants in Delhi, India: a qualitative study

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Kusuma Yadlapalli S

2009-07-01

Full Text Available Abstract Background The developing countries are experiencing epidemiological transition and hypertension has emerged as a major threat to health in these countries. Understanding people's perceptions is important for any prevention and control activities and lay explanatory models (EMs provide an opportunity to gain insights into the people's perceptions. This qualitative study is taken up with an objective of understanding EMs of neo- and settled-migrants regarding hypertension. Methods Qualitative methods with grounded theory approach were used to elicit EMs of hypertension held by neo- and settled-migrants. In-depth interviews with key-informants and focus group discussions with community members were conducted. The data were subjected to thorough reading and analysed by segregating the text under different themes. Results Hypertension has been perceived as a common and serious problem in the community. Lay conceptions have identified hypertension as symptomatic with ambiguity over perceived symptoms. City life has been perceived as a major predisposing factor for developing hypertension. City life has been corroborated with pollution and adulteration of food, stress, high fat diet along with physical inactivity and certain attitudes. The concepts of hypertension were interconnected and linked to their day-to-day living in the city. Inadequacy of awareness has been acknowledged and there was a felt need for awareness campaigns and screening programmes in the community. The EMs of hypertension among the neo- and settled-migrants and men and women were broadly similar. However, there were slight variations by gender and migration status in the perceived pathways to hypertension. Conclusion Hypertension has been perceived as a common and serious problem in the community. Hypertension has been perceived as symptomatic; however, ambiguity prevails over perceived symptoms. Awareness and knowledge about hypertension and its consequences are

Pattern of left ventricular geometry in hypertension: a study of a ...

African Journals Online (AJOL)

Background: Hypertension is a leading cause of cardioxasular morbidity and mortality in Nigeria. The main aim of this study was to deterine the prevalence of left ventricular hypertrophy and left ventricular geometric patterns among hypertensives in Kano, Nigeria. Methods: The study was cross-sectional in design, and ...

Rationale and design of the screening of pulmonary hypertension in systemic lupus erythematosus (SOPHIE) study.

Science.gov (United States)

Huang, Duo; Cheng, Yang-Yang; Chan, Pak-Hei; Hai, Jojo; Yiu, Kai-Hang; Tse, Hung-Fat; Wong, Ka-Lam; Fan, Katherine; Li, Ying Wah; Ng, Woon-Leung; Yim, Cheuk-Wan; Wong, Cheuk-Hon John; Tam, Lai-Shan; Wong, Priscilla C H; Wong, Chi-Yuen; Ho, Chup-Hei; Leung, Alexander M H; Mok, Chi-Chiu; Lam, Ho; Lau, Chak-Sing; Cheung, Tommy; Ho, Carmen; Law, Sharon W Y; Chan, Esther W; Yin, Li-Xue; Yue, Wen-Sheng; Mok, Toi Meng; Evora, Mario Alberto; Siu, Chung-Wah

2018-01-01

Current guideline-recommended screening for pulmonary hypertension in patients with systemic sclerosis has not been evaluated in systemic lupus erythematosus (SLE), which is disproportionately prevalent in Asians. This multicentre, cross-sectional screening study aims to study the prevalence of pulmonary hypertension among SLE patients using these guidelines, and identify independent predictors and develop a prediction model for pulmonary hypertension in SLE patients. SLE patients from participating centres will undergo an echocardiography- and biomarker-based pulmonary hypertension screening procedure as in the DETECT study. Standard right heart catheterisation will be provided to patients with intermediate or high echocardiographic probability of pulmonary hypertension. Those with low echocardiographic probability will rescreen within 1 year. The primary measure will be the diagnosis and types of pulmonary hypertension and prevalence of pulmonary hypertension in SLE patients. The secondary measures will be the predictors and prediction models for pulmonary hypertension in SLE patients. The estimated sample size is approximately 895 participants. The results of the SOPHIE study will be an important contribution to the literature of SLE-related pulmonary hypertension and may be immediately translatable to real clinical practice. Ultimately, this study will provide the necessary evidence for establishing universal guidelines for screening of pulmonary hypertension in SLE patients.

Breakfast cereals and risk of hypertension in the Physicians' Health Study I.

Science.gov (United States)

Kochar, Jinesh; Gaziano, J Michael; Djoussé, Luc

2012-02-01

Hypertension is a major public health problem. While many dietary factors affect the risk of developing hypertension, limited data are available on the association between consumption of breakfast cereal and incident hypertension. We examined the association between breakfast cereal consumption and the risk of hypertension. We prospectively analyzed data from 13,368 male participants of the Physicians' Health Study I. Consumption of breakfast cereals was estimated using an abbreviated food frequency questionnaire and incident hypertension was ascertained through yearly follow-up questionnaires. The average age of study participants was 52.4 ± 8.9 years (range 39.7-85.9) during the initial assessment of cereal intake (1981-1983). During a mean follow up of 16.3 years, 7267 cases of hypertension occurred. The crude incidence rates of hypertension were 36.7, 34.0, 31.7, and 29.6 cases/1000 person-years for people reporting breakfast cereal intake of 0, ≤1, 2-6, and ≥7 servings/week, respectively. In a Cox regression model adjusting for age, smoking, body mass index, alcohol consumption, fruit and vegetable consumption, physical activity, and history of diabetes mellitus, hazard ratios (95% CI) for hypertension were 1.0 (reference), 0.93 (0.88-0.99), 0.88 (0.83-0.94), and 0.81 (0.75-0.86) from the lowest to the highest category of cereal consumption, respectively (p for trend cereals and was observed in lean as well as overweight or obese participants. The results of this longitudinal cohort study suggest that whole grain breakfast cereal consumption confers a lower risk of hypertension in middle-aged adult males. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

hypertension

Directory of Open Access Journals (Sweden)

Emine Hatipoglu

2013-05-01

Full Text Available Hypertension is a common disease associated with important cardiovascular complications. Persistent blood pressure of 140/90 or higher despite combined use of a reninangiotensin system blocker, calcium channel blocker and a diuretic at highest tolerated doses constitutes resistant hypertension. Excess sympathetic activity plays an important pathogenic role in resistant hypertension in addition to contributing to the development of metabolic problems, in particular diabetes. Reduction of renal sympathetic activity by percutaneous catheter-based radiofrequency ablation via the renal arteries has been shown in several studies to decrease blood pressure in patients with resistant hypertension, and importantly is largely free of significant complications. However, longer term follow-up is required to confirm both long-term safety and efficacy.

Clinical factors associated with readmission for postpartum hypertension in women with pregnancy-related hypertension: a nested case control study.

Science.gov (United States)

Hirshberg, A; Levine, L D; Srinivas, S K

2016-05-01

To evaluate the association between mode of delivery and length of labor on readmission for postpartum hypertension in women with pregnancy-related hypertension. Nested case control study within a cohort of 99 women with pregnancy-related hypertension who delivered at our institution between 2005 and 2009. Data were abstracted for clinical and labor information. Mode of delivery and length of labor were compared between women with previously diagnosed pregnancy-related hypertension readmitted within 4 weeks post partum (25 cases) and those not readmitted (74 controls). Categorical and continuous variables were compared using χ(2) and T-tests, respectively. Multivariable logistic regression controlled for confounders. Hypertension readmission was not associated with mode of delivery (cases: 10(40%) spontaneous vaginal delivery, 15(60%) cesarean delivery; controls: 38(51%) spontaneous vaginal delivery, 36(49%) cesarean delivery, P=0.33). Length of labor appeared longer in cases, with a trend toward significance (median: 15.5 [7,28] h vs 10.75 [5.8,15.9] h, P=0.12) and was significantly associated with readmission after controlling for delivery mode, induction and parity (adjusted odds ratio=1.06 [1 to 1.12], P=0.048). Readmitted patients were less likely to have initially been started on antihypertensive medications after controlling for age, race and chronic hypertension (adjusted odds ratio=0.23 [0.06 to 0.88], P=0.03). Postpartum readmission for hypertension in women with known pregnancy-related hypertension is not associated with mode of delivery, appears increased in those with longer length of labor and decreased in those initially started on antihypertensive medications. This provides targets for future research to continue to improve transitions of care and reduce preventable readmissions.

Time trend in hypertension prevalence, awareness, treatment, and control in a contemporary cohort of HIV-infected patients: the HIV and Hypertension Study.

Science.gov (United States)

De Socio, Giuseppe Vittorio; Ricci, Elena; Maggi, Paolo; Parruti, Giustino; Celesia, Benedetto Maurizio; Orofino, Giancarlo; Madeddu, Giordano; Martinelli, Canio; Menzaghi, Barbara; Taramasso, Lucia; Bonfanti, Paolo; Pucci, Giacomo; Schillaci, Giuseppe

2017-02-01

Hypertension control is often inadequate in HIV patients. In a contemporary, nationwide cohort of Italian HIV-infected adults, we assessed time trends in hypertension prevalence, awareness, treatment, and control. We also evaluated predictors of cardiovascular events and of new-onset hypertension. Multicenter prospective cohort study, sampling 961 consecutive HIV patients (71% men, mean age 46 ± 9 years, 30% hypertensive) examined in 2010-2014 and after a median follow-up of 3.4 years. Among hypertensive patients, hypertension awareness (63% at baseline and 92% at follow-up), treatment (54 vs. 79%), and control (35 vs. 59%) all improved during follow-up. The incidence of new-onset hypertension was 50.1/1000 person-years (95% confidence interval, 41.2-60.3). Multivariable-adjusted predictors of hypertension were age, BMI, estimated cardiovascular risk, blood pressure, and advanced HIV clinical stage.In total, 35 new cardiovascular events were reported during follow-up (11.1/1000 person-years). In a multivariate model, baseline cardiovascular risk and hypertensive status predicted incident cardiovascular events, whereas a higher CD4 cell count had a protective role. In treated hypertensive patients, the use of integrase strand transfer inhibitors at follow-up was associated with a lower SBP (average yearly change, -3.8 ± 1.6 vs. -0.9 ± 0.5 mmHg in integrase strand transfer inhibitor users vs. nonusers, respectively, P = 0.02). Hypertension awareness, treatment, and control rates all improved in adult Italian HIV patients over the last few years, although hypertension remains highly prevalent (41%) in middle-aged HIV patients, and significantly impacts cardiovascular morbidity. Traditional risk factors and advanced HIV disease predict new-onset hypertension, whereas CD4 cell count favorably affects future cardiovascular events.

Relationship Between Prehypertension/Hypertension and Periodontal Disease: A Prospective Cohort Study.

Science.gov (United States)

Kawabata, Yuya; Ekuni, Daisuke; Miyai, Hisataka; Kataoka, Kota; Yamane, Mayu; Mizutani, Shinsuke; Irie, Koichiro; Azuma, Tetsuji; Tomofuji, Takaaki; Iwasaki, Yoshiaki; Morita, Manabu

2016-03-01

Most cross-sectional studies have found a significant positive relationship between periodontal disease and prehypertension/hypertension. However, these studies had limitations and there are few prospective cohort studies in young adults. The purpose of this prospective cohort study was to investigate whether periodontal disease was related to prehypertension/hypertension in Japanese university students. Students (n = 2,588), who underwent health examinations before entering university and before graduation, were included in the analysis. The association between periodontal disease such as the percentage of bleeding on probing (BOP) and community periodontal index (CPI) scores, and change in blood pressure status was determined. At the reexamination, the numbers of participants with prehypertension (systolic blood pressure 120-139mm Hg or diastolic blood pressure 80-89mm Hg) and hypertension (≥140/90mm Hg) were 882 (34.1%) and 109 (4.2%), respectively. In a logistic regression model, the risk of hypertension was significantly associated with male (odds ratio (OR): 6.31; 95% confidence interval (CI): 2.63-15.13; P periodontal disease defined as the presence of both probing pocket depth (PPD) ≥ 4mm and BOP ≥ 30% at baseline (OR: 2.74; 95% CI: 1.19-6.29; P = 0.02) in participants with prehypertension at baseline. On the other hand, the risk of prehypertension was not associated with presence of periodontal disease (OR: 0.93; 95% CI: 0.51-1.70; P = 0.82). In the short-term prospective cohort study, a significant association between presence of periodontal disease and hypertension was observed in Japanese university students. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Karşıyaka Prevalance and Awareness of Hypertension Study (KARHIP

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Nihat Pekel

2016-01-01

Conclusions: Hypertension prevalances in our study were similar to the PatenT 2 trial prevalances, which were 46 % for the middle age group and 78% for the geriatric age group. Compared to PatenT 2 data, the rate of hypertension awareness (54.7% vs 72.3% and the rate of being under treatment (47.5% vs 69.4% were higher. The rate of controlled hypertension was a little bit higher (28.7 % vs 34.7% in our group, whereas control rates in aware and treated groups were similar (53.9 % and 50.1 % in both studies.

Pre-Hypertension and Hypertension in Adolescence: How much ...

African Journals Online (AJOL)

Background: Hypertension is an important worldwide public-health challenge because of its high frequency and concomitant risks of cardiovascular and kidney disease. Previous studies have documented that hypertension may begin in adolescence, perhaps even in childhood. Objectives: This study set out to determine ...

Causes of secondary hypertension in the young population: A monocentric study.

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Noilhan, C; Barigou, M; Bieler, L; Amar, J; Chamontin, B; Bouhanick, B

2016-06-01

To study the prevalence of different causes of hypertension in young adults referred to a hypertension center in the south west of France. We conducted a retrospective overview of patients younger than 40years old hospitalized consecutively in the Hypertension department of Toulouse University Hospital between 2012 and 2014. Clinical data about gender, age, anthropomorphic parameters and blood pressure measurement by 24h Ambulatory Blood Pressure Monitoring (ABPM) were recorded. Biological data concerned dosages of kalemia, renin and aldosterone in the supine or after 15min of seating. Recorded radiological examinations were renal artery ultrasound and abdominal CT scan. One hundred and forty-eight detailed medical records were analyzed, 69 women and 79 men. Among the 69 women, the causes of secondary hypertension were primary aldosteronism (n=7), fibromuscular dysplasia (n=5) and renal disease (n=4). Oral contraceptives were involved in 13 women. In addition, essential hypertension concerned 40 women (58%). Among the 79 men, the causes of secondary hypertension were primary aldosteronism (n=10), fibromuscular dysplasia (n=3), left main renal artery entrapment by a diaphragmatic crura (n=2), renal disease (n=1), pheochromocytoma (n=3) and coarctation of the aorta (n=2). In addition, essential hypertension concerned 58 men (73%). In our population, the prevalence of secondary hypertension is close to 33% (42% of females and 27% of males), with the following main causes: primary aldosteronism for 11.5%; fibromuscular dysplasia for 5.4%. Oral contraceptives were involved in the hypertension of 19% of the females. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Comparisons of hypertension-related costs from multinational clinical studies.

Science.gov (United States)

Mullins, C Daniel; Sikirica, Mirko; Seneviratne, Viran; Ahn, Jeonghoon; Akhras, Kasem S

2004-01-01

This study identifies and compares the individual cost components of hospital and ambulatory services that manage the care of hypertensive patients in eight countries: the US, the UK, France, Spain, Germany, Italy, Canada and Australia. Hypertension-related costs are classified according to four major cardiovascular events: (i) acute myocardial infarction; (ii) congestive heart failure; (iii) stroke; and (iv) renal failure, which was subdivided into renal failure treated by dialysis and renal failure treated by kidney transplantation. To make cross-country costs comparisons, we used the DRG codes used in the US and DRG-like codes from each country. US cost information was obtained from hypertension data available from the literature and health economics researchers. For costs in other countries, we consulted with national health economics experts in each country, used analyses by the Research Triangle Institute, and performed Medline and international literature searches. When available, we obtained information from the countries' public and private nationally representative data sources. For cross-country currency adjustments, all currencies were converted using the Purchasing Power Parities from the Organisation for Economic Cooperation and Development, and then converted into inflation-adjusted year 2000 US dollars. There exists considerable variation in hypertension-related costs from multinational clinical studies. This study documents that costs are generally higher in the US than in other countries; however, this is not always true. In particular, costs of treating heart failure in France and the costs of renal failure without transplantation in Germany and the UK are relatively high. While analysing multinational hypertensive cost data, this study also addresses the impact of cross-country cost variations on cost analyses. During the last decade, drug-development researchers have drawn extensively upon multinational trials to resolve enrollment problems and

Control of Hypertension in STULONG - Twenty Years Lasting Primary Preventive Study

Czech Academy of Sciences Publication Activity Database

Tomečková, Marie; Stanovská, Zuzana; Boudík, F.; Zvárová, Jana

22 Suppl. 2, - (2004), s. 271 ISSN 0263-6352. [European Meeting on Hypertension /14./. 13.06.2004-17.06.2004, Paris] R&D Projects: GA MŠk LN00B107 Keywords : hypertension * primary preventive study Subject RIV: BB - Applied Statistics, Operational Research

Milan hypertensive rat as a model for studying cation transport abnormality in genetic hypertension

International Nuclear Information System (INIS)

Ferrari, P.; Barber, B.R.; Torielli, L.; Ferrandi, M.; Salardi, S.; Bianchi, G.

1987-01-01

Environmental factors, genetic polymorphisms, and different experimental designs have been the main impediments to evaluating a genetic association between cell membrane cation transport abnormalities and human essential or genetic hypertension. We review the results obtained in the Milan hypertensive strain of rats (MHS) and in its appropriate control normotensive strain (MNS) to illustrate our approach to defining the role of cation transport abnormality in a type of genetic hypertension. Before the development of a difference in blood pressure between the two strains, the comparison of kidney and erythrocyte functions showed that MHS had an increased glomerular filtration rate and urinary output, and lower plasma renin and urine osmolality. Kidney cross-transplantation between the strains showed that hypertension is transplanted with the kidney. Proximal tubular cell volume and sodium content were lower in MHS while sodium transport across the brush border membrane vesicles of MHS was faster. Erythrocytes in MHS were smaller and had lower sodium concentration, and Na+-K+ cotransport and passive permeability were faster. The differences in volume, sodium content, and Na+-K+ cotransport between erythrocytes of the two strains persisted after transplantation of bone marrow to irradiated F1 (MHS X MNS) hybrids. Moreover, in normal segregating F2 hybrid populations there was a positive correlation between blood pressure and Na+-K+ cotransport. These results suggest a genetic and functional link in MHS between cell membrane cation transport abnormalities and hypertension. Thus, erythrocyte cell membrane may be used for approaching the problem of defining the genetically determined molecular mechanism underlying the development of a type of essential hypertension. 35 references

Essential hypertension vs. secondary hypertension among children.

Science.gov (United States)

Gupta-Malhotra, Monesha; Banker, Ashish; Shete, Sanjay; Hashmi, Syed Sharukh; Tyson, John E; Barratt, Michelle S; Hecht, Jacqueline T; Milewicz, Diane M; Boerwinkle, Eric

2015-01-01

The aim was to determine the proportions and correlates of essential hypertension among children in a tertiary pediatric hypertension clinic. We evaluated 423 consecutive children and collected demographic and clinical history by retrospective chart review. We identified 275 (65%) hypertensive children (blood pressure >95th percentile per the "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents") from 423 children referred to the clinic for history of elevated blood pressure. The remainder of the patients had normotension (11%), white coat hypertension (11%), prehypertension (10%), and pending diagnosis (3%). Among the 275 hypertensive children, 43% (n = 119; boys = 56%; median age = 12 years; range = 3-17 years) had essential hypertension and 57% (n = 156; boys = 66%; median age = 9 years; range = 0.08-19 years) had secondary hypertension. When compared with those with secondary hypertension, those with essential hypertension had a significantly older age at diagnosis (P = 0.0002), stronger family history of hypertension (94% vs. 68%; P secondary hypertension. The phenotype of essential hypertension can present as early as 3 years of age and is the predominant form of hypertension in children after age of 6 years. Among children with hypertension, those with essential hypertension present at an older age, have a stronger family history of hypertension, and have lower prevalence of preterm birth. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Hypertension in postmenopausal women: how to approach hypertension in menopause.

Science.gov (United States)

Modena, Maria Grazia

2014-09-01

During fertile life women are usually normo or hypotensive. Hypertension may appear during pregnancy and this represents a peculiar phenomenon increasing nowadays for delay time of pregnancy. Gestational hypertension appears partially similar to hypertension in the context of metabolic syndrome for a similar condition of increased waste circumference. Parity, for the same pathogenesis, has been reported to be associated to peri and postmenopausal hypertension, not confirmed by our study of parous women with transitional non persistent perimenopausal hypertension. Estrogen's deficiency inducing endothelial dysfunction and increased body mass index are the main cause for hypertension in this phase of life. For these reasons lifestyle modification, diet and endothelial active drugs represent the ideal treatment. Antioxidant agents may have a role in prevention and treatment of hypertension. In conclusion, hypertension in women represents a peculiar constellation of different biological and pathogenic factors, which need a specific gender related approach, independent from the male model.

Study of left ventricular diastolic dysfunction in recently diagnosed hypertensives in Central Nepal

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Shankar Laudari

2016-03-01

Full Text Available CORRECTION: The conclusion on the PDF of this article was replaced on 17th April 2016. The corrected PDF is now available by clicking on the link below.Background & Objectives: Ectopic Left ventricular diastolic dysfunction is now well established as a cause of left sided heart failure and as a powerful predictor of cardiovascular events. It is attributed mostly to systemic hypertension. The objective of the study was to determine the prevalence of left ventricular diastolic dysfunction in recently diagnosed hypertensives in Nepalese population using echocardiography. Materials & Methods: Two-dimensional echocardiography was performed on 120 newly diagnosed patients of systemic hypertension. Transmitral Doppler indexes of diastolic function, Valsalva maneuver applied to the same mitral inflow pattern, pulsed tissue Doppler of the mitral annulus, deceleration time, isovolumic relaxation time and pulmonary venous flow pattern.Results: The age of the patients in our study ranged from 20 to 84 years with mean age of 50years±14.13 years (standard deviation and male:female ratio being 1.35:1. Hypertensive patients were highest in age group 45-64 years followed by 25-44 years in both the genders. Majority of the patients had stage 1 hypertension (44.16% followed by stage 2 HTN in 34.17% and pre-hypertension in 21.67%. The majority of the patients in our study had Grade 1 LVDD (66.67%, 10.83% patients had Grade II LVDD, only 2.50% had non-restrictive Grade III LVDD and none had LVDD-IV. Stage II hypertensives had more LVDD(I+II+III: 39/41-95.12% than stage I hypertensives(39/53-73.58% and pre-hypertensives (8/26-30.77%. The association between stages of systemic HTN and LVDD was found to be highly statistically significant (p=0.002. Conclusion: Our study showed that left ventricular diastolic dysfunction is a common entity in Nepalese population with systemic hypertension.JCMS Nepal. 2016;12(1:14-18.

Study of determinants of nonadherence to anti-hypertensive medications in essential hypertension at a Teaching Hospital in Southern India

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R C Kumaraswamy

2015-01-01

Full Text Available Introduction: Hypertension is a chronic asymptomatic disease, often goes unnoticed for decades before it presents to the medical fraternity with devastating consequences. Low patient adherence is amenable for modification for better control of hypertension, if factors contributing to it are understood. Study was undertaken with the aims of assessing the factors responsible and their relative contributions toward nonadherence among hypertensives. Materials and Methods: We conducted a prospective observational study from August 2013 to August 2014. We included those, who attended the medicine outpatient department with a diagnosis of essential hypertension of more than 1 year duration. Results: A total of 516 patients were enrolled in the study, of which 132 (25.58% were nonadherent. Marital status (P = 0.017, socioeconomic status (P = 0.000, level of education (P = 0.034, such as, illiteracy was associated with highest level of nonadherence compared with those with pre-matric and undergraduate education, whereas those with post graduate level of education showed absolute adherence to drugs and domiciliary status (P = 0.045 had statistically significant association with nonadherence. Other factors like younger age and male sex were associated with a higher degree of nonadherence, however statistical significance could not be obtained.

Hypertension in pregnancy

Directory of Open Access Journals (Sweden)

Andrea Ungar

2007-03-01

Full Text Available Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses current concepts regarding the hypertensive disorders of gestation, focusing on chronic hypertension. Chronic hypertension is defined as blood pressure exceeding 140/90 mmHg before pregnancy or before 20 weeks gestation. Hypertensive disorders in pregnancy may cause maternal and fetal morbidity and remain a leading source of maternal mortality. A prompt diagnosis is needed also because hypertension may be an indicator of pre-eclampsia, a condition which can evolve into serious complications. Maintaining blood pressure below 140/90 mmHg is recommended, although treatment should be determined on an individual basis. Many anti-hypertensive agents appear to be safe for use during pregnancy: methildopa has been the most studied of the anti-hypertensive drugs and has the best safety record. Labetalol, idralazine and nifedipine also have been found to be safe; ACE-inhibitors are absolutely contraindicated, because they are associated with intrauterine growth retardation.

Major inducing factors of hypertensive complications and the interventions required to reduce their prevalence: an epidemiological study of hypertension in a rural population in China.

Science.gov (United States)

Zhang, Min; Meng, Yong; Yang, Yongli; Liu, Yancai; Dong, Caiqin; Xiao, Jianming; Zhao, Ling; Li, Fang

2011-05-11

The complications of hypertension cause severe health problems in rural areas in China. We (i) screened the major factors inducing hypertensive complications and provided intervention measures; and (ii) verified the efficacy of the New Rural Cooperative Medical Scheme (NRCMS; a medical insurance scheme for rural residents) for hypertension management. A survey was conducted in the villages of Yunnan (an underdeveloped province in southwest China). The NRCMS was initiated there in 2005. Data were collected through questionnaires, physical examination, electrocardiography, as well as blood and urine tests. To detect factors inducing hypertension complications, a generalized estimating equations model was developed. Multivariable logistic regression was used to analyze influencing factors for hypertension control. Poor management of hypertension was observed in women. Being female, old, poorly educated, a smoker, ignorant of the dangerousness of hypertension, and having uncontrolled hypertension made patients more prone to hypertension complications. Combination therapy with ≥ 2 drugs helped control hypertension, but most rural patients disliked multidrug therapy because they considered it to be expensive and inconvenient. The NRCMS contributed little to reduce the prevalence of complications and improve control of hypertension. The present study suggested that the NRCMS needs to be reformed to concentrate on early intervention in hypertension and to concentrate on women. To increase hypertension control in rural areas in China, compound products containing effective and inexpensive drugs (and not multidrug therapy) are needed.

Prevalence of prehypertension and hypertension and associated risk factors among Turkish adults: Trabzon Hypertension Study.

Science.gov (United States)

Erem, Cihangir; Hacihasanoglu, Arif; Kocak, Mustafa; Deger, Orhan; Topbas, Murat

2009-03-01

To estimate the prevalence, awareness and control of prehypertension (preHT) and hypertension (HT) as defined by JNC-7 criteria in the Trabzon Region and its associations with demographic factors (age, sex, obesity, marital status, reproductive history in women and level of education), socioeconomic factors (household income and occupation), family history of selected medical conditions (diabetes, hypertension, obesity and cardiovascular disease), lifestyle factors (smoking habits, physical activity and alcohol consumption) in the adult population. In this cross-sectional survey, a sample of households was systematically selected from the central province of Trabzon and its nine towns. A total of 4809 adult subjects (2601 women and 2208 men) were included in the study. Demographic and socioeconomic factors, family history of selected medical conditions, and lifestyle factors were obtained for all participants. Systolic blood pressure (BP) and diastolic BP levels were measured for all subjects. The persons included in the questionnaire were invited to the local medical centers for blood examination between 08:00-10:00 following 12 hours of fasting. The levels of serum glucose (FBG), total cholesterol (Total-C), high density cholesterol (HDL-C), low density cholesterol (LDL-C) and triglycerides were measured with autoanalyzer. Definition and classification of HT was performed according to guidelines from the US JNC-7 report. Prevalence, awareness, treatment and control of HT were assessed. The prevalences of HT and preHT were 44.0% (46.1% in women and 41.6% in men) and 14.5% (12.6% in women and 16.8% in men), respectively. Overall, only 41% of the hypertensive individuals had been previously diagnosed. Furthermore, 54.5% of the hypertensive subjects were being treated with antihypertensive drugs (AHD), but only 24.3% of treated subjects had their BP adequately controlled. Among all hypertensive subjects (known and newly diagnosed), only 5.43% had their BP under

Plasma ET-1 Concentrations are Elevated in Patients with Hypertension - Meta-Analysis of Clinical Studies.

Science.gov (United States)

Xu, Mei; Lu, Yong-Ping; Hasan, Ahmed Abdallah; Hocher, Berthold

2017-01-01

A recent study revealed that global overexpression of ET-1 causes a slight reduction in systemic blood pressure. Moreover, heterozygous ET-1 knockout mice are hypertensive. The role of ET-1 in human hypertension was so far not addressed by a strict meta-analysis of published human clinical studies. We included studies published between January 1, 1990 and February 28, 2017. We included case control studies analyzing untreated essential hypertension or hypertensive patients where antihypertensive medication was discontinued for at least two weeks. Based on the principle of Cochrane systematic reviews, case control studies (CCSs) in PubMed (Medline) and Google Scholar designed to identify the role of endothelin-1 (ET-1) in the pathophysiological of hypertension were screened. Review Manager Version 5.0 (Rev-Man 5.0) was applied for statistical analysis. Mean difference and 95% confidence interval (CI) were shown in inverse variance (IV) fixed-effects model or IV random-effects models. Eleven studies fulfilling our in- and exclusion criteria were eligible for this meta-analysis. These studies included 450 hypertensive patients and 328 controls. Our meta-analysis revealed that ET-1 plasma concentrations were higher in hypertensive patients as compared to the control patients [mean difference between groups 1.57 pg/mL, 95%CI [0.47∼2.68, P = 0.005]. These finding were driven by patients having systolic blood pressure higher than 160 mmHg and diastolic blood pressure higher than 100 mmHg. This meta-analysis showed that hypertensive patients do have elevated plasma ET-1 concentrations. This finding is driven by those patients with high systolic/diastolic blood pressure. Given that the ET-1 gene did not appear in any of the whole genome association studies searching for hypertension associated gene loci, it is very likely that the elevated plasma ET-1 concentrations in hypertensive patients are secondary to hypertension and may reflect endothelial cell damage. © 2017 The

Short-term variability and nocturnal decline in ambulatory blood pressure in normotension, white-coat hypertension, masked hypertension and sustained hypertension: a population-based study of older individuals in Spain.

Science.gov (United States)

Gijón-Conde, Teresa; Graciani, Auxiliadora; López-García, Esther; Guallar-Castillón, Pilar; García-Esquinas, Esther; Rodríguez-Artalejo, Fernando; Banegas, José R

2017-06-01

Blood pressure (BP) variability and nocturnal decline in blood pressure are associated with cardiovascular outcomes. However, little is known about whether these indexes are associated with white-coat and masked hypertension. We performed a cross-sectional analysis of 1047 community-dwelling individuals aged ⩾60 years in Spain in 2012. Three observer-measured home BPs and 24-h ambulatory blood pressure monitoring (ABPM) were performed under standardized conditions. BP variability was defined as BP s.d. and coefficient of variation. Differences in BP variability and nocturnal BP decrease between groups were adjusted for sociodemographic and clinical covariates using generalized linear models. Of the cohort, 21.7% had white-coat hypertension, 7.0% had masked hypertension, 21.4% had sustained hypertension, and 49.9% were normotensive. Twenty-four hour, daytime and night-time systolic BP s.d. and coefficients of variation were significantly higher in subjects with white-coat hypertension than those with normotension (Pcoat hypertension than in those with normotension (Pcoat hypertension group and lowest in the masked hypertension group in all patients and untreated patients (Pcoat hypertension, 78.1% of subjects with masked hypertension, and 72.2% of subjects with sustained hypertension (Pcoat hypertension and blunted nocturnal BP decrease was observed more frequently in subjects with masked hypertension. These findings may help to explain the reports of increased cardiovascular risk in patients with white-coat hypertension and poor prognosis in those with masked hypertension, highlighting the importance of ABPM.

Major inducing factors of hypertensive complications and the interventions required to reduce their prevalence: an epidemiological study of hypertension in a rural population in China

Directory of Open Access Journals (Sweden)

Xiao Jianming

2011-05-01

Full Text Available Abstract Background The complications of hypertension cause severe health problems in rural areas in China. We (i screened the major factors inducing hypertensive complications and provided intervention measures; and (ii verified the efficacy of the New Rural Cooperative Medical Scheme (NRCMS; a medical insurance scheme for rural residents for hypertension management. Methods A survey was conducted in the villages of Yunnan (an underdeveloped province in southwest China. The NRCMS was initiated there in 2005. Data were collected through questionnaires, physical examination, electrocardiography, as well as blood and urine tests. To detect factors inducing hypertension complications, a generalized estimating equations model was developed. Multivariable logistic regression was used to analyze influencing factors for hypertension control. Results Poor management of hypertension was observed in women. Being female, old, poorly educated, a smoker, ignorant of the dangerousness of hypertension, and having uncontrolled hypertension made patients more prone to hypertension complications. Combination therapy with ≥2 drugs helped control hypertension, but most rural patients disliked multidrug therapy because they considered it to be expensive and inconvenient. The NRCMS contributed little to reduce the prevalence of complications and improve control of hypertension. Conclusions The present study suggested that the NRCMS needs to be reformed to concentrate on early intervention in hypertension and to concentrate on women. To increase hypertension control in rural areas in China, compound products containing effective and inexpensive drugs (and not multidrug therapy are needed.

Intracerebroventricular metformin attenuates salt-induced hypertension in spontaneously hypertensive rats

DEFF Research Database (Denmark)

Petersen, J S; Andersen, D; Muntzel, M S

2001-01-01

The aim of this study was to examine the effects of long-term continuous intracerebroventricular (icv) infusion of metformin on blood pressure (BP) in spontaneously hypertensive rats (SHR). To accelerate the development of hypertension, SHR were fed a 8% NaCl diet during the 3-week study period...... to hexamethonium was attenuated by all doses of metformin suggesting that chronic icv metformin decreased central sympathetic outflow. The highest doses of metformin (100 and 200 microg/day) also prevented development of hypertension, but these doses were highly neurotoxic as demonstrated by histologic evaluation...... doses of metformin attenuates hypertension and decreases the hypotensive responses to ganglionic blockade in SHR, suggesting a centrally elicited sympathoinhibitory action....

Blood pressure reactivity to psychological stress predicts hypertension in the CARDIA study.

Science.gov (United States)

Matthews, Karen A; Katholi, Charles R; McCreath, Heather; Whooley, Mary A; Williams, David R; Zhu, Sha; Markovitz, Jerry H

2004-07-06

A longstanding but controversial hypothesis is that individuals who exhibit frequent, large increases in blood pressure (BP) during psychological stress are at risk for developing essential hypertension. We tested whether BP changes during psychological stress predict incident hypertension in young adults. We used survival analysis to predict hypertensive status during 13 years of follow-up in a sample of >4100 normotensive black and white men and women (age at entry, 18 to 30 years) enrolled in the CARDIA study. BP responses to 3 psychological challenges--cold pressor, star tracing, and video game tasks--were measured. Hypertensive status was defined as use of antihypertensive medication or measured BP > or =140/90 mm Hg. After adjustment for race, gender, covariates (education, body mass index, age, and resting pressure), and their significant interactions, the larger the BP responses were to each of the 3 tasks, the earlier hypertension occurred (Pvideo game was apparent for men. Young adults who show a large BP response to psychological stress may be at risk for hypertension as they approach midlife.

Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study

OpenAIRE

Behrens, Ida; Basit, Saima; Melbye, Mads; Lykke, Jacob A; Wohlfahrt, Jan; Bundgaard, Henning; Thilaganathan, Baskaran; Boyd, Heather A

2017-01-01

Objectives To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time.Design Nationwide register based cohort study.Setting Denmark.Populations 482 972 primiparous women with a first live birth or stillbirth between 1995 and 2012 (cumulative incidence analyses), and 1 025 118 women with at least one live birth or stillbirth between 1978 and 2012 (Cox regression analyses).Main outco...

Märt Haamer: Tsahknal pole Overalliga mingisugust seost / Märt Haamer ; intervjueerinud Jan Jõgis-Laats

Index Scriptorium Estoniae

Haamer, Märt, 1973-

2009-01-01

Overall Eesti juhi Märt Haameri väitel pole Anders Tsahkna ühtegi riigihanget Overalli ettevõtetele suunanud. Overalli omandusse kuuluv firma Gennet Lab on olnud alltöövõtja paaris E-tervise Sihtasutuse korraldatud hankes

Hyperuricemia and risk of incident hypertension: a systematic review and meta-analysis of observational studies.

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Ji Wang

Full Text Available Observational studies of the relationship between hyperuricemia and the incidence of hypertension are controversial. We conducted a systematic review and meta-analysis to assess the association and consistency between uric acid levels and the risk of hypertension development.We searched MEDLINE, EMBASE, CBM (Chinese Biomedicine Database through September 2013 and reference lists of retrieved studies to identify cohort studies and nested case-control studies with uric acid levels as exposure and incident hypertension as outcome variables. Two reviewers independently extracted data and assessed study quality using Newcastle-Ottawa Scale. Extracted information included study design, population, definition of hyperuricemia and hypertension, number of incident hypertension, effect sizes, and adjusted confounders. Pooled relative risks (RRs and corresponding 95% confidence intervals (CIs for the association between hyperuricemia and risk of hypertension were calculated using a random-effects model.We included 25 studies with 97,824 participants assessing the association between uric acid and incident hypertension in our meta-analysis. The quality of included studies is moderate to high. Random-effects meta-analysis showed that hyperuricemia was associated with a higher risk of incident hypertension, regardless of whether the effect size was adjusted or not, whether the data were categorical or continuous as 1 SD/1 mg/dl increase in uric acid level (unadjusted: RR = 1.73, 95% CI 1.46∼2.06 for categorical data, RR = 1.22, 95% CI 1.03∼1.45 for a 1 SD increase; adjusted: RR = 1.48, 95% CI 1.33∼1.65 for categorical data, RR = 1.15, 95% CI 1.06∼1.26 for a 1 mg/dl increase, and the risk is consistent in subgroup analyses and have a dose-response relationship.Hyperuricemia may modestly increase the risk of hypertension incidence, consistent with a dose-response relationship.

Study of socio-demographic factors affecting prevalence of hypertension among bank employees of Surat City.

Science.gov (United States)

Momin, Mohmmedirfan H; Desai, Vikas K; Kavishwar, Abhay B

2012-01-01

Cardiovascular diseases including hypertension are increasing in developing countries especially among high-risk group people like bank employees. A cross-sectional study of 1493 bank employees of Surat city was conducted during August, 2004 to September, 2005 to study the prevalence of hypertension among bank employees and the effects of socio-demographic factors on prevalence of hypertension. Data were analyzed using epi 6 software. The χ[2] -test was applied as a nonparametric test of statistical significance. Prevalence of hypertension was 30.4% and prehypertension was 34.5%. Out of 455 found as hypertensive, 258 (56.70%) were not having any symptoms at the time of examination. Prevalence was high among persons with age 50 years and above (48.5%); among male (32.5%) as compared to female (23.1%); among employees having small family size; among separated/divorcee person (40.0%). Prevalence of hypertension increased with seniority of the official position of bank employee with highest prevalence among managers (45.9%). Prevalence of hypertension was noted highest among the higher socioeconomic group; SEC I (35.0%) followed by class II (20.4%). Effects of different risk factors of hypertension were observed here. This study may help in identifying the common profile of hypertensive or persons at risk, which may further help in identifying the risk group and planning the group specific IEC interventions.

AN EPIDEMIOLOGICAL STUDY ON HYPERTENSION AND ITS DIETARY CORRELATES IN A RURAL POPULATION OF MEERUT

Directory of Open Access Journals (Sweden)

Monika Gupta

2012-07-01

Full Text Available Background: Hypertension is the commonest cardiovascular disorder accounting for 20-50% of all cardiovascular deaths and it is a major health problem affecting most of the countries in the world. Objective: To find out the prevalence of hypertension and to assess the relation of dietary factors with hypertension Methodology: A Community based cross-sectional study was conducted in rural field practice area of department of Community Medicine, Subharti Medical College, Meerut. A personal house to house visit was made to each household selected by systematic random sampling technique and data was collected using a predesigned and pretested interview and examination schedule All the members from selected households were included in the study. Hypertension was defined as Systolic BP e”140mmHg and/or diastolic BP e” 90mmHg or subjects currently taking anti-hypertensive treatment. Total period of study was October 2009 to September 2011. Data was analysed in Microsoft excel using percentiles, Chi-square test and Chi-square test for trend. Results: The overall prevalence of hypertension was found to be 18%. A significant association was found between hypertension and type of diet and additional salt intake while no significant association was observed with frequency of intake of junk food. Conclusion: Prevalence of hypertension is found to be high (18% so there is a need to create awareness about hypertension in the community.

AN EPIDEMIOLOGICAL STUDY ON HYPERTENSION AND ITS DIETARY CORRELATES IN A RURAL POPULATION OF MEERUT

Directory of Open Access Journals (Sweden)

Monika Gupta

2012-06-01

Full Text Available Background: Hypertension is the commonest cardiovascular disorder accounting for 20-50% of all cardiovascular deaths and it is a major health problem affecting most of the countries in the world. Objective: To find out the prevalence of hypertension and to assess the relation of dietary factors with hypertension Methodology: A Community based cross-sectional study was conducted in rural field practice area of department of Community Medicine, Subharti Medical College, Meerut. A personal house to house visit was made to each household selected by systematic random sampling technique and data was collected using a predesigned and pretested interview and examination schedule All the members from selected households were included in the study. Hypertension was defined as Systolic BP e”140mmHg and/or diastolic BP e” 90mmHg or subjects currently taking anti-hypertensive treatment. Total period of study was October 2009 to September 2011. Data was analysed in Microsoft excel using percentiles, Chi-square test and Chi-square test for trend. Results: The overall prevalence of hypertension was found to be 18%. A significant association was found between hypertension and type of diet and additional salt intake while no significant association was observed with frequency of intake of junk food. Conclusion: Prevalence of hypertension is found to be high (18% so there is a need to create awareness about hypertension in the community.

An Epidemiological Study Of Hypertension Amongst Children From Various Primary Schools Of Surat City

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Thakor H.G

1998-01-01

Full Text Available Research question: What is the prevalence of hypertension in school children aged 10 years and above? Objectives: 1. To find out the prevalence of hypertension. 2. To generate a profile of hypertensive cases. Study design: Cross-sectional. Setting: Selected primary schools run by Surat Manipal Corporation. Participants: School children aged 10 years and above. Sample size: 2250 children (1092 boys, 158girls Study variables: Age, sex, body weight, body mass index Outcome variables: Prevalence of hypertension. Statistical analysis: X2 test Results: Overall prevalence of hypertension in children was 2.3 percent, separately in girls and 0.9 percent in boys. Body weight above 40kgms and body mass index (BMI above 20 were differentiating points as children weighing more than 40kgms and/or with BMI more than 20 significantly higher prevalence of hypertension. Most of the cases were asymptomatic and also had no suggestive symptoms in the past.

Case Study: Intra-abdominal hypertension | Veldsman | South ...

African Journals Online (AJOL)

South African Journal of Clinical Nutrition. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 27, No 2 (2014) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Case Study: Intra-abdominal hypertension.

[Secondary hypertension].

Science.gov (United States)

Yoshida, Yuichi; Shibata, Hirotaka

2015-11-01

Hypertension is a common disease and a crucial predisposing factor of cardiovascular diseases. Approximately 10% of hypertensive patients are secondary hypertension, a pathogenetic factor of which can be identified. Secondary hypertension consists of endocrine, renal, and other diseases. Primary aldosteronism, Cushing's syndrome, pheochromocytoma, hyperthyroidism, and hypothyroidism result in endocrine hypertension. Renal parenchymal hypertension and renovascular hypertension result in renal hypertension. Other diseases such as obstructive sleep apnea syndrome are also very prevalent in secondary hypertension. It is very crucial to find and treat secondary hypertension at earlier stages since most secondary hypertension is curable or can be dramatically improved by specific treatment. One should keep in mind that screening of secondary hypertension should be done at least once in a daily clinical practice.

[Hypertension in polycystic ovary syndrome].

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Ben Salem Hachmi, L; Ben Salem Hachmi, S; Bouzid, C; Younsi, N; Smida, H; Bouguerra, R; Ben Slama, C

2006-01-01

Polycystic ovary syndrome (PCOS) is associated with multiple cardiovascular risk factors. The aims of this study are to investigate the prevalence of hypertension in a female population with PCOS and to correlate hypertension with her clinical and hormonal profile. it is a transversal study of 79 PCOS patients with mean age of 25 +/- 7 years (range 13-44). PCOS diagnosis is made by Rotterdam consensus criteria's (2003). WHO definition of hypertension is used (BP 140/90 mmHg). Blood pressure is measured three times in each patient. Ovarian echography and biochemical assays (GnRH test, androgens, cholesterol, triglycerides, and oral glucose tolerance test) are made before the 5th day of the menstrual cycle. 12% of PCOS women have hypertension. Family history of hypertension is not a predictive factor of hypertension in our study. PCOS patients with hypertension are not significantly older than those without hypertension (28.4 +/- 6.5 vs. 25.2 +/- 7; p = 0.12). If compared to PCOS women without hypertension, those with hypertension have a significantly higher BMI (39.2 +/- 7 vs. 29.6; p = 0.0004). PCOS patients with and without hypertension do not differ significantly in their level of androgens and total cholesterol. Triglycerides level is higher in PCOS patients with hypertension (p = 0.06). In oral glucose tolerance test, areas under the curve of insulin and glucose are significantly higher in PCOS patients with hypertension (respectively p = 0.06 and 0.02). The area under the curve of LH during GnRH test is lower in PCOS patients with hypertension (p = 0.04).

Hypertension in Danish seafarers

DEFF Research Database (Denmark)

Tu, Mingshan; Jepsen, Jørgen Riis

2016-01-01

Background: Due to the high prevalence of arterial hypertension and its role in the development of athe- rosclerosis, myocardial infarction and stroke, hypertension is a major public health challenge worldwide. There is limited knowledge of the prevalence of hypertension among seafarers who......, however, are known to have an excess morbidity and mortality from these disorders. This article addresses the prevalence of hypertension among Danish seafarers and discusses potential risk factors for hypertension in maritime settings. Materials and methods: A representative sample of 629 Danish seafarers...... who had statutory medical examinations was studied from the beginning of October 2011 to the end of June 2012. The medical examination included measurements of blood pressure. The prevalence of hypertension in the study po- pulation was stratified by age, work place on board, smoking status, alcohol...

Hypertension awareness and control among young adults in the national longitudinal study of adolescent health.

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Gooding, Holly C; McGinty, Shannon; Richmond, Tracy K; Gillman, Matthew W; Field, Alison E

2014-08-01

Young adults are less likely than older adults to be aware they have hypertension or to be treated for hypertension. To describe rates of hypertension awareness and control in a cohort of young adults and understand the impact of health insurance, utilization of preventive care, and self-perception of health on rates of hypertension awareness and control in this age group. Cross-sectional study of 13,512 young adults participating in Wave IV of the National Longitudinal Study of Adolescent Health in 2007-2008. We defined hypertension as an average of two measured systolic blood pressures (SBP) ≥ 140 mmHg, diastolic blood pressures (DBP) ≥ 90 mmHg, or self-report of hypertension. We defined hypertension awareness as reporting having been told by a health care provider that one had high blood pressure, and assessed awareness among those with uncontrolled hypertension. We considered those aware of having hypertension controlled if their average measured SBP was young adults with hypertension, 2,531 (76%) were uncontrolled, and 1,893 (75%) of those with uncontrolled hypertension were unaware they had hypertension. After adjustment for age, sex, race/ethnicity, weight status, income, education, alcohol and tobacco use, young adults with uncontrolled hypertension who had (vs. didn't have) routine preventive care in the past 2 years were 2.4 times more likely (95% confidence interval [CI] 1.68-3.55) to be aware, but young adults who believed they were in excellent (vs. less than excellent) health were 64% less likely to be aware they had hypertension (OR 0.36, 95% CI 0.23-0.57). Neither preventive care utilization nor self-rated health was associated with blood pressure control. In this nationally representative group of young adults, rates of hypertension awareness and control were low. Efforts to increase detection of hypertension must address young adults' access to preventive care and perception of their need for care.

ESSENTIAL ARTERIAL HYPERTENSION AND RISK FACTORS ASSOCIATED WITH HYPERTENSIVE NEPHROPATHY

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Boban Milojković

2014-12-01

Full Text Available Arterial hypertension is a major risk factor that predisposes to cardiovascular disorders and is responsible for most of the morbidity and mortality in patients. Hypertension is closely associated with the kidney, because kidney disease can be both the cause and consequence of increased blood pressure. Elevation of blood pressure is a strong independent risk factor for hypertensive nephropathy and development of ESRD. The pathogenesis of ischemic hypertensive nephropathy (IHN is multifactoral, and in addition to blood pressure other factors contribute to the development of this renal pathology and its progression to end-stage renal disease. These include obesity, smoking, male gender and other still unknown risk factors. The aim of this paper was to analyse the association between essential arterial hypertension and renal hypertensive disease and prevalence of other atherosclerotic risk factors in patients with developed hypertensive renal disease. In this prospective cross sectional study 283 patients of both genders with diagnosed essential hypertension and hypertensive renal disease were analysed. The anamnestic data related to age, duration of hypertension, history of smoking, presence of hypertensive retinopathy, hypertrophy of the left chamber and data about previous renal diseases were collected through conversation and medical documentation. The clinical examination comprise determination of blood pressure, body mass index (BMI, lipid parameters (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides, serum urea and creatinine, urine, albumin and protein concentration. The total number of 283 patients (185 males and 98 females with HN was analyzed. The analysis revealed significantly higher proportion of males aged over 60 years with IHN. The mean age of examined hypertensive patients with IHN is 62.6±8.8 years with duration of hypertension 19.8±5.9 years. All examined patients had hypertensive retinopathy and

Hypertension Subtypes among Hypertensive Patients in Ibadan

OpenAIRE

Abiodun M. Adeoye; Adewole Adebiyi; Bamidele O. Tayo; Babatunde L. Salako; Adesola Ogunniyi; Richard S. Cooper

2014-01-01

Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% fema...

Diabetes and hypertension: experimental models for pharmacological studies

NARCIS (Netherlands)

van Zwieten, P. A.

1999-01-01

Since hypertensive and diabetes-mellitus frequently occur simultaneously there exists a requirement for animal models where both pathological entities are combined. The streptozotocin (STZ)-spontaneously hypertensive rat (STZ-SHR) and the obese Zucker rat are examples of animal models where

Non-compliance to anti-hypertensive medication and its associated factors among hypertensives

International Nuclear Information System (INIS)

Bilal, A.; Riaz, M.; Shafiq, N.U.; Ahmed, M.; Sheikh, S.; Rasheed, S.

2015-01-01

Non-compliance to anti-hypertensive drugs can have negative impact on cardiovascular outcome. Various studies have been conducted on the issue but the factors are not yet explored properly, particularly in Pakistan. This study was conducted to determine the frequency and factors associated with non-compliance to anti-hypertensive medications in Karachi. Methods: This descriptive cross sectional study was conducted on 113 indoor hypertensive patients included by purposive sampling, aged 30 years and above diagnosed at least 6 months back in public sector tertiary care institutes of Karachi from March to October 2011. Data was collected through a questionnaire in Urdu. Demographic data, hypertension diagnosis, medical co-morbidity, current number of anti-hypertensive medicines, frequency of missing prescribed antihypertensive therapy and other factors affecting compliance pertaining to medicines, patient, physician and health care centre were included in the questionnaire. Results: This study revealed that 68.14% patients were non-compliant. Non-compliance was found to be associated with gender and socioeconomic status. Duration of hypertension, duration between follow up visits to physician, number of drugs, careless attitude, role of physician and limiting access to health care center are found to be important factors in non-compliance. Conclusions: Multiple factors including patients, medicine and health care system related, which can be prevented with simple measures, were found responsible for higher prevalence of non-compliance against anti-hypertensive medicines. (author)

Association between anthropometric indicators of adiposity and hypertension in a Brazilian population: Baependi Heart Study.

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Camila Maciel de Oliveira

Full Text Available Recently, some studies have evaluated the role of adiposity measures in the prediction of hypertension risk, but the results are conflicting. Thus, the aim of this study was to compare which of the four indicators of adiposity (waist circumference-WC, body mass index-BMI, body adiposity index-BAI, and visceral adiposity index-VAI were better associated with hypertension in a Brazilian population.For this study, were selected 1627 individuals (both genders, and aged over 18 years resident in the municipality of Baependi, a city located in the Southeast of Brazil. WC, BMI, BAI and VAI were determined according to a standard protocol. Hypertension was defined as mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, and/or antihypertensive drug use. The indicators of adiposity WC, BMI, BAI, and VAI were higher in hypertensive when compared to non-hypertensive individuals. In addition, WC and BMI were most strongly associated with hypertension in men and women, respectively. The area under the curve (AUC of WC was significantly higher than VAI in men. In women, both AUC of BMI and WC showed higher discriminatory power to predict hypertension than BAI and VAI.The indicators of adiposity WC and BMI were better associated with hypertension than BAI and VAI, in both genders, and it could be a useful tools for the screening of hypertensive patients.

Ocular Hypertension

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... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Leer en Español: ¿Qué es la hipertensión ocular? ...

Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

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Patel NH

2012-11-01

Full Text Available Nirali H Patel,1 Sarah K Romero,2 David C Kaelber31Division of Emergency Medicine, Akron Children's Hospital, Akron, OH, USA; 2Division of Emergency Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA; 3Departments of Information Services, Internal Medicine, Pediatrics, and Epidemiology and Biostatistics, The Center for Clinical Informatics Research and Education, The MetroHealth System and School of Medicine, Case Western Reserve University, Cleveland OH, USAAbstract: Hypertension (HTN in the pediatric population is estimated to have a world-wide prevalence of 2%-5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1 safely lower blood pressure, and (2 treat/minimize acute end organ damage, while (3 identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8

Prevalence of hypertension and hypertension control rates among elderly adults during the cold season in rural Northeast China: a cross-sectional study.

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Kawazoe, Nobuo; Zhang, Xiumin; Chiang, Chifa; Liu, Hongjian; Li, Jinghua; Hirakawa, Yoshihisa; Aoyama, Atsuko

2018-05-01

Objective: The burden of noncommunicable diseases (NCDs) is increasing in China, together with economic development and social changes. The prevalence of risk factors for NCDs, such as overweight/obesity, hypertension, diabetes, and dyslipidemia, is reported to be high even among poor residents of rural areas. We aimed to investigate the prevalence of hypertension among elderly adults in rural Northeast China and the proportion with controlled hypertension among those on antihypertensive medication (hypertension control rate). We also aimed to examine the association of hypertension control with health facilities that provide treatment. Methods: We conducted a community-based cross-sectional study in six rural villages of Northeast China from February to early March, 2012. We interviewed 1593 adults aged 50-69 years and measured their blood pressure. We examined the differences in mean blood pressure between participants who obtained antihypertensive medication from village clinics and those who obtained medication from other sources, using analysis of covariance adjusted for several covariates. Results: The prevalence of hypertension among participants was as high as 63.3%, but the hypertension control rate was only 8.4%. Most villagers (98.1%) were not registered in the chronic disease treatment scheme of the public rural health insurance. The mean systolic blood pressure, adjusted for the covariates, of participants who obtained antihypertensive medication from village clinics was significantly lower than that of participants who obtained medication from township hospitals (by 16.5 mmHg) or from private pharmacies (by 7.3 mmHg). Conclusion: The prevalence of hypertension was high and the hypertension control rate low among elderly villagers during the cold season. As treatment at village clinics, which villagers can access during the cold season seems to be more effective than self-medication or treatment at distant hospitals, improving the quality of treatment

Prevalence of Hypertension in Professional Drivers (from the RACER-ABPM Study).

Science.gov (United States)

Platek, Anna E; Szymanski, Filip M; Filipiak, Krzysztof J; Kotkowski, Marcin; Rys, Anna; Semczuk-Kaczmarek, Karolina; Adamkiewicz, Karolina

2017-11-15

Professional drivers are a group exposed to many cardiovascular risk factors. Nonsystematic working hours, stress, low physical activity, and unhealthy dietary habits are common among professional drivers. These translate into high risk of cardiovascular disease. The aim of the current analysis was to establish the prevalence of arterial hypertension in a group of continuous professional drivers. The RACER (Risk of Adverse Cardiovascular Events among professional dRivers in Poland) study is a prospective study focused on assessing cardiovascular risk factors in professional drivers. Patients included in the study were screened for the classical and nonclassical cardiovascular risk factors and had an ambulatory blood pressure monitoring (ABPM) performed. Of the RACER study population, 144 drivers were included into the RACER-ABPM study. Of this group 135 (95.7%) were male at mean age of 50.2 ± 9.3 years, with mean body mass index of 32.3 ± 3.0 kg/m 2 . In 21.3% of patients, family history of cardiovascular disease was noted, 28.1% were current smokers, and 2.9% had diabetes mellitus. Arterial hypertension was previously diagnosed in 39 patients (27.9%). In ABPM, the mean 24-hour blood pressure (BP) values were 130.3 ± 14.3 and 80.9 ± 9.9 for systolic and diastolic BP, respectively, and 46.1% of patients could be categorized as dippers. Based on the ABPM results, arterial hypertension was diagnosed in 104 of patients (73.8%). Patients with hypertension tend to be more often male and have a family history of cardiovascular disease. In conclusion, arterial hypertension is highly prevalent in professional drivers. Also abnormal day-to-night BP value patterns are often seen in this group. Copyright © 2017 Elsevier Inc. All rights reserved.

Laparoscopic versus open splenectomy for portal hypertension: a systematic review of comparative studies.

Science.gov (United States)

Cai, Yunqiang; Liu, Zhihong; Liu, Xubao

2014-08-01

Laparoscopic splenectomy has become the gold-standard procedure for normal to moderately enlarged spleens. However, the safety of laparoscopic splenectomy for patients with portal hypertension remains controversial. We carried out this systematic review to identify the feasibility and safety of laparoscopic splenectomy in treating portal hypertension. A systematic search for comparative studies that compared laparoscopic splenectomy with open splenectomy for portal hypertension was carried out. Studies were independently reviewed for quality, inclusion and exclusion criteria, demographic characteristics, and perioperative outcomes. Although laparoscopic splenectomy is associated with longer operating time, it offers advantages over the open procedure in terms of less blood loss, lower operative complications, earlier resumption of oral intake, and shorter posthospital stay. Therefore, laparoscopic splenectomy is a safe and feasible intervention for portal hypertension. © The Author(s) 2014.

Hypertension in Asymptomatic, Young Medical Students with Parental History of Hypertension

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Simran Sidhu

2017-11-01

Full Text Available Introduction: Family history of hypertension in medical students is an important, non-modifiable risk factor for hypertension in future. Aim: To determine the prevalence of sustained hypertension in young asymptomatic medical students with a parental history of hypertension. Materials and Methods: A cross-sectional study was conducted in a medical college of Dehradun. A total of 104 medical students with parental history of hypertension (Group A and 100 medical students without a parental history of hypertension (Group B were included. Electronically blood pressures were recorded on two separate occasions at an interval of 15 days. Comparison was done using Chi-square test/Likelihood ratio, Un-paired t-test and ANCOVA. Results: Overall, Group A had significantly higher percentage of prehypertensive (56.7% and hypertensive (17.3% students as compared to Group B which were 19% and 1%, respectively. Group A students had significantly higher Systolic Blood Pressure (SBP and Diastolic Blood Pressure (DBP as compared to Group B, even after controlling for the differences in Body Mass Index (BMI and gender (p<0.001. Conclusion: Hypertension was significantly higher in asymptomatic, healthy medical students with parental history of hypertension as compared to those with normotensive parents. We need to orient medical students to improve their knowledge, attitude and lifestyle practices early in life to prevent, treat hypertension and prevent its subsequent morbidity and mortality.

Association between perceived racial discrimination and hypertension: findings from the ELSA-Brasil study.

Science.gov (United States)

Mendes, Patrícia Miranda; Nobre, Aline Araújo; Griep, Rosane Härter; Guimarães, Joanna Miguez Nery; Juvanhol, Leidjaira Lopes; Barreto, Sandhi Maria; Pereira, Alexandre; Chor, Dóra

2018-03-01

"Pardos" and blacks in Brazil and blacks in the USA are at greater risk of developing arterial hypertension than whites, and the causes of this inequality are still little understood. Psychosocial and contextual factors, including racial discrimination, are indicated as conditions associated with this inequality. The aim of this study was to identify the association between perceived racial discrimination and hypertension. The study evaluated 14,012 workers from the ELSA-Brazil baseline population. Perceived discrimination was measured by the Lifetime Major Events Scale, adapted to Portuguese. Classification by race/color followed the categories proposed by Brazilian Institute of Geography and Statistics (IBGE). Hypertension was defined by standard criteria. The association between the compound variable - race/racial discrimination - and hypertension was estimated by Poisson regression with robust variance and stratified by the categories of body mass index (BMI) and sex. Choosing white women as the reference group, in the BMI 25kg/m2 and men in any BMI category, no effect of racial discrimination was identified. Despite the differences in point estimates of prevalence of hypertension between "pardo" women who reported and those who did not report discrimination, our results are insufficient to assert that an association exists between racial discrimination and hypertension.

Prevalence of Hypertension in Akwa Ibom State, South-South Nigeria: Rural versus Urban Communities Study

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Effiong Ekong Akpan

2015-01-01

Full Text Available Recent studies have shown an increasing trend in the prevalence of hypertension in rural communities compared to that of the urban communities. This study was therefore carried out to determine the prevalence of hypertension and its predictors (if any in both urban and rural communities of Akwa Ibom State of Nigeria. Subjects and Method. This was a cross-sectional study of urban and rural communities of Akwa Ibom State for the prevalence of hypertension and its predictors. Two urban cities and two rural communities were randomly selected from the three senatorial districts of the state. Hypertension was defined based on the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension. Results. Nine hundred and seventy-eight (978 participants were recruited from rural areas and five hundred and ninety (590 from urban centers. The rural populace had higher systolic, diastolic, and mean arterial blood pressure than the urban populace (P<0.001, < 0.002, < 0.001, resp.. The prevalence of hypertension was significantly higher in the rural populace than in the urban populace [44.3% (95% CI 41.1–47.4% versus 28.6% (95% CI 24.9–32.3%]. Age, BMI, and proteinuria were independent predictors of hypertension occurrence. Conclusion. There is an epidemiologic change in the prevalence of hypertension in the rural communities of Nigeria.

A STUDY ON PLASMA 25 - HYDROXY VITAMIN D LEVELS AS A RISK FACTOR IN PRIMARY HYPERTENSION

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Ravinandana Gowda

2015-07-01

Full Text Available BACKGROUND: Recent research shows that vitamin D deficiency could be a risk factor in many chronic diseases like hypertension, diabetes mellitus, dyslipidemia, cardiovascular disease, some cancers, auto immune disease and tuberculosis. AIMS AND OBJECTIVES: To determine serum 25 - hydroxy vitamin D levels in patients with primary hypertension. This study also attempts to demonstrate an inverse co - relation between vitamin D levels and primary hypertension. MATERIALS AND METHOD S: 30 patients who are primary hype rtensive were selected, their vitamin D levels measured and the vitamin D levels were compared to age and sex matched non hypertensive controls. STATISTICAL METHODS: Descriptive and inferential statistical analysis has been carried out in the present study . ANOVA test and Chi - square test was applied for quantitative and qualitative data respectively to find significant associations between two variables. RESULTS: It is seen from this study that serum vitamin D levels was lower in hypertensive patients when compared to non - hypertensive controls. Hypertensive patients had lower levels of vitamin D with vitamin D status of deficiency in 50% of the cases and insufficiency in 43.3% of the cases and normal levels in 6.7% of the cases. Non hypertensive controls sho wed vitamin D status of normal in 66.7% of controls and insufficiency in 33.3% of the controls without deficiency. Age of the cases, duration of hypertension, systolic blood pressure and diastolic blood pressure inversely correlated to vitamin D levels. Bo dy mass index, diet of the patient, alcohol consumption, number of anti - hypertensive drugs, drug compliance, family history of hypertension and fundus status did not correlate to vitamin D levels. CONCLUSIONS: Based on the observations of the study, Vitami n D is an independent risk factor that is associated with primary or essential hypertension. The level of vitamin D also correlated inversely to age, duration of

Cardiovascular reactivity in young adults with hypertensive and normotensive parents: A gender based comparative study

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Anjali Verma

2017-01-01

Full Text Available Introduction: Essential hypertension begins due to mutation of specific genes that contribute to the risk of developing hypertension. Genetic contribution was recognized 25 years ago, now formulated from time to time. Some studies have also proven that the hypertension in father had strong contribution in their individual than mother. The aim of the study is to compare the cardiovascular reactivity in male and female subjects with hypertensive and normotensive parents. Materials and methods: This comparative study was conducted in physiology department of Teerthanker Mahaveer medical college and research center, Moradabad. The research work was initiated after taken the ethical clearance from the ethical committee of the college. Three different stressors: cold pressor task, cycling and videogame were used. Total 120 subjects were taken for the study in which 77 were male and 43 were female. Result: Male subjects of normotensive parents had slightly higher HR rate (mean: 76.73/min compared to the female subjects (mean: 75/min with p value >0.05. Female subjects of hypertensive parents had higher HR rate (mean: 82.72/min compared to the male subjects (mean: 73.95/min with p value <0.001. Conclusion: Male subjects with normotensive parents had higher resting HR, SBP &DBP than Female subjects with normotensive parents, but the difference was significant only in SBP. Female subjects with hypertensive parents group was showing higher resting HR than male subjects with hypertensive parents group, remains higher after stress also with insignificant difference. Thus, subjects with hypertensive parents showing increased CVR to stress are more likely to develop future hypertension, and the risk is greater for male subjects.

Frequency and co-prescription pattern of Chinese herbal products for hypertension in Taiwan: a Cohort study.

Science.gov (United States)

Yang, Pei-Rung; Shih, Wei-Tai; Chu, Yen-Hua; Chen, Pau-Chung; Wu, Ching-Yuan

2015-06-06

Chinese herbal products (CHPs) have been frequently used among patients with chronic diseases including hypertension; however, the co-prescription pattern of herbal formulae and single herbs remain uncharacterized. Thus, this large-scale pharmacoepidemiological study evaluated the frequency and co-prescription pattern of CHPs for treating hypertension in Taiwan from 2003 to 2009. The database of traditional Chinese medicine (TCM) outpatient claims was obtained from the National Health Insurance in Taiwan. Patients with hypertension during study period were defined according to diagnostic codes in the International Classification of Disease Ninth Revision, Clinical Modification. The frequencies and percentages of herbal formula and single herb prescriptions for hypertension were analyzed. We also applied association rules to evaluate the CHPs co-prescription patterns. The hypertension cohort included 154,083 patients, 123,240 patients of which (approximately 80 %) had used TCM at least once. In total, 81,582 visits involving CHP prescriptions were hypertension related; Tian-Ma-Gou-Teng-Yin and Dan Shen (Radix Salvia Miltiorrhizae) were the most frequently prescribed herbal formula and single herb, respectively, for treating hypertension. This study elucidated the utilization pattern of CHPs for treating hypertension. Future studies on the efficacy and safety of these CHPs and on drug-herb interactions are warranted.

Poor hypertension control in Greek patients with diabetes in rural areas. The VANK study in primary care.

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Skliros, E; Sotiropoulos, A; Vasibossis, A; Xipnitos, C; Chronopoulos, I; Razis, N; Merkouris, Panagiotis

2007-01-01

This study aimed to determine hypertension prevalence and levels of awareness, treatment and control of hypertension among diabetic patients using data from the VANK study. The sample consisted of 221 men and women (122/99) diagnosed with type 2 diabetes. Semi-structured interviews were conducted with all participants. Controlled hypertension definition was based on having a systolic blood pressure (BP) of hypertension was 194/221 (87.7%). In total, 34.1% of patients (66/194) were not aware of having hypertension. Of those who were aware of having hypertension (n = 128, 65.9%), all were treated. Among those treated, only 11 persons (11/194, 5.6%) had systolic BP hypertensive patients (n = 128) received antihypertensive drug therapy, in only 8.6% (11/128) the treatment was effective (BP hypertension from primary care physicians, as well as regular surveillance to detect developing hypertension in diabetic patients.

Hypertensive target organ damage in Ghanaian civil servants with hypertension.

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Juliet Addo

2009-08-01

Full Text Available Low levels of detection, treatment and control of hypertension have repeatedly been reported from sub Saharan Africa, potentially increasing the likelihood of target organ damage.A cross-sectional study was conducted on 1015 urban civil servants aged > or = 25 years from seven central government ministries in Accra, Ghana. Participants diagnosed to have hypertension were examined for target organ involvement. Hypertensive target organ damage was defined as the detection of any of the following: left ventricular hypertrophy diagnosed by electrocardiogram, reduction in glomerular filtration rate, the presence of hypertensive retinopathy or a history of a stroke.Of the 219 hypertensive participants examined, 104 (47.5% had evidence of target organ damage. The presence of target organ damage was associated with higher systolic and diastolic blood pressure levels. The odds of developing hypertensive target organ damage was five to six times higher in participants with blood pressure (BP > or = 180/110 mmHg compared to those with BP < 140/90 mmHg, and there was a trend to higher odds of target organ damage with increasing BP (p = 0.001. Women had about lower odds of developing target organ damage compared to men.The high prevalence of target organ damage in this working population associated with increasing blood pressure, emphasises the need for hypertension control programs aimed at improving the detection of hypertension, and importantly addressing the issues inhibiting the effective treatment and control of people with hypertension in the population.

Frequency and determinants of white coat hypertension in mild to moderate hypertension: a primary care-based study. Monitorización Ambulatoria de la Presión Arterial (MAPA)-Area 5 Working Group.

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Martínez, M A; García-Puig, J; Martín, J C; Guallar-Castillón, P; Aguirre de Cárcer, A; Torre, A; Armada, E; Nevado, A; Madero, R S

1999-03-01

Most of the previous studies on white coat hypertension were performed in hypertension clinics or academic settings and included relatively small series of patients. Consequently, the prevalence of white coat hypertension in primary care settings and the clinical and epidemiologic characteristics of this subgroup of patients are not well known. We performed this study to estimate the frequency of white coat hypertension in a population of mildly to moderately hypertensive subjects attended in a primary care setting and to examine possible epidemiologic and clinical factors that may identify these patients. Patients included in the study underwent clinical interview, measurement of clinic blood pressure (BP) on three visits, determination of serum lipids, glucose, uric acid, and urinary albumin excretion, 24-h ambulatory BP monitoring, and M-mode and Doppler echocardiography. Patients were classified as white coat hypertensives if their daytime ambulatory BP were < 135/85 mm Hg. We studied 345 patients, 136 (39%) of whom were diagnosed with white coat hypertension. The frequency of white coat hypertension was inversely proportional to the severity of clinic BP values. The diagnosis of white coat hypertension was independently associated with female gender and low educational level. Left ventricular mass index and urinary albumin excretion were lower in the white-coat hypertensive group compared with the group with sustained hypertension. Our results show that a high proportion of patients with mild to moderate hypertension attended in a primary care setting have white coat hypertension. Some clinical characteristics may be helpful in the identification of this group of subjects. White coat hypertensives show less target-organ damage than sustained hypertensive patients.

Sex differences in the risk profile of hypertension: a cross-sectional study.

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Ghosh, Saswata; Mukhopadhyay, Simantini; Barik, Anamitra

2016-07-27

To assess the socioeconomic and behavioural risk factors associated with hypertension among a sample male and female population in India. Cross-sectional survey data from a Health and Demographic Surveillance System (HDSS) of rural West Bengal, India was used. 27 589 adult individuals (13 994 males and 13 595 females), aged ≥18 years, were included in the study. Hypertension was defined as mean systolic blood pressure (SBP) ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg, or if the subject was undergoing regular antihypertensive therapy. Prehypertension was defined as SBP 120-139 mm Hg and DBP 80-89 mm Hg. Individuals were categorised as non-normotensives, which includes both the prehypertensives and hypertensives. Generalised ordered logit model (GOLM) was deployed to fulfil the study objective. Over 39% of the men and 25% of the women were prehypertensives. Almost 12.5% of the men and 11.3% of the women were diagnosed as hypertensives. Women were less likely to be non-normotensive compared to males. Odds ratios estimated from GOLM indicate that women were less likely to be hypertensive or prehypertensive, and age (OR 1.04, 95% CI 1.03 to 1.05; and OR 1.08, 95% CI 1.07 to 1.09 for males and females, respectively) and body mass index (OR 1.64, 95% CI 1.38 to 1.97 for males; and OR 1.32, 95% CI 1.08 to 1.60 for females) are associated with hypertension. An elevated level of hypertension exists among a select group of the rural Indian population. Focusing on men, an intervention could be designed for lifestyle modification to curb the prevalence of hypertension. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Noncirrhotic portal hypertension.

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Da, Ben L; Koh, Christopher; Heller, Theo

2018-05-01

Noncirrhotic portal hypertension represents a heterogeneous group of liver disorders that is characterized by portal hypertension in the absence of cirrhosis. The purpose of this review is to serve as a guide on how to approach a patient with noncirrhotic portal hypertension with a focus on recent developments. Recent studies pertaining to noncirrhotic portal hypertension have investigated aetiological causes, mechanisms of disease, noninvasive diagnostic modalities, clinical characteristics in the paediatric population and novel treatment targets. Noncirrhotic portal hypertension is an underappreciated clinical entity that can be difficult to diagnosis without a healthy suspicion. Diagnosis then relies on a comprehensive understanding of the causes and clinical manifestations of this disease, as well as a careful interpretation of the liver biopsy. Noninvasive approaches to diagnosis may play a significant role moving forward in this disease. Treatment in NCPH remains largely targeted at the individual sequalae of portal hypertension.

Study on inhibition of hypertension by low dose radiation

International Nuclear Information System (INIS)

Yamaoka, Kiyonori; Nakazono, Koichi; Watanabe, Nobukazu; Inoue, Masayasu.

1992-01-01

To elucidate the pathogenesis of hypertension, superoxide dismutase (HB-SOD) with high affinity for vascular endothelial cells was administered to spontaneously hypertensive rats (SHR). HB-SOD but not native SOD markedly decreased the blood pressure of SHR but not of control rats. The results suggest that regulation of superoxide and the related metabolites in and around vascular endothelial cells is important for controling blood pressure in hypertensive subjects. (author)

Dietary habits of hypertensive patients in a tertiary hypertension ...

African Journals Online (AJOL)

Introduction: The prescriptions regarding non-pharmacological care in the management of hypertension has been carefully defined by the various practice guidelines. However, there is paucity of data on dietary practices in our environment, therefore this study set out to determine the dietary practices of hypertensive ...

EXPERIENCE OF BARRIERS TO HYPERTENSION MANAGEMENT IN MINANGKABAU ETHNIC GROUP IN PAYAKUMBUH INDONESIA: A PHENOMENOLOGICAL STUDY

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Vera Kurnia

2018-05-01

Full Text Available Background: Understanding barriers to hypertension managements remains important to reduce the hypertension rate in community. Minangkabau is one of the ethnic groups in West Sumatra Indonesia that has a high proportion of people with hypertension although its management has been implemented. Objective: This study aims to explore the experiences of barriers to hypertension management in Minangkabau ethnic group in Payakumbuh, Indonesia. Methods: This was a phenomenological study with twelve respondents selected using purposive sampling. Data were collected using in-depth interview. Colaizzi’s content analysis method was used for data analysis. Results: Five themes were emerged from the data, namely: (i lack of self-motivation in the management of hypertension, (ii disobedience in the management of hypertension, (iii culture pattern of food intake, (iv lack of social support, and (v excessive stress and anxiety. Conclusions: The barriers to hypertension management in Minangkabau ethnic group are closely related to its culture both in lifestyle and in food intake of the family members and the community. Nurses are expected toalways give health education about hypertension and finding the way to control it.

Prevalence and determinants of hypertension in Myanmar - a nationwide cross-sectional study.

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Bjertness, Marius B; Htet, Aung Soe; Meyer, Haakon E; Htike, Maung Maung Than; Zaw, Ko Ko; Oo, Win Myint; Latt, Tint Swe; Sherpa, Lhamo Y; Bjertness, Espen

2016-07-18

Non-communicable diseases (NCDs), malaria and tuberculosis dominate the disease pattern in Myanmar. Due to urbanization, westernized lifestyle and economic development, it is likely that NCDs such as cerebrovascular disease and ischemic heart disease are on a rise. The leading behavioral- and metabolic NCDs risk factors are tobacco smoke, dietary risks and alcohol use, and high blood pressure and body mass index, respectively. The study aimed at estimating the prevalence and determinants of hypertension, including metabolic-, behavioral- and socio-demographic risk factors. A nationwide, cross-sectional study of 7429 citizens of Myanmar aged 15-64 years were examined in 2009, using the WHO STEPS methodology. In separate analyses by gender, odds radios (ORs) and 95 % confidence intervals (CIs) for determinants of hypertension were estimated using logistic regression analyses. Confounders included in analyses were chosen based on Directed acyclic graphs (DAGs). The prevalence of hypertension was 30.1 % (95 % CI: 28.4-31.8) in males and 29.8 % (28.5-31.1) in females. The mean BMI was 21.7 (SD 4.3) kg/m(2) for males and 23.0 (5.1) kg/m(2) for females. In fully adjusted analyses, we found in both genders increased OR for hypertension if the participants had high BMI (males: OR = 2.6; 95 % CI 2.1-3.3, females: OR = 2.3; 2.0-2.7) and high waist circumference (males: OR = 3.4; 1.8-6.8, females: OR = 2.7; 2.2-3.3). In both sexes, associations were also found between hypertension and low physical activity at work, or living in urban areas or the delta region. Being underweight and use of sesame oil in cooking was associated with lower odds for hypertension. The prevalence of hypertension was high and associated with metabolic-, behavioral- and socio-demographic factors. Due to expected rapid economic growth in Myanmar we recommend similar studies in the future to follow up and describe trends in the risk factors, especially modifiable factors, which will

The metabolic syndrome and risk of myocardial infarction in familial hypertension (hypertension heredity in Malmö evaluation study).

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Fedorowski, Artur; Burri, Philippe; Hulthén, Lennart; Melander, Olle

2009-01-01

The aim of this study was to examine whether three main definitions of the metabolic syndrome (MetS)--WHO, National Cholesterol Education Program--Adult Treatment Panel III and International Diabetes Federation--identify the same individuals and are able to predict incident myocardial infarction (MI) in families with essential hypertension. The tested definitions were prospectively related to data on MI in a cohort of approximately 1700 individuals with overt essential hypertension and their normotensive first-degree relatives. At baseline, 616 participants had MetS, yet only 209 of them (33.9%) were identified by all definitions, and compatibility rate for each pair of definitions was approximately 50%. During follow-up (Tmean approximately 6.6 years) 53 participants developed MI and they were generally older and more dysmetabolic than the rest of the cohort. There were also more men, smokers and diabetic individuals in this group. After adjustment for all conventional cardiovascular risk factors, including hypertension and diabetes, only the National Cholesterol Education Program definition could predict the increased risk of MI [odds ratio (OR) = 2.2, confidence interval (CI) = 1.2-4.0, P = 0.01]. Among individual MetS components, incident MI was independently associated with three of them: low high-density lipoprotein-cholesterol (OR = 2.03, CI = 1.09-3.78, P = 0.025) insulin resistance (OR = 2.02, CI = 1.08-3.78, P = 0.028) and increased albumin excretion rate (OR = 1.24, CI = 0.99-1.55, P = 0.060). The presence of MetS in hypertensive and genetically hypertension prone individuals may signal the increased risk of future MI. However, only the National Cholesterol Education Program criteria appear to have a sufficient predictive accuracy.

Non-replication study of a genome-wide association study for hypertension and blood pressure in African Americans

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Kidambi Srividya

2012-04-01

Full Text Available Abstract Background A recent genome wide association study in 1017 African Americans identified several single nucleotide polymorphisms that reached genome-wide significance for systolic blood pressure. We attempted to replicate these findings in an independent sample of 2474 unrelated African Americans in the Milwaukee metropolitan area; 53% were women and 47% were hypertensives. Methods We evaluated sixteen top associated SNPs from the above genome wide association study for hypertension as a binary trait or blood pressure as a continuous trait. In addition, we evaluated eight single nucleotide polymorphisms located in two genes (STK-39 and CDH-13 found to be associated with systolic and diastolic blood pressures by other genome wide association studies in European and Amish populations. TaqMan MGB-based chemistry with fluorescent probes was used for genotyping. We had an adequate sample size (80% power to detect an effect size of 1.2-2.0 for all the single nucleotide polymorphisms for hypertension as a binary trait, and 1% variance in blood pressure as a continuous trait. Quantitative trait analyses were performed both by excluding and also by including subjects on anti-hypertensive therapy (after adjustments were made for anti-hypertensive medications. Results For all 24 SNPs, no statistically significant differences were noted in the minor allele frequencies between cases and controls. One SNP (rs2146204 showed borderline association (p = 0.006 with hypertension status using recessive model and systolic blood pressure (p = 0.02, but was not significant after adjusting for multiple comparisons. In quantitative trait analyses, among normotensives only, rs12748299 was associated with SBP (p = 0.002. In addition, several nominally significant associations were noted with SBP and DBP among normotensives but none were statistically significant. Conclusions This study highlights the importance of replication to confirm the validity of genome wide

STUDY ON PLATELET INDICES IN PREGNANCY INDUCED HYPERTENSION

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Rabi a Parveen

2015-10-01

Full Text Available INTRODUCTION : Pregnancy induced hypertension includes gestational hypertension, preeclampsia, and eclampsia. In PIH, lower the platelet count, greater are maternal and fetal morbidity and mortality. Recent studies suggest that platele t parameters like platelet indices are most simple and cost effective method for prediction of PIH, way before the appearance of derangements in PT, APTT, TT values so we undertook this study with an aim to see an association between platelet indices and pregnancy induced hypertension. MATERIAL AND METHOD : This was prospective analytical case control study. Study included 125 cases, who were diagnosed as PIH with B.P. > 140/90 mmHg, detected after 20 weeks of pregnancy. Under all aseptic precautions samples were collected randomly in EDTA vials . Samples were analysed for platelet indices . RESULT : Maximum number of cases of Preeclampsia (88.57% & Eclampsia (87.5% were fo und in age group of 21 to 25 . Controls were of same age group i.e. 21 to 25 years. It was observed that platelet count showed gradual decrease in eclampsia (1.44580± 36,210 & pre - e clampsia patients (1.97850± 39,010 as compared to normotensive subjects (2.42620± 40,412. MPV showed gradual increase in eclampsia ( 10.49 ±1.12 & pre - eclampsia ( 9.14 ±0.612 patients as compared to normotensive subjects ( 8.422 ±0.743. PDW value also shows gradual increase in eclampsia ( 18.39 ±2.62 & pre - eclampsia ( 16.29 ±2.34 p atients as compared to normotensive subjects ( 12.09 ±2.53. CONCLUSION : Study showed that platelet indices were important, simple, effortless and cost effective investigations which can be used for early recognition of preventable eclampsia complications.

Perivesical varices and portal hypertension: imaging study

International Nuclear Information System (INIS)

Mallorquin Jimenez, F.; Medina Benitez, A.; Lopez Machado, E.; Pardo Moreno, M.D.; Garrido Moreno, C.; Pastor Rull, J.

1995-01-01

Nine patients with portal hypertension syndrome and Perivesical varices are studied retrospectively by means of imaging techniques including ultrasound, duplex Doppler, color Doppler, CT and angiography. All the patients presented portal thrombosis and thickening of the bladder wall. These collaterals either represent a shunting of hepato pedal flow or correspond to blood stasis associated with said syndrome. Ultrasound, whether involving duplex Doppler or color Doppler techniques, is highly useful to detect the presence of Perivesical varices which appear as tubular or rounded hypo echogenic areas in the bladder wall. Given the association of this entity with bladder wall thickening, it should be taken into account in any clinical situation involving said change, especially in patients with portal hypertension; moreover knowledge of its presence is of great importance when the possibility of creating shunts by means of interventional or surgical vascular procedures or other types of abdominal procedures are being considered because of the risk of bleeding. (Author)

Vegetarian diet reduces the risk of hypertension independent of abdominal obesity and inflammation: a prospective study.

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Chuang, Shao-Yuan; Chiu, Tina H T; Lee, Chun-Yi; Liu, Ting-Ting; Tsao, Chwen Keng; Hsiung, Chao A; Chiu, Yen-Feng

2016-11-01

A vegetarian diet may prevent elevation of blood pressures and lower the risk for hypertension through lower degrees of obesity, inflammation, and insulin resistance. This study investigated the association between a vegetarian diet and hypertension incidence in a cohort of Taiwanese adult nonsmokers and examined whether this association was mediated through inflammation, abdominal obesity, or insulin resistance (using fasting glucose as a proxy). This matched cohort study was from the 1994-2008 MJ Health Screening Database. Each vegetarian was matched with five nonvegetarians by age, sex, and study site. The analysis included 4109 nonsmokers (3423 nonvegetarians and 686 vegetarians), followed for a median of 1.61 years. The outcome includes hypertension incidence, as well as SBP and DBP levels. Regression analysis was performed to assess the association between vegetarian diet and hypertension incidence or future blood pressure levels in the presence/absence of potential mediators. Vegetarians had a 34% lower risk for hypertension, adjusting for age and sex (odds ratio: 0.66, 95% confidence interval: 0.50-0.87; SBP: -3.3 mmHg, P vegetarian diet and hypertension appeared to be consistent across age groups. Taiwanese vegetarians had lower incidence of hypertension than nonvegetarians. Vegetarian diets may protect against hypertension beyond lower abdominal obesity, inflammation, and insulin resistance.

A Propensity-Matched Study of Hypertension and Increased Stroke-Related Hospitalization in Chronic Heart Failure

NARCIS (Netherlands)

G.S. Filippatos (Gerasimos); C. Adamopoulos (Chris); X. Sui (Xuemei); T.E. Love (Thomas); P.M. Pullicino (Patrick); J. Lubsen (Jacob); G. Bakris (George); S.D. Anker (Stefan); G. Howard (George); D.T. Kremastinos (Dimitrios); A. Ahmed (Ali)

2008-01-01

textabstractHypertension is a risk factor for heart failure and stroke. However, the effect of hypertension on stroke in patients with heart failure has not been well studied. In the Digitalis Investigation Group trial, 3,674 (47%) of the 7,788 patients had a history of hypertension. Probability or

Association of overtime work and hypertension in a Japanese working population: a cross-sectional study.

Science.gov (United States)

Imai, Teppei; Kuwahara, Keisuke; Nishihara, Akiko; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Miyamoto, Toshiaki; Kochi, Takeshi; Eguchi, Masafumi; Uehara, Akihiko; Kuroda, Reiko; Omoto, Daisuke; Nagata, Tomohisa; Pham, Ngoc Minh; Kurotani, Kayo; Nanri, Akiko; Akter, Shamima; Kabe, Isamu; Mizoue, Tetsuya; Sone, Tomofumi; Dohi, Seitaro

2014-12-01

Long working hours have been associated with an increased risk of cardiovascular disease, but its relationship with hypertension remains unclear. The objective of this study is to examine the relationship between overtime and presence of hypertension using data from a large-scale multi-company study in Japan. Participants were 52 365 workers of four companies that provided both health-checkup data and self-reported data on overtime worked. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, and/or the use of antihypertensive drug. Logistic regression analysis was performed to determine the odds ratio for hypertension for each category of overtime work (work: 17.5, 12.0, 11.1 and 9.1% for the shortest (work and presence of hypertension.

Hypertension: adherence to treatment in rural Bangladesh – findings from a population-based study

OpenAIRE

Khanam, Masuma Akter; Lindeboom, Wietze; Koehlmoos, Tracey Lynn Perez; Alam, Dewan Shamsul; Niessen, Louis; Milton, Abul Hasnat

2014-01-01

Background: Poor adherence has been identified as the main cause of failure to control hypertension. Poor adherence to antihypertensive treatment is a significant cardiovascular risk factor, which often remains unrecognized. There are no previous studies that examined adherence with antihypertensive medication or the characteristics of the non-adherent patients in Bangladesh.Objective: This paper aims to describe hypertension and factors affecting adherence to treatment among hypertensive per...

Vitamin D and risk of pregnancy related hypertensive disorders: mendelian randomisation study.

Science.gov (United States)

Magnus, Maria C; Miliku, Kozeta; Bauer, Anna; Engel, Stephanie M; Felix, Janine F; Jaddoe, Vincent W V; Lawlor, Debbie A; London, Stephanie J; Magnus, Per; McGinnis, Ralph; Nystad, Wenche; Page, Christian M; Rivadeneira, Fernando; Stene, Lars C; Tapia, German; Williams, Nicholas; Bonilla, Carolina; Fraser, Abigail

2018-06-20

To use mendelian randomisation to investigate whether 25-hydroxyvitamin D concentration has a causal effect on gestational hypertension or pre-eclampsia. One and two sample mendelian randomisation analyses. Two European pregnancy cohorts (Avon Longitudinal Study of Parents and Children, and Generation R Study), and two case-control studies (subgroup nested within the Norwegian Mother and Child Cohort Study, and the UK Genetics of Pre-eclampsia Study). 7389 women in a one sample mendelian randomisation analysis (751 with gestational hypertension and 135 with pre-eclampsia), and 3388 pre-eclampsia cases and 6059 controls in a two sample mendelian randomisation analysis. Single nucleotide polymorphisms in genes associated with vitamin D synthesis (rs10741657 and rs12785878) and metabolism (rs6013897 and rs2282679) were used as instrumental variables. Gestational hypertension and pre-eclampsia defined according to the International Society for the Study of Hypertension in Pregnancy. In the conventional multivariable analysis, the relative risk for pre-eclampsia was 1.03 (95% confidence interval 1.00 to 1.07) per 10% decrease in 25-hydroxyvitamin D level, and 2.04 (1.02 to 4.07) for 25-hydroxyvitamin D levels effect of 25-hydroxyvitamin D on the risk of gestational hypertension or pre-eclampsia: odds ratio 0.90 (95% confidence interval 0.78 to 1.03) and 1.19 (0.92 to 1.52) per 10% decrease, respectively. The two sample mendelian randomisation estimate gave an odds ratio for pre-eclampsia of 0.98 (0.89 to 1.07) per 10% decrease in 25-hydroxyvitamin D level, an odds ratio of 0.96 (0.80 to 1.15) per unit increase in the log(odds) of 25-hydroxyvitamin D level effect of vitamin D status on gestational hypertension or pre-eclampsia. Future mendelian randomisation studies with a larger number of women with pre-eclampsia or more genetic instruments that would increase the proportion of 25-hydroxyvitamin D levels explained by the instrument are needed. Published by the BMJ

Association between Dietary Patterns and the Risk of Hypertension among Chinese: A Cross-Sectional Study

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Pei-Fen Zheng

2016-04-01

Full Text Available Epidemiological studies of different dietary patterns and the risk of hypertension among a middle-aged Chinese population remain extremely scare. Thus, the aim of this study was to identify dietary patterns and investigate the relationship between dietary patterns and the risk of hypertension among Chinese adults aged 45–60 years. The present cross-sectional study includes 2560 participants who reported their dietary intake using a validated food frequency questionnaire (FFQ. Dietary patterns were identified using factor analysis. Anthropometric measurements were obtained using standardized procedures. We used log-binomial regression analysis to examine the associations between dietary patterns and hypertension risk. Four major dietary patterns were identified and labeled as traditional Chinese, animal food, western fast-food, and high-salt patterns. After adjusting for potential confounders, participants in the highest quartile of animal food pattern scores had a greater prevalence ratio (PR for hypertension (PR = 1.26; 95% confidence interval (CI: 1.064–1.727; p < 0.05 in comparison to those from the lowest quartile. Compared with the lowest quartile of high-salt pattern, the highest quartile had a higher prevalence ratio for hypertension (PR = 1.12; 95% CI: 1.013–1.635; p < 0.05. Conclusions: Our findings indicated that animal food and high-salt patterns were associated with increased risk of hypertension, while traditional Chinese and western fast-food patterns were not associated with the risk of hypertension. Further prospective studies are warranted to confirm these findings.

Hypertension

Science.gov (United States)

... role in the start and continuation of primary hypertension. Secondary hypertension is due to other diseases such as kidney ... the body can greatly improve or even cure secondary hypertension. Obstructive sleep apnea is a potentially serious sleep ...

Plasma ET-1 Concentrations Are Elevated in Pregnant Women with Hypertension -Meta-Analysis of Clinical Studies

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Yong-Ping Lu

2017-11-01

Full Text Available Background/Aims: The ET system might be involved in the pathogenesis of hypertensive disorders during pregnancy. The objective is to analyse the impact of ET-1 in hypertensive pregnant women by a strict meta-analysis of published human clinical studies. Methods: Based on the principle of Cochrane systematic reviews, Cohort studies in PubMed (Medline, Google Scholar and China Biological Medicine Database (CBM-disc designed to identify the role of endothelin-1 (ET-1 in the pathophysiology of gestational hypertension and preeclampsia were screened. Review Manager Version 5.0 (Rev-Man 5.0 was applied for statistical analysis. Mean difference and 95% confidence interval (CI were shown in inverse variance (IV fixed-effects model or IV random-effects model. Results: Sixteen published cohort studies including 1739 hypertensive cases and 409 controls were used in the meta-analysis. ET-1 plasma concentrations were higher in hypertensive pregnant women as compared to the controls (mean difference between groups: 19.02 [15.60～22.44], P < 0.00001,. These finding were driven by severity of hypertension and/or degree of proteinuria. Conclusion: Plasma ET-1 concentrations are elevated in hypertensive disorders during human pregnancy. In particular women with preeclampsia (hypertensive pregnant women with proteinuria have substantially elevated plasma ET-1 concentration as compared to pregnant women with normal blood pressure.

Estimation of Hypertension Risk from Lifestyle Factors and Health Profile: A Case Study

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Zhuoyuan Zheng

2014-01-01

Full Text Available Hypertension is a highly prevalent risk factor for cardiovascular disease and it can also lead to other diseases which seriously harm the human health. Screening the risks and finding a clinical model for estimating the risk of onset, maintenance, or the prognosis of hypertension are of great importance to the prevention or treatment of the disease, especially if the indicator can be derived from simple health profile. In this study, we investigate a chronic disease questionnaire data set of 6563 rural citizens in East China and find out a clinical signature that can assess the risk of hypertension easily and accurately. The signature achieves an accuracy of about 83% on the external test dataset, with an AUC of 0.91. Our study demonstrates that a combination of simple lifestyle features can sufficiently reflect the risk of hypertension onset. This finding provides potential guidance for disease prevention and control as well as development of home care and home-care technologies.

A Study on Renin-Angiotensin System and Total Exchangeable Sodium in Hypertension

International Nuclear Information System (INIS)

Choe, Kang Won; Park, Jung Sik; Lee, Jung Sang; Koh, Chang Soon

1976-01-01

The etiologic role of renin-angiotensin system and sodium-volume status in the pathophysiology of various forms of hypertension was investigated. Plasma renin activity (PRA) was measured by radioimmunoassay, while sodium-volume status was evaluated by the determination of total exchangeable sodium(NaE) using isotope dilution method. The subjects consisted of 25 controls, 24 patients with essential hypertension, 22 patients with chronic renal failure (13 with hypertension, 9 without hypertension) and 14 patients with malignant hypertension. The results were as follows: 1) An inverse correlation between NaE and PRA was noted in control subjects (r=-0.598, p 0.1) 3) Absolute value of PRA was not deviated significantly from control group (2.53±1.416 ng/ml/hr) except in malignant hypertension (6.09±2.042, p 0.1). It is suggested that renin-angiotensin system plays a predominant role in the pathogenesis of malignant hypertension and in hypertension of chronic renal failure, though sodium retention is also contributing factor. PRA variation in essential hypertension does not appear to be associated with any consistent change in Na-volume status, suggesting the existence of another mechanism in the genesis of hypertension and PRA variation.

Angiotensinogen gene polymorphism predicts hypertension, and iridological constitutional classification enhances the risk for hypertension in Koreans.

Science.gov (United States)

Cho, Joo-Jang; Hwang, Woo-Jun; Hong, Seung-Heon; Jeong, Hyun-Ja; Lee, Hye-Jung; Kim, Hyung-Min; Um, Jae-Young

2008-05-01

This study investigated the relationship between iridological constitution and angiotensinogen (AGN) gene polymorphism in hypertensives. In addition to angiotensin converting enzyme gene, AGN genotype is also one of the most well studied genetic markers of hypertension. Furthermore, iridology, one of complementary and alternative medicine, is the diagnosis of the medical conditions through noting irregularities of the pigmentation in the iris. Iridological constitution has a strong familial aggregation and is implicated in heredity. Therefore, the study classified 87 hypertensive patients with familial history of cerebral infarction and controls (n = 88) according to Iris constitution, and determined AGN genotype. As a result, the AGN/TT genotype was associated with hypertension (chi2 = 13.413, p iridological constitutional classification increased the relative risk for hypertension in the subjects with AGN/T allele. These results suggest that AGN polymorphism predicts hypertension, and iridological constitutional classification enhances the risk for hypertension associated with AGN/T in a Korean population.

Altered vasoactive balance in hypertension: A pharmacogenomic study

Czech Academy of Sciences Publication Activity Database

Zicha, Josef

2006-01-01

Roč. 24, č. S6 (2006), s. 24-24 ISSN 0263-6352. [Scientific Meeting of the International Society of Hypertension /21./. 15.10.2006-19.10.2006, Fukuoka] R&D Projects: GA MZd(CZ) NR7786 Institutional research plan: CEZ:AV0Z50110509 Keywords : vasoactive balance * hypertension * recombinant inbred strains Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery

Effect of Age on Hypertension: Analysis of Over 4,800 Referred Hypertensive Patients

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Anderson Gunnar

1999-01-01

Full Text Available We evaluate in this study the factors associated with the effect of age on blood pressure in more than 4800 patients. Their physicians referred them to evaluate for secondary causes for their hypertension. Factors studied included history and physical examination, serum sodium, potassium and creatinine, a stimulated plasma renin and catecholamine. We also studied the blood pressure response to infusion of either saralasin (an angiotensin II analogue or enalapril (an angiotensin converting enzyme inhibitor, and plasma aldosterone and cortisol after infusion of saline. We measured serum thyroxin and thyroid stimulating hormone concentrations on 1061 consecutive patients in this series. The results of our study show that increased age is associated with a significant increase in the prevalence of hypertension and especially of systolic hypertension after age 60 years. Increased obesity between age 30-50 years is associated with significant increases in diastolic blood pressure and this trend is also seen in African-Americans who are heavier than whites. Increased age is associated with an increased prevalence of secondary forms of hypertension including atherosclerotic renovascular hypertension, renal insufficiency and primary hypothyroidism.

Prevalence and determinants of hypertension in Myanmar - a nationwide cross-sectional study

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Marius B. Bjertness

2016-07-01

Full Text Available Abstract Background Non-communicable diseases (NCDs, malaria and tuberculosis dominate the disease pattern in Myanmar. Due to urbanization, westernized lifestyle and economic development, it is likely that NCDs such as cerebrovascular disease and ischemic heart disease are on a rise. The leading behavioral- and metabolic NCDs risk factors are tobacco smoke, dietary risks and alcohol use, and high blood pressure and body mass index, respectively. The study aimed at estimating the prevalence and determinants of hypertension, including metabolic-, behavioral- and socio-demographic risk factors. Methods A nationwide, cross-sectional study of 7429 citizens of Myanmar aged 15–64 years were examined in 2009, using the WHO STEPS methodology. In separate analyses by gender, odds radios (ORs and 95 % confidence intervals (CIs for determinants of hypertension were estimated using logistic regression analyses. Confounders included in analyses were chosen based on Directed acyclic graphs (DAGs. Results The prevalence of hypertension was 30.1 % (95 % CI: 28.4–31.8 in males and 29.8 % (28.5–31.1 in females. The mean BMI was 21.7 (SD 4.3 kg/m2 for males and 23.0 (5.1 kg/m2 for females. In fully adjusted analyses, we found in both genders increased OR for hypertension if the participants had high BMI (males: OR = 2.6; 95 % CI 2.1–3.3, females: OR = 2.3; 2.0–2.7 and high waist circumference (males: OR = 3.4; 1.8–6.8, females: OR = 2.7; 2.2–3.3. In both sexes, associations were also found between hypertension and low physical activity at work, or living in urban areas or the delta region. Being underweight and use of sesame oil in cooking was associated with lower odds for hypertension. Conclusions The prevalence of hypertension was high and associated with metabolic-, behavioral- and socio-demographic factors. Due to expected rapid economic growth in Myanmar we recommend similar studies in the future to follow up and describe

[Knowledge level of hypertensive patients about hypertension. Relationship between knowledge level and hypertension control].

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Benítez Camps, M; Egocheaga Cabello, M Isabel; Dalfó Baqué, A; Bajo García, J; Vara González, L; Sanchis Doménech, C; Martín Rioboo, E; Ureña Fernández, T; Domínguez Sardiña, M; Bonet Pla, A

2015-01-01

To assess the knowledge of the hypertensive patients about their hypertension and their relation to its control. Cross-sectional study among 400 hypertensive patients, all over 18 years, selected from 50 primary-care centres, who responded to an hypertension-related survey. Included variables were survey items, age, gender, educational level, professional occupation, blood pressure data and antihypertensive treatment. The obtained differences were analyzed using the chi-square test, Kruskal-Wallis, Wilcoxon, Anova and Bonferroni methods. There were 323 valid surveys. 52.9% of respondents were women, the average age: 65.4 years (SD: 11.2), 54.8% of them had primary education. 39.6% were aware of the objectives of systolic BP control. Only 19.6% having knowledge of those for diastolic BP control, with no differences between controlled and uncontrolled (systolic BP: 39% vs 38.1%, P=.887; diastolic BP: 19.2% vs 21%, P=.721). Over 70% knew about lifestyle changes, without significant differences between controlled and uncontrolled respondents. 82% of controlled respondents, and 79% of those uncontrolled, recognized the chronical nature of the treatment (P=.548), but 15.1% of the controlled respondents and 12.4% of uncontrolled respondents did not see the relation between the treatment and hypertension control (P=.525). 31.1% believed to be well-controlled, but in fact was not. Our patients doesn't know blood pressure targets of control. There isn't relationship between this knowledge and control of hypertension. Copyright © 2014 SEHLELHA. Published by Elsevier Espana. All rights reserved.

Cardiovascular Health and Incident Hypertension in Blacks: JHS (The Jackson Heart Study).

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Booth, John N; Abdalla, Marwah; Tanner, Rikki M; Diaz, Keith M; Bromfield, Samantha G; Tajeu, Gabriel S; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P; Spruill, Tanya M; Shimbo, Daichi; Muntner, Paul

2017-08-01

Several modifiable health behaviors and health factors that comprise the Life's Simple 7-a cardiovascular health metric-have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in JHS (the Jackson Heart Study)-a cohort of blacks. We analyzed participants without hypertension or cardiovascular disease at baseline (2000-2004) who attended ≥1 follow-up visit in 2005 to 2008 or 2009 to 2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure (BP), total cholesterol, and fasting glucose were assessed at baseline and categorized as ideal, intermediate, or poor using the American Heart Association's Life's Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic BP ≥140 mm Hg, diastolic BP ≥90 mm Hg, or self-reported taking antihypertensive medication. The percentage of participants with ≤1, 2, 3, 4, 5, and 6 ideal Life's Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0%, and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median, 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5, and 6 versus ≤1 ideal component were 0.80 (0.61-1.03), 0.58 (0.45-0.74), 0.30 (0.23-0.40), 0.26 (0.18-0.37), and 0.10 (0.03-0.31), respectively ( P trend hypertension risk. © 2017 American Heart Association, Inc.

Association between exposure to noise and risk of hypertension: a meta-analysis of observational epidemiological studies.

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Fu, Wenning; Wang, Chao; Zou, Li; Liu, Qiaoyan; Gan, Yong; Yan, Shijiao; Song, Fujian; Wang, Zhihong; Lu, Zuxun; Cao, Shiyi

2017-12-01

An increasing amount of original studies suggested that exposure to noise could be associated with the risk of hypertension, but the results remain inconsistent and inconclusive. We aimed to synthesize available epidemiological evidence about the relationship between various types of noise and hypertension, and to explore the potential dose-response relationship between them in an up-to-date meta-analysis. We conducted a literature search of PubMed and Embase from these databases' inception through December 2016 to identify observational epidemiological studies examining the association between noise and risk of hypertension. A random effects model was used to combine the results of included studies. Dose-response meta-analysis was conducted to examine the potential dose-response relationship. In total, 32 studies (five cohort studies, one case-control study, and 26 cross-section studies) involving 264 678 participants were eligible for inclusion. Pooled result showed that living or working in environment with noise exposure was significantly associated with increased risk of hypertension (odds ratio 1.62; 95% confidence interval: 1.40-1.88). We found no evidence of a curve linear association between noise and risk of hypertension. A dose-response analysis suggested that, for an increment of per 10 dB(A) of noise, the combined odds ratio of hypertension was 1.06 (95% confidence interval: 1.04-1.08). Integrated epidemiological evidence supports the hypothesis that exposure to noise may be a risk factor of hypertension, and there is a positive dose-response association between them.

[Prevalence of hypertension in elderly long-term care residents in Spain. The Geriatric HTA study].

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Martín-Baranera, Montserrat; Sánchez Ferrín, Pau; Armario, Pedro

2006-11-11

This study aimed to estimate the prevalence of hypertension in elderly long-term care residents in Spain and to describe such population in terms of comorbidity and hypertension treatment and control. A countrywide cross-sectional study was conducted in May 2003 among long-term care residents aged 65 or more. Patients in palliative care units were excluded. Hypertension was defined in patients who fulfilled at least one of the following criteria: diagnosis of hypertension on the medical record, antihypertensive medication and/or highest blood pressure values during the previous year > or = 140/90 mmHg. Overall, 13,272 subjects - mean age (standard deviation) 82.9 (7.5) years (range: 65-106 years) - were included from 223 centres; 70.6% were women. Almost 2 thirds of patients met at least one hypertension criterion (8,242 patients, 62.1%; 95% confidence interval, 61.3-62.9%). In those patients, other frequent cardiovascular risk factors were obesity (26.3%), diabetes (25.7%) and dislipemia (23.8%). A concomitant diagnosis of dementia, peripheral vascular disease, stroke or congestive heart failure was present in 37.1%, 28.3%, 26.0% and 25.1%, respectively. The proportion of hypertensive patients receiving at least one antihypertensive drug was 69.7%. Diuretics were the most commonly used agents (46.3%), followed by angiotensine converting enzyme inhibitors (34.6%). The latest blood pressure measurement was < 140/90 mmHg in 60.4% of the hypertensive patients. Elderly long-term care residents in Spain showed a high prevalence of hypertension and other cardiovascular risk factors, and a substantial degree of associated clinical conditions. The proportion of antihypertensive drug therapy was comparable to those reported in similar studies.

Shoshin beriberi-thiamine responsive pulmonary hypertension in exclusively breastfed infants: A study from northern India.

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Bhat, Javeed Iqbal; Rather, Hilal Ahmad; Ahangar, Ambreen Ali; Qureshi, Umar Amin; Dar, Parvez; Ahmed, Qazi Iqbal; Charoo, Bashir Ahmed; Ali, Syed Wajid

To study the effect of thiamine administration on the resolution of pulmonary hypertension in exclusively breastfed infants. Prospective cohort study. Hospital based study of a tertiary care hospital. A total of 29 infants with 17 males (58.6%) and 12 females (41.4%) were included in the study. In addition to the management of shock, right heart failure and renal failure, patients received intravenous thiamine 100mg/kg IV followed by 10mg/day till introduction of supplementary feeds. Resolution of shock, metabolic complications and pulmonary hypertension. Mean age at presentation was 78.45±30.7 days. All infants were exclusively breastfed. 86.2% of mothers were on customary dietary restrictions. Biventricular failure and tachycardia was commonly present. There were four deaths in our series. Acute metabolic acidosis was a universal feature with a mean pH of 7.21±0.15. Pulmonary hypertension was present in all patients on admission. Intravenous thiamine 100mg/kg IV stat was given immediately after documenting pulmonary hypertension. Repeat echocardiography showed complete resolution of pulmonary hypertension. Many infants present to us with Shoshin beriberi with unusually high pulmonary pressures. These patients respond to thiamine challenge with prompt resolution of metabolic complications and reversal of pulmonary hypertension. We believe this is first of its kind from the region, which is reported. Copyright © 2016. Published by Elsevier B.V.

Better physician-patient communication; an important milestone in control of hypertension, a multicenter study from karachi, pakistan

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Almas, Y.; Bhamani, F.

2014-01-01

Control of hypertension is an important cornerstone in prevention of cardiovascular morbidity and mortality. This study was designed to compare physician encounter score in patients with controlled and uncontrolled hypertension. It was conducted at three tertiary care hospitals in Karachi. Patients were categorized into controlled and uncontrolled hypertension based on their initial blood pressure readings on presentation. Primary outcome variable was control of hypertension and physician encounter score (a composite score of 12 item question) was the main candidate variable. Higher scores reflected favorable encounter with physician. Mean age of participants was 57.7 +- 12 years; 224 (50.1%) were men. Controlled hypertension was present in 72.3% (323) and uncontrolled hypertension was present in 27.4% (124). Mean physician encounter score in uncontrolled hypertensive was 7.25 +- 2.64 versus 7.83 +- 2.22 (p=0.02) in controlled hypertensive. Patient-physician encounter is an important milestone in control of hypertension in hypertensive patients and directly translates into better adherence to antihypertensives in these patients. (author)

Diagnostic status of hypertension on the adherence to the Dietary Approaches to Stop Hypertension (DASH diet

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Hyun Kim, PhD

2016-12-01

Full Text Available The Dietary Approaches to Stop Hypertension (DASH diet is a widely recommended diet for individuals with hypertension. Adherence to the DASH diet has been shown to be effective for controlling hypertension, but it is unclear whether a hypertension diagnosis has an impact on adherence to the diet and nutrient intake. This study examined the association between hypertension diagnosis and the DASH nutrient intake using the multivariate linear regression method. The sample was composed of individuals with hypertension in the National Health and Nutrition Examination Survey (NHANES from 2007 to 2012. The outcome was the DASH accordance score (0 to 9 points, which measures the intake of nine nutrients compared to target amounts. Study findings indicate that a diagnostic status of hypertension was associated with increased consumption of sodium, saturated fat, total fat, and protein. Adherence to the DASH diet was more likely to be associated with health conditions such as obesity and heart diseases and lifestyle behaviors such as current smoking status and physical activity. Individuals diagnosed with hypertension showed less adherence to the DASH diet than those not diagnosed with hypertension, so a diagnosis of hypertension did not seem to provide an incentive to engage in healthy dietary behavior. Overall, regardless of diagnostic status, individuals with hypertension did not seem to follow the DASH guidelines.

Study of prevalence of type 2 diabetes mellitus and hypertension in overweight and obese people

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Abhijit Mandal

2014-01-01

Full Text Available Context: In recent years, there has been a marked change in life-style of South Asian countries caused by economic growth, affluence, urbanization and dietary westernization. Few studies on the prevalence of obesity, hypertension and diabetes in the Indian population have been reported. However, there has been scarce literature on the study of prevalence of type 2 diabetes mellitus (DM and Hypertension in overweight and obese people in India with criteria suggested by World Health Organization (WHO for Asians. Information on such public health issues would provide evidence based data to develop guidelines and policies on this subject. Aim: The aim of this article is to determine the prevalence of hypertension and type 2 DM in overweight and obese people. Setting and Design: A cross-sectional study consisted of people selected from the out-patient department and indoors of a large defense hospital in a semi urban area of Assam. Materials and Methods: Patients with overweight and obesity, reporting for consultation and medical examination were taken into the study. The data collected was analyzed using the criteria for overweight, obesity, diabetes and hypertension defined by WHO, Joint National Committee VII and International Diabetes Federation, American Diabetes Association. A descriptive statistical analysis has been carried out in the study. Results: A total of 300 people were the subject population of this study. Among the subject population, there were 97 overweight and 203 obese. The 56 subjects were found to be diabetic. The prevalence of type 2 DM in overweight subjects was 15.5% and in obese was 20.2% and overall was 18.7%. Prevalence of hypertension in the overweight population was 8.2% and in obese was 22.2% and overall found to be 17.7%. Conclusions: The prevalence of type 2 DM, hypertension in the obese group of the study population were found to be 20.2%, 22.2% and in the overweight population were 15.5% and 8.2%, respectively

Salt intake, obesity, and pre-hypertension among Iranian adults: a cross-sectional study

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Khosravi, A.; Toghianifar, N.; Sarrafzodegan, N

2012-01-01

Objective: Overweight and obese subjects are prone to have a high salt intake. This study was aimed to investigate the relationship between salt intake and pre hypertension among overweight and obese subjects. Methodology: This was across-sectional study performed in the setting of a community-based intervention: the Isfahan Healthy Heart Program (IHHP). In total, 806 subjects with normal blood pressure or pre hypertension entered the study. Salt intake, BMI, and blood pressure were measured using standard methods. Results: The salt intake was 9.19 +- 5.34, 11.6 6.87, and 11.64 +- 6.68 gm/d in normal-weight, overweight and obese subjects with normal blood pressure, respectively (p=0.0001). The values for normal-weight, overweight and obese pre hypertensive subjects were 12.04 +- 8.03, 12.41 +- 6.45, and 12.52+- 7.63 gm/d, respectively (p=0.236). The unadjusted odds ratio for pre hypertension among obese subjects was 4.78 (95% Cl: 2.38 - 9.60). The odds ratio was 4.73 (95% CI 2.19-10.19), 4.65 (95%CI 2.15-10.05), and 3.37 (95%CI 1.45-7.85) after adjustment for socio demographic characteristics, lifestyle factors, and salt intake, respectively. An increase of one gram per day in the daily salt intake increased the probability of having pre hypertension by 5% after adjusting for age, education, BMI, and lifestyle factors. Conclusion: The findings of this study support a role for high salt intake in the high blood pressure of overweight and obese subjects. (author)

Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study

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Korf, E S C; van Straaten, E C W; de Leeuw, F-E

2007-01-01

HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white...... matter hyperintensities. METHODS: In the Leukoaraiosis And DISability in the elderly (LADIS) study, we investigated the relationships between DM, hypertension, blood pressure and MTA in 582 subjects, stratified by white matter hyperintensity severity, using multinomial logistic regression. MTA...... was visually scored for the left and right medial temporal lobe (score 0-4), and meaned. RESULTS: Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95...

Hypertension: adherence to treatment in rural Bangladesh – findings from a population-based study

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Khanam, Masuma Akter; Lindeboom, Wietze; Koehlmoos, Tracey Lynn Perez; Alam, Dewan Shamsul; Niessen, Louis; Milton, Abul Hasnat

2014-01-01

Background Poor adherence has been identified as the main cause of failure to control hypertension. Poor adherence to antihypertensive treatment is a significant cardiovascular risk factor, which often remains unrecognized. There are no previous studies that examined adherence with antihypertensive medication or the characteristics of the non-adherent patients in Bangladesh. Objective This paper aims to describe hypertension and factors affecting adherence to treatment among hypertensive persons in rural Bangladesh. Design The study population included 29,960 men and women aged 25 years and older from three rural demographic surveillance sites of the International Center for Diarrheal Disease Research, Bangladesh (icddr,b): Matlab, Abhoynagar, and Mirsarai. Data was collected by a cross-sectional design on diagnostic provider, initial, and current treatment. Discontinuation of medication at the time of interview was defined as non-adherence to treatment. Results The prevalence of hypertension was 13.67%. Qualified providers diagnosed only 53.5% of the hypertension (MBBS doctors 46.1 and specialized doctors 7.4%). Among the unqualified providers, village doctors diagnosed 40.7%, and others (nurse, health worker, paramedic, homeopath, spiritual healer, and pharmacy man) each diagnosed less than 5%. Of those who started treatment upon being diagnosed with hypertension, 26% discontinued the use of medication. Age, sex, education, wealth, and type of provider were independently associated with non-adherence to medication. More men discontinued the treatment than women (odds ratio [OR] 1.74, confidence interval [CI] 1.48–2.04). Non-adherence was greater when hypertension was diagnosed by unqualified providers (OR 1.52, CI 1.31–1.77). Hypertensive patients of older age, least poor quintile, and higher education were less likely to be non-adherent. Patients with cardiovascular comorbidity were also less likely to be non-adherent to antihypertensive medication (OR 0

Vascular inflammatory cells in hypertension

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David G. Harrison

2012-05-01

Full Text Available Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. Recent studies have shown that mice lacking macrophages have blunted hypertension in response to angiotensin II and that genetic deletion of macrophages markedly reduces experimental hypertension. Dendritic cells have also been implicated in this disease. Many hypertensive stimuli have triggering effects on the central nervous system and signals arising from the circumventricular organ seem to promote inflammation. Studies have suggested that central signals activate macrophages and T cells, which home to the kidney and vasculature and release cytokines, including IL-6 and IL-17, which in turn cause renal and vascular dysfunction and lead to blood pressure elevation. These recent discoveries provide a new understanding of hypertension and provide novel therapeutic opportunities for treatment of this serious disease.

Study on predictors of health outcome in patients attending hypertension intervention programme in Malaysia.

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Wahab, Rasidah Abd.

2008-01-01

The aim of this study is to explore predictor of health outcomes among Malaysian hypertensive patients attending a standard hypertension intervention programme. Among the psychological predictors studied are illness perception, health locus of control, and self-efficacy. Quality of life, anxiety and depression and demographic variables are among the predictors included in the study. Two series of studies were conducted to answer the research question formulated for each study. Study 1 aims to...

[Control of hypertension in nursing homes].

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Thomas, J M; Alvarez, W; Mulaj, M; De Breucker, S; Leeman, M; Pepersack, T

2006-09-01

In a cross sectional study we determined prevalence of hypertension among institutionalized old subjects. Prevalence of hypertension was 69%. Among detected hypertensive patients, 76% received an antihypertensive drug treatment. 61% of the declared hypertensive patients and 80% of the treated hypertensive patients had their blood pressure controlled. The general practitioners should better detect and treat this common geriatric problem associated with a high comorbidity.

Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension.

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Pedrosa, Rodrigo P; Drager, Luciano F; Gonzaga, Carolina C; Sousa, Marcio G; de Paula, Lílian K G; Amaro, Aline C S; Amodeo, Celso; Bortolotto, Luiz A; Krieger, Eduardo M; Bradley, T Douglas; Lorenzi-Filho, Geraldo

2011-11-01

Recognition and treatment of secondary causes of hypertension among patients with resistant hypertension may help to control blood pressure and reduce cardiovascular risk. However, there are no studies systematically evaluating secondary causes of hypertension according to the Seventh Joint National Committee. Consecutive patients with resistant hypertension were investigated for known causes of hypertension irrespective of symptoms and signs, including aortic coarctation, Cushing syndrome, obstructive sleep apnea, drugs, pheochromocytoma, primary aldosteronism, renal parenchymal disease, renovascular hypertension, and thyroid disorders. Among 125 patients (age: 52±1 years, 43% males, systolic and diastolic blood pressure: 176±31 and 107±19 mm Hg, respectively), obstructive sleep apnea (apnea-hypopnea index: >15 events per hour) was the most common condition associated with resistant hypertension (64.0%), followed by primary aldosteronism (5.6%), renal artery stenosis (2.4%), renal parenchymal disease (1.6%), oral contraceptives (1.6%), and thyroid disorders (0.8%). In 34.4%, no secondary cause of hypertension was identified (primary hypertension). Two concomitant secondary causes of hypertension were found in 6.4% of patients. Age >50 years (odds ratio: 5.2 [95% CI: 1.9-14.2]; Phypertension. Age >50 years, large neck circumference measurement, and snoring are good predictors of obstructive sleep apnea in this population.

Family clustering of secondary chronic kidney disease with hypertension or diabetes mellitus. A case-control study.

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de Almeida, Fernando Antonio; Ciambelli, Giuliano Serafino; Bertoco, André Luz; Jurado, Marcelo Mai; Siqueira, Guilherme Vasconcelos; Bernardo, Eder Augusto; Pavan, Maria Valeria; Gianini, Reinaldo José

2015-02-01

In Brazil hypertension and type 2 diabetes mellitus are responsible for 60% of cases of end-stage renal disease in renal replacement therapy. In the United States studies have identified family clustering of chronic kidney disease, predominantly in African-Americans. A single Brazilian study observed family clustering among patients with chronic kidney disease when compared with hospitalized patients with normal renal function. This article aims to assess whether there is family clustering of chronic kidney disease in relatives of individuals in renal replacement therapy caused by hypertension and/or diabetes mellitus. A case-control study with 336 patients in renal replacement therapy with diabetes mellitus or hypertension for at least 5 years (cases) and a control matched sample group of individuals with hypertension or diabetes mellitus and normal renal function (n = 389). Individuals in renal replacement therapy (cases) had a ratio of 2.35 (95% CI 1.42-3.89, p hypertension or diabetes mellitus).

Hypertension hos gravide

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Mathiesen, Elisabeth R; Johansen, Marianne; Kamper, Anne Lise

2009-01-01

There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...

Longitudinal Study of Hypertensive Subjects With Type 2 Diabetes Mellitus: Overall and Cardiovascular Risk.

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Safar, Michel E; Gnakaméné, Jean-Barthélémy; Bahous, Sola Aoun; Yannoutsos, Alexandra; Thomas, Frédérique

2017-06-01

Despite adequate glycemic and blood pressure control, treated type 2 diabetic hypertensive subjects have a significantly elevated overall/cardiovascular risk. We studied 244 816 normotensive and 99 720 hypertensive subjects (including 7480 type 2 diabetics) attending medical checkups between 1992 and 2011. We sought to identify significant differences in overall/cardiovascular risk between hypertension with and without diabetes mellitus. Mean follow-up was 12.7 years; 14 050 all-cause deaths were reported. From normotensive to hypertensive populations, a significant progression in overall/cardiovascular mortality was observed. Mortality was significantly greater among diabetic than nondiabetic hypertensive subjects (all-cause mortality, 14.05% versus 7.43%; and cardiovascular mortality, 1.28% versus 0.7%). No interaction was observed between hemodynamic measurements and overall/cardiovascular risk, suggesting that blood pressure factors, even during drug therapy, could not explain the differences in mortality rates between diabetic and nondiabetic hypertensive patients. Using cross-sectional regression models, a significant association was observed between higher education levels, lower levels of anxiety and depression, and reduced overall mortality in diabetic hypertensive subjects, while impaired renal function, a history of stroke and myocardial infarction, and increased alcohol and tobacco consumption were significantly associated with increased mortality. Blood pressure and glycemic control alone cannot reverse overall/cardiovascular risk in diabetics with hypertension. Together with cardiovascular measures, overall prevention should include recommendations to reduce alcohol and tobacco consumption and improve stress, education levels, and physical activity. © 2017 American Heart Association, Inc.

Body Mass Index, Smoking and Hypertensive Disorders during Pregnancy: A Population Based Case-Control Study.

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Thuridur A Gudnadóttir

Full Text Available While obesity is an indicated risk factor for hypertensive disorders of pregnancy, smoking during pregnancy has been shown to be inversely associated with the development of preeclampsia and gestational hypertension. The purpose of this study was to investigate the combined effects of high body mass index and smoking on hypertensive disorders during pregnancy. This was a case-control study based on national registers, nested within all pregnancies in Iceland 1989-2004, resulting in birth at the Landspitali University Hospital. Cases (n = 500 were matched 1:2 with women without a hypertensive diagnosis who gave birth in the same year. Body mass index (kg/m2 was based on height and weight at 10-15 weeks of pregnancy. We used logistic regression models to calculate odds ratios and corresponding 95% confidence intervals as measures of association, adjusting for potential confounders and tested for additive and multiplicative interactions of body mass index and smoking. Women's body mass index during early pregnancy was positively associated with each hypertensive outcome. Compared with normal weight women, the multivariable adjusted odds ratio for any hypertensive disorder was 1.8 (95% confidence interval, 1.3-2.3 for overweight women and 3.1 (95% confidence interval, 2.2-4.3 for obese women. The odds ratio for any hypertensive disorder with obesity was 3.9 (95% confidence interval 1.8-8.6 among smokers and 3.0 (95% confidence interval 2.1-4.3 among non-smokers. The effect estimates for hypertensive disorders with high body mass index appeared more pronounced among smokers than non-smokers, although the observed difference was not statistically significant. Our findings may help elucidate the complicated interplay of these lifestyle-related factors with the hypertensive disorders during pregnancy.

Study on the relationship between serum sex hormones levels and essential hypertension

International Nuclear Information System (INIS)

Song Qingzhang; Yang Xiuhong; Di Fang

2006-01-01

Objective: To investigate the possible relationship existing between serum sex hormones levels and development of essential hypertension. Methods: Serum sex hormones (LH, FSH, E 2 , P, T) levels were determined with RIA in 87 males and 81 post-menopausal women with essential hypertension as well as in 44 normotensive males and 40 normotensive post-menopausal women serving as controls. Results: The serum E 2 , progesterone and testosterone levels in the hypertensives were significantly higher than those in the respective controls (P 0.05). Sex hormones levels were not much different among hypertensives of various stages (I , II, III). The serum E 2 levels in male hypertensives and progesterone levels in female hypertensives were not correlated with the respective FSH and LH levels. Conclusion: The authors suggested that the changes of serum sex hormones levels might be a risk factor rather than a consequence of the development of essential hypertension. (authors)

Hemodynamic Effects of Phenylephrine, Vasopressin, and Epinephrine in Children With Pulmonary Hypertension: A Pilot Study.

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Siehr, Stephanie L; Feinstein, Jeffrey A; Yang, Weiguang; Peng, Lynn F; Ogawa, Michelle T; Ramamoorthy, Chandra

2016-05-01

During a pulmonary hypertensive crisis, the marked increase in pulmonary vascular resistance can result in acute right ventricular failure and death. Currently, there are no therapeutic guidelines for managing an acute crisis. This pilot study examined the hemodynamic effects of phenylephrine, arginine vasopressin, and epinephrine in pediatric patients with pulmonary hypertension. In this prospective, open-label, nonrandomized pilot study, we enrolled pediatric patients previously diagnosed with pulmonary hypertensive who were scheduled electively for cardiac catheterization. Primary outcome was a change in the ratio of pulmonary-to-systemic vascular resistance. Baseline hemodynamic data were collected before and after the study drug was administered. Eleven of 15 participants were women, median age was 9.2 years (range, 1.7-14.9 yr), and median weight was 26.8 kg (range, 8.5-55.2 kg). Baseline mean pulmonary artery pressure was 49 ± 19 mm Hg, and mean indexed pulmonary vascular resistance was 10 ± 5.4 Wood units. Etiology of pulmonary hypertensive varied, and all were on systemic pulmonary hypertensive medications. Patients 1-5 received phenylephrine 1 μg/kg; patients 6-10 received arginine vasopressin 0.03 U/kg; and patients 11-15 received epinephrine 1 μg/kg. Hemodynamics was measured continuously for up to 10 minutes following study drug administration. After study drug administration, the ratio of pulmonary-to-systemic vascular resistance decreased in three of five patients receiving phenylephrine, five of five patients receiving arginine vasopressin, and three of five patients receiving epinephrine. Although all three medications resulted in an increase in aortic pressure, only arginine vasopressin consistently resulted in a decrease in the ratio of systolic pulmonary artery-to-aortic pressure. This prospective pilot study of phenylephrine, arginine vasopressin, and epinephrine in pediatric patients with pulmonary hypertensive showed an increase in aortic

Biology of portal hypertension.

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McConnell, Matthew; Iwakiri, Yasuko

2018-02-01

Portal hypertension develops as a result of increased intrahepatic vascular resistance often caused by chronic liver disease that leads to structural distortion by fibrosis, microvascular thrombosis, dysfunction of liver sinusoidal endothelial cells (LSECs), and hepatic stellate cell (HSC) activation. While the basic mechanisms of LSEC and HSC dysregulation have been extensively studied, the role of microvascular thrombosis and platelet function in the pathogenesis of portal hypertension remains to be clearly characterized. As a secondary event, portal hypertension results in splanchnic and systemic arterial vasodilation, leading to the development of a hyperdynamic circulatory syndrome and subsequently to clinically devastating complications including gastroesophageal varices and variceal hemorrhage, hepatic encephalopathy from the formation of portosystemic shunts, ascites, and renal failure due to the hepatorenal syndrome. This review article discusses: (1) mechanisms of sinusoidal portal hypertension, focusing on HSC and LSEC biology, pathological angiogenesis, and the role of microvascular thrombosis and platelets, (2) the mesenteric vasculature in portal hypertension, and (3) future directions for vascular biology research in portal hypertension.

?I have to live like I?m old.? Young adults? perspectives on managing hypertension: a multi-center qualitative study

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Johnson, Heather M.; Warner, Ryan C.; LaMantia, Jamie N.; Bowers, Barbara J.

2016-01-01

Background In the U.S., young adults (18?39 year-olds) have the lowest hypertension control rates among hypertensive adults. Understanding young adults? unique perceptions about hypertension and perceived barriers to hypertension control is critical to develop effective interventions for this population. This multi-center study explored young adults?: 1) emotions and reactions after a hypertension diagnosis, 2) attitudes about managing hypertension (lifestyle changes, follow-up visits, antihy...

Evaluation of BAG3 levels in healthy subjects, hypertensive patients, and hypertensive diabetic patients.

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Derosa, Giuseppe; Maffioli, Pamela; Rosati, Alessandra; M, De Marco; Basile, Anna; D'Angelo, Angela; Romano, Davide; Sahebkar, Amirhossein; Falco, Antonia; Turco, Maria C

2018-03-01

BAG3 is a member of human BAG (Bcl-2-associated athanogene) proteins and plays a role in apoptosis, cell adhesion, cytoskeleton remodeling, and autophagy. The aim of this study was to evaluate BAG3 levels in healthy subjects, hypertensive patients, and hypertensive diabetic patients. We enrolled 209 Caucasian adults, of both sex, 18-75 years of age, 77 were healthy controls, 62 were affected by hypertension, and 70 were affected by hypertension and type 2 diabetes. All patients underwent an assessment that included medical history, physical examination, vital signs, a 12-lead electrocardiogram, measurements of systolic (SBP), and diastolic blood pressure (DBP), heart rate (HR), fasting plasma glucose (FPG), glycated hemoglobin (HbA 1c ), triglycerides (TG), transaminases, high sensitivity C-reactive protein (Hs-CRP), and BAG3. We observed higher blood pressure values in hypertensive, and hypertensive diabetic patients compared to controls. As expected, FPG and HbA 1c were higher in diabetic hypertensive patients, compared to the other two groups. No Tg levels differences were recorded among the three groups. Hs-CRP was higher in diabetic hypertensive patients compared to healthy subjects. Finally, BAG3 levels were higher in hypertensives, and hypertensive diabetic patients compared to controls. We observed higher levels of BAG3 in hypertensive patients compared to healthy controls, and even higher levels in hypertensive diabetic patients compared to healthy subjects. This paper could be the first of a long way to identify potential involvement of deregulated BAG3 levels in cardiometabolic diseases. © 2017 Wiley Periodicals, Inc.

Primary lung hypertension in-patient with hypertension portal

International Nuclear Information System (INIS)

Restrepo Uribe; Villa Restrepo, Alfredo

1990-01-01

Thorax x-rays were reviewed in 18 patients with portal hypertension. In 28% of these we found radiologic signs of pulmonary hypertension of the precapillary type. The existing relation between primary pulmonary hypertension and portal hypertension has been established in different scientific papers. In the published series the incidence of primary pulmonary hypertension is less than the one of found in these patients the physiopathology of this association is reviewed, and as a hypothetic manner it is postulated the possible roll of the hypoxaemia of the residents, at the altitude of the Bogota city. (2.640 mts) as a helping factor in this phenomenon

The Current Situation of Hypertension among Rural Minimal Assurance Family Participants in Liaoning (China): A Cross-Sectional Study.

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Chen, Yintao; Yu, Shasha; Chen, Shuang; Guo, Xiaofan; Li, Yuan; Li, Zhao; Sun, Yingxian

2016-12-02

In China, the prevalence of hypertension is increasing and is showing an epidemic accelerating trend. However, there is a lack of studies reporting the hypertension status of rural residents with minimum living allowances. We performed a cross-sectional study including 11,435 (5285 men and 6150 women) from the general population aged ≥35 years in the Liaoning Province of China from 2012 to 2013, of which 1258 (11.0%) participants came from minimal assurance families. Anthropometric measurements, laboratory examinations and self-reported lifestyle factor information were collected by trained personnel. Multivariate logistic regression was used to detect the association between socioeconomic status (SES) and the risk of hypertension. We found that the prevalence of hypertension was as high as 61.9% in participants from minimal assurance families and the odd ratio for hypertension was 1.32 (95% CI: 1.15-1.52). The awareness, treatment, and control rates among treated hypertensive participants did not increase with higher level of income and education. In the total sample, the lower income levels increased the risk for hypertension, but education didn't show a significant association with hypertension. Thus, there is a severe hypertension situation in the Liaoning rural population of minimal assurance families, which need more attention and prevention and control measures for hypertension.

Resistant Hypertension.

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Doroszko, Adrian; Janus, Agnieszka; Szahidewicz-Krupska, Ewa; Mazur, Grzegorz; Derkacz, Arkadiusz

2016-01-01

Resistant hypertension is a severe medical condition which is estimated to appear in 9-18% of hypertensive patients. Due to higher cardiovascular risk, this disorder requires special diagnosis and treatment. The heterogeneous etiology, risk factors and comorbidities of resistant hypertension stand in need of sophisticated evaluation to confirm the diagnosis and select the best therapeutic options, which should consider lifestyle modifications as well as pharmacological and interventional treatment. After having excluded pseudohypertension, inappropriate blood pressure measurement and control as well as the white coat effect, suspicion of resistant hypertension requires an analysis of drugs which the hypertensive patient is treated with. According to one definition - ineffective treatment with 3 or more antihypertensive drugs including diuretics makes it possible to diagnose resistant hypertension. A multidrug therapy including angiotensin - converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, diuretics, long-acting calcium channel blockers and mineralocorticoid receptor antagonists has been demonstrated to be effective in resistant hypertension treatment. Nevertheless, optional, innovative therapies, e.g. a renal denervation or baroreflex activation, may create a novel pathway of blood pressure lowering procedures. The right diagnosis of this disease needs to eliminate the secondary causes of resistant hypertension e.g. obstructive sleep apnea, atherosclerosis and renal or hormonal disorders. This paper briefly summarizes the identification of the causes of resistant hypertension and therapeutic strategies, which may contribute to the proper diagnosis and an improvement of the long term management of resistant hypertension.

Comparison of demographic, clinical, and laboratory parameters between patients with sustained normotension, white coat hypertension, masked hypertension, and sustained hypertension.

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Afsar, Baris

2013-03-01

After measurement of office blood pressure (BP) and ambulatory BP monitoring (ABPM), 4 groups of patients were identified namely: (i) sustained normotensive patients (BPs are normal both clinically and by ABPM); (ii) white coat hypertensive patients (clinical BP were above limits, but ABPM were normal); (iii) masked hypertensive patients (clinical BP were normal, but ABPM were high); (iv) sustained hypertensive patients (both office and ABPM were high). The exact pathophysiologic mechanisms of these conditions are not exactly known. Besides in the literature there are only few studies that compare the 4 groups of patients together. Thus the study was carried out to compare patients with sustained normotension (SNT), white coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT). All patients underwent history taking, physical examination, laboratory analysis, and ABPM. They were referred to the cardiology department for echocardiographic evaluation. In total 85 patients with SNT, 112 patients with WCHT, 31 patients with MHT, and 81 patients with SHT were included. Going from SNT to SHT, body mass index (p<0.0001), waist circumference (p<0.0001), fasting blood glucose (p=0.002), and uric acid (p=0.029) rose progressively. Presence of metabolic syndrome was also highest in SHT and lowest in SNT (p<0.0001). Most of the metabolic risk factors were higher in patients with MHT and SHT when compared to SNT and WCHT. Studies are needed to determine whether metabolic risk factors play a causative role for the development of MHT and SHT. Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

PM2.5 and Diabetes and Hypertension Incidence in the Black Women's Health Study.

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Coogan, Patricia F; White, Laura F; Yu, Jeffrey; Burnett, Richard T; Seto, Edmund; Brook, Robert D; Palmer, Julie R; Rosenberg, Lynn; Jerrett, Michael

2016-03-01

Clinical studies have shown that exposure to fine particulate matter (PM2.5) can increase insulin resistance and blood pressure. The epidemiologic evidence for an association of PM2.5 exposure with the incidence of type 2 diabetes or hypertension is inconsistent. Even a modest association would have great public health importance given the ubiquity of exposure and high prevalence of the conditions. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident type 2 diabetes and hypertension associated with exposure to PM2.5 in a large cohort of African American women living in 56 metropolitan areas across the US, using data from the Black Women's Health Study. Pollutant levels were estimated at all residential locations over follow-up with a hybrid model incorporating land use regression and Bayesian Maximum Entropy techniques. During 1995 to 2011, 4,387 cases of diabetes and 9,570 cases of hypertension occurred. In models controlling for age, questionnaire cycle, and metro area, there were positive associations with diabetes (HR = 1.13, 95% CI = 1.04, 1.24) and hypertension (HR = 1.06, 95% CI = 1.00, 1.12) per interquartile range of PM2.5 (2.9 μg/m). Multivariable HRs, however, were 0.99 (95% CI = 0.90, 1.09) for diabetes and 0.99 (95% CI = 0.93, 1.06) for hypertension. Our results provide little support for an association of PM2.5 with diabetes or hypertension incidence.

Secondary Hypertension

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Secondary hypertension Overview Secondary hypertension (secondary high blood pressure) is high blood pressure that's caused by another medical condition. Secondary hypertension can be caused by conditions that affect your kidneys, ...

A STUDY OF ELECTROCARDIOGRAPHY AND KIDNEY FUNCTION TEST IN NEWLYDIAGNOSED HYPERTENSIVE PATIENTS IN COASTAL ANDHRA PRADESH

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Ramswaroop

2017-11-01

Full Text Available BACKGROUND As per the fact sheet published by World Health Organisation, South East Asia, nearly one billion people have high blood pressure and are one of the most common causes of premature death worldwide. About one third of the adult population in the South East Asia region is having hypertension. In our country, the number of people with hypertension are undiagnosed and untreated, so early detection and treatment of hypertension will decrease the complication of hypertension and premature death due to it. MATERIALS AND METHODS This is a prospective study conducted in the Department of General Medicine, Konaseema Institute of Medical Sciences, Amalapuram, from May 2015 to August 2017. This study was started with an aim to know that electrocardiographic abnormalities and kidney function at the time of diagnosis of hypertension in a patient in coastal Andhra Pradesh. RESULTS We have found ECG changes in both the stages of hypertensive group patients. In stage-1 hypertensive group patients, out of 80 patients, 6 patients having sinus tachycardia, 2 having sinus bradycardia, 4 patients having left bundle-branch block and 6 having right bundle-branch block. ST elevation was found in 1 patient and ST depression was found in 8 patients. AV block was present in 2 patients. Right ventricular hypertrophy was present in 1 patient and left ventricular hypertrophy was present in 4 patients. T-wave inversion was found in 4 patients. In stage-2 hypertensive patients, sinus tachycardia in 6 patients and bradycardia in 1 patient, LBBB was found in 8 patients. ST depression was found in 6 patients and ST elevation was found in 2 patients out of 40 patients. AV block was present in 3 patients. Left ventricular hypertrophy patients 16 out of 40, but right ventricular hypertrophy was only 1. T-wave inversion was found in 6 patients. CONCLUSION In our study, we have found that stage-2 hypertensive patients have higher BMI, serum urea and creatinine than stage-1

Prevalence of hypertension in adults in the Šumadija district, Serbia: A cross sectional study

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Marinković Mirjana

2014-01-01

Full Text Available Background/Aim. World Health Organization (WHO studies on the global level have shown that one of the major problems of the public health is hypertension. Blood pressure level greater than 140/90 mmHg is directly and predictively linked to other cardiovascular diseases. The aim of this research was to determine the prevalence of hypertension and the risk groups among the adult population in the Šumadija District, Serbia. Methods. This cross-sectional study included 1.669 elderly population of the Šumadija District, aged 25-74. The study was performed according to the protocol of the Country Wide Integrated Noncommunicable Disease Intervention (CINDI international program. Results. In the Šumadija District more than a half of the population aged 25-74 suffers from hypertension (53%. In the Šumadija District 9% of population has undiagnosed hypertension. In the group of people familiar with their high blood pressure problems, good disease control is achieved in only 46% of them. Statistically, hypertension occurs more frequently in males aged 45-74, of lower education, and in rural population. This is the target group for implementation of the high risk strategy. Statistically, there is a higher prevalence of hypertension in people suffering from myocardial infarction (p = 0.04, angina pectoris (p = 0.00, other cardiac diseases (cardiac insufficiency (p = 0.00 and cerebrovascular crises (p = 0.04. Conclusion. A continuous increase of patients with hypertension, coupled with the developed complications and increase in cardiovascular diseases as a cause of death, points to the lack of effective access to prevention and early detection of these diseases in the primary health care among the risk groups in Šumadija.

Epidemiology of hypertensive kidney disease.

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Udani, Suneel; Lazich, Ivana; Bakris, George L

2011-01-01

The prevalence of hypertension, chronic kidney disease (CKD) and end-stage renal disease (ESRD) attributable to hypertension continues to rise worldwide. Identifying the precise prevalence of CKD attributable to hypertension is difficult owing to the absence of uniform criteria to establish a diagnosis of hypertensive nephropathy. Despite the increasing prevalence of CKD-associated hypertension, awareness of hypertension among individuals with CKD remains suboptimal and rates of blood-pressure control remain poor. Targeted subgroups involved in studies of CKD seem to reach better rates of blood-pressure control, suggesting that this therapeutic goal can be achieved in patients with CKD. Elevated blood-pressure levels are associated with CKD progression. However, the optimal blood-pressure level and pharmacological agent remains unclear. Physicians treating patients with CKD must recognize the importance of maintaining optimal salt and volume balance to achieve blood-pressure goals. Furthermore, agents that modify the renin-angiotensin-aldosterone axis can be an important adjunct to therapy and physicians must monitor expected changes in serum creatinine and electrolyte levels after their administration. Hypertension remains a common factor complicating CKD. Future investigations identifying early signs of hypertension-related CKD, increasing awareness of the effects of hypertension in CKD and determining optimal therapeutic interventions might help reduce the incidence of hypertensive nephropathy.

Causal mechanisms of masked hypertension: socio-psychological aspects.

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Ogedegbe, Gbenga

2010-04-01

The contribution of Dr Thomas Pickering's study to the measurement of blood pressure (BP) is the defining aspect of his academic career and achievement - narrowly defined. In this regard, two important areas characterized his study as it relates to masked hypertension. First, he introduced the term, masked hypertension, to replace the rather inappropriate term 'reverse white-coat hypertension' and 'white-coat normotension'; thus drawing attention to the fact that these patients are genuinely hypertensive by ambulatory BP but were missed by normal office BP. More importantly, he rightly maintained that masked hypertension is a true continuum of sustained hypertension rather than an aberrant measurement artifact. Second, is his pivotal study on the important role of psychosocial factors as a potential mechanism for the development of masked hypertension. In this regard, he explained masked hypertension as a conditioned response to anxiety in office settings, and highlighted the role that diagnostic labeling plays in its development. His view of masked hypertension is that of a continuum from prehypertension (based on office BP measurement) to masked hypertension (based on ambulatory BP) and finally to sustained hypertension (based on both office and ambulatory BP). He strongly believes that it is the prehypertensive patients who progress to masked hypertension. Subsequently, patients who are prehypertensive should be screened for masked hypertension and treated. In this manuscript, we summarize his study as it relates to the definition of masked hypertension, the psychosocial characteristics, mechanisms and its clinical relevance.

Characteristics of Resistant Hypertension in a Large Ethnically Diverse Hypertension Population of an Integrated Health System

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Sim, John J.; Bhandari, Simran K.; Shi, Jiaxiao; In Liu, Lu A.; Calhoun, David A.; McGlynn, Elizabeth A.; Kalantar-Zadeh, Kamyar; Jacobsen, Steven J.

2013-01-01

Objective To evaluate the prevalence and characterize resistant hypertension from a large representative population with successful hypertension management and reliable health information. Patient and Methods We performed a cross sectional study using clinical encounter, laboratory, and administrative information from the Kaiser Permanente Southern California health system during 1/1/2006–12/31/2007. From individuals age >17 years with hypertension, resistant hypertension was identified and prevalence determined. Multivariable logistic regression was used to calculate odds ratios (OR) with adjustments for demographics, clinical variables, and medication use. Results Among 470,386 hypertensive individuals, 12.8% were identified as resistant representing15.3% of those on medications. Overall, 37,061 (7.9%) had uncontrolled hypertension while on ≥ 3 medicines. OR (95% confidence interval) for resistant hypertension were greater for black race (1.68, 1.62–1.75), older age (1.11, 1.10–1.11 for every 5 year increase), males (1.06, 1.03–1.10), and obesity (1.46, 1.42–1.51). Medication adherence rates were higher in resistant hypertension (93 vs 90%, phypertension. Conclusion Within a more standardized hypertension treatment environment, we observed a rate of resistant hypertension comparable to past studies using more fragmented data sources. Past observations have been limited due to non-representative populations, reliability of the data, heterogeneity of the treatment environments, and less than ideal control rates. This cohort which was established with an electronic medical record based approach has the potential to provide a better understanding of resistant hypertension and outcomes. PMID:24079679

Pattern of utilization of benzodiazepines in patients with hypertension: A pilot study

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Divac Nevena

2006-01-01

Full Text Available Background/Aim. The analysis of drug prescribing in general practice in Serbia showed that the use of benzodiazepines is most frequently associated with hypertension. The aim of this study was to establish the correlation of the characteristics of patients with hypertension to antihypertensive drug therapy, and the intake of benzodiazepines. Methods. A special questionnaire was used for interviewing the patients (n = 171 chronically treated for hypertenson. Statistical tests used were χ2-test and Student's t-test. Results. No differences were noted in terms of age, gender, education, body weight, smoking habits and blood pressure (155±4.9/100±2.7 mmHg vs. 160±2.2/105±3.7 mmHg, between the group I (antihypertensive drugs+benzodiazepines: n = 79, and the group II (antihypertensives only: n = 92. The patients taking benzodiazepines received a lower number of different antihypertensive drugs (2.3±0.09 vs. 2.7±0.10; p < 0.01, but the total antihypertensive drug load was significantly greater than in the group II (2.6±0.10 vs. 1.9±0.15 defined daily doses (DDD/patient/day; p < 0.01. Benzodiazepines were taken for anxiety (62% and hypertension (21%, rarely for insomnia, mostly once a day, at bedtime. About half the patients took benzodiazepines regularly for months or years aware of the risk for addiction. Diazepam was used by 82% of the patients. The average daily exposure to benzodiazepines was 0.45±0.05 DDD/patient/day. The drug was bought without prescription in 25% of the patients, and without consulting a physician in 12% of them. Conclusion. The study confirmed a close association of hypertension with the use of benzodiazepines. The frequent use of benzodiazepines in the patients with hypertension might be caused by an inadequate response to antihypertensive drug therapy, besides anxiety and insomnia. The therapeutic efficacy of a long-term use of low doses of benzodiazepines in hypertension requires further investigation.

Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study.

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Pace, Romina; Brazeau, Anne-Sophie; Meltzer, Sara; Rahme, Elham; Dasgupta, Kaberi

2017-11-15

The conjoint association of gestational diabetes mellitus (GDM) and gestational hypertension (GH) with cardiometabolic disease has not been well studied. We evaluated a combined GDM/GH risk indicator in both mothers and fathers because of shared spousal behaviors and environments. In the present population-based retrospective cohort study, GH was identified in matched pairs of mothers with GDM or without GDM (matched on age group, health region, and year of delivery) who had singleton live births in Quebec, Canada (1990-2007). A total of 64,232 couples were categorized based on GDM/GH status (neither, either, or both). Associations with diabetes, hypertension, and a composite of cardiovascular disease (CVD) and mortality were evaluated using Cox proportional hazard models (from 12 weeks postpartum to March 2012). Compared with having neither GDM nor GH, having either was associated with incident diabetes (hazard ratio (HR) = 14.7, 95% confidence interval (CI): 12.9, 16.6), hypertension (HR = 1.9, 95% CI: 1.8, 2.0), and CVD/mortality (HR = 1.4, 95% CI: 1.2, 1.7). We found associations of greater magnitude among participants who had both (for diabetes, HR = 36.9, 95% CI: 26.0, 52.3; for hypertension, HR = 5.7, 95% CI: 4.9, 6.7; and for CVD/mortality, HR = 2.4, 95% CI: 1.6, 3.5). Associations with diabetes were also observed in fathers (for either, HR = 1.2, 95% CI: 1.1, 1.3; for both, HR = 1.8, 95% CI: 1.4, 2.3). In conclusion, we found associations of a combined GDM/GH indicator with cardiometabolic disease in mothers and with diabetes in fathers, with stronger associations when both GDM and GH were present. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Exploratory studies of some Mexican medicinal plants. Cardiovascular effects in rats with and without hypertension.

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Gil Alfonso Magos-Guerrero

2017-09-01

Full Text Available Background: Papaveraceae Argemone mexicana L., Burseraceae Bursera simaruba (L. Sarg., Acanthaceae Justicia spicigera Schltdl. and Selaginellaceae Selaginella lepidophylla (Hook. & Grev. Spring., have been used in Mexican traditional medicine to treat hypertension. The objective of this study was to further characterize the cardiovascular effects of the methanol extracts of such plants. Methods: The medicinal plants were collected and taxonomically identified; the methanol extract of each explored plant were administrated to conscious and unconscious male Wistar rats with and without glucose induced hypertension. The blood pressure and heart rate were evaluated before and after the extract administration. Vascular reactivity experiments were conducted in rat aortic rings obtained from rats with and without sugar induced hypertension, a model widely used to study such effects with cardiovascular agents. Results: After oral administration in normotensive conscious rats all tested extracts decreased the heart rate, such effect was only observed in hypertensive conscious rats after the administration of B. simaruba; only A. mexicana and B. simaruba decreased the blood pressure after oral administration. All extracts administrated by intravenous injection diminished the mean arterial pressure. Dose response curves to cumulative concentrations of all the extracts promote vascular relaxation in precontracted aortas from rats with and without sugar induced hypertension. Conclusions: The present study indicated that B. simaruba is worthy of further investigation as a potential phytotherapeutic agent for treating hypertension. [J Complement Med Res 2017; 6(3.000: 274-279

Morphologic changes of cerebral veins in hypertensive rats: venous collagenosis is associated with hypertension.

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Zhou, Min; Mao, Lijuan; Wang, Ying; Wang, Qian; Yang, Zhiyun; Li, Shurong; Li, Ling

2015-03-01

The aims of this study were to determine whether arterial hypertension could affect the venous system of brain and to find out the consequent pathologic changes of cerebral veins. Thirty male Sprague-Dawley rats were divided into 2 groups: a sham-clipped group and a stroke-prone renovascular hypertensive rat group. A 2-kidney 2-clip rat model was used to induce renovascular hypertension in the hypertensive group. Systolic blood pressure was measured by tail cuff once each week. Susceptibility-weighted imaging (SWI) was performed at 12, 16, and 20 weeks after surgery. All the rats were sacrificed after the SWI examination at 20 weeks after surgery. The brains were extracted and embedded in paraffin for histologic examination. Masson trichrome staining was performed to identify venous collagenosis. The sham group demonstrated less prominence of cerebral veins compared with hypertensive groups (P veins on SWI as a sign of venous hypertension and the thickened cerebral venous walls (venous collagenosis), which may play a role in cerebral ischemia and/or infarction, are both consequences of long-term hypertension in hypertensive rats. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Cerebrovascular gene expression in spontaneously hypertensive rats

DEFF Research Database (Denmark)

Grell, Anne-Sofie; Frederiksen, Simona Denise; Edvinsson, Lars

2017-01-01

Hypertension is a hemodynamic disorder and one of the most important and well-established risk factors for vascular diseases such as stroke. Blood vessels exposed to chronic shear stress develop structural changes and remodeling of the vascular wall through many complex mechanisms. However......, the molecular mechanisms involved are not fully understood. Hypertension-susceptible genes may provide a novel insight into potential molecular mechanisms of hypertension and secondary complications associated with hypertension. The aim of this exploratory study was to identify gene expression differences......, the identified genes in the middle cerebral arteries from spontaneously hypertensive rats could be possible mediators of the vascular changes and secondary complications associated with hypertension. This study supports the selection of key genes to investigate in the future research of hypertension-induced end...

Home blood-pressure monitoring in a hypertensive pregnant population: cost minimisation study.

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Xydopoulos, G; Perry, H; Sheehan, E; Thilaganathan, B; Fordham, R; Khalil, A

2018-03-08

Traditional monitoring of blood pressure in hypertensive pregnant women requires frequent visits to the maternity outpatient services. Home blood-pressure monitoring (HBPM) could offer a cost-saving alternative that is acceptable to patients. The main objective of this study was to undertake a health economic analysis of HBPM compared with traditional monitoring in hypertensive pregnant women. This was a case-control study. Cases were pregnant women with hypertension who had HBPM with or without the adjunct of a smartphone app, via a specially designed pathway. The control group were managed as per existing hospital guidelines. Specific outcome measures were the number of outpatient visits, inpatient bed stays and investigations performed. Maternal, fetal and neonatal adverse outcomes were also recorded. Health economic analysis was performed using two methods: direct cost comparison of the study dataset and process scenario modelling. There were 108 women in the HBPM group, of whom 29 recorded their results on the smartphone app (App-HBPM) and 79 in their notes (Non-app HBPM). The control group comprised of 58 patients. There were significantly more women with chronic hypertension in the HBPM group (49.1% vs 25.9%, P = 0.004). The HBPM group had significantly longer duration of monitoring (9 weeks vs 5 weeks P = 0.004) and started monitoring from an earlier gestation (30 weeks vs 33.6 weeks, P = 0.001). Despite these differences, the mean saving per week for HBPM compared with the control group was £200.69. For the App-HBPM cohort, the saving per week compared with the control group was £286.53. The process modelling method predicted savings of between £98.32 and £245.80 per week using HBPM compared to the traditional monitoring. HBPM in hypertensive pregnancies appears to be cost-saving compared with traditional monitoring, without compromising maternal, fetal or neonatal safety. Larger studies are required to confirm these findings. This article is

CADIOVASCULAR HEALTH AND INCIDENT HYPERTENSION IN AFRICAN AMERICANS: THE JACKSON HEART STUDY

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Booth, John N.; Abdalla, Marwah; Tanner, Rikki M.; Diaz, Keith M.; Bromfield, Samantha G.; Tajeu, Gabriel S.; Correa, Adolfo; Sims, Mario; Ogedegbe, Gbenga; Bress, Adam P.; Spruill, Tanya M.; Shimbo, Daichi; Muntner, Paul

2018-01-01

Several modifiable health behaviors and health factors that comprise the Life’s Simple 7, a cardiovascular health metric, have been associated with hypertension risk. We determined the association between cardiovascular health and incident hypertension in the Jackson Heart Study, a cohort of African-Americans. We analyzed participants without hypertension or cardiovascular disease at baseline (2000–2004) who attended ≥1 follow-up visit in 2005–2008 or 2009–2012 (n=1878). Body mass index, physical activity, diet, cigarette smoking, blood pressure, total cholesterol and fasting glucose were assessed at baseline and categorized as ideal, intermediate or poor using the American Heart Association’s Life’s Simple 7 definitions. Incident hypertension was defined at the first visit wherein a participant had systolic blood pressure≥140 mmHg, diastolic blood pressure≥90 mmHg or self-reported taking antihypertensive medication. There percentage of participants with ≤1, 2, 3, 4, 5 and 6 ideal Life’s Simple 7 components was 6.5%, 22.4%, 34.4%, 25.2%, 10.0% and 1.4%, respectively. No participants had 7 ideal components. During follow-up (median: 8.0 years), 944 (50.3%) participants developed hypertension, including 81.3% with ≤1 and 11.1% with 6 ideal components. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with 2, 3, 4, 5 and 6 versus ≤1 ideal component were 0.80 (0.61–1.03), 0.58 (0.45–0.74), 0.30 (0.23–0.40), 0.26 (0.18–0.37) and 0.10 (0.03–0.31), respectively (p-trendhypertension risk. PMID:28652461

Uric Acid Is a Strong Risk Marker for Developing Hypertension From Prehypertension: A 5-Year Japanese Cohort Study.

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Kuwabara, Masanari; Hisatome, Ichiro; Niwa, Koichiro; Hara, Shigeko; Roncal-Jimenez, Carlos A; Bjornstad, Petter; Nakagawa, Takahiko; Andres-Hernando, Ana; Sato, Yuka; Jensen, Thomas; Garcia, Gabriela; Rodriguez-Iturbe, Bernardo; Ohno, Minoru; Lanaspa, Miguel A; Johnson, Richard J

2018-01-01

Prehypertension frequently progresses to hypertension, a condition associated with high morbidity and mortality from cardiovascular diseases and stroke. However, the risk factors for developing hypertension from prehypertension remain poorly understood. We conducted a retrospective cohort study using the data from 3584 prehypertensive Japanese adults (52.1±11.0 years, 2081 men) found to be prehypertensive in 2004 and reexamined in 2009. We calculated the cumulative incidences of hypertension over 5 years, examined risk factors, and calculated odds ratios (ORs) for developing hypertension after adjustments for age, sex, body mass index, smoking and drinking habits, baseline systolic and diastolic blood pressure, pulse rate, diabetes mellitus, dyslipidemia, chronic kidney disease, and serum uric acid levels. The additional analysis evaluated whether serum uric acid (hyperuricemia) constituted an independent risk factor for developing hypertension. The cumulative incidence of hypertension from prehypertension over 5 years was 25.3%. There were no significant differences between women and men (24.4% versus 26.0%; P =0.28). The cumulative incidence of hypertension in subjects with hyperuricemia (n=726) was significantly higher than those without hyperuricemia (n=2858; 30.7% versus 24.0%; P hypertension from prehypertension were age (OR, 1.023; P hypertension from prehypertension. Further studies are needed to determine whether treatment of hyperuricemia in prehypertensive subjects could impede the onset of hypertension. © 2017 American Heart Association, Inc.

Prevalence of hypertension in rural areas of china: a meta-analysis of published studies.

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Xiaofang Chen

Full Text Available Hypertension is one of the leading causes of disease burden across the world. In China, the latest nationwide survey of prevalence of hypertension was ten year ago, and data in rural areas is little known. More information about hypertension prevalence could help to improve overall antihypertensive health care. We aimed to estimate the pooled prevalence of hypertension in rural areas of China.Comprehensive electronic searches of PubMed, Web of Knowledge, Chinese Web of Knowledge, Wangfang, Weipu and SinoMed databases were conducted to identify any study in each database published from January 1, 2004 to December 31, 2013, reporting the prevalence of hypertension in Chinese rural areas. Prevalence estimates were stratified by age, area, sex, publication year, and sample size. All statistical calculations were made using the Stata Version 11.0 (College Station, Texas and Statsdirect Version 2.7.9.We identified 124 studies with a total population of 3,735,534 in the present meta-analysis. Among people aged 18 years old in Chinese rural areas, the summarized prevalence is 22.81% (19.41%-26.41%. Subgroup analysis shows the following results: for male 24.46% (21.19%-27.89%, for female 22.17% (18.25%-26.35%. For 2004-2006: 18.94% (14.41%-23.94%, for 2007-2009, 21.24% (15.98%-27.01% for 2010-2013: 26.68%, (20.79%-33.02%. For Northern region 25.76% (22.36%-29.32%, for Southern region 19.30%, (15.48%-24.08%.The last decade witnessed the growth in prevalence of hypertension in rural areas of China compared with the fourth national investigation, which has climbed the same level as the urban area. Guidelines for screening and treatment of hypertension in rural areas need to be given enough attention.

Drug induced hypertension--An unappreciated cause of secondary hypertension.

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Grossman, Alon; Messerli, Franz H; Grossman, Ehud

2015-09-15

Most patients with hypertension have essential hypertension or well-known forms of secondary hypertension, such as renal disease, renal artery stenosis, or common endocrine diseases (hyperaldosteronism or pheochromocytoma). Physicians are less aware of drug induced hypertension. A variety of therapeutic agents or chemical substances may increase blood pressure. When a patient with well controlled hypertension is presented with acute blood pressure elevation, use of drug or chemical substance which increases blood pressure should be suspected. Drug-induced blood pressure increases are usually minor and short-lived, although rare hypertensive emergencies associated with use of certain drugs have been reported. Careful evaluation of prescription and non-prescription medications is crucial in the evaluation of the hypertensive individual and may obviate the need for expensive and unnecessary evaluations. Discontinuation of the offending agent will usually achieve adequate blood pressure control. When use of a chemical agent which increases blood pressure is mandatory, anti-hypertensive therapy may facilitate continued use of this agent. We summarize the therapeutic agents or chemical substances that elevate blood pressure and their mechanisms of action. Copyright © 2015 Elsevier B.V. All rights reserved.

Portal Hypertension

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... Overview of Gallbladder Cancer Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD, Professor of Medicine, ... Liver Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension Portal hypertension is abnormally high blood pressure in ...

Nocturnal Hypertension: Neglected Issue in Comprehensive Hypertension Management

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Andi Kristanto

2016-09-01

Full Text Available The body circardian rhythm affects blood pressure variability at day and night, therefore blood pressure at day and night might be different. Nocturnal hypertension is defined as increase of blood pressure >120/70mmHg at night, which is caused by disturbed circadian rhythm, and associated with higher cardiovascular and cerebrovascular events also mortality in hypertensive patients. Nocturnal hypertension and declining blood pressure pattern, can only be detected by continuous examination for 24 hours, also known as ambulatory blood pressure measurement (ABPM. Chronotherapy, has become a strategy for managing the hypertensive nocturnal patients, by taking hypertensive medication at night to obtain normal blood pressure decrease in accordance with the normal circadian rhythm and, improving blood pressure control.

Influence of White-Coat Hypertension on Left Ventricular Deformation 2- and 3-Dimensional Speckle Tracking Study.

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Tadic, Marijana; Cuspidi, Cesare; Ivanovic, Branislava; Ilic, Irena; Celic, Vera; Kocijancic, Vesna

2016-03-01

We sought to compare left ventricular deformation in subjects with white-coat hypertension to normotensive and sustained hypertensive patients. This cross-sectional study included 139 untreated subjects who underwent 24-hour ambulatory blood pressure monitoring and completed 2- and 3-dimensional examination. Two-dimensional left ventricular multilayer strain analysis was also performed. White-coat hypertension was diagnosed if clinical blood pressure was elevated and 24-hour blood pressure was normal. Our results showed that left ventricular longitudinal and circumferential strains gradually decreased from normotensive controls across subjects with white-coat hypertension to sustained hypertensive group. Two- and 3-dimensional left ventricular radial strain, as well as 3-dimensional area strain, was not different between groups. Two-dimensional left ventricular longitudinal and circumferential strains of subendocardial and mid-myocardial layers gradually decreased from normotensive control to sustained hypertensive group. Longitudinal and circumferential strains of subepicardial layer did not differ between the observed groups. We concluded that white-coat hypertension significantly affects left ventricular deformation assessed by 2-dimensional traditional strain, multilayer strain, and 3-dimensional strain. © 2016 American Heart Association, Inc.

Mineralocorticoid hypertension

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Vishal Gupta

2011-01-01

Full Text Available Hypertension affects about 10 - 25% of the population and is an important risk factor for cardiovascular and renal disease. The renin-angiotensin system is frequently implicated in the pathophysiology of hypertension, be it primary or secondary. The prevalence of primary aldosteronism increases with the severity of hypertension, from 2% in patients with grade 1 hypertension to 20% among resistant hypertensives. Mineralcorticoid hypertension includes a spectrum of disorders ranging from renin-producing pathologies (renin-secreting tumors, malignant hypertension, coarctation of aorta, aldosterone-producing pathologies (primary aldosteronism - Conns syndrome, familial hyperaldosteronism 1, 2, and 3, non-aldosterone mineralocorticoid producing pathologies (apparent mineralocorticoid excess syndrome, Liddle syndrome, deoxycorticosterone-secreting tumors, ectopic adrenocorticotropic hormones (ACTH syndrome, congenitalvadrenal hyperplasia, and drugs with mineraocorticoid activity (locorice, carbenoxole therapy to glucocorticoid receptor resistance syndromes. Clinical presentation includes hypertension with varying severity, hypokalemia, and alkalosis. Ratio of plasma aldosterone concentraion to plasma renin activity remains the best screening tool. Bilateral adrenal venous sampling is the best diagnostic test coupled with a CT scan. Treatment is either surgical (adrenelectomy for unilateral adrenal disease versus medical therapy for idiopathic, ambiguous, or bilateral disease. Medical therapy focuses on blood pressure control and correction of hypokalemia using a combination of anti-hypertensives (calcium channel blockers, angiotensin converting enzyme inhibitors, or angiotensin receptor blockers and potassium-raising therapies (mineralcorticoid receptor antagonist or potassium sparing diuretics. Direct aldosterone synthetase antagonists represent a promising future therapy.

Apparent and true resistant hypertension: definition, prevalence and outcomes.

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Judd, E; Calhoun, D A

2014-08-01

Resistant hypertension, defined as blood pressure (BP) remaining above goal despite the use of > or =3 antihypertensive medications at maximally tolerated doses (one ideally being a diuretic) or BP that requires > or =4 agents to achieve control, has received more attention with increased efforts to improve BP control rates and the emergence of device-based therapies for hypertension. This classically defined resistant group consists of patients with true resistant hypertension, controlled resistant hypertension and pseudo-resistant hypertension. In studies where pseudo-resistant hypertension cannot be excluded (for example, 24-h ambulatory BP not obtained), the term apparent resistant hypertension has been used to identify 'apparent' lack of control on > or =3 medications. Large, well-designed studies have recently reported the prevalence of resistant hypertension. Pooling prevalence data from these studies and others within North America and Europe with a combined sample size of >600,000 hypertensive participants, the prevalence of resistant hypertension is 14.8% of treated hypertensive patients and 12.5% of all hypertensives. However, the prevalence of true resistant hypertension, defined as uncontrolled both by office and 24-h ambulatory BP monitoring with confirmed medication adherence, may be more meaningful in terms of identifying risk and estimating benefit from newer therapies like renal denervation. Rates of cardiovascular events and mortality follow mean 24-h ambulatory BPs in patients with resistant hypertension, and true resistant hypertension represents the highest risk. The prevalence of true resistant hypertension has not been directly measured in large trials; however, combined data from smaller studies suggest that true resistant hypertension is present in half of the patients with resistant hypertension who are uncontrolled in the office. Our pooled analysis shows prevalence rates of 10.1% and 7.9% for uncontrolled resistant hypertension among

[A specific questionnaire to evaluate therapeutic inertia in hypertensive patients: a pilot study].

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Pretorean, T; Claisse, G; Delsart, P; Caudrelier, T; Devos, P; Mounier-Vehier, C

2014-02-01

Therapeutic inertia (TI) is a recent concept still unknown by many physicians. In chronic diseases such as hypertension, it is defined as the tendency of physicians not to increase or change antihypertensive medications when the target blood pressure is not reached. Acting on TI could improve blood pressure control in France. This was a single-center prospective pilot study conducted by hypertension specialist physicians at the University Cardio-Vascular Center in Lille (France). It was conducted between March and June 2011. Data was collected from 161 hypertensive patients (mean age: 61.64±11.18 years; 98 (60.9%) male; 75 secondary prevention patients). Each physician completed a questionnaire on therapeutic inertia. TI was defined as a consultation in which treatment change was indicated (systolic blood pressure [BP]≥140 and/or diastolic BP≥90mmHg in all patients), but did not occur, with absence of an adapted justification of this choice. We considered as an adapted justification: a white coat effect demonstrated by ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring; scheduled reassessment of the BP by ABPM; recent change in antihypertensive treatment (less than 4 weeks); hospitalization needed for complete evaluation of secondary causes of hypertension and a more detailed assessment of potential target organ damage in patients with grade 1 or 2 hypertension. Our study aimed to evaluate rates of TI, to identify factors associated with TI, and to test the TI questionnaire. Therapeutic inertia as defined in this study occurred in 11 consultations (8.3%) of the 133 hypertensive patients having uncontrolled BP above or equal to 140 and/or 90mmHg. Significant factors associated with TI were older age (Z=2.35, PP>0.05) and the number of consultations (Z=1.92, 0.1>P>0.05) exhibited a significant trend to be associated with TI. Although the rate of TI was low in our study conducted in a specialized center, a well-accepted definition of

Renovascular hypertension in spontaneous hypertensive rats: an experimental model of renal artery stenosis superimposed on essential hypertension.

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Rosenthal, T; Bass, A; Grossman, E; Shani, M; Griffel, B; Adar, R

1987-09-01

Renovascular hypertension superimposed on essential hypertension, a condition encountered in the elderly, was studied. An experimental animal model consisting of a two-kidney one-clip Goldblatt preparation in the spontaneous hypertensive (SHR) rat, that would simulate this condition, was designed. A 0.25 mm silver clip was placed on the left renal artery of SHR male rats. The same procedure performed on WKY rats served as control. All experiments were performed on low, normal, and rich sodium diet. Systolic blood pressure (BP) was measured by tail-cuff method. Plasma renin concentration (PRC) was determined before and after clipping of the renal artery. Results were as follows: Mean systolic BP increased significantly in clipped rats fed with normal and rich sodium diets. SHR showed an increase from 144 +/- 3 (mean + s.e.m.) to 168 +/- 3 mmHg, and WKY rats showed an increase from 120 +/- 2 to 139 +/- 5 mmHg. There was a two- to threefold rise in PRC. A low-salt diet given prior to clipping prevented the appearance of renovascular hypertension despite a significant rise in PRC. We concluded that renal artery narrowing plays a significant role in the rise of BP in the basically essential type of hypertension.

The Effectiveness of Hypertensive Management Programs and Social Support in Primary Health Care Systems: Preliminary Study

OpenAIRE

Pantip Sangprasert; Surasak Buranatrevedh; Duangnate Pipatsatitpong

2016-01-01

This quasi-experimental study used inclusion criteria obtaining samples taken from high-risk and grade I hypertensive patients aged 35 to 59 without hypertensive complications. The two related groups comprised 36 individuals. Both were enrolled in a hypertensive management program comprising health education strategies, respiratory training, advice on limiting salt and fat intake, exercise, group discussion with social support, telephon counseling, and home visits. Three perceptio...

Animal models for the study of primary and secondary hypertension in humans

OpenAIRE

Lin, Hiu Yu; Lee, Yee Ting; Chan, Yin Wah; Tse, Gary

2016-01-01

Hypertension is a significant cause of morbidity and mortality worldwide. It is defined as systolic and diastolic blood pressures (SBP/DBP) >140 and 90 mmHg, respectively. Individuals with an SBP between 120 and 139, or DBP between 80 and 89 mmHg, are said to exhibit pre-hypertension. Hypertension can have primary or secondary causes. Primary or essential hypertension is a multifactorial disease caused by interacting environmental and polygenic factors. Secondary causes are renovascular hyper...

Hypertension control in a large multi-ethnic cohort in Amsterdam, The Netherlands: the HELIUS study

NARCIS (Netherlands)

Agyemang, Charles; Kieft, Suzanne; Snijder, Marieke B.; Beune, Erik J.; van den Born, Bert-Jan; Brewster, Lizzy M.; Ujcic-Voortman, Joanne J.; Bindraban, Navin; van Montfrans, Gert; Peters, Ron J.; Stronks, Karien

2015-01-01

Hypertension is a major problem among European ethnic minority groups. We assessed the current situation of hypertension prevalence and its management among a multi-ethnic population in Amsterdam, The Netherlands. Data from the HELIUS study were used including 12,974 participants (1871 Ghanaian,

Renal sympathetic denervation in hypertension.

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Doumas, Michael; Faselis, Charles; Papademetriou, Vasilios

2011-11-01

Despite the abundance of antihypertensive drugs, resistant hypertension remains a major clinical problem. Recent technological advances render interventional management of resistant hypertension one of the hottest topics in the hypertension field. The aim of this review is to present the pathophysiologic background and the mechanisms mediating blood pressure reduction after renal sympathetic denervation, to analyze recent findings with this fascinating approach and to critically suggest future research directions. Catheter-based, ablation-induced renal sympathetic denervation was initially studied in 45 patients with resistant hypertension in a proof-of-concept study. Impressive blood pressure reductions of about 30/15  mmHg were achieved at 6 months, without serious complications. A second, controlled, randomized (but not blinded) study confirmed the results, verifying the efficacy and safety of the procedure. A recent report revealed the 2-year durability of blood pressure reduction. Data published so far indicate that ablation-induced renal denervation is a feasible, effective, and well tolerated interventional approach for the management of resistant hypertension. The groundbreaking studies of renal denervation in drug-resistant hypertension pave the way for further research in other disease conditions in which sympathetic overactivity seems to play a critical role. This initial wave of enthusiasm needs to be followed by rigorous investigation, for the proper identification of the potential and the limitations, indications, and contraindications of this approach.

Prognostic model for chronic hypertension in women with a history of hypertensive pregnancy disorders at term.

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Visser, V S; Hermes, W; Twisk, J; Franx, A; van Pampus, M G; Koopmans, C; Mol, B W J; de Groot, C J M

2017-10-01

The association between hypertensive pregnancy disorders and cardiovascular disease later in life is well described. In this study we aim to develop a prognostic model from patients characteristics known before, early in, during and after pregnancy to identify women at increased risk of cardiovascular disease e.g. chronic hypertension years after pregnancy complicated by hypertension at term. We included women with a history of singleton pregnancy complicated by hypertension at term. Women using antihypertensive medication before pregnancy were excluded. We measured hypertension in these women more than 2years postpartum. Different patients characteristics before, early in, during and after pregnancy were considered to develop a prognostic model of chronic hypertension at 2-years. These included amongst others maternal age, blood pressure at pregnancy intake and blood pressure six weeks post-partum. Univariable analyses followed by a multivariable logistic regression analysis was performed to determine which combination of predictors best predicted chronic hypertension. Model performance was assessed by calibration (graphical plot) and discrimination (area under the receiver operating characteristic (AUC)). Of the 305 women in who blood pressure 2.5years after pregnancy was assessed, 105 women (34%) had chronic hypertension. The following patient characteristics were significant associated with chronic hypertension: higher maternal age, lower education, negative family history on hypertensive pregnancy disorders, higher BMI at booking, higher diastolic blood pressure at pregnancy intake, higher systolic blood pressure during pregnancy and higher diastolic blood pressure at six weeks post-partum. These characteristics were included in the prognostic model for chronic hypertension. Model performance was good as indicated by good calibration and good discrimination (AUC; 0.83 (95% CI 0.75 - 0.92). Chronic hypertension can be expected from patient characteristics

Physical Activity and the Prevention of Hypertension

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Diaz, Keith M.; Shimbo, Daichi

2013-01-01

As the worldwide prevalence of hypertension continues to increase, the primary prevention of hypertension has become an important global public health initiative. Physical activity is commonly recommended as an important lifestyle modification that may aid in the prevention of hypertension. Recent epidemiologic evidence has demonstrated a consistent, temporal, and dose-dependent relationship between physical activity and the development of hypertension. Experimental evidence from interventional studies have further confirmed a relationship between physical activity and hypertension as the favorable effects of exercise on blood pressure reduction have been well characterized in recent years. Despite the available evidence strongly supporting a role for physical activity in the prevention of hypertension, many unanswered questions regarding the protective benefits of physical activity in high-risk individuals, the factors that may moderate the relationship between physical activity and hypertension, and the optimal prescription for hypertension prevention remain. We review the most recent evidence for the role of physical activity in the prevention of hypertension and discuss recent studies that have sought to address these unanswered questions. PMID:24052212

Genome-wide association study of young-onset hypertension in the Han Chinese population of Taiwan.

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Hsin-Chou Yang

Full Text Available Young-onset hypertension has a stronger genetic component than late-onset counterpart; thus, the identification of genes related to its susceptibility is a critical issue for the prevention and management of this disease. We carried out a two-stage association scan to map young-onset hypertension susceptibility genes. The first-stage analysis, a genome-wide association study, analyzed 175 matched case-control pairs; the second-stage analysis, a confirmatory association study, verified the results at the first stage based on a total of 1,008 patients and 1,008 controls. Single-locus association tests, multilocus association tests and pair-wise gene-gene interaction tests were performed to identify young-onset hypertension susceptibility genes. After considering stringent adjustments of multiple testing, gene annotation and single-nucleotide polymorphism (SNP quality, four SNPs from two SNP triplets with strong association signals (-log(10(p>7 and 13 SNPs from 8 interactive SNP pairs with strong interactive signals (-log(10(p>8 were carefully re-examined. The confirmatory study verified the association for a SNP quartet 219 kb and 495 kb downstream of LOC344371 (a hypothetical gene and RASGRP3 on chromosome 2p22.3, respectively. The latter has been implicated in the abnormal vascular responsiveness to endothelin-1 and angiotensin II in diabetic-hypertensive rats. Intrinsic synergy involving IMPG1 on chromosome 6q14.2-q15 was also verified. IMPG1 encodes interphotoreceptor matrix proteoglycan 1 which has cation binding capacity. The genes are novel hypertension targets identified in this first genome-wide hypertension association study of the Han Chinese population.

A cross-sectional study of hypertensive outpatients to determine the ...

African Journals Online (AJOL)

Background: Erectile dysfunction (ED) is common amongst hypertensive men. Hypertensive patients often attribute it to antihypertensive drugs, although conflicting evidence linking ED with antihypertensive medication exists. The objectives were to determine the prevalence and severity of ED, the type of treatment sought, ...

ABCC-JNIH Adult Health Study Hiroshima, 1958 to 1959. Hypertension and ischemic heart disease

Energy Technology Data Exchange (ETDEWEB)

Switzer, S

1963-11-12

The interrelations of hypertension, ischemic heart disease, blood lipid levels and ionizing irradiation were investigated among 1051 male and 1872 female members of the ABCC-JNIH Adult Health Study. No significant effect of ionizing irradiation upon the cardiovascular system were detected. No major difference in age-sex specific mean blood pressures between Adult Health Study subjects and a suitable American comparison group was found. An accelerated course with fulminating vascular deterioration was suspected in only 1% of the hypertensive subjects. As a result, advanced retinopathy and renal failure were rarely seen. Electrocardiographic evidence of left ventricular hypertrophy occurred in 7.2% of the hypertensive subjects in this study, and was readily correlated with ambient systolic blood pressure. Evidences of ischemic heart disease and congestive failure were rare and distinctly less common than in American males unselected as to blood pressure levels. In contrast, mortality statistics indicate cerebrovascular disease to be at least as common in Japan as in the United States. Adult Health Study data exhibit low serum cholesterol concentrations by Western standards and elevated levels are predominantly limited to the obese. Both factors appear of importance in the occasional hypertensive subject with ischemic heart disease. The therapeutic implication of this observation is briefly discussed. 57 references, 10 tables.

Does being under treatment improve knowledge attitude practice for hypertension: A hospital-based study from North India

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Rajiv Kumar Gupta

2017-01-01

Full Text Available Background: Studies suggest that approximately half of patients with raised blood pressure (BP are undetected, that half of those detected are not treated, and that half of those treated are not controlled, famously described as the “rule of halves.” Importantly, the cornerstone of the primary prevention of cardiovascular diseases is early detection and drug treatment (antihypertensive of patients with high BP. Studies across populations in developed world have shown that awareness and management of high BP levels are far from optimal. The present study was planned with the aim to assess the knowledge, attitude, and practices (KAP regarding hypertension in hypertensive patients visiting Tertiary Care Hospital in North-West India. Materials and Methods: Already diagnosed hypertensive patients seeking care at the tertiary care center were selected for this study. The participants were recruited using consecutive sampling technique. All participants were interviewed with the help of a semi-structured questionnaire after obtaining a written informed consent. The components of the KAP were recorded using a score sheet. Results: In all, 394 hypertensive patients of whom majority (239/394; 61% were males, were included in the study. The KAP score among the study subjects was 88.4%, 90.83%, and 95.83%, respectively. Males had higher knowledge about normal BP levels which was statistically significant (P < 0.01. Among the attitude, regular intake of anti-hypertensive drugs, regular investigations, lifestyle changes, avoidance of salt and allopathic medicines being the best for the treatment of hypertension were found to be significant statistically (P < 0.01. Conclusion: The high score among the study population can be attributed to the fact that all study participants were diagnosed patients of hypertension seeking care in a tertiary care hospital.

Tyrosine hydroxylase polymorphism (C-824T) and hypertension: a population-based study

DEFF Research Database (Denmark)

Nielsen, Søren J; Jeppesen, Jørgen Lykke; Torp-Pedersen, Christian

2010-01-01

Sympathetic nervous system (SNS) overactivity is present in a large proportion of the hypertensive population and precedes the development of established hypertension. Variations in the proximal promoter of the tyrosine hydroxylase (TH) gene have been shown to influence biochemical and physiologi......Sympathetic nervous system (SNS) overactivity is present in a large proportion of the hypertensive population and precedes the development of established hypertension. Variations in the proximal promoter of the tyrosine hydroxylase (TH) gene have been shown to influence biochemical...

Gender disparities in hypertension among different ethnic groups in Amsterdam, the Netherlands: The SUNSET study

NARCIS (Netherlands)

Agyemang, Charles; de Munter, Jeroen; van Valkengoed, Irene; van den Born, Bert-Jan; Stronks, Karien

2008-01-01

BACKGROUND Studies have consistently shown a lower prevalence of hypertension in women than in men. Obesity is an important risk factor for hypertension, and the rate of obesity is particularly high among ethnic minority women. It is therefore questionable whether the lower prevalence of

Diabetes and Hypertension in India: A Nationally Representative Study of 1.3 Million Adults.

Science.gov (United States)

Geldsetzer, Pascal; Manne-Goehler, Jennifer; Theilmann, Michaela; Davies, Justine I; Awasthi, Ashish; Vollmer, Sebastian; Jaacks, Lindsay M; Bärnighausen, Till; Atun, Rifat

2018-03-01

Understanding how diabetes and hypertension prevalence varies within a country as large as India is essential for targeting of prevention, screening, and treatment services. However, to our knowledge there has been no prior nationally representative study of these conditions to guide the design of effective policies. To determine the prevalence of diabetes and hypertension in India, and its variation by state, rural vs urban location, and individual-level sociodemographic characteristics. This was a cross-sectional, nationally representative, population-based study carried out between 2012 and 2014. A total of 1 320 555 adults 18 years or older with plasma glucose (PG) and blood pressure (BP) measurements were included in the analysis. State, rural vs urban location, age, sex, household wealth quintile, education, and marital status. Diabetes (PG level ≥126 mg/dL if the participant had fasted or ≥200 mg/dL if the participant had not fasted) and hypertension (systolic BP≥140 mm Hg or diastolic BP≥90 mm Hg). Of the 1 320 555 adults, 701 408 (53.1%) were women. The crude prevalence of diabetes and hypertension was 7.5% (95% CI, 7.3%-7.7%) and 25.3% (95% CI, 25.0%-25.6%), respectively. Notably, hypertension was common even among younger age groups (eg, 18-25 years: 12.1%; 95% CI, 11.8%-12.5%). Being in the richest household wealth quintile compared with being in the poorest quintile was associated with only a modestly higher probability of diabetes (rural: 2.81 percentage points; 95% CI, 2.53-3.08 and urban: 3.47 percentage points; 95% CI, 3.03-3.91) and hypertension (rural: 4.15 percentage points; 95% CI, 3.68-4.61 and urban: 3.01 percentage points; 95% CI, 2.38-3.65). The differences in the probability of both conditions by educational category were generally small (≤2 percentage points). Among states, the crude prevalence of diabetes and hypertension varied from 3.2% (95% CI, 2.7%-3.7%) to 19.9% (95% CI, 17.6%-22.3%), and 18.0% (95% CI, 16

Effects of hypertension and ovariectomy on rat hepatocytes. Are amlodipine and lacidipine protective? (A stereological and histological study).

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Dursun, Hakan; Albayrak, Fatih; Uyanik, Abdullah; Keleş, Nuri Osman; Beyzagül, Polat; Bayram, Ednan; Halici, Zekai; Altunkaynak, Zuhal Berrin; Süleyman, Halis; Okçu, Nihat; Ünal, Bünyamin

2010-12-01

Calcium channel blockers are increasingly used for the treatment of hypertension. Menopause and hypertension are both important risk factors for liver damage and several other circulatory abnormalities. The aim of this study was to determine the effects of amlodipine and lacidipine in an ovariectomy-induced postmenopausal period model and a deoxycorticosterone acetate-salt-induced hypertensive model in rats. In this study, animals were divided into six groups as follows: control (Group 1), hypertension (Group 2), ovariectomy (Group 3), ovariectomy and hypertension (Group 4), ovariectomy, hypertension and amlodipine-treated (Group 5), and ovariectomy, hypertension and lacidipine-treated (Group 6). At the end of the experiment, the livers were removed and tissue samples were histologically and stereologically examined. The numerical densities of the hepatocytes according to group were 0.000422, 0.00329, 0.000272, 0.00259, 0.00374 and 0.000346 μm3, respectively. Significant differences were found between values of all groups (phypertension in Groups 5 and 6. Our experimental results show that both hypertension and the postmenopausal period have negative effects on the number of hepatocytes and histological structure of the liver. Both amlodipine and lacidipine appear to ameliorate the hypertension and/or postmenopausal period-related decrease in hepatocyte number. We thus suggest that lacidipine and particularly amlodipine have important protective and recovering effects on the liver.

Risk factors for the development of essential hypertension in a Mongolian population of China: a case-control study.

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Dalai, N; Cui, H; Yan, M; Rile, G; Li, S; Su, X

2014-04-29

Lifestyle, habits, diet, and genetics are all important factors associated with the prevalence of hypertension. Many association studies have been performed in the Chinese Han population, whereas data explaining the high prevalence of hypertension in the Mongolian population remain scarce. In the present study, we aimed to determine the factors associated with the development of essential hypertension in Mongolians. A total of 194 hypertensive cases and 201 controls from Dongwu County were enrolled in the study. Demographics, anthropometric and blood biochemical parameters, food intake, lifestyle, habits, education, occupation, and family history were recorded for each subject. Genotype and allele frequencies of six single nucleotide polymorphisms (SNPs) of the kallikrein 1 (KLK1) gene were also examined. Mean body mass index, waistline, hipline, blood sugar, blood urea nitrogen, creatinine, uric acid, total cholesterol, triglyceride, and low-density lipoprotein levels were all significantly higher in the hypertensive group (Pcontrols (Pcontrol groups (P>0.05). These results suggest that dietary history and habits have the most important influence on the development of essential hypertension in the Mongolian population.

Endothelial function in children with white-coat hypertension.

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Jurko, Alexander; Jurko, Tomas; Minarik, Milan; Mestanik, Michal; Mestanikova, Andrea; Micieta, Vladimir; Visnovcova, Zuzana; Tonhajzerova, Ingrid

2018-01-29

Several studies have demonstrated endothelial dysfunction in patients with essential hypertension. However, the presence of endothelial dysfunction in children with white-coat hypertension has not been studied. We evaluated the endothelial function in children with white-coat hypertension and essential hypertension using a novel method based on the assessment of flow-mediated dilation (FMD). Study involved 106 children: 30 white-coat hypertensives (age 16.3 ± 1.3 years, mean ± SD), 30 essential hypertensives (age 16.4 ± 1.3 years), and 46 healthy controls (age 16.2 ± 1.4 years). Ultrasound scans of the right brachial artery were performed using Prosound F75 Aloka system during protocol: baseline (1 min), forearm ischemia (5 min), and post-occlusion phase (3 min). FMD (%) was expressed as a change of the arterial diameter from baseline to maximum post-occlusion value and the values coat hypertension compared to control group (p coat hypertensives compared to controls (p coat hypertension could help to elucidate the mechanisms of the increased cardiovascular risk that could be similar as found in essential hypertension; therefore, white-coat hypertension should not be considered a benign phenomenon.

First Trimester Urine and Serum Metabolomics for Prediction of Preeclampsia and Gestational Hypertension: A Prospective Screening Study.

Science.gov (United States)

Austdal, Marie; Tangerås, Line H; Skråstad, Ragnhild B; Salvesen, Kjell; Austgulen, Rigmor; Iversen, Ann-Charlotte; Bathen, Tone F

2015-09-08

Hypertensive disorders of pregnancy, including preeclampsia, are major contributors to maternal morbidity. The goal of this study was to evaluate the potential of metabolomics to predict preeclampsia and gestational hypertension from urine and serum samples in early pregnancy, and elucidate the metabolic changes related to the diseases. Metabolic profiles were obtained by nuclear magnetic resonance spectroscopy of serum and urine samples from 599 women at medium to high risk of preeclampsia (nulliparous or previous preeclampsia/gestational hypertension). Preeclampsia developed in 26 (4.3%) and gestational hypertension in 21 (3.5%) women. Multivariate analyses of the metabolic profiles were performed to establish prediction models for the hypertensive disorders individually and combined. Urinary metabolomic profiles predicted preeclampsia and gestational hypertension at 51.3% and 40% sensitivity, respectively, at 10% false positive rate, with hippurate as the most important metabolite for the prediction. Serum metabolomic profiles predicted preeclampsia and gestational hypertension at 15% and 33% sensitivity, respectively, with increased lipid levels and an atherogenic lipid profile as most important for the prediction. Combining maternal characteristics with the urinary hippurate/creatinine level improved the prediction rates of preeclampsia in a logistic regression model. The study indicates a potential future role of clinical importance for metabolomic analysis of urine in prediction of preeclampsia.

First Trimester Urine and Serum Metabolomics for Prediction of Preeclampsia and Gestational Hypertension: A Prospective Screening Study

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Marie Austdal

2015-09-01

Full Text Available Hypertensive disorders of pregnancy, including preeclampsia, are major contributors to maternal morbidity. The goal of this study was to evaluate the potential of metabolomics to predict preeclampsia and gestational hypertension from urine and serum samples in early pregnancy, and elucidate the metabolic changes related to the diseases. Metabolic profiles were obtained by nuclear magnetic resonance spectroscopy of serum and urine samples from 599 women at medium to high risk of preeclampsia (nulliparous or previous preeclampsia/gestational hypertension. Preeclampsia developed in 26 (4.3% and gestational hypertension in 21 (3.5% women. Multivariate analyses of the metabolic profiles were performed to establish prediction models for the hypertensive disorders individually and combined. Urinary metabolomic profiles predicted preeclampsia and gestational hypertension at 51.3% and 40% sensitivity, respectively, at 10% false positive rate, with hippurate as the most important metabolite for the prediction. Serum metabolomic profiles predicted preeclampsia and gestational hypertension at 15% and 33% sensitivity, respectively, with increased lipid levels and an atherogenic lipid profile as most important for the prediction. Combining maternal characteristics with the urinary hippurate/creatinine level improved the prediction rates of preeclampsia in a logistic regression model. The study indicates a potential future role of clinical importance for metabolomic analysis of urine in prediction of preeclampsia.

Cervical Spondylosis and Hypertension

Science.gov (United States)

Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

2015-01-01

Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

Ambient air pollution and pregnancy-induced hypertensive disorders

DEFF Research Database (Denmark)

Pedersen, Marie; Stayner, Leslie; Slama, Rémy

2014-01-01

to ambient air pollution and pregnancy-induced hypertensive disorders including gestational hypertension and preeclampsia. We searched electronic databases for English language studies reporting associations between ambient air pollution and pregnancy-induced hypertensive disorders published between December.......5), carbon monoxide (CO), ozone (O3), proximity to major roads, and traffic density met our inclusion criteria. Most studies reported that air pollution increased risk for pregnancy-induced hypertensive disorders. There was significant heterogeneity in meta-analysis, which included 16 studies reporting...... on gestational hypertension and preeclampsia as separate or combined outcomes; there was less heterogeneity in findings of the 10 studies reporting solely on preeclampsia. Meta-analyses showed increased risks of hypertensive disorders in pregnancy for all pollutants except CO. Random-effect meta...

Compliance to antihypertensive drugs, salt restriction, exercise and control of systemic hypertension in hypertensive patients at abbottabad

International Nuclear Information System (INIS)

Ahmed, N.; Waqas, A.; Khaliq, M.A.

2008-01-01

Hypertension is one of the most important cardiovascular risk factor but its control is still a challenge for physicians all around the world. Control of blood pressure can reduce cardiovascular morbidity and mortality, so the compliance to antihypertensive drugs and life style modification play an important role for the control of hypertension. This analytical (cross-sectional) study was conducted to assess prevalence of control of hypertension among hypertensive patients and to assess the relationship of control of hypertension with factors like compliance to antihypertensive drugs, salt restriction and exercise among the hypertensive patients. This study was conducted at outpatient clinic of medicine at Shahina Jamil Hospital Abbottabad from April 2007 to September 2007. Eighty-nine patients seen in the outpatient clinic of medicine were enrolled in the study. All the patients with age 15 years or above, diagnosed as a case of systemic hypertension were included. Among eighty nine patients, 67 were female and 22 were male with mean age of 55.8+-13.4 years, mean systolic and diastolic blood pressure of 160+-28.6 and 97.8+-14.1 mm Hg respectively, and pulse rate of 85.9+-11.4 per minutes. Out of 89 patients, 25.8% were having controlled hypertension, 48.3% were compliant and 51.7% were not compliant to antihypertensive drugs, 55.1% were having salt restriction and 44.9% were having no salt restriction and 23.6% were used to do physical activity while 76.4% were not used to do physical activity. In group A consisted of patients with controlled hypertension, 95.7% patients were compliant to antihypertensive patients, 95.7% were having salt restriction and 43.5% were used to do physical activity. In group B consisted of patients with uncontrolled hypertension, only 31.8% were compliant to antihypertensive drugs, 40.9% were having salt restriction, 16.7% were used to do physical activity. Hypertension can be controlled if the hypertensive patients have good compliance

Study on the medical meteorological forecast of the number of hypertension inpatient based on SVR

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Zhai, Guangyu; Chai, Guorong; Zhang, Haifeng

2017-06-01

The purpose of this study is to build a hypertension prediction model by discussing the meteorological factors for hypertension incidence. The research method is selecting the standard data of relative humidity, air temperature, visibility, wind speed and air pressure of Lanzhou from 2010 to 2012(calculating the maximum, minimum and average value with 5 days as a unit ) as the input variables of Support Vector Regression(SVR) and the standard data of hypertension incidence of the same period as the output dependent variables to obtain the optimal prediction parameters by cross validation algorithm, then by SVR algorithm learning and training, a SVR forecast model for hypertension incidence is built. The result shows that the hypertension prediction model is composed of 15 input independent variables, the training accuracy is 0.005, the final error is 0.0026389. The forecast accuracy based on SVR model is 97.1429%, which is higher than statistical forecast equation and neural network prediction method. It is concluded that SVR model provides a new method for hypertension prediction with its simple calculation, small error as well as higher historical sample fitting and Independent sample forecast capability.

Increased Risk of New-Onset Hypertension After Shock Wave Lithotripsy in Urolithiasis: A Nationwide Cohort Study.

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Huang, Shi-Wei; Tsai, Chung-You; Wang, Jui; Pu, Yeong-Shiau; Chen, Pei-Chun; Huang, Chao-Yuan; Chien, Kuo-Liong

2017-10-01

Although shock wave lithotripsy is minimally invasive, earlier studies argued that it may increase patients' subsequent risk of hypertension and diabetes mellitus. This study evaluated the association between shock wave lithotripsy and new-onset hypertension or diabetes mellitus. The Taiwanese National Health Insurance Research Database was used to identify 20 219 patients aged 18 to 65 years who underwent the first stone surgical treatment (shock wave lithotripsy or ureterorenoscopic lithotripsy) between January 1999 and December 2011. A Cox proportional model was applied to evaluate associations. Time-varying Cox models were applied to evaluate the association between the number of shock wave lithotripsy sessions and the incidence of hypertension or diabetes mellitus. After a median follow-up of 74.9 and 82.6 months, 2028 and 688 patients developed hypertension in the shock wave lithotripsy and ureterorenoscopic lithotripsy groups, respectively. Patients who underwent shock wave lithotripsy had a higher probability of developing hypertension than patients who underwent ureterorenoscopic lithotripsy, with a hazard ratio of 1.20 (95% confidence interval, 1.10-1.31) after adjusting for covariates. The risk increased as the number of shock wave lithotripsy sessions increased. However, the diabetes mellitus risk was similar in the shock wave lithotripsy and ureterorenoscopic lithotripsy groups. Furthermore, the hazard ratio did not increase as the number of shock wave lithotripsy sessions increased. Shock wave lithotripsy consistently increased the incidence of hypertension on long-term follow-up. Therefore, alternatives to urolithiasis treatment (eg, endoscopic surgery or medical expulsion therapy) could avoid the hypertension risk. Furthermore, avoiding multiple sessions of shock wave lithotripsy could also evade the hypertension risk. © 2017 American Heart Association, Inc.

The Effectiveness of Hypertensive Management Programs and Social Support in Primary Health Care Systems: Preliminary Study

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Pantip Sangprasert

2016-11-01

Full Text Available This quasi-experimental study used inclusion criteria obtaining samples taken from high-risk and grade I hypertensive patients aged 35 to 59 without hypertensive complications. The two related groups comprised 36 individuals. Both were enrolled in a hypertensive management program comprising health education strategies, respiratory training, advice on limiting salt and fat intake, exercise, group discussion with social support, telephon counseling, and home visits. Three perception and preventive behavior questionnaires and home behavior records collected data according to individual hypertension risk factors. The study was carried out for four months. Descriptive statistics and a paired t-test were used. Results showed a statistical significance difference with increased total mean scores with the following variances:healthstatus,self-efficacyanddecreasedbarrierperception(p=.000, .008and.022, respectively. There was noticeable improvement in exercise and stress management, but no significant change in overall preventive behavior for hypertension (p >.05. Systolic and diastolic blood pressure and heart rate were lower (p .05. Primary healthcare services should also be a strategic development, especially focus socially-supported on mental wellbeing whichis beneficial for riskandhypertensive groups.

Triglyceride and glucose (TyG) index as a predictor of incident hypertension: a 9-year longitudinal population-based study.

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Zheng, Rongjiong; Mao, Yushan

2017-09-13

Hypertension and the triglyceride and glucose index both have been associated with insulin resistance; however, the longitudinal association remains unclear. This study was designed to investigate the longitudinal association between the triglyceride and glucose index and incident hypertension among the Chinese population. We studied 4686 subjects (3177 males and 1509 females) and followed up for 9 years. The subjects were divided into four groups based on the triglyceride and glucose index. Univariate and multivariate Cox regression models were used to analyse the risk factors of hypertension. After 9 years of follow-up, 2047 subjects developed hypertension. The overall 9-year cumulative incidence of hypertension was 43.7%, ranging from 28.5% in quartile 1 to 36.9% in quartile 2, 49.2% in quartile 3 and 59.8% in quartile 4 (p for trend triglyceride and glucose index was associated with an increased risk of subsequent incident hypertension. The triglyceride and glucose index can predict the incident hypertension among the Chinese population.

Hypertension prevalence and living conditions related to air pollution: results of a national epidemiological study in Lebanon.

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Salameh, Pascale; Chahine, Mirna; Hallit, Souheil; Farah, Rita; Zeidan, Rouba Karen; Asmar, Roland; Hosseiny, Hassan

2018-04-01

Hypertension is a risk factor of several diseases, linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution exposure items to hypertension, but results were inconsistent. Our objective was to assess the association of living conditions related to air pollution to hypertension in Lebanon, a Middle Eastern country. A national cross-sectional study was conducted all over Lebanon. Blood pressure and its related medications were assessed to be able to classify participants as hypertensive or not. Moreover, in addition to living conditions related to air pollution exposure, we assessed potential predictors of hypertension, including sociodemographic characteristics, self-reported health information and biological measurements. Furthermore, we assessed dose-effect relationship of air pollution items in relation with hypertension. Living conditions related to indoor and outdoor air pollution exposures were associated with hypertension, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (15% increase in risk of disease for every additional pollution exposure item), after adjustment for sociodemographics and biological characteristics (Ora = 1.15 [1.03-1.28]). Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of air pollution on chronic diseases. The work on reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.

Accelerometer-determined physical activity and all-cause mortality in a national prospective cohort study of hypertensive adults.

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Loprinzi, Paul D

2016-05-01

Research in the general population suggests an inverse association between physical activity and all-cause mortality. Less research on this topic has been conducted among hypertensive adults, but the limited studies also suggest an inverse association between physical activity and all-cause mortality among hypertensive adults. At this point, sex-specific differences are not well understood, and all of the physical activity-mortality studies among hypertensive adults have employed a self-report measure of physical activity. Therefore, the purpose of this study was to examine the sex-specific association between objectively measured physical activity and all-cause mortality among a national sample of hypertensive adults. Data from the 2003 to 2006 National Health and Nutrition Examination Survey, with follow-up through 2011, were employed. Hypertension status was defined using measured blood pressure and use of blood pressure-lowering medication. Physical activity was assessed via accelerometry. After adjustments, for every 60-min increase in physical activity, hypertensive adults had a 19% (hazard rate = 0.81; 95% confidence interval: 0.72-0.91) reduced risk of all-cause mortality. There was also evidence of a dose-response relationship. Compared with those in the lowest tertile, those in the middle and upper tertiles had a 31 and 42% reduced all-cause mortality risk, respectively. There was no evidence of a sex-specific interaction effect. Among hypertensive adults, objectively measured physical activity is associated with all-cause mortality risk in a dose-response manner.

Hypertension in women

OpenAIRE

Hage, Fadi G; Mansur, Sulaf J; Xing, Dongqi; Oparil, Suzanne

2013-01-01

Hypertension is the most common modifiable risk factor for cardiovascular disease, the leading cause of death in both men and women. The prevalence and severity of hypertension rise markedly with age, and blood pressure control becomes more difficult with aging in both genders, particularly in women. In addition, there are forms of hypertension that occur exclusively in women, e.g., hypertension related to menopause, oral contraceptive use, or pregnancy (e.g., chronic hypertension, gestationa...

In vivo neutron activation analysis in a study of cadmium and hypertension in South Wales

International Nuclear Information System (INIS)

Morgan, W.D.; Cummins, P.E.; Elwood, P.C.; Evans, C.J.; Dutton, J.; Sivyer, A.

1980-01-01

There is conflicting evidence concerning the influence of cadmium on the incidence of essential hypertension. Blood and urine are not very good indicators of body burden, and furthermore, the importance in such studies of matching for age and smoking habit has often been overlooked. In this respect, the technique for cadmium measurements in vivo by neutron capture prompt gamma analysis has many advantages. Fast neutron irradiation of a subject generates a thermal neutron flux at depths within the body such that capture reactions may occur. These will take place predominantly with hydrogen but also with cadmium and other body elements depending upon their cross-section and tissue abundance. The characteristic 559 keV prompt gamma rays from cadmium are detected using a 21% efficient Ge(Li) detector which is shielded against neutron and gamma radiation emerging both from the source and shield and from the subject. A detection limit (2 s.d. of the background) of 3.2 mg cadmium in the kidney is achieved for an organ dose of 0.3 rem delivered in 33 min. A study of 30 hypertensive subjects and 30 controls, matched for age, sex and smoking habit, has shown a mean kidney cadmium content of 3.3 +- 2.3 mg in the hypertensives which is not significantly different from the 4.4 +- 2.7 mg in the controls. However, in 13 pairs of non-smokers within the study, the mean value of 2.4 +- 2.5 mg in the hypertensives was significantly (p < 0.05) lower than the 3.9 +- 1.2 mg observed in the controls. Since the hypertensive patients had been treated for several years this raises the question of whether such therapy has reduced the level of renal cadmium below that which might be found in untreated hypertensives. Finally, the study confirmed the previously reported association between cigarette smoking and cadmium burden

A haemodynamic study of pulmonary hypertension in chronic hypersensitivity pneumonitis.

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Oliveira, Rudolf K F; Pereira, Carlos A C; Ramos, Roberta P; Ferreira, Eloara V M; Messina, Carolina M S; Kuranishi, Lilian T; Gimenez, Andrea; Campos, Orlando; Silva, Célia M C; Ota-Arakaki, Jaquelina S

2014-08-01

Chronic hypersensitivity pneumonitis is a common fibrotic interstitial lung disease. The prevalence of pulmonary hypertension diagnosed by right heart catheterisation and its cardiopulmonary function findings in patients with chronic hypersensitivity pneumonitis are unknown. Consecutive symptomatic patients with chronic hypersensitivity pneumonitis were prospectively evaluated. All patients were submitted to right heart catheterisation, pulmonary function testing, a 6-min walk test, echocardiography, blood gas determination and N-terminal pro-brain natriuretic peptide analyses. Nonhypoxaemic patients also underwent incremental cardiopulmonary exercise testing. 50 patients underwent right heart catheterisation; 25 (50%) of these had pulmonary hypertension and 22 (44%) had a pre-capillary haemodynamic pattern. The patients with pre-capillary pulmonary hypertension had lower forced vital capacity (mean ± sd 50 ± 17% versus 69 ± 22% predicted, p<0.01), carbon monoxide diffusing capacity (37 ± 12% versus 47 ± 14% predicted, p<0.01), arterial oxygen tension (median (interquartile range) 59.0 (47.8-69.3) versus 73.0 (62.2-78.5) mmHg, p<0.01) and saturation after the 6-min walk test (78 ± 8% versus 86 ± 7%, p<0.01). In pre-capillary pulmonary hypertension, oxygen uptake was also lower at the anaerobic threshold (41 ± 11% versus 50 ± 8% predicted, p=0.04) and at peak exercise (12.8 ± 1.6 versus 15.0 ± 2.5 mL · kg(-1) · min(-1), p=0.02). Pre-capillary pulmonary hypertension is common in symptomatic chronic hypersensitivity pneumonitis and is related to interstitial lung disease severity. Additionally, pulmonary hypertension is more prevalent in hypoxaemic patients with impaired lung function and exercise capacity. ©ERS 2014.

Does hypertension remain after kidney transplantation?

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Gholamreza Pourmand

2015-05-01

Full Text Available Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61% patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8% the cause of end-stage renal disease (ESRD was unknown followed by HTN (26.3%. A total of 166 (41.5% patients had been hypertensive before transplantation and 234 (58.5% had normal blood pressure. Among these 234 individuals, 94 (40.2% developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8% remained hypertensive after transplantation. Totally 180 (45% patients had post-transplantation HTN and 220 patients (55% didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.

Study of serum lipid profile in pregnancy induced hypertension in ...

African Journals Online (AJOL)

At recent times, there has been a great interest on the role of lipid metabolism in the development of pregnancy induced hypertension and pre-eclampsia ... Results: Mean serum triglyceride was higher in (Group 1) pregnant women with pregnancy induced hypertension than in Groups 2 and 3, this was however not ...

Lack of control of hypertension in primary cardiovascular disease prevention in Europe: Results from the EURIKA study.

Science.gov (United States)

Borghi, Claudio; Tubach, Florence; De Backer, Guy; Dallongeville, Jean; Guallar, Eliseo; Medina, Jesús; Perk, Joep; Roy, Carine; Banegas, José R; Rodriguez-Artalejo, Fernando; Halcox, Julian P

2016-09-01

The prevalence of and factors associated with uncontrolled hypertension and apparent resistant hypertension were assessed in the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; NCT00882336). EURIKA was a cross-sectional observational study including patients being treated for the primary prevention of cardiovascular disease in 12 European countries. Patients were assessed if they were being treated for hypertension (N=5220). Blood pressure control was defined according to European guidelines, with sensitivity analysis taking account of patients' age and diabetes status. Associated factors were assessed using multivariate analysis. In the primary analysis, a total of 2691 patients (51.6%) had uncontrolled hypertension. Factors significantly associated with an increased risk of having uncontrolled hypertension included female sex (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.93-2.73), body mass index (BMI; OR per kg/m(2): 1.03; 95% CI: 1.01-1.04), and geographic location. A total of 749 patients (14.3%) had apparent resistant hypertension. Factors significantly associated with an increased risk of having apparent resistant hypertension included BMI (OR per kg/m(2): 1.06; 95% CI: 1.04-1.08), diabetes (OR: 1.28; 95% CI: 1.06-1.53), use of statins (OR: 1.36; 95% CI: 1.15-1.62), serum uric acid levels (OR: 1.16; 95% CI: 1.09-1.23), and geographic location. Similar results were seen in sensitivity analyses. Over 50% of patients treated for hypertension continued to have uncontrolled blood pressure and 14.3% had apparent resistant hypertension. Positive associations were seen with other cardiovascular risk factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Hypertension in the Parsi community of Bombay: a study on prevalence, awareness and compliance to treatment

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Kuruvilla Thomas

2003-01-01

Full Text Available Abstract Background Uncontrolled hypertension (HT is an established risk factor for the development of vascular diseases. Prevalence varies in different communities and no such study has been conducted in the Parsi community living in Bombay, India. The objectives of this study were to determine the prevalence, awareness, compliance to medication and control of HT in this community. Method We used a 1 in 4 random selection of subjects who were ≥ 20 years of age. A questionnaire was administered and the blood pressure (BP was measured by a doctor. HT was defined as diastolic blood pressure (DBP ≥ 90 mm Hg ± systolic pressure (SBP ≥ 140 mm Hg. Isolated systolic hypertension (ISH was defined as SBP ≥ 160 mm Hg with DBP Results 2879 subjects ≥ 20 years of age were randomly selected of which 2415 (84% participated in the study. The overall prevalence of HT in the community was 36.4%, of whom 48.5% were unaware of their hypertensive status. Of those aware of having HT, 36.4% were non-compliant with their anti-hypertensive drugs and only 13.6% had optimally controlled HT. Prevalence of ISH using the present criteria was 19.5% and 73% of hypertensives ≥ 60 years had ISH. Conclusion This study shows that prevalence of HT in the Parsi community is high and nearly half are unaware of their hypertensive status. ISH is the dominant form of HT in the elderly. Compliance to treatment is poor and optimal BP control is achieved in only a small minority. The study highlights the need for regular screening coupled with educational programs to detect and optimally treat HT in the community.

Joint Effects of Physical Activity and BMI on Risk of Hypertension in Women: A Longitudinal Study

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Caroline Jackson

2014-01-01

Full Text Available Introduction. There is debate as to whether physical activity counteracts the adverse effect of weight on health outcomes. We investigated how physical activity modifies the effect of body mass index (BMI on hypertension risk. Methods. BMI, physical activity, and hypertension were measured at baseline and at three-year interval for 14 years (from 1996 to 2010, in 10,339 participants in the Australian Longitudinal Study on Women’s Health. Generalised estimating equation models for binary repeated measures were performed to determine the individual and joint effects of BMI and physical activity on incident hypertension. Results. At baseline (mean age 47.6±1.5 SD, 57% were healthy weight, 28% overweight, and 14% obese. Increasing BMI and decreasing physical activity were associated with increased risk of hypertension. Physical activity attenuated the positive association between weight and risk of hypertension, especially for obese women. Compared to healthy weight high active women, risk of hypertension in obese high active women was 3.4 times greater (OR 3.43, 95% CI 2.68, 4.39 and in obese inactive women 4.9 times greater (OR 4.91, 95% CI 3.92, 6.13. Conclusions. Both physical activity and maintenance of a healthy body weight are associated with lower risk of hypertension. Physical activity reduced but did not remove the effect of obesity on hypertension risk.

Prediction of primary vs secondary hypertension in children.

Science.gov (United States)

Baracco, Rossana; Kapur, Gaurav; Mattoo, Tej; Jain, Amrish; Valentini, Rudolph; Ahmed, Maheen; Thomas, Ronald

2012-05-01

Despite current guidelines, variability exists in the workup of hypertensive children due to physician preferences. The study evaluates primary vs secondary hypertension diagnosis from investigations routinely performed in hypertensive children. This retrospective study included children 5 to 19 years with primary and secondary hypertension. The proportions of abnormal laboratory and imaging tests were compared between primary and secondary hypertension groups. Risk factors for primary vs secondary hypertension were evaluated by logistic regression and likelihood function analysis. Patients with secondary hypertension were younger (5-12 years) and had a higher proportion of abnormal creatinine, renal ultrasound, and echocardiogram findings. There was no significant difference in abnormal results of thyroid function, urine catecholamines, plasma renin, and aldosterone. Abnormal renal ultrasound findings and age were predictors of secondary hypertension by regression and likelihood function analysis. Children aged 5 to 12 years with abnormal renal ultrasound findings and high diastolic blood pressures are at higher risk for secondary hypertension that requires detailed evaluation. © 2012 Wiley Periodicals, Inc.

Management of hypertension in pregnancy.

Science.gov (United States)

Chung, N A; Beevers, D G; Lip, G Y

2001-01-01

Hypertension is an important cause of both maternal and fetal morbidity and mortality in pregnant women. There are still no definitive guidelines as to when and how patients should be treated, but it is important that appropriate treatment is initiated early in patients at highest risk and they are closely monitored. Hypertension in pregnancy can be a difficult condition to diagnose and treat because of the numerous and differing classification systems that have been used in the past. One classification system, which accounts for the multisystem involvement which can occur in pre-eclampsia and eclampsia, divides hypertension in pregnancy into 3 main groups: pre-eclampsia, gestational hypertension and chronic hypertension. Little benefit to the fetus has been shown from treating gestational and chronic hypertension, but studies in this area have been small and would not have had the power to show a difference in outcome between treated and untreated groups. However, the reduction in morbidity and mortality in the treatment of pre-eclampsia is significant. Therefore, all pregnancies complicated by hypertension require monitoring to detect the possible onset of superimposed pre-eclampsia/eclampsia. Institutions should have a management strategy for those mothers with severe hypertension including a multidisciplinary approach, where the patient is to be monitored and which antihypertensive agents are to be used. It should not be forgotten that the definitive treatment for severe hypertension is delivery of the fetus despite risks to fetal morbidity and mortality. This will reduce blood pressure, but hypertension per se may still persist post partum requiring short term therapy.

The prevalence and correlated determinants of hypertension and type 2 diabetes: a large community-based study in Isfahan, Iran

International Nuclear Information System (INIS)

Maracy, M.R.; Feizi, A.; Bagherynejad, M

2012-01-01

Objective: Despite progress in prevention, detection, treatment and control of hypertension and diabetes, their increasing trend of prevalence remains an important public health problem. In general, only a small proportion of hypertension and diabetes is associated with an underlying disease, i.e. most cases are related to modifiable risk factors. Accordingly, as a large scale community-based study in Iran, the purpose of the present research was to evaluate the prevalence and correlated determinants of hypertension and diabetes among the general population in Isfahan. Methodology: In a cross-sectional study during 2007-2009, 3000 people aged 15-65 years were selected through multi-stage cluster random sampling from the general population in Isfahan. Total and age-sex specific prevalence of hypertension and diabetes were estimated. Multivariate logistic regression was used for studying risk factors and determining their level of association with the risk of hypertension and diabetes simultaneously. Results: The prevalence of hypertension and diabetes was 22.23% and 6.5% respectively among the studied population. Sex specific prevalence of hypertension was 22.4% and 22.06% for women and men, respectively. The corresponding values were 8.27% and 4.86% for diabetes (P < 0.05). Hypertension and diabetes were most prevalent among the age groups of 55-65 years and 45-54 years, respectively. The most important determinants of having hypertension were body mass index (BMI) (P < 0.01), age (P < 0.01), physical activity (P < 0.1) and sex (P < 0.05). Age (P < 0.01), sex (P < 0.05), BMI (P < 0.1), and family history (P < 0.01) were the major determinants of diabetes. Conclusion: The prevalence of diabetes and hypertension was high among the studied population. Furthermore, similar to previous studies, the modifiable risk factors played an important role in their incidence. Therefore, primary prevention is of high importance as a natural extension of hypertension and diabetes

Long-term prognosis after acute myocardial infarction in patients with a history of arterial hypertension. TRACE study group

DEFF Research Database (Denmark)

Gustafsson, F; Køber, L; Torp-Pedersen, C

1998-01-01

AIMS: The objective of the study was to investigate the influence of a history of arterial hypertension on long-term prognosis after an acute myocardial infarction in a representative population, and secondly to assess the impact on prognosis of left ventricular systolic function in hypertensives......%) of the patients had a history of arterial hypertension. During the time of observation 763 (50.6%) hypertensives and 2253 (43.7%) normotensives died, corresponding to a risk ratio for death in hypertensives of 1.23 (1.13-1.33, P .... CONCLUSION: A history of arterial hypertension is a moderate risk factor for mortality after an acute myocardial infarction in patients aged 65 years or less. This excess risk is present at all levels of left ventricular systolic function....

Hypertension Knowledge-Level Scale (HK-LS): A Study on Development, Validity and Reliability

OpenAIRE

Erkoc, Sultan Baliz; Isikli, Burhanettin; Metintas, Selma; Kalyoncu, Cemalettin

2012-01-01

This study was conducted to develop a scale to measure knowledge about hypertension among Turkish adults. The Hypertension Knowledge-Level Scale (HK-LS) was generated based on content, face, and construct validity, internal consistency, test re-test reliability, and discriminative validity procedures. The final scale had 22 items with six sub-dimensions. The scale was applied to 457 individuals aged ≥18 years, and 414 of them were re-evaluated for test-retest reliability. The six sub-dimensio...

Job Strain, Workplace Discrimination, and Hypertension among Older Workers: The Health and Retirement Study.

Science.gov (United States)

Mezuk, Briana; Kershaw, Kiarri N; Hudson, Darrell; Lim, Kyuang Ah; Ratliff, Scott

2011-03-01

Job strain has been associated with hypertension among younger workers; however, whether this relationship persists among older workers, particularly older racial/ethnic minorities, is unresolved. This study evaluated whether job strain and workplace discrimination are associated with hypertension and poor blood pressure control among older workers and whether these relationships vary by gender and race/ethnicity. Data were drawn from the Health and Retirement Study, and analysis was restricted to employed participants with complete information on job strain and blood pressure (N = 3,794). In adjusted models, high job strain was associated with lower likelihood of hypertension (odds ratio (OR): 0.75, 95% confidence interval (CI): 0.63, 0.89) relative to low job strain. Stratified analyses indicated this association was only significant among white (OR: 0.71, 95% CI: 0.58, 0.86) and male (OR: 0.61, 95% CI: 0.47, 0.79) workers. High job strain was not significantly associated with hypertension among African American (OR: 1.14, 95% CI: 0.63, 2.07) or Hispanic (OR: 0.56, 95% CI: 0.29, 1.09) workers. Workplace discrimination was not associated with hypertension among any group. Neither job strain nor discrimination was associated with poor blood pressure control. These findings suggest that persistence in work characterized by high job strain in later life may signal resilience to the influence of work-related stressors on health. Future research efforts should examine the factors that contribute to gender and racial differences in these relationships.

Association between Anthropometric Measures and Indicators for Hypertension Control among Kazakh-Chinese Hypertension Patients in Xinjiang, China: Results from a Cross-sectional Study.

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Qinghua Zhang

Full Text Available Among Kazakh-Chinese population in Xinjiang province of China, prevalence of obesity and hypertension were 40.1% and 50.3% respectively, the highest across all ethnic groups residing in this pastureland. Despite this, there remained a dearth of information regarding the association between the anthropometric measures [body mass index (BMI, waist circumference (WC, waist-hip ratio (WHR, Waist-to-height ratio (WHtR etc.] and indicators for hypertension control [achieved levels of systolic and diastolic blood pressures (SBP and DBP, pulse pressure index (PPI, ankle-brachial index (ABI etc.] among them.A cross-sectional study was conducted in Xinjiang to determine the distribution and inter-relationships of the anthropometric measures and indicators for achieved BP control as well as their predictors among hypertension patients of Kazakh-Chinese ethnicity. Out of 550 randomly selected patients, 516 completed the interview, anthropometry and BP assessments.In the sample population, average SBP, DBP and PP were 156.26±24.40mmHg, 87.55±14.73mmHg and 68.71±19.39mmHg respectively. Bivariate analysis identified age, gender, education, duration of hypertension, WC and BMI being factors influencing the achieved levels of BP. Adjusted multiple linear regression models elicited positive associations of age (βa = 0.152, p = 0.001 and duration of hypertension (βa = 0.132, p = 0.003 with achieved level of SBP as well as BMI (βa = 0.135, p = 0.002 with DBP. Age (βa = 0.207, p<0.001 and WHtR (βa = 0.304, p = 0.005 were positively and WC (βa = -0.406, p<0.001 was negatively associated with PPI. Increasing age (βa = -0.125, p = 0.005, female gender (βa = -0.122, p = 0.005 and 5years' duration of hypertension (βa = -0.091, p<0.039 were negatively associated with ABI. After adjustment for socio-demographic variables, hypertensive patients with (reference = without abdominal obesity had 93% (p = 0.013 higher odds of missing the target BP control

Blood Pressure Control in Hypertensive Patients in the "Hiperdia Program": A Territory-Based Study

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Clarita Silva de Souza

2014-06-01

Full Text Available Background: Systemic hypertension is highly prevalent and an important risk factor for cardiovascular events. Blood pressure control in hypertensive patients enrolled in the Hiperdia Program, a program of the Single Health System for the follow-up and monitoring of hypertensive patients, is still far below the desired level. Objective: To describe the epidemiological profile and to assess blood pressure control of patients enrolled in Hiperdia, in the city of Novo Hamburgo (State of Rio Grande do Sul, Brazil. Methods: Cross-sectional study with a stratified cluster random sample, including 383 adults enrolled in the Hiperdia Program of the 15 Basic Health Units of the city of Porto Alegre, conducted between 2010 and 2011. Controlled blood pressure was defined as ≤140 mmHg × 90 mmHg. The hypertensive patients were interviewed and their blood pressure was measured using a calibrated aneroid device. Prevalence ratios (PR with 95% confidence interval, Wald's χ2 test, and simple and multiple Poisson regression were used in the statistical analysis. Results: The mean age was 63 ± 10 years, and most of the patients were females belonging to social class C, with a low level of education, a sedentary lifestyle, and family history positive for systemic hypertension. Diabetes mellitus (DM was observed in 31%; adherence to the antihypertensive treatment in 54.3%; and 33.7% had their blood pressure controlled. DM was strongly associated with inadequate BP control, with only 15.7% of the diabetics showing BP considered as controlled. Conclusion: Even for hypertensive patients enrolled in the Hiperdia Program, BP control is not satisfactorily reached or sustained. Diabetic hypertensive patients show the most inappropriate BP control.

Sex differences in the medication choice for hypertension in general practice. A study with written case simulations

NARCIS (Netherlands)

Klungel, O.H.; Paes, A.H.P.; de Boer, A; Kuyvenhoven, M.; Seidell, J C; Bakker, A

The objective of this study was to explore explanations for the preference of physicians to prescribe beta-blockers to hypertensive men and diuretics to hypertensive women. A qualitative study among 12 family physicians was conducted with a combination of written case simulations, semi-structured

Hypertensive disease and renal hypertensions: renal structural and functional studies by using dynamic computed tomography

International Nuclear Information System (INIS)

Arabidze, G.G.; Pogrebnaya, G.N.; Todua, F.I.; Sokolova, R.I.; Kozdoba, O.A.

1989-01-01

Dynamic computed tomography was conducted by the original methods; the findings were analyzed by taking into account time-density curves which made it possible to gain an insight into the status of blood flow and filtration in each individual kidney. Computed tomography and dynamic computed tomography revealed that hypertensive disease was characterized by normal volume and thickness of the renal cortical layer and symmetric time-density curves, whereas a hypertensive type of chronic glomerulonephritis featured lower renal cartical layer thickness, reduced renal volume, symmetrically decrease amplitudes of the first and second peaks of the time-density curve, chronic pyelonephritis showed asymmetric time-density diagrams due to the lower density areas in the afflicted kidney

Instruments of health literacy used in nursing studies with hypertensive elderly

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Ana Larissa Gomes Machado

Full Text Available This study aimed to analyze nursing research regarding the instruments used to evaluate health literacy in elderly hypertensive patients. This is an integrative literature review done in the databases LILACS, PubMed, CINAHL, Scopus, and Cochrane, in June 2013. The articles, electronically available, were selected for full-text review by nurses, who assessed health literacy of elderly with hypertension. Eight studies were selected for analysis and four different instruments were used in the research. The instruments were developed according to a methodology and they were all designed to evaluate the abilities of elderly regarding reading, numeracy, pronunciation and recognition of some health-related words. The nursing research analyzed in this study revealed the gaps in care related to measures aimed to increase patient's involvement in decision-making. Also, the instruments used for measuring health literacy showed limitations, and there is no gold standard test.

Gamma-glutamyltransferase, fatty liver index and hepatic insulin resistance are associated with incident hypertension in two longitudinal studies.

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Bonnet, Fabrice; Gastaldelli, Amalia; Pihan-Le Bars, Florence; Natali, Andrea; Roussel, Ronan; Petrie, John; Tichet, Jean; Marre, Michel; Fromenty, Bernard; Balkau, Beverley

2017-03-01

We hypothesized that liver markers and the fatty liver index (FLI) are predictive of incident hypertension and that hepatic insulin resistance plays a role. The association between liver markers and incident hypertension was analysed in two longitudinal studies of normotensive individuals, 2565 from the 9-year data from an epidemiological study on the insulin resistance cohort and the 321 from the 3-year 'Relationship between Insulin Sensitivity and Cardiovascular disease' cohort who had a measure of endogenous glucose production. The FLI is calculated from BMI, waist circumference, triglycerides and gamma-glutamyltransferase (GGT) and the hepatic insulin resistance index from endogenous glucose production and fasting insulin. The incidence of hypertension increased across the quartiles groups of both baseline GGT and alanine aminotransferase. After adjustment for sex, age, waist circumference, fasting glucose, smoking and alcohol intake, only GGT was significantly related with incident hypertension [standardized odds ratio: 1.21; 95% confidence interval (1.10-1.34); P = 0.0001]. The change in GGT levels over the follow-up was also related with an increased risk of hypertension, independently of changes in body weight. FLI analysed as a continuous value, or FLI at least 60 at baseline were predictive of incident hypertension in the multivariable model. In the RISC cohort, the hepatic insulin resistance index was positively related with the risk of 3-year incident hypertension [standardized odds ratio: 1.54 (1.07-2.22); P = 0.02]. Baseline GGT and FLI, as well as an increase in GGT over time, were associated with the risk of incident hypertension. Enhanced hepatic insulin resistance predicted the onset of hypertension and may be a link between liver markers and hypertension.

Validation of an arterial tortuosity measure with application to hypertension collection of clinical hypertensive patients.

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Diedrich, Karl T; Roberts, John A; Schmidt, Richard H; Kang, Chang-Ki; Cho, Zang-Hee; Parker, Dennis L

2011-10-18

Hypertension may increase tortuosity or twistedness of arteries. We applied a centerline extraction algorithm and tortuosity metric to magnetic resonance angiography (MRA) brain images to quantitatively measure the tortuosity of arterial vessel centerlines. The most commonly used arterial tortuosity measure is the distance factor metric (DFM). This study tested a DFM based measurement's ability to detect increases in arterial tortuosity of hypertensives using existing images. Existing images presented challenges such as different resolutions which may affect the tortuosity measurement, different depths of the area imaged, and different artifacts of imaging that require filtering. The stability and accuracy of alternative centerline algorithms was validated in numerically generated models and test brain MRA data. Existing images were gathered from previous studies and clinical medical systems by manually reading electronic medical records to identify hypertensives and negatives. Images of different resolutions were interpolated to similar resolutions. Arterial tortuosity in MRA images was measured from a DFM curve and tested on numerically generated models as well as MRA images from two hypertensive and three negative control populations. Comparisons were made between different resolutions, different filters, hypertensives versus negatives, and different negative controls. In tests using numerical models of a simple helix, the measured tortuosity increased as expected with more tightly coiled helices. Interpolation reduced resolution-dependent differences in measured tortuosity. The Korean hypertensive population had significantly higher arterial tortuosity than its corresponding negative control population across multiple arteries. In addition one negative control population of different ethnicity had significantly less arterial tortuosity than the other two. Tortuosity can be compared between images of different resolutions by interpolating from lower to higher

Myocardial Performance Index in Childhood Onset Essential Hypertension and White Coat Hypertension.

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Gupta-Malhotra, Monesha; Hamzeh, Rabih K; Poffenbarger, Tim; McNiece-Redwine, Karen; Hashmi, Syed Shahrukh

2016-03-01

As a global measure of ventricular systolic and diastolic function, the myocardial performance index (MPI) can be an early indicator of hypertensive cardiomyopathy in children with essential hypertension (EH). Children with untreated newly diagnosed EH and white coat hypertension (WCH) by a 24-hour ambulatory blood pressure monitoring (ABPM), both groups without any identifiable etiology for the hypertension, were enrolled for the study. Echocardiograms and vascular ultrasounds for carotid artery intimal medial thickness were performed on all children prior to therapy. Diastolic function (peak E and A velocities, E/A ratio, isovolumic relaxation time, and deceleration times) and MPI were evaluated by simultaneous transmitral and transaortic spectral Doppler flow velocities. Systolic function was evaluated by shortening fraction and ejection fraction. A cohort of 66 children (24 with EH, 42 with WCH, males 61%, median age of 13 years, range 10-17 years) were enrolled in the study. The demographic, anthropometric, laboratory tests, vascular ultrasound, and conventional echocardiographic parameters were similar between the 2 groups. There was a very small difference in MPI between the EH and WCH children (0.28 SD: 0.07 vs. 0.31 SD: 0.08, P = 0.045). However, in EH children, MPI increased by 0.14 units for every 10 unit increase in mean ABPM systolic BP (95% confidence interval: 0.03-0.25). We found the increasing MPI was associated with increasing 24-hour mean systolic BP in children with EH. Therefore, MPI may have utility as a single, quick, noninvasive method of detection and tracking of subclinical hypertensive heart disease. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Pulmonary hypertension CT imaging

International Nuclear Information System (INIS)

Nedevska, A.

2013-01-01

Full text: The right heart catheterization is the gold standard in the diagnosis and determines the severity of pulmonary hypertension. The significant technical progress of noninvasive diagnostic imaging methods significantly improves the pixel density and spatial resolution in the study of cardiovascular structures, thus changes their role and place in the overall diagnostic plan. Learning points: What is the etiology, clinical manifestation and general pathophysiological disorders in pulmonary hypertension. What are the established diagnostic methods in the diagnosis and follow-up of patients with pulmonary hypertension. What is the recommended protocol for CT scanning for patients with clinically suspected or documented pulmonary hypertension. What are the important diagnostic findings in CT scan of a patient with pulmonary hypertension. Discussion: The prospect of instantaneous complex - anatomical and functional cardiopulmonary and vascular diagnostics seems extremely attractive. The contrast enhanced multislice computed (CT ) and magnetic resonance imaging are very suitable methods for imaging the structures of the right heart, with the possibility of obtaining multiple projections and three-dimensional imaging reconstructions . There are specific morphological features that, if carefully analyzed, provide diagnostic information. Thus, it is possible to avoid or at least reduce the frequency of use of invasive diagnostic cardiac catheterization in patients with pulmonary hypertension. Conclusion: This review focuses on the use of contrast-enhanced CT for comprehensive evaluation of patients with pulmonary hypertension and presents the observed characteristic changes in the chest, lung parenchyma , the structures of the right half of the heart and pulmonary vessels

Autoradiographic study of the regional distribution of gastric blood flow in portal hypertensive rats

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Geraghty, J.G.; Angerson, W.J.; Carter, D.C.

1989-01-01

This study measures regional gastric blood flow in portal hypertensive rats at three separate periods after portal vein ligation using quantitative autoradiography with 14C-labeled iodoantipyrine. The level of corpus mucosal blood flow was significantly reduced in 3-day portal vein-ligated animals compared with sham-operated control animals (30.4 +/- 2.3 vs. 47.1 +/- 5.6 ml/100 g.min). There was no significant difference in corpus mucosal blood flow between portal vein-ligated and sham-operated animals at 7- and 28-day periods, although the level of perfusion was higher in the 28-day portal vein-ligated group. There was no significant difference in antral mucosal or muscle blood flow between portal hypertensive and control animals at any of the study periods. We conclude that the acute period after portal vein ligation is associated with a reduced corpus mucosal microcirculation but that this effect is not sustained in portal hypertensive animals studied at later intervals after portal vein ligation

Interactions of Genes and Sodium Intake on the Development of Hypertension: A Cohort-Based Case-Control Study

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Mei-Ling Chen

2018-05-01

Full Text Available There have been few studies investigating interactions of G-protein beta3 subunit (GNB3 C825T (rs5443 and dietary sodium intake on the risk of hypertension, i.e., BP salt sensitivity. The study aims to evaluate joint effects of GNB3 polymorphisms and sodium consumption on the development of hypertension. A cohort-based case-control study was conducted in 2014. There are 233 participants with newly diagnosed hypertension in the case group and 699 participants in the gender-matched control group. The primary outcome is the development of hypertension over a 10-year period. The determinants of hypertension were three genotypes of SNP in GNB3 (TT; CT; and CC and two dietary salt categories on the basis of the level of sodium consumption representing high (>4800 mg/day and low-sodium (<2400 mg/day diets. The development of hypertension increased with participants carrying TT genotype and high-sodium diets comparing with those carrying TC or CC genotype with low-sodium diets (adjusted OR 3.23, 95% CI 1.52–6.83 (Rothman synergy index = 3.79. The study suggests that GNB3 C825T polymorphism may influence the response of the renin-angiotensin system to high-sodium diet. It implies that GNB3 can be served as an easy, inexpensive, and early genetic marker of salt sensitivity to blood pressure. Salt-sensitive individuals should pay more attention to salt intake to reduce cardiovascular morbidity or mortality.

Risk Assessment and Prevention of Hypertension in Filipino Americans.

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Ma, Grace X; Lee, Minsun; Bhimla, Aisha; Tan, Yin; Gadegbeku, Crystal A; Yeh, Ming Chin; Aczon, Hermie

2017-08-01

Despite that Filipino Americans represent an important target group for hypertension, health behaviors associated with hypertension in this population have not been well studied. Two hundred Filipino Americans from eight community-based organizations completed the study. Information was collected to determine whether modifiable behavioral factors, as well as acculturation and demographic characteristics, were associated with hypertension status in Filipino Americans. Approximately 67% of Filipino Americans were hypertensive. Logistic regression analysis showed that adding salt, physical inactivity, and old age were significantly associated with hypertension status after controlling for other covariates. The present study confirmed a high rate of hypertension among Filipino Americans and demonstrates the association of hypertension status with behavioral factors. These findings highlight the need for targeted interventions to prevent and manage hypertension in this high-risk community by facilitating health behaviors, particularly, salt reduction and physical activity.

Long-term renal outcome in patients with malignant hypertension: a retrospective cohort study

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Amraoui, Fouad; Bos, Sarah; Vogt, Liffert; van den Born, Bert-Jan

2012-01-01

Background: Malignant hypertension is frequently complicated by renal insufficiency. Although the survival of this hypertensive emergency has improved, recent data on renal outcome and its predictors are lacking. We assessed renal outcome and its predictors in patients with malignant hypertension.

Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

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Neto José

2011-03-01

Full Text Available Abstract Background Blood pressure (BP within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage. Methods This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution. Discussion The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe

Pulmonary hypertension due to left heart disease.

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Berthelot, Emmanuelle; Bailly, Minh Tam; Hatimi, Safwane El; Robard, Ingrid; Rezgui, Hatem; Bouchachi, Amir; Montani, David; Sitbon, Olivier; Chemla, Denis; Assayag, Patrick

Pulmonary hypertension due to left heart disease, also known as group 2 pulmonary hypertension according to the European Society of Cardiology/European Respiratory Society classification, is the most common cause of pulmonary hypertension. In patients with left heart disease, the development of pulmonary hypertension favours right heart dysfunction, which has a major impact on disease severity and outcome. Over the past few years, this condition has been considered more frequently. However, epidemiological studies of group 2 pulmonary hypertension are less exhaustive than studies of other causes of pulmonary hypertension. In group 2 patients, pulmonary hypertension may be caused by an isolated increase in left-sided filling pressures or by a combination of this condition with increased pulmonary vascular resistance, with an abnormally high pressure gradient between arteries and pulmonary veins. A better understanding of the conditions underlying pulmonary hypertension is of key importance to establish a comprehensive diagnosis, leading to an adapted treatment to reduce heart failure morbidity and mortality. In this review, epidemiology, mechanisms and diagnostic approaches are reviewed; then, treatment options and future approaches are considered. Copyright © 2017. Published by Elsevier Masson SAS.

Dose-Response Association Between Physical Activity and Incident Hypertension: A Systematic Review and Meta-Analysis of Cohort Studies.

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Liu, Xuejiao; Zhang, Dongdong; Liu, Yu; Sun, Xizhuo; Han, Chengyi; Wang, Bingyuan; Ren, Yongcheng; Zhou, Junmei; Zhao, Yang; Shi, Yuanyuan; Hu, Dongsheng; Zhang, Ming

2017-05-01

Despite the inverse association between physical activity (PA) and incident hypertension, a comprehensive assessment of the quantitative dose-response association between PA and hypertension has not been reported. We performed a meta-analysis, including dose-response analysis, to quantitatively evaluate this association. We searched PubMed and Embase databases for articles published up to November 1, 2016. Random effects generalized least squares regression models were used to assess the quantitative association between PA and hypertension risk across studies. Restricted cubic splines were used to model the dose-response association. We identified 22 articles (29 studies) investigating the risk of hypertension with leisure-time PA or total PA, including 330 222 individuals and 67 698 incident cases of hypertension. The risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92-0.96) with each 10 metabolic equivalent of task h/wk increment of leisure-time PA. We found no evidence of a nonlinear dose-response association of PA and hypertension ( P nonlinearity =0.094 for leisure-time PA and 0.771 for total PA). With the linear cubic spline model, when compared with inactive individuals, for those who met the guidelines recommended minimum level of moderate PA (10 metabolic equivalent of task h/wk), the risk of hypertension was reduced by 6% (relative risk, 0.94; 95% confidence interval, 0.92-0.97). This meta-analysis suggests that additional benefits for hypertension prevention occur as the amount of PA increases. © 2017 American Heart Association, Inc.

Increased planned delivery contributes to declining rates of pregnancy hypertension in Australia: a population-based record linkage study.

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Roberts, Christine L; Algert, Charles S; Morris, Jonathan M; Ford, Jane B

2015-10-05

Since the 1990s, pregnancy hypertension rates have declined in some countries, but not all. Increasing rates of early planned delivery (before the due date) have been hypothesised as the reason for the decline. The aim of this study was to explore whether early planned delivery can partly explain the declining pregnancy hypertension rates in Australia. Population-based record linkage study utilising linked birth and hospital records. A cohort of 1,076,122 deliveries in New South Wales, Australia, 2001-2012. Pregnancy hypertension (including gestational hypertension, pre-eclampsia and eclampsia) was the main outcome; pre-eclampsia was a secondary outcome. From 2001 to 2012, pregnancy hypertension rates declined by 22%, from 9.9% to 7.7%, and pre-eclampsia by 27%, from 3.3% to 2.4% (trend prate was predicted to increase to 10.5%. Examination of annual gestational age distributions showed that pregnancy hypertension rates actually declined from 38 weeks gestation and were steepest from 41 weeks; at least 36% of the decrease could be attributed to planned deliveries. The risk factors for pregnancy hypertension were also risk factors for planned delivery. It appears that an unanticipated consequence of increasing early planned deliveries is a decline in the incidence of pregnancy hypertension. Women with risk factors for hypertension were relatively more likely to be selected for early delivery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Preliminary studies of pulmonary perfusion scanning in patients with pulmonary hypertension

International Nuclear Information System (INIS)

Shi Rongfang; Liu Xiujie; Wang Yanqun

1986-01-01

A comparative analysis of pulmonary perfusion scanning through cardiac catheterization of 57 patients including 32 patients with congenital heart disease, 8 patients with chronic pulmonary thromboembolism and 7 patients with primary pulmonary hypertension is reported. The lung scintigram obtained with In-113m or Tc-99m-MAA represents the distribution of pulmonary blood. It has been found that the lung scintigram was abnormal in patients of congenital heart disease with pulmonary hypertension (i. e. pulmonary artery pressure between 41-80 mmHg) and the extent of radoiactive regional defects is proportional to the level of pulmonary hypertension. The results of the analysis indicated that pulmonary perfusion scanning being a noninvasive technique would be a useful method in evaluating the level of pulmonary hypertension in patients with left to right shunt before and after surgical operation

Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension.

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Wang, Lei; Li, Nanfang; Yao, Xiaoguang; Chang, Guijuan; Zhang, Delian; Heizhati, Mulalibieke; Wang, Menghui; Luo, Qin; Kong, Jianqiong

2017-01-01

Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. Detection rate of secondary causes and coexisting diseases of hypertension was 39.5% among 3003 hypertensive patients. Obstructive sleep apnea (OSA) was the most common, accounting for 24.7% of patients, followed by primary aldosteronism (PA) (5.8%) and PA + OSA (4.9%). Endocrine hypertension accounted for 12.1% of patients, including 10.7% of patients with PA, 1.1% with hypothyroidism, 0.1% with pheochromocytoma, 0.1% with Cushing's syndrome, and 0.1% with hyperthyroidism, respectively. Those who smoke, those who are obese, and those who have diabetes accounted for 31.3%, 27.5%, and 16.6% of total patients, respectively. There were overlapping conditions in secondary causes and coexisting diseases of hypertension. OSA was the most common in each age- and BMI-stratified group. Findings from the current study suggest an increasing frequency of secondary forms of hypertension, highlighting the burden of OSA and PA in hypertensive patients.

Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension

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Lei Wang

2017-01-01

Full Text Available Background. Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. Methods. Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. Results. Detection rate of secondary causes and coexisting diseases of hypertension was 39.5% among 3003 hypertensive patients. Obstructive sleep apnea (OSA was the most common, accounting for 24.7% of patients, followed by primary aldosteronism (PA (5.8% and PA + OSA (4.9%. Endocrine hypertension accounted for 12.1% of patients, including 10.7% of patients with PA, 1.1% with hypothyroidism, 0.1% with pheochromocytoma, 0.1% with Cushing’s syndrome, and 0.1% with hyperthyroidism, respectively. Those who smoke, those who are obese, and those who have diabetes accounted for 31.3%, 27.5%, and 16.6% of total patients, respectively. There were overlapping conditions in secondary causes and coexisting diseases of hypertension. OSA was the most common in each age- and BMI-stratified group. Conclusion. Findings from the current study suggest an increasing frequency of secondary forms of hypertension, highlighting the burden of OSA and PA in hypertensive patients.

Health system strengthening and hypertension management in China.

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Huang, Kehui; Song, Yu Ting; He, Yong Huan; Feng, Xing Lin

2016-01-01

Non-communicable diseases are the leading causes of global burden of diseases, and hypertension is one of the most important risk factors. Hypertension prevalence doubled in China in the past decade and affects more than 300 million Chinese people. In the review we systematically searched peer-reviewed publications that link health system level factors with hypertension management in China and provide the current knowledge on how to improve a country's health system to manage the hypertension epidemic. A framework was developed to guide the review. The database of PubMed, CNKI were systematically searched from inception to April 13, 2016. Two authors independently screened the searched results for inclusion, conducted data extraction and appraised the quality of studies. Key findings were described according to the framework. Five hundred seventy-two publications were identified, where 11 articles were left according to the inclusion and exclusion criteria. The study periods range from 2010 to 2015. All about 11 researches linked health system factors to the outcome of hypertension management. And the outcomes were just focused on the awareness, treatment and control of hypertension but not hypertension incidence. One study is about the role of health system governance, investigating the performance of different organized community health care centers; three studies were about health financing comparing differences in insurance coverage; three studies were about health information practicing the hypertension guidelines of China or the WHO, and the rest three about mechanisms of health service delivery. No researches were identified about physical resources for health and human resources for health. Hypertension prevalence has been rising rapidly in China and the management of hypertension in China is a detection problem rather than treatment problem. Limited evidence shows the positive effect of health system factors on hypertension management and joint efforts

[Epidemiological study of hypertension in Dongxiang population of Dongxiang county in Gansu province].

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Li, X H; Qiao, Y; Xie, P; Ma, H Z; Ma, Y A

2016-09-24

Objective: To investigate the prevalence, awareness, treatment and control rate of hypertension among Dongxiang population of Dongxiang county in Gansu province, and analyze risk factors of hypertension in this population. Methods: A total of 1 879 Dongxiang residents of Dongxiang county in Gansu province aged 18 years and over were selected in one town and eight villages by random cluster method from April to June in 2014. All subjects were interviewed and physical examination including blood pressure measurement was performed. Multivariate logistic regression analysis was used to analyze the risk factors of hypertension. Results: Prevalence of hypertension in this population was 21.4%(402/1 879). Prevalence of hypertension increased with aging and was 7.9%(35/441) in 18-39 years old people, and 20.2%(151/749)in 40-59 years old people, and 31.3%(216/689)in ≥60 years old people ( P old group (8.0%(20/249)vs. 7.8%(15/192), P >0.05) and 40-59 years old group (19.8%(78/393) vs. 20.5%(73/356), P >0.05), while the prevalence of hypertension was significantly higher in male than in female(34.2%(123/360) vs. 28.3%(93/329), P old group. Prevalence of hypertension was also significantly higher in rural area residents than in county town residents (23.4%(255/1 090) vs.18.6%(147/789), P county residents. Multivariate logistic regression analysis showed that age, family history of hypertension, high body mass index, less physical activity and more static state were risk factors of hypertension in this population( P county in Gansu province. Hypertension prevention focusing on risk factors control and treatment strategies should be enhanced in this population.

Hypertension and health outcomes in the PICU.

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Ehrmann, Brett J; Selewski, David T; Troost, Jonathan P; Hieber, Susan M; Gipson, Debbie S

2014-06-01

Reports of the burden of hypertension in hospitalized children are emerging, but the prevalence and significance of this condition within the PICU are not well understood. The aims of this study were to validate a definition of hypertension in the PICU and assess the associations between hypertension and acute kidney injury, PICU length of stay, and mortality. Single-center retrospective study using a database of PICU discharges between July 2011 and February 2013. All children discharged from the PICU with length of stay more than 6 hours, aged 1 month through 17 years. Exclusions were traumatic brain injury, incident renal transplant, or hypotension. None. Potential definitions of hypertension utilizing combinations of standardized cutoff percentiles, durations, initiation or dose escalation of antihypertensives, and/or billing diagnosis codes for hypertension were compared using receiver operator characteristic curves against a manual medical record review. Multivariable logistic and linear regression analyses were conducted using the selected definition of hypertension to assess its independent association with acute kidney injury and PICU length of stay, respectively. A definition requiring three systolic and/or diastolic readings above standardized 99th percentiles plus 5 mm Hg over 1 day was selected (area under the curve, 0.91; sensitivity, 94%; specificity, 87%). Among the 1,215 patients in this analysis, the prevalence of hypertension was 25%. Hypertension was independently associated with acute kidney injury (odds ratio, 2.89; 95% CI, 1.64-5.09; p hypertension group-but were statistically different (p = 0.02). Hypertension is common in the PICU and is associated with worse clinical outcomes. Future studies are needed to confirm these results.

Prevalence of Hypertension and Association of Obesity with Hypertension in School Ggoing Children of Surat City, Western India

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Salvi S. Shah

2013-08-01

Full Text Available Purpose: The association of obesity with hypertension has been recognized for the decades which are the important risk factors for the cardiovascular disease. So the purpose of the present study was to determine association of obesity with hypertension in school going children of Surat. Methodology: School going children aged between 12-18 years, of five schools in Surat were selected for the study. Height and weight were measured and BMI was calculated. Blood pressure measurements were taken as per recommendation of American heart society and family history of hypertension has also been assessed. Hypertension was considered if blood pressure is more than 95th percentile according to the update of task force report and Obesity was diagnosed by BMI for age. Results: Of 682 children, 8.94% were obese and 20.09% were hypertensive. Conclusion: Obesity is strongly associated with hypertension in children and both together may risk factors for later coronary disease.

Management of hypertension using dietary approach to stop ...

African Journals Online (AJOL)

Background: Dietary interventions are important behavioural strategies for hypertension risk reduction. While dietary management of hypertension with DASH significantly lowers blood pressure, investigation of the management of hypertension with local diets in Nigeria is limited. Objective: This study was designed to study ...

Hypertension Knowledge-Level Scale (HK-LS: A Study on Development, Validity and Reliability

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Cemalettin Kalyoncu

2012-03-01

Full Text Available This study was conducted to develop a scale to measure knowledge about hypertension among Turkish adults. The Hypertension Knowledge-Level Scale (HK-LS was generated based on content, face, and construct validity, internal consistency, test re-test reliability, and discriminative validity procedures. The final scale had 22 items with six sub-dimensions. The scale was applied to 457 individuals aged ≥18 years, and 414 of them were re-evaluated for test-retest reliability. The six sub-dimensions encompassed 60.3% of the total variance. Cronbach alpha coefficients were 0.82 for the entire scale and 0.92, 0.59, 0.67, 0.77, 0.72, and 0.76 for the sub-dimensions of definition, medical treatment, drug compliance, lifestyle, diet, and complications, respectively. The scale ensured internal consistency in reliability and construct validity, as well as stability over time. Significant relationships were found between knowledge score and age, gender, educational level, and history of hypertension of the participants. No correlation was found between knowledge score and working at an income-generating job. The present scale, developed to measure the knowledge level of hypertension among Turkish adults, was found to be valid and reliable.

Hypertension Knowledge-Level Scale (HK-LS): a study on development, validity and reliability.

Science.gov (United States)

Erkoc, Sultan Baliz; Isikli, Burhanettin; Metintas, Selma; Kalyoncu, Cemalettin

2012-03-01

This study was conducted to develop a scale to measure knowledge about hypertension among Turkish adults. The Hypertension Knowledge-Level Scale (HK-LS) was generated based on content, face, and construct validity, internal consistency, test re-test reliability, and discriminative validity procedures. The final scale had 22 items with six sub-dimensions. The scale was applied to 457 individuals aged ≥ 18 years, and 414 of them were re-evaluated for test-retest reliability. The six sub-dimensions encompassed 60.3% of the total variance. Cronbach alpha coefficients were 0.82 for the entire scale and 0.92, 0.59, 0.67, 0.77, 0.72, and 0.76 for the sub-dimensions of definition, medical treatment, drug compliance, lifestyle, diet, and complications, respectively. The scale ensured internal consistency in reliability and construct validity, as well as stability over time. Significant relationships were found between knowledge score and age, gender, educational level, and history of hypertension of the participants. No correlation was found between knowledge score and working at an income-generating job. The present scale, developed to measure the knowledge level of hypertension among Turkish adults, was found to be valid and reliable.

STUDY OF LIPOPROTEIN (A LEVELS AS A RISK FACTOR IN PATIENTS WITH ESSENTIAL HYPERTENSION IN A TERTIARY CARE HOSPITAL

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Arun S. Menon

2016-06-01

Full Text Available BACKGROUND Lipoprotein (a has been identified as an important, independent, causal risk factor for various cardiovascular diseases, but its association with hypertension has shown differing results. The studies regarding this association are limited. AIMS AND OBJECTIVES In the present study, the levels of Lp (a and other lipid parameters like Serum Total Cholesterol, Serum LDL Cholesterol, Serum HDL Cholesterol, serum triglycerides have been studied in hypertensive and non-hypertensive patients to investigate any significant relationship between the same. MATERIALS AND METHODS 30 essential hypertensive patients were selected and were compared with 30 controls matched in terms of age and sex. Lipid profile including Total cholesterol, LDL- Cholesterol, HDL- Cholesterol, Triglycerides and Lp (a were studied in both groups. RESULTS Hypertensive patients were observed to have higher levels of Serum Total Cholesterol, Serum Triglycerides, Serum LDL cholesterol, but it was not found to be significant. But lipoprotein (a was found to be significantly higher (p<0.01 in cases than in controls.

A STUDY ON HYPERTENSION AND IT’S DETERMINANTS AMONG MALE BUS DRIVERS IN STATE ROAD TRANSPORT CORPORATION, VISAKHAPATNAM, ANDHRA PRADESH

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Bhaskara Rao

2015-10-01

Full Text Available INTRODUCTION: Hypertension is an iceberg disease and it remains silent, being generally asymptomatic most of its course. It is one of the major risk factors for cardiovascular mortality, which accounts for 20 - 50% of all deaths. The nature of profession puts bus drivers at higher risk of developing hypertension. Due to lack of information regarding the prevalence of hypertension and its determinants among the RTC bus drivers in Visakhapatnam, the present study is carried out. OBJECTIVE : To measure occurrence of certain ri sk factors for hypertension among bus drivers and to study the proportion of bus drivers having hypertension METHODOLOGY: A cross sectional descriptive study was conducted among bus drivers working in APSRTC Visakhapatnam city during months of Dec . 2014 – Jan . 2 015. One of the six bus depots was randomly selected, a prior permission from the depot manager was taken and convenient sample of 100 bus drivers considered for study. Data was collected using a pre tested semi structured questionnaire to the study subject s after obtaining informed consent. All the individuals who are willing to participate were included and those not willing to participate and who were60years of age were excluded from the study. Data was analyzed by using Microsoft excel, sta tistical tests were applied where ever necessary and p value of <0.05 was considered as statistical significant. Study materials include mercury sphygmomanometer, stethoscope, measuring tape, weighing machine. RESULTS: The mean age of study population was 42.9years, majority (90% of them belongs to class II and III according to modified B. G. Prasad’s classification, prevalence of hypertension among study population was (36%, of whom 44.4% of participants were not aware of their hypertensive status. Famil y history of hypertension observed in 46% of the study population. About 59% of the study population were overweight & obese, of them 45.7% had hypertension

Resistant hypertension.

Science.gov (United States)

Wei, Fang-Fei; Zhang, Zhen-Yu; Huang, Qi-Fang; Yang, Wen-Yi; Staessen, Jan A

2018-06-15

The publication of the first non-randomised proof-of-concept trial of renal denervation as a treatment modality in treatment-resistant hypertension set the stage for a search for novel devices with the expectation that technology would reduce the burden of hypertension by reducing or eliminating the costly and lifelong use of blood pressure lowering medications. As we demonstrate in this review, this idea so attractive to manufacturers and invasive cardiologists and radiologists overlooked decades of careful pathophysiological research in a disease, which still remains enigmatic but remains the major cause of cardiovascular mortality worldwide. To make our point, we first reviewed the prevalence and risks associated with treatment-resistant hypertension. Next, we highlighted the key points required for the diagnosis of treatment-resistant hypertension, including the recording of the ambulatory blood pressure and the assessment of adherence to medication. Finally, we summarised new insights in the management of treatment-resistant hypertension by medication and devices and in the future research. Throughout our review, we focused on new evidence became available since 2013. Our conclusion is that optimising medical treatment based on simple algorithms remains the state of the art in treatment-resistant hypertension.

Recurrence of hypertensive disorders of pregnancy

DEFF Research Database (Denmark)

van Oostwaard, Miriam F; Langenveld, Josje; Schuit, Ewoud

2015-01-01

OBJECTIVE: We performed an individual participant data (IPD) metaanalysis to calculate the recurrence risk of hypertensive disorders of pregnancy (HDP) and recurrence of individual hypertensive syndromes. STUDY DESIGN: We performed an electronic literature search for cohort studies that reported ...

Is tinnitus an early voice of masked hypertension? High masked hypertension rate in patients with tinnitus.

Science.gov (United States)

Gun, Taylan; Özkan, Selçuk; Yavuz, Bunyamin

2018-04-23

Tinnitus is hearing a sound without any external acoustic stimulus. There are some clues of hypertension can cause tinnitus in different ways. The aim of the study was to evaluate the relationship between tinnitus and masked hypertension including echocardiographic parameters and severity of tinnitus. This study included 88 patients with tinnitus of at least 3 months duration and 85 age and gender-matched control subjects. Tinnitus severity index was used to classify the patients with tinnitus. After a complete medical history, all subjects underwent routine laboratory examination, office blood pressure measurement, hearing tests and ambulatory blood pressure monitoring. Masked hypertension is defined as normal office blood pressure measurement and high ambulatory blood pressure level. Baseline characteristics in patients and controls were similar. Prevalence of masked hypertension was significantly higher in patients with tinnitus than controls (18.2% vs 3.5%, p = 0.002). Office diastolic BP (76 ± 8.1 vs. 72.74 ± 8.68, p = 0.01), ambulatory 24-H diastolic BP (70.2 ± 9.6 vs. 66.9 ± 6.1, p = 0.07) and ambulatory daytime diastolic BP (73.7 ± 9.5 vs. 71.1 ± 6.2, p = 0.03) was significantly higher in patients with tinnitus than control group. Tinnitus severity index in patients without masked hypertension was 0 and tinnitus severity index in patients with masked hypertension were 2 (1-5). This study demonstrated that masked hypertension must be kept in mind if there is a complaint of tinnitus without any other obvious reason.

Hypertension control in brazilian publications

Energy Technology Data Exchange (ETDEWEB)

Pinho, Natália de Alencar; Pierin, Angela Maria Geraldo, E-mail: pierin@usp.br [Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP (Brazil)

2013-09-15

Hypertension is a major public health problem due to its high prevalence and cardiovascular complications. Its treatment is aimed at reducing cardiovascular morbidity and mortality, its goal being to maintain blood pressure levels below 140/90 mm Hg. Hypertension control in Brazil is low, and nationwide rates are unknown. The objective of this review was to provide an overview on hypertension control in Brazil from publications in a database. We identified 45 publications. In population-based studies, the highest control rate (57.6%) was reported in a multicenter study in 100 municipalities and the city of São José do Rio Preto, São Paulo state (52.4%), while the lowest rates (around 10%) were identified in microregions of the Rio Grande do Sul state and in the city of Tubarão, Santa Catarina state. In conclusion, the studies assessed showed a wide variation in hypertension control rates. It is worth noting that the comparison between studies was a major limiting factor, because of the different methods used.

Hypertension control in brazilian publications

International Nuclear Information System (INIS)

Pinho, Natália de Alencar; Pierin, Angela Maria Geraldo

2013-01-01

Hypertension is a major public health problem due to its high prevalence and cardiovascular complications. Its treatment is aimed at reducing cardiovascular morbidity and mortality, its goal being to maintain blood pressure levels below 140/90 mm Hg. Hypertension control in Brazil is low, and nationwide rates are unknown. The objective of this review was to provide an overview on hypertension control in Brazil from publications in a database. We identified 45 publications. In population-based studies, the highest control rate (57.6%) was reported in a multicenter study in 100 municipalities and the city of São José do Rio Preto, São Paulo state (52.4%), while the lowest rates (around 10%) were identified in microregions of the Rio Grande do Sul state and in the city of Tubarão, Santa Catarina state. In conclusion, the studies assessed showed a wide variation in hypertension control rates. It is worth noting that the comparison between studies was a major limiting factor, because of the different methods used

Pulmonary hypertension associated with non-cirrhotic portal hypertension in systemic lupus erythematosus.

OpenAIRE

Woolf, D.; Voigt, M. D.; Jaskiewicz, K.; Kalla, A. A.

1994-01-01

A case of non-cirrhotic portal hypertension in a patient with systemic lupus erythematosus, the first of our knowledge, is described. Severe pulmonary hypertension was associated with the portal hypertension and with markers of active auto-immunity. Pulmonary hypertension has not previously been associated with non-cirrhotic portal hypertension. The coexistence of vasculopathy of the portal and pulmonary vascular beds in this patient with active autoimmunity supports the postulate that portal...

Mean intraocular pressure in hypertensive adults

International Nuclear Information System (INIS)

Irum, S.; Malik, A.M.; Saeed, M.

2015-01-01

To determine the mean Intraocular Pressure (IOP) in already diagnosed adult hypertensive patients with different grades of hypertension. Study Design: Cross-sectional descriptive study. Place and Duration of Study: Combined Military Hospital, Lahore, from March 2012 to Aug 2012. Patients and Methods: A total of 178 already diagnosed hypertensive patients were selected. A detailed history of ocular or systemic diseases was taken. Intraocular pressure was measured with help of Goldmann applanation tonometer. Three consecutive readings of IOP of each eye were taken at 30 minutes interval and mean calculated. Blood pressure was recorded in seated position from right upper arm, by mercury sphygmomanometer. Blood pressure measurements were determined by taking the mean value of three systolic and diastolic readings. Results: The results of intraocular pressure (IOP) between various grades of hypertension were determined. There was an increase in mean IOP with rise in blood pressure. The subjects with grade I hypertension showed a mean IOP of 13.95 ± 3.74 mmHg, while grade II and grade III hypertensive subjects had mean IOPs as 18.10 ± 3.32 and 20.21 ± 2.52 mmHg respectively. Conclusion: A higher value of mean IOP was found with increase in systolic and diastolic blood pressures. (author)

Pulmonary Hypertension

Science.gov (United States)

Kim, John S.; McSweeney, Julia; Lee, Joanne; Ivy, Dunbar

2015-01-01

Objective Review the pharmacologic treatment options for pulmonary arterial hypertension (PAH) in the cardiac intensive care setting and summarize the most-recent literature supporting these therapies. Data Sources and Study Selection Literature search for prospective studies, retrospective analyses, and case reports evaluating the safety and efficacy of PAH therapies. Data Extraction Mechanisms of action and pharmacokinetics, treatment recommendations, safety considerations, and outcomes for specific medical therapies. Data Synthesis Specific targeted therapies developed for the treatment of adult patients with PAH have been applied for the benefit of children with PAH. With the exception of inhaled nitric oxide, there are no PAH medications approved for children in the US by the FDA. Unfortunately, data on treatment strategies in children with PAH are limited by the small number of randomized controlled clinical trials evaluating the safety and efficacy of specific treatments. The treatment options for PAH in children focus on endothelial-based pathways. Calcium channel blockers are recommended for use in a very small, select group of children who are responsive to vasoreactivity testing at cardiac catheterization. Phosphodiesterase type 5 inhibitor therapy is the most-commonly recommended oral treatment option in children with PAH. Prostacyclins provide adjunctive therapy for the treatment of PAH as infusions (intravenous and subcutaneous) and inhalation agents. Inhaled nitric oxide is the first line vasodilator therapy in persistent pulmonary hypertension of the newborn, and is commonly used in the treatment of PAH in the Intensive Care Unit (ICU). Endothelin receptor antagonists have been shown to improve exercise tolerance and survival in adult patients with PAH. Soluble Guanylate Cyclase Stimulators are the first drug class to be FDA approved for the treatment of chronic thromboembolic pulmonary hypertension. Conclusions Literature and data supporting the

The relationship of bone and blood lead to hypertension: Further analyses of the normative aging study data

Energy Technology Data Exchange (ETDEWEB)

Hu, H.; Kim, Rokho; Korrick, S. [Harvard Medical School, Boston, MA (United States)]|[Harvard Health of Public Health, Boston, MA (United States); Rotnitzky, A. [Harvard School of Public Health, Boston, MA (United States)] [and others

1996-12-31

In an earlier report based on participants in the Veterans Administration Normative Aging Study, we found a significant association between the risk of hypertension and lead levels in tibia. To examine the possible confounding effects of education and occupation, we considered in this study five levels of education and three levels of occupation as independent variables in the statistical model. Of 1,171 active subjects seen between August 1991 and December 1994, 563 provided complete data for this analysis. In the initial logistic regression model, acre and body mass index, family history of hypertension, and dietary sodium intake, but neither cumulative smoking nor alcohol ingestion, conferred increased odds ratios for being hypertensive that were statistically significant. When the lead biomarkers were added separately to this initial logistic model, tibia lead and patella lead levels were associated with significantly elevated odds ratios for hypertension. In the final backward elimination logistic regression model that included categorical variables for education and occupation, the only variables retained were body mass index, family history of hypertension, and tibia lead level. We conclude that education and occupation variables were not confounding the association between the lead biomarkers and hypertension that we reported previously. 27 refs., 3 tabs.

Health-related quality of life in paediatric arterial hypertension: a cross-sectional study.

Science.gov (United States)

Petek, Tadej; Hertiš, Tjaša; Marčun Varda, Nataša

2018-05-01

.34; p = .009). Pearson's r values ranged between 0.62 to 0.79 in patient and 0.56 to 0.80 in control sample (p < .001). Interestingly, hypertensive children reported lower social functioning scores than hypertensive adolescents (p < .001). This cross-sectional study gives insight into the detrimental impact of hypertension on children's and adolescents HRQoL, which may inform public health experts. Furthermore, it shows that clinicians should aim to improve patients' physical and psychosocial well-being throughout their development.

Idiopathic portal hypertension

International Nuclear Information System (INIS)

Han, Tae Kyun; Ryu, Dae Sik; Kim, Heung Chul; Hur, Hun; Eom, Kyeung Tae; Namkung, Sook; Park, Man Soo; Hwang, Woo Chul; Lee, Kwan Seop

1996-01-01

To describe the radiologic findings of idiopathic portal hypertension and to find the points of differentiation between idiopathic portal hypertension and liver cirrhosis. Four portograms in five patients who for four years had suffered from pathologically confirmed idiopathic portal hypertension were retrospectively analyzed and compared with a portogram obtained from a control subject with liver cirrhosis. Portographic finding s of idiopathic portal hypertension were paucity of medium-sized portal branches, irregular and obtuse-angled division of peripheral branches, abrupt interruption and an avascular area beneath the liver margin. A portogram of idiopathic portal hypertension may be useful in differentiation this and liver cirrhosis

Epidemic of hypertension in Ghana: a systematic review

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Bosu William K

2010-07-01

Full Text Available Abstract Background Hypertension is a major risk factor for many cardiovascular diseases in developing countries. A comprehensive review of the prevalence of hypertension provides crucial information for the evaluation and implementation of appropriate programmes. Methods The PubMed and Google Scholar databases were searched for published articles on the population-based prevalence of adult hypertension in Ghana between 1970 and August 2009, supplemented by a manual search of retrieved references. Fifteen unique population-based articles in non-pregnant humans were obtained. In addition, two relevant unpublished graduate student theses from one university department were identified after a search of its 1996-2008 theses. Results The age and sex composition of study populations, sampling strategy, measurement of blood pressure, definition of hypertension varied between studies. The prevalence of hypertension (BP ≥ 140/90 mmHg ± antihypertensive treatment ranged from 19% to 48% between studies. Sex differences were generally minimal whereas urban populations tended to have higher prevalence than rural population in studies with mixed population types. Factors independently associated with hypertension included older age group, over-nutrition and alcohol consumption. Whereas there was a trend towards improved awareness, treatment and control between 1972 and 2005, less than one-third of hypertensive subjects were aware they had hypertension and less than one-tenth had their blood pressures controlled in most studies. Conclusion Hypertension is clearly an important public health problem in Ghana, even in the poorest rural communities. Emerging opportunities such as the national health insurance scheme, a new health policy emphasising health promotion and healthier lifestyles and effective treatment should help prevent and control hypertension.

Managing hypertension: relevant biomarkers and combating bioactive compounds

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Bryan Singharaj

2017-06-01

Full Text Available Hypertension is one of the most common chronic diseases which affects many people who belong to a higher age range. The standard definition that is offered to the general public has a minimum age of 18 years to be diagnosed with hypertension. Many studies have been conducted in the hopes of finding consistent data that provides information on the biomarkers of hypertension and effective forms of treatment. However, there is a tendency for skewed data due to the ineffectiveness of diagnosing hypertension, due to variability in technique or even negligence. Interestingly, research has indicated that there are connections to certain biomarkers of hypertension. However,the results have been deemed inconclusive. Moreover, the results provide promising data for future studies that have an emphasis on biomarkers. The biomarkers that have been consistently brought to researchers’ attention include the following: circulating C-reactive protein (CRP, plasminogen activator inhibitor-1 (PAI-1, urinary albumin:creatinine ratio (UACR, and aldosterone:renin ratio (ARR. These four biomarkers have become the foundation of multiple hypertension studies, even though the only formal conclusion drawn from these studies is that there is a wide range of variables that have some kind of influence on hypertension. More recently, treatment options for hypertension have increasingly become an emphasis for studies, with research predicting that nutrition plays a key role in the managing of diseases. Furthermore, the role of bioactive compounds has gained traction in hypertension research, being loosely correlated to managing specific biomarkers. Ultimately, these correlations to bioactive compounds like antioxidants would demonstrate that certain functional foods have the capacity to help treat hypertension. The modality is to find an alternative option for managing or treating hypertension through natural sources of food or food products fortified with ingredients to

Development and Pilot Study of Group-Based Dietary Self-Management Program for Community Dwellers with Hypertension

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Arfiza Ridwan

2012-08-01

Full Text Available Background: In most countries worldwide, hypertension is considered as an important problem. Moreover, an increasing trend in the prevalence and incidence has been reported in most countries. This increasing trend requires an innovative approach to improve the lifestyle modification of hypertensive sufferers including their dietary behaviors. Objective: This developmental research aims to develop a program for improving the dietary behaviors of community dwellers with hypertension. Method: The process of this program development includes a literature review related to the self-management programs for hypertension, and dietary behavior outcomes, expert validation, and pilot testing. Result: The setting, strategies, duration, and outcome measurement from the literature review were taken into consideration to develop the new program. The newly developed group-based self-management program consists of: 1 the sharing and reflecting of individual current dietary behavior, 2 group educational session, 3 individual comparison of behavior and reflection of obstacles, 4 individual goal setting, and 5 follow up. In the educational session, the DASH eating plan is used as the reference as it is commonly used in studies about diet for hypertension. Key words: hypertension, self-management, group based program, dietary behaviors.

Cardiovascular morbidity of severe resistant hypertension among treated uncontrolled hypertensives: a 4-year follow-up study.

Science.gov (United States)

Kasiakogias, Alexandros; Tsioufis, Costas; Dimitriadis, Kyriakos; Konstantinidis, Dimitrios; Koumelli, Areti; Leontsinis, Ioannis; Andrikou, Eirini; Vogiatzakis, Nikos; Marinaki, Smaragdi; Petras, Dimitrios; Fragoulis, Christos; Konstantinou, Konstantinos; Papademetriou, Vasilios; Tousoulis, Dimitrios

2018-05-01

Data regarding the prognosis of resistant hypertension (RHTN) with respect to its severity is limited. We investigated the cardiovascular risk of severe RHTN in a prospective observational study. A cohort of 1700 hypertensive patient with treated uncontrolled HTN was followed for a mean period of 3.6 ± 1.8 years. At baseline, standard clinical and laboratory workup was performed, including testing for secondary causes of RHT where applicable. Three groups were identified depending on presence of RHTN (office-based uncontrolled HTN under at least three drugs including a diuretic) and levels of office systolic blood pressure (BP): 1187 patients (70%) without RHTN, 313 (18%) with not-severe RHTN (systolic BP < 160 mmHg) and 200 (12%) with severe RHTN (systolic BP ≥ 160 mmHg). Endpoint of interest was cardiovascular morbidity set as the composite of coronary heart disease and stroke. During follow-up, incidence rates of cardiovascular events per 1000 person-years were 7.1 cases in the non-RHTN group, 12.4 cases in the not-severe RHTN group and 18 cases in the severe RHTN group. Unadjusted analysis showed that compared to uncontrolled patients without RHTN, patients with not-severe RHTN exhibited a similar risk but patients with severe RHTN had a significantly higher risk, by 2.5 times (CI: 1.28-4.73, p = 0.007). Even after multivariate adjustment for established risk factors including BP levels and isolated systolic HTN, severe RHTN remained as an independent predictor of the cardiovascular outcome (OR: 2.30, CI: 1.00-5.29, p = 0.05). In conclusion, among treated yet uncontrolled hypertensive patients, severe RHTN exhibits a significantly higher cardiovascular risk indicating the need for prompt management.

Malignant hypertension and hypertensive encephalopathy in primary aldosteronism caused by adrenal adenoma

Directory of Open Access Journals (Sweden)

Bortolotto Luiz Aparecido

2003-01-01

Full Text Available Two cases are reported as follows: 1 1 female patient with accelerated-malignant hypertension secondary to an aldosterone-producing adrenal adenoma; and 2 1 female patient with adrenal adenoma, severe hypertension, and hypertensive encephalopathy. This association is a rare clinical finding, and malignant hypertension may modify the hormonal characteristic of primary aldosteronism, making its diagnosis more difficult. The diagnosis of primary aldosteronism should be considered in patients with malignant hypertension or hypertensive encephalopathy if persistent hypokalemia occurs. Identification of primary aldosteronism is of paramount importance for the patient's evolution, because the surgical treatment makes the prognosis more favorable.

Effects of psychological stress on hypertension in middle-aged Chinese: a cross-sectional study.

Directory of Open Access Journals (Sweden)

Bo Hu

Full Text Available We examined the effect and relative contributions of different types of stress on the risk of hypertension. Using cluster sampling, 5,976 community-dwelling individuals aged 40-60 were selected. Hypertension was defined according to the Seventh Report of the Joint National Committee, and general psychological stress was defined as experiencing stress at work or home. Information on known risk factors of hypertension (e.g., physical activity levels, food intake, smoking behavior was collected from participants. Logistic regression analysis was used to determine the associations between psychological stress and hypertension, calculating population-attributable risks and 95% confidence intervals (CIs. General stress was significantly related to hypertension (odds ratio [OR] = 1.247, 95% CI [1.076, 1.446]. Additionally, after adjustment for all other risk factors, women showed a greater risk of hypertension if they had either stress at work or at home: OR = 1.285, 95% CI (1.027, 1.609 and OR = 1.231, 95% CI (1.001, 1.514, respectively. However, this increased risk for hypertension by stress was not found in men. General stress contributed approximately 9.1% (95% CI [3.1, 15.0] to the risk for hypertension. Thus, psychological stress was associated with an increased risk for hypertension, although this increased risk was not consistent across gender.

Alterations of the Gut Microbiome in Hypertension

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Qiulong Yan

2017-08-01

Full Text Available Introduction: Human gut microbiota is believed to be directly or indirectly involved in cardiovascular diseases and hypertension. However, the identification and functional status of the hypertension-related gut microbe(s have not yet been surveyed in a comprehensive manner.Methods: Here we characterized the gut microbiome in hypertension status by comparing fecal samples of 60 patients with primary hypertension and 60 gender-, age-, and body weight-matched healthy controls based on whole-metagenome shotgun sequencing.Results: Hypertension implicated a remarkable gut dysbiosis with significant reduction in within-sample diversity and shift in microbial composition. Metagenome-wide association study (MGWAS revealed 53,953 microbial genes that differ in distribution between the patients and healthy controls (false discovery rate, 0.05 and can be grouped into 68 clusters representing bacterial species. Opportunistic pathogenic taxa, such as, Klebsiella spp., Streptococcus spp., and Parabacteroides merdae were frequently distributed in hypertensive gut microbiome, whereas the short-chain fatty acid producer, such as, Roseburia spp. and Faecalibacterium prausnitzii, were higher in controls. The number of hypertension-associated species also showed stronger correlation to the severity of disease. Functionally, the hypertensive gut microbiome exhibited higher membrane transport, lipopolysaccharide biosynthesis and steroid degradation, while in controls the metabolism of amino acid, cofactors and vitamins was found to be higher. We further provided the microbial markers for disease discrimination and achieved an area under the receiver operator characteristic curve (AUC of 0.78, demonstrating the potential of gut microbiota in prediction of hypertension.Conclusion: These findings represent specific alterations in microbial diversity, genes, species and functions of the hypertensive gut microbiome. Further studies on the causality relationship between

Erectile Dysfunction in 101 Consecutive Hypertensive Patients and ...

African Journals Online (AJOL)

In a 6 month prospective questionnaire study of 101 consecutive newly referred hypertensive patients and 86 normotensive volunteers, the relationship of erectile dysfunction and hypertension in these patients was studied using a modified international index of erectile function (IIEF). The mean age of the hypertensive ...

Hypertension prevalence, awareness, treatment and its correlates among people 35 years and older: Result from pilot phase of the Azar cohort study.

Science.gov (United States)

Ghorbani, Zohreh; Shamshirgaran, Seyed Morteza; Ghaffari, Samad; Sarbakhsh, Parvin; Najafipour, Farzad; Aminisani, Nayyereh

2018-01-01

There is remarkable alteration in hypertension prevalence and awareness, and their correlates among various geographic locations and ethnic groups. The aim of this study was to report hypertension prevalence, awareness, and its correlates as well as hypertension treatment, and control among Azari people aged 35 years and older. The pilot phase of the Azar Cohort Study; a state level of a nationwide PERSIAN cohort study was conducted in Khameneh city between October 2014 and January 2015. All people 35 years of age and above were invited to take part in this study. A comprehensive range of different biomarkers, lifestyle, socioeconomic factors, and health-related factors was collected. Blood pressure was measured by a trained nurse/midwife. Descriptive statistical methods were used to present general characteristics of the study population as frequency tables. Separate multiple logistic regression models were built to assess the predictors of hypertension prevalence. A total of 1038 people were included in this study. The overall prevalence of hypertension was 22.9%. Awareness of hypertension was 60.5% and in those with known hypertension, 84% were using the antihypertensive medications, of those 68.5% had controlled hypertension. After adjustment; age (odds ratios [OR] adj = 1.12 95% confidence interval [CI]: 1.09-1.15), gender (OR adj = 1.65 95% CI: 1.08-2.51), obesity OR adj = 2.51 (1.40-4.88), waist-to-hip ratio (WHR) (OR adj = 1.70 (1.05-2.75), and comorbidities (OR adj = 2.51 (1.72-3.66) were independent predictors of hypertension. Age, sex, body mass index, WHR, and comorbidities were known as predictors of hypertension in this study, health promotion strategies including lifestyle modification to reduce overweight/obesity and secondary prevention programs for early detection of hypertension in high-risk groups according to age, gender, and disease profile are recommended.

Socioeconomic inequality in hypertension in Iran.

Science.gov (United States)

Fateh, Mansooreh; Emamian, Mohammad Hassan; Asgari, Fereshteh; Alami, Ali; Fotouhi, Akbar

2014-09-01

Hypertension covers a large portion of burden of diseases, especially in the developing countries. The unequal distribution of hypertension in the population may affect 'health for all' goal. This study aimed to investigate the socioeconomic inequality of hypertension in Iran and to identify its influencing factors. We used data from Iran's surveillance system for risk factors of noncommunicable diseases which was conducted on 89 400 individuals aged 15-64 years in 2005. To determine the socioeconomic status of participants, a new variable was created using a principal component analysis. We examined hypertension at different levels of this new variable and calculated slop index of inequality (SII) and concentration index (C) for hypertension. We then applied Oaxaca-Blinder decomposition analysis to determine the causes of inequality. The SII and C for hypertension were -32.3 and -0.170, respectively. The concentration indices varied widely between different provinces in Iran and was lower (more unequal) in women than in men. There was significant socioeconomic inequality in hypertension. The results of decomposition indicated that 40.5% of the low-socioeconomic group (n = 18190) and 16.4% of the high-socioeconomic group (n = 16335) had hypertension. Age, education level, sex and residency location were the main associated factors of the difference among groups. According to our results, there was an inequality in hypertension in Iran, so that individuals with low socioeconomic status had a higher prevalence of hypertension. Age was the most contributed factor in this inequality and women in low-socioeconomic group were the most vulnerable people for hypertension.

Fruit and vegetables consumption and incident hypertension: dose-response meta-analysis of prospective cohort studies.

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Wu, L; Sun, D; He, Y

2016-10-01

The role of dietary factors on chronic diseases seems essential in the potentially adverse or preventive effects. However, no evidence of dose-response meta-analysis of prospective cohort studies has verified the association between the intake of fruit and/or vegetables and the risk of developing hypertension. The PubMed and Embase were searched for prospective cohort studies. A generic inverse-variance method with random effects model was used to calculate the pooled relative risks (RRs) and 95% confidence intervals (CIs). Generalized least squares trend estimation model was used to calculate the study-specific slopes for the dose-response analyses. Seven articles comprised nine cohorts involving 185 676 participants were assessed. The highest intake of fruit or vegetables separately, and total fruit and vegetables were inversely associated with the incident risk of hypertension compared with the lowest level, and the pooled RRs and 95% CIs were 0.87 (0.79, 0.95), 0.88 (0.79, 0.99) and 0.90 (0.84, 0.98), respectively. We also found an inverse dose-response relation between the risk of developing hypertension and fruit intake, and total fruit and vegetables consumption. The incident risk of hypertension was decreased by 1.9% for each serving per day of fruit consumption, and decreased by 1.2% for each serving per day of total fruit and vegetables consumption. Our results support the recommendation to increase the consumption of fruit and vegetables with respect to preventing the risk of developing hypertension. However, further large prospective studies and long-term high-quality randomized controlled trials are still needed to confirm the observed association.

Late life socioeconomic status and hypertension in an aging cohort: the Atherosclerosis Risk in Communities Study.

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McDoom, M Maya; Palta, Priya; Vart, Priya; Juraschek, Stephen P; Kucharska-Newton, Anna; Diez Roux, Ana V; Coresh, Josef

2018-06-01

To investigate the association between individual and area-level socioeconomic status and hypertension risk among individuals later in life. We used Cox proportional hazards models to examine the association of socioeconomic status with incident hypertension using race-specific neighborhood socioeconomic status, median household income, and education among 3372 participants (mean age, 61 years) from the Atherosclerosis Risk in Communities Study at Visit 4 (1996-1998). Incident hypertension was defined as self-reported diagnosis or reported use of antihypertensive medications. Over a median follow-up time of 9.4 years, there were 1874 new cases of hypertension (62.1 per 1000 person-years). Overall, being in high as compared with low socioeconomic status categories was associated with a lower risk of developing hypertension in late life, with hazard ratios (95% confidence intervals) of 0.87 (0.77-0.98) for high neighborhood socioeconomic status tertile, 0.79 (0.69-0.90) for high individual income, and 0.75 (0.63-0.89) for college education after adjustment for traditional risk factors. These findings were consistent and robust whenever accounting for competing risks of all-cause mortality. No significant interactions by race and age (dichotomized at age 65) were observed. Among participants free of hypertension in midlife, high neighborhood and individual socioeconomic status are associated with a decreased risk of incident hypertension. Our findings support population-level interventions, such as blood pressure screening at senior centers and faith-based organizations, that are tailored to shift the distribution of blood pressure and reduce hypertension health inequalities among older adults.

The OXIMAPA Study: Hypertension Control by ABPM and Association with Sleep Apnea Syndrome by Pulse Oximetry.

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Maricoto, Tiago; Silva, Eurico Alves Rodrigues; Damião, Pedro; Bastos, José Mesquita

2017-02-27

Ambulatory blood pressure monitoring by automatic device is the best blood pressure evaluation method and sleep apnea syndrome is the leading cause of poor control. Oximetry allows screening these individuals but its usefulness has been poorly explored in Primary Health Care. The aim was to evaluate the blood pressure control at the office and with ambulatory blood pressure monitoring by automatic device and to relate it to sleep apnea syndrome. We selected a sample of 50 participants, representative of 3036 hypertensive patients. The variables were: blood pressure value at the office and blood pressure with ambulatory blood pressure monitoring by automatic device; presence of criteria of sleep apnea syndrome in oximetry. The prevalence of uncontrolled blood pressure was 56% on office evaluation and 68% on ambulatory blood pressure monitoring by automatic device. It was found: 36% of daytime hypertension, 52% nocturnal hypertension, 40% non-dipper profile, 16% of white coat hypertension and 28% masked hypertension. The prevalence of sleep apnea syndrome was 16%. Blood pressure in ambulatory blood pressure monitoring by automatic device and blood pressure in office showed no statistically significant association (p = 0.761). We found a statistically significant association between sleep apnea syndrome and daytime hypertension (p = 0.019) and non-dipper profile (p = 0.005). Ambulatory blood pressure monitoring by automatic device detected more 12% of uncontrolled hypertension than office blood pressure. Sleep apnea syndrome is strongly associated with uncontrolled hypertension and oximetry may be a good screening method, but should be studied further.

Resistant Hypertension and Cardiorenovascular Risk

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Prkacin Ingrid

2017-06-01

Full Text Available Studies have documented independent contribution of sympathetic activation to the cardiovascular disease continuum. Hypertension is one of the leading modifiable factors. Most if not all the benefit of antihypertensive treatment depends on blood pressure lowering, regardless how it is obtained. Resistant hypertension is defined as blood pressure that remains uncontrolled in spite of the concurrent use of three antihypertensive drugs of different classes. Ideally, one of the three drugs should be a diuretic, and all drugs should be prescribed at optimal dose amounts. Poor adherence to antihypertensive therapy, undiscovered secondary causes (e.g. obstructive sleep apnea, primary aldosteronism, renal artery stenosis, and lifestyle factors (e.g. obesity, excessive sodium intake, heavy alcohol intake, various drug interactions are the most common causes of resistant hypertension. Cardio(renovascular morbidity and mortality are significantly higher in resistant hypertensive than in general hypertensive population, as such patients are typically presented with a long-standing history of poorly controlled hypertension. Early diagnosis and treatment is needed to avoid further end-organ damage to prevent cardiorenovascular remodeling. Treatment strategy includes lifestyle changes, adding a mineralocorticoid receptor antagonist, treatment adherence in cardiovascular prevention and, in case of failure to control blood pressure, renal sympathetic denervation or baroreceptor activation therapy. The comparative outcomes in resistant hypertension deserve better understanding. In this review, the most current approaches to resistant hypertension and cardiovascular risk based on the available literature evidence will be discussed.

[Hypertension in women].

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Tagle, Rodrigo; Tagle V, Rodrigo; Acevedo, Mónica; Valdés, Gloria

2013-02-01

The present review examines the types of hypertension that women may suffer throughout life, their physiopathological characteristics and management. In early life, the currently used low-dose oral contraceptives seldom cause hypertension. Pregnancy provokes preeclampsia, its main medical complication, secondary to inadequate transformation of the spiral arteries and the subsequent multisystem endothelial damage caused by deportation of placental factors and microparticles. Hypertension in preeclampsia is an epiphenomenon which needs to be controlled at levels that reduce maternal risk without impairing placental perfusion. The hemodynamic changes of pregnancy may unmask a hypertensive phenotype, may exacerbate a chronic hypertension, or may complicate hypertension secondary to lupus, renovascular lesions, and pheochromocytoma. On the other hand a primary aldosteronism may benefit from the effect of progesterone and present as a postpartum hypertension. A hypertensive pregnancy, especially preeclampsia, represents a risk for cardiac, vascular and renal disease in later life. Menopause may mimic a pheochromocytoma, and is associated to endothelial dysfunction and salt-sensitivity. Among women, non-pharmacological treatment should be forcefully advocated, except for sodium restriction during pregnancy. The blockade of the renin-angiotensin system should be avoided in women at risk of pregnancy; betablockers could be used with precautions during pregnancy; diuretics, ACE inhibitors and angiotensin receptor antagonists should not be used during breast feeding. Collateral effects of antihypertensives, such as hyponatremia, cough and edema are more common in women. Thus, hypertension in women should be managed according to the different life stages.

Hormones and Hypertension

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... role in the start and continuation of primary hypertension. Secondary hypertension is due to other diseases such as kidney ... the body can greatly improve or even cure secondary hypertension. Resources • Find-an-Endocrinologist: www.hormone.org or ...

Prenatal Exposure to the Pesticide DDT and Hypertension Diagnosed in Women before Age 50: A Longitudinal Birth Cohort Study

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Cirillo, Piera M.; Terry, Mary Beth; Krigbaum, Nickilou Y.; Flom, Julie D.; Cohn, Barbara A.

2013-01-01

Background: Elevated levels of the pesticide DDT (dichlorodiphenyltrichloroethane) have been positively associated with blood pressure and hypertension in studies among adults. Accumulating epidemiologic and toxicologic evidence suggests that hypertension during adulthood may also be affected by earlier life and possibly the prenatal environment. Objectives: We assessed whether prenatal exposure to the pesticide DDT increases risk of adult hypertension. Methods: We examined concentrations of DDT (p,p´- and o,p´-) and its metabolite p,p´-DDE (dichlorodiphenyldichloroethylene) in prenatal serum samples from a subset of women (n = 527) who had participated in the prospective Child Health and Development Studies birth cohort in the San Francisco Bay area while they were pregnant between 1959 and 1967. We surveyed daughters 39–47 years of age by telephone interview from 2005 to 2008 to obtain information on self-reported physician-diagnosed hypertension and use of hypertensive medication. We used multivariable regression analysis of time to hypertension based on the Cox proportional hazards model to estimate relative rates for the association between prenatal DDT exposures and hypertension treated with medication in adulthood, with adjustment for potential confounding by maternal, early-life, and adult exposures. Results: Prenatal p,p´-DDT exposure was associated with hypertension [adjusted hazard ratio (aHR) = 3.6; 95% CI: 1.8, 7.2 and aHR = 2.5; 95% CI: 1.2, 5.3 for middle and high tertiles of p,p´-DDT relative to the lowest tertile, respectively]. These associations between p,p´-DDT and hypertension were robust to adjustment for independent hypertension risk factors as well as sensitivity analyses. Conclusions: These findings suggest that the association between DDT exposure and hypertension may have its origins early in development. PMID:23591545

[Secondary Arterial Hypertension: Uncertainties in Diagnosis].

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Dinis, Paulo Gomes; Cachulo, Maria Carmo; Fernandes, Andreia; Paiva, Luis; Gonçalves, Lino

2017-06-30

Arterial hypertension is regarded today as a global public health problem, and the prevalence rate in Portugal is 26.9%. According to the etiology, is classified into primary or secondary arterial hypertension. In about 90% of cases it is not possible to establish a cause, so is called primary arterial hypertension. In the remaining 5 to 10%, it can be identified secondary causes, which are potentially treatable. For secondary arterial hypertension study to be cost-effective, it is essential to understand which patients investigate, and evaluate the best strategy to adopt. The main causes identified as responsible for secondary arterial hypertension are: kidney disease; endocrine and vascular diseases and obstructive sleep apnea. Among these some are consensual, and others more controversial in the literature. In this regard we present two cases of arterial hypertension, which are potentially secondary in etiology, but still focus of debate.

Prevalence, awareness, treatment, and control rate of hypertension in HIV-infected patients: the HIV-HY study.

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De Socio, Giuseppe Vittorio; Ricci, Elena; Maggi, Paolo; Parruti, Giustino; Pucci, Giacomo; Di Biagio, Antonio; Calza, Leonardo; Orofino, Giancarlo; Carenzi, Laura; Cecchini, Enisia; Madeddu, Giordano; Quirino, Tiziana; Schillaci, Giuseppe

2014-02-01

We aimed to assess the prevalence of hypertension in an unselected human immunodeficiency virus (HIV)-infected population and to identify factors associated with hypertension prevalence, treatment, and control. We used a multicenter, cross-sectional, nationwide study that sampled 1,182 unselected, consecutive, HIV-infected patients. Office blood pressure was accurately measured with standard procedures. Patients were 71% men and 92% white, with a median age of 47 years (range = 18-78); 6% were antiretroviral treatment naive. The overall prevalence of hypertension was 29.3%; high-normal pressure accounted for an additional 12.3%. Among hypertensive subjects, 64.9% were aware of their hypertensive condition, 52.9% were treated, and 33.0% were controlled (blood pressure < 140/90 mm Hg). Blood pressure-lowering medications were used in monotherapy in 54.3% of the subjects. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers were the most frequently used drugs (76.1%: monotherapy = 39.1%, combination treatment = 37.0%). In multivariable regression models, hypertension was independently predicted by traditional risk factors, including age ≥50 years, male sex, family history of cardiovascular disease, body mass index ≥25 kg/m2, previous cardiovascular events, diabetes, central obesity, and metabolic syndrome, as well as by duration of HIV infection, duration of antiretroviral therapy, and nadir CD4+ T-cell count <200/μl. The choice of protease inhibitors vs. nonnucleoside reverse transcriptase inhibitors as a third antiretroviral drug was irrelevant. Hypertension affects nearly 30% of HIV adult outpatients in Italy. More than one-third of the hypertensive subjects are unaware of their condition, and more than two-thirds are uncontrolled. A higher level of attention to the diagnosis and treatment of hypertension is mandatory in this setting.

Dairy consumption, systolic blood pressure, and risk of hypertension: Mendelian randomization study

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This study examined whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal. A Mendelian randomization study was employed, using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental var...

Management of diabetic hypertensives

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Ganesh, Jai; Viswanathan, Vijay

2011-01-01

Hypertension occurs twice as commonly in diabetics than in comparable nondiabetics. Patients with both disorders have a markedly higher risk for premature microvascular and macrovascular complications. Aggressive control of blood pressure (BP) reduces both micro- and macrovascular complications. In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs) are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs) if patients are intolerant of them. Recent studies suggest ARBs to be on par with ACEI in reducing both macro- and microvascular risks. Adding both these agents may have a beneficial effect on proteinuria, but no extra macrovascular risk reduction. Thiazides can also be used as first line drugs, but are better used along with ACEI/ARBs. Beta-blockers [especially if the patient has coronary artery disease] and calcium channel blockers are used as second line add-on drugs. Multidrug regimens are commonly needed in diabetic hypertensives. Achieving the target BP of <130/80 is the priority rather than the drug combination used in order to arrest and prevent the progression of macro- and microvascular complications in diabetic hypertensives. PMID:22145142

Clinical Observation on Hypertension in Diabetes Mellitus(Hypertension : Pathophysiology and Treatment)

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奈良, 芳則; 尾崎, 信紘; 山田, 彬; 浜, 斉; 谷, 長行; Nara, Yoshinori; Ozaki, Nobuhiro; Yamada, Akira; Hama, Hitoshi; Tani, Nagayuki

1989-01-01

The incidence of hypertension is approximately twice as common in patients with diabetes mellitus as it is in those without. Both hypertension and diabetes mellitus are major risk factors for arteriosclerotic diseases (cerebral infarction, cardiovascular disease etw). A positive correlation exists between the presence of hypertension and retinopathy or nephropathy in patients with diabetes mellitus. This article provides practical approach in the management of hypertension with diabetes melli...

Genome-wide association study of blood pressure extremes identifies variant near UMOD associated with hypertension.

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Sandosh Padmanabhan

2010-10-01

Full Text Available Hypertension is a heritable and major contributor to the global burden of disease. The sum of rare and common genetic variants robustly identified so far explain only 1%-2% of the population variation in BP and hypertension. This suggests the existence of more undiscovered common variants. We conducted a genome-wide association study in 1,621 hypertensive cases and 1,699 controls and follow-up validation analyses in 19,845 cases and 16,541 controls using an extreme case-control design. We identified a locus on chromosome 16 in the 5' region of Uromodulin (UMOD; rs13333226, combined P value of 3.6 × 10⁻¹¹. The minor G allele is associated with a lower risk of hypertension (OR [95%CI]: 0.87 [0.84-0.91], reduced urinary uromodulin excretion, better renal function; and each copy of the G allele is associated with a 7.7% reduction in risk of CVD events after adjusting for age, sex, BMI, and smoking status (H.R. = 0.923, 95% CI 0.860-0.991; p = 0.027. In a subset of 13,446 individuals with estimated glomerular filtration rate (eGFR measurements, we show that rs13333226 is independently associated with hypertension (unadjusted for eGFR: 0.89 [0.83-0.96], p = 0.004; after eGFR adjustment: 0.89 [0.83-0.96], p = 0.003. In clinical functional studies, we also consistently show the minor G allele is associated with lower urinary uromodulin excretion. The exclusive expression of uromodulin in the thick portion of the ascending limb of Henle suggests a putative role of this variant in hypertension through an effect on sodium homeostasis. The newly discovered UMOD locus for hypertension has the potential to give new insights into the role of uromodulin in BP regulation and to identify novel drugable targets for reducing cardiovascular risk.

Prevalence and control of hypertension among a Community of Elderly Population in Changning District of shanghai: a cross-sectional study.

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Yang, Zhi-Qi; Zhao, Qi; Jiang, Ping; Zheng, Song-Bai; Xu, Biao

2017-12-28

Hypertension is considered a major public health challenge. It is the most important risk factor for cardiovascular disease and is a prominent risk for China's elderly population. However, few studies have addressed the effect of blood pressure control on elderly hypertension patients in China. In response, this study aimed to investigate the prevalence and control of hypertension in the elderly population in Shanghai's communities. A secondary data analysis based on a government-financed health check-up program for an elderly population aged 65 and older from 2012 to 2014 was conducted in a central district of Shanghai. Of the 44,978 study participants, 20,305 (45.1%) were males and 24,673 (54.9%) were females. The participants' median age was 72. Half of the participants were overweight or obese (BMI ≥ 24.0 kg/m 2 ). The prevalence of hypertension was 59.9%. In the 18,032 participants without prior diagnosis of hypertension, 5530 (30.7%) had increased blood pressure. Among the 26,946 confirmed hypertension patients, the proportions of treatment and blood pressure control were 32.8% and 43.4% respectively. Multivariate analysis showed that the uncontrolled hypertension was significantly associated with older age, being overweight or obese, a lower level of education, an unbalanced dietary pattern, regular drinking and non-comorbidities. The prevalence of hypertension was high in China's elderly population. The proportion of individuals who received treatment remained low, and blood pressure control was poor among hypertension patients. These results indicate that improvement of the ability to manage and control hypertension among urban elderly residents is urgently needed.

The prevalence of resistant arterial hypertension and secondary causes in a cohort of hypertensive patients: a single center experience

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Luigi Petramala

2017-11-01

Full Text Available The prevalence of resistant hypertension (RHT still remains unknown. Aim of the study was to investigate in a large cohort of hypertensive patients the prevalence of RHT, and to identify in these patients the secondary forms of arterial hypertension (SH. We enrolled a series of 3685 consecutive hypertensive patients. All patients underwent complete physical examination, laboratory tests, screening for SH. Ambulatory blood pressure monitoring (ABPM was performed to exclude white-coat hypertension. Further, we investigated for any obstructive sleep apnea syndrome (OSA. Only 232 (5.8% hypertensive patients fulfilled criteria for RHT. 91 (39% had a SH; 56 (61% hypertensive patients had a primary aldosteronism, 22 (24% had OSA, 7 (7.7% had a hypercortisolism, and 5 (5.5% had a renovascular hypertension (RVH. Only one patient had adrenal pheochromocytoma. An accurate definition and investigation into RHT is needed. We recommend ABPM to all patients at diagnosis. Finally, all patients must be screened for SH, such as adrenal hypertension, OSA and RVH, especially those who are apparently resistant to polypharmacological treatment.

Genetik og hypertension

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Ellervik, Christina; Tarnow, Lisa; Pedersen, Erling Bjerregaard

2009-01-01

Monogenic forms of hypertension are very rare, but have a well-characterized heredity. Primary hypertension is very common with a complex and polygenic heredity. Primary hypertension arises due to an interaction between multiple genetic and environmental factors. Its heredity is unknown, although...

Increased dementia risk predominantly in diabetes mellitus rather than in hypertension or hyperlipidemia: a population-based cohort study.

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Fan, Yen-Chun; Hsu, Jung-Lung; Tung, Hong-Yi; Chou, Chia-Chi; Bai, Chyi-Huey

2017-02-06

The pathophysiology of insulin resistance-induced hypertension and hyperlipidemia might entail differences in dementia risk in cases with hypertension and hyperlipidemia without prior diabetes mellitus (DM). This study investigated whether incident hypertension, incident hyperlipidemia, or both, increased the dementia risk in patients with and without DM. A nationwide retrospective cohort study was conducted. The study sample was obtained from the National Health Insurance Research Database. We enrolled 10,316 patients with a new diagnosis of DM between 2000 and 2002 in the DM cohort. For the same period, we randomly selected 41,264 patients without DM in the non-DM cohort (matched by age and sex at a 1:4 ratio with the DM cohort). Both cohorts were then separately divided into four groups on the basis of incident hypertension or incident hyperlipidemia status. In total, 51,580 patients aged between 20 and 99 years were enrolled. The dementia risk was higher in the DM cohort than in the non-DM cohort (adjusted hazard ratio (HR) = 1.47, 95% confidence interval (CI) = 1.30-1.67, p hypertension and hyperlipidemia did not significantly increase compared with that in those without hypertension and hyperlipidemia (p = 0.529). Similar results were observed in those with either hypertension (p = 0.341) or hyperlipidemia (p = 0.189). In the non-DM cohort, patients with both hypertension and hyperlipidemia had a higher dementia risk (adjusted HR = 1.33, 95% CI = 1.09-1.63, p = 0.006). The results remained largely unchanged in patients with only hypertension (adjusted HR = 1.22, 95% CI = 1.05-1.40, p = 0.008). However, the dementia risk did not increase significantly in patients with only hyperlipidemia (p = 0.187). The development of hypertension, hyperlipidemia, or both, following a diagnosis of incident diabetes is secondary to diabetes onset and likely mediated through insulin resistance associated with diabetes, which

Healthful Dietary Patterns and the Risk of Hypertension Among Women With a History of Gestational Diabetes Mellitus: A Prospective Cohort Study.

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Li, Shanshan; Zhu, Yeyi; Chavarro, Jorge E; Bao, Wei; Tobias, Deirdre K; Ley, Sylvia H; Forman, John P; Liu, Aiyi; Mills, James; Bowers, Katherine; Strøm, Marin; Hansen, Susanne; Hu, Frank B; Zhang, Cuilin

2016-06-01

Women who developed gestational diabetes mellitus represent a high-risk population for hypertension later in life. The role of diet in the progression of hypertension among this susceptible population is unknown. We conducted a prospective cohort study of 3818 women with a history of gestational diabetes mellitus in the Nurses' Health Study II as part of the ongoing Diabetes & Women's Health Study. These women were followed-up from 1989 to 2011. Incident hypertension was identified through self-administered questionnaires that were validated previously by medical record review. Adherence scores for the alternative Healthy Eating Index 2010, the alternative Mediterranean diet, and the Dietary Approaches to Stop Hypertension were computed for each participant. Cox proportional hazard models were used to evaluate the associations between dietary scores and hypertension while adjusting for major risk factors for hypertension. We documented 1069 incident hypertension cases during a median of 18.5 years of follow-up. After adjustment for major risk factors for hypertension, including body mass index, alternative Healthy Eating Index 2010, alternative Mediterranean diet, and Dietary Approaches to Stop Hypertension scores were significantly inversely associated with the risk of hypertension; hazard ratio and 95% confidence interval comparing the extreme quartiles (highest versus lowest) were 0.76 (0.61-0.94; P for linear trend =0.03) for AHEI score, 0.72 (0.58-0.90; P for trend =0.01) for Dietary Approach to Stop Hypertension score, and 0.70 (0.56-0.88; P for trend =0.002) for alternative Mediterranean diet score. Adherence to a healthful dietary pattern was related to a lower subsequent risk of developing hypertension among women with a history of gestational diabetes mellitus. © 2016 American Heart Association, Inc.

Vascular Smooth Muscle Cells From Hypertensive Patient-Derived Induced Pluripotent Stem Cells to Advance Hypertension Pharmacogenomics.

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Biel, Nikolett M; Santostefano, Katherine E; DiVita, Bayli B; El Rouby, Nihal; Carrasquilla, Santiago D; Simmons, Chelsey; Nakanishi, Mahito; Cooper-DeHoff, Rhonda M; Johnson, Julie A; Terada, Naohiro

2015-12-01

Studies in hypertension (HTN) pharmacogenomics seek to identify genetic sources of variable antihypertensive drug response. Genetic association studies have detected single-nucleotide polymorphisms (SNPs) that link to drug responses; however, to understand mechanisms underlying how genetic traits alter drug responses, a biological interface is needed. Patient-derived induced pluripotent stem cells (iPSCs) provide a potential source for studying otherwise inaccessible tissues that may be important to antihypertensive drug response. The present study established multiple iPSC lines from an HTN pharmacogenomics cohort. We demonstrated that established HTN iPSCs can robustly and reproducibly differentiate into functional vascular smooth muscle cells (VSMCs), a cell type most relevant to vasculature tone control. Moreover, a sensitive traction force microscopy assay demonstrated that iPSC-derived VSMCs show a quantitative contractile response on physiological stimulus of endothelin-1. Furthermore, the inflammatory chemokine tumor necrosis factor α induced a typical VSMC response in iPSC-derived VSMCs. These studies pave the way for a large research initiative to decode biological significance of identified SNPs in hypertension pharmacogenomics. Treatment of hypertension remains suboptimal, and a pharmacogenomics approach seeks to identify genetic biomarkers that could be used to guide treatment decisions; however, it is important to understand the biological underpinnings of genetic associations. Mouse models do not accurately recapitulate individual patient responses based on their genetics, and hypertension-relevant cells are difficult to obtain from patients. Induced pluripotent stem cell (iPSC) technology provides a great interface to bring patient cells with their genomic data into the laboratory and to study hypertensive responses. As an initial step, the present study established an iPSC bank from patients with primary hypertension and demonstrated an effective

Increased mean aliphatic lipid chain length in left ventricular hypertrophy secondary to arterial hypertension: A cross-sectional study.

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Evaristi, Maria Francesca; Caubère, Céline; Harmancey, Romain; Desmoulin, Franck; Peacock, William Frank; Berry, Matthieu; Turkieh, Annie; Barutaut, Manon; Galinier, Michel; Dambrin, Camille; Polidori, Carlo; Miceli, Cristina; Chamontin, Bernard; Koukoui, François; Roncalli, Jerôme; Massabuau, Pierre; Smih, Fatima; Rouet, Philippe

2016-11-01

About 77.9 million (1 in 4) American adults have high blood pressure. High blood pressure is the primary cause of left ventricular hypertrophy (LVH), which represents a strong predictor of future heart failure and cardiovascular mortality. Previous studies have shown an altered metabolic profile in hypertensive patients with LVH. The goal of this study was to identify blood metabolomic LVH biomarkers by H NMR to provide novel diagnostic tools for rapid LVH detection in populations of hypertensive individuals. This cross-sectional study included 48 hypertensive patients with LVH matched with 48 hypertensive patients with normal LV size, and 24 healthy controls. Two-dimensional targeted M-mode echocardiography was performed to measure left ventricular mass index. Partial least squares discriminant analysis was used for the multivariate analysis of the H NMR spectral data. From the H NMR-based metabolomic profiling, signals coming from methylene (-CH2-) and methyl (-CH3) moieties of aliphatic chains from plasma lipids were identified as discriminant variables. The -CH2-/-CH3 ratio, an indicator of the mean length of the aliphatic lipid chains, was significantly higher (P hypertensive group without LVH and controls. Receiver operating characteristic curve showed that a cutoff of 2.34 provided a 52.08% sensitivity and 85.42% specificity for discriminating LVH (AUC = 0.703, P-value hypertension.

Ecological Study of HIV Infection and Hypertension in Sub-Saharan Africa: Is There a Double Burden of Disease?

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C Angkurawaranon

Full Text Available Data on prevalence of hypertension were derived from a systematic search of literature published between 1975 and 2014 with corresponding national estimates on HIV prevalence and antiretroviral therapy (ART coverage from the Demographic and Health Surveys and the joint United Nations Programme on HIV/AIDS databases. National estimates on gross national income (GNI and under-five mortality were obtained from the World Bank database. Linear regression analyses using robust standard errors (allowing for clustering at country level were carried out for associations of age-standardised hypertension prevalence ratios (standardized to rural Uganda's hypertension prevalence data with HIV prevalence, adjusted for national indicators, year of study and sex of the study population.In total, 140 estimates of prevalence of hypertension representing 25 nations were sex-and area-matched with corresponding HIV prevalence. A two-fold increase in HIV prevalence was associated with a 9.29% increase in age, sex and study year-adjusted prevalence ratio for hypertension (95% CI 2.0 to 16.5, p = 0.01, which increased to 16.3% (95% CI 9.3 to 21.1 after adjusting for under-five mortality, GNI per capita and ART coverage.Countries with a pronounced burden of HIV may also have an increased burden of non-communicable diseases such as hypertension with potential economic and health systems implications.

Primary hypertension and special aspects of hypertension in older children and adolescents

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Ellis D

2011-07-01

Full Text Available Demetrius Ellis, Yosuke MiyashitaChildren’s Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, PA, USAAbstract: The prevalence of hypertension has increased at an accelerated rate in older children and adolescents. This has raised great concern about premature development of cardiovascular disease, which has major long-term health and financial implications. While obesity and sedentary habits largely explain this phenomenon, there are other social and cultural influences that may unmask genetic susceptibility to hypertension in the pediatric population. While it is essential to exclude numerous causes of secondary hypertension in every child, these disorders are not discussed in this review. Rather, the aim of this review is to familiarize pediatricians with casual and ambulatory blood pressure measurement, epidemiology, pathophysiology, and management of several common conditions that play a role in the development of hypertension in children and adolescents. Besides primary hypertension and obesity-related hypertension, emphasis is given to epidemiology, measurement of blood pressure, including ambulatory blood pressure monitoring, hypertension associated with drug use, teenage pregnancy, and video and computer games. Lastly, because pediatricians are increasingly confronted with special issues concerning the management of the hypertensive athlete, this topic is also addressed.Keywords: hypertension, adolescents, obesity, drugs, pregnancy, athletes

Managing hypertension in the newborn infants

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Azar Nickavar

2014-01-01

Full Text Available Hypertension in newborn infants, particularly those requiring intensive care, is becoming increasingly recognized, with prevalence of 0.2-3%. Recent studies have established normative tables for blood pressure (BP in both term and pre-term infants based on the gestational age, postnatal age, gender, weight and height, identifying the neonates at increased risk for early-onset cardiovascular disease. Common causes of neonatal hypertension include thromboembolic complications secondary to umbilical artery catheterization, congenital renal structural malformation, renovascular disease, aortic coarctation, as well as acute kidney injury and certain medications. A careful diagnostic evaluation should lead to identification of the underlying cause of hypertension in most infants. Treatment options should be tailored to the severity; and underlying cause of hypertension, including intravenous and/or oral therapy. This review summarizes recent work in these areas, focusing on optimal BP measurement, definition, evaluation and management of hypertension as well as advances in drug therapy of neonatal hypertension.

Prevalence and risk factors of hypertension for the middle-aged population in China - results from the China Health and Retirement Longitudinal Study (CHARLS).

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Li, Zhen; Fu, Chang; Yang, Fan; Mao, Zongfu

2018-03-19

The prevalence of hypertension in middle-aged people is increasing. However, few studies have examined the risk factors of hypertension among the middle-aged population. The aim of this study is to present the prevalence of hypertension and its risk factors for the middle-aged population in China. The data were from the third-wave national survey (2015) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7,178 respondents aged 45-59 years were included in this study. Hypertension was defined as SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg or currently taking antihypertensive medicines. Multivariate logistic regression analyses were used to identify the risk factors of hypertension. The prevalence of hypertension was 29.12% (95%CI = 28.07-30.17). Hypertension was more prevalent among men than women (31.63% vs. 27.03%). Older age, higher BMI, chronic diseases, and poor health status were independently associated with hypertension in both genders (p < 0.05). Among women, college education (OR = 0.302, 95%CI = 0.152-0.598), marriage or cohabitation (OR = 0.756, 95%CI = 0.584-0.98), and drinking more than once a month (OR = 0.645, 95% = 0.498-0.836) led to a decreased likelihood of hypertension. Individuals with larger waist circumference were more likely to have hypertension (OR = 1.57, 95%CI = 1.294-1.906). Our results indicate that hypertension is highly prevalent in the middle-aged population in China. Men are more likely to have hypertension than women. Older age, higher BMI, chronic diseases and poor self-rated health are risk factors for hypertension in both genders. Large waist circumference, singleness, low educational level, and non-drinking are risk factors of hypertension among women but not among men.

"I have to live like I'm old." Young adults' perspectives on managing hypertension: a multi-center qualitative study.

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Johnson, Heather M; Warner, Ryan C; LaMantia, Jamie N; Bowers, Barbara J

2016-03-11

In the U.S., young adults (18-39 year-olds) have the lowest hypertension control rates among hypertensive adults. Understanding young adults' unique perceptions about hypertension and perceived barriers to hypertension control is critical to develop effective interventions for this population. This multi-center study explored young adults': 1) emotions and reactions after a hypertension diagnosis, 2) attitudes about managing hypertension (lifestyle changes, follow-up visits, antihypertensive medication use), 3) opinions about their healthcare system's hypertension education materials, and 4) opinions about using social media to manage hypertension. Young adults (18-39 year-olds) with a diagnosis of hypertension and regular primary care access were recruited by the Wisconsin Research and Education Network (WREN). Two focus groups (one per age range: 18-29 years, 30-39 years) were conducted in three Midwestern Family Medicine Clinics (academic, rural, and urban). Conventional content analysis was performed. Thirty-eight young adults (mean: 26.7 [9.6] years old, 34% male, 45% Black, 42% with ≥1 year of college) identified barriers to managing hypertension. Emergent themes overlapped across age groups and geographic regions. Most respondents were surprised and angry about a hypertension diagnosis; they expected to develop hypertension, but at a much older age. A hypertension diagnosis negatively altered their "young" self-identity; suggested behavior changes and antihypertensive medications made them feel "older" than their peers. Young adults missed blood pressure follow-up visits due to co-payments, transportation barriers, and longer than desired wait times for brief visits. Contrary to our hypothesis, most young adults disliked social media or text messaging to support self-management; they were most concerned that their peers would see the hypertension communication. Current hypertension education materials were described as not addressing young adults' health

ABO and RhD blood groups and gestational hypertensive disorders: a population-based cohort study.

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Lee, B K; Zhang, Z; Wikman, A; Lindqvist, P G; Reilly, M

2012-09-01

To examine the association between ABO and RhD blood groups and gestational hypertensive disorders in a large population-based cohort. Cohort study. Risks of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia, estimated by odds ratios for maternal ABO blood group and RhD status. National health registers of Sweden. All singleton deliveries in Sweden born to first-time mothers during the period 1987-2002 [total n = 641 926; any gestational hypertensive disorders, n = 39 011 (6.1%); pre-eclampsia cases, n = 29 337 (4.6%); severe pre-eclampsia cases, n = 8477 (1.3%)]. Using blood group O as a reference, odds ratios of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia were obtained from logistic regression models adjusted for potential confounding factors. Gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia. Compared with blood group O, all non-O blood groups had modest but statistically significantly higher odds of pre-eclampsia. Blood group AB had the highest risk for pre-eclampsia (OR = 1.10, 95% CI 1.04-1.16) and severe pre-eclampsia (OR = 1.18, 95% CI 1.07-1.30). RhD-positive mothers had a small increased risk for pre-eclampsia (OR = 1.07, 95% CI 1.03-1.10). In the largest study on this topic to date, women with AB blood group have the highest risks of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia, whereas women with O blood group have the lowest risks of developing these disorders. Although the magnitude of increased risk is small, this finding may help improve our understanding of the etiology of pre-eclampsia. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Blood Pressure Control in Hypertensive Patients, Cardiovascular Risk Profile and the Prevalence of Masked Uncontrolled Hypertension (MUCH).

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Naser, Nabil; Dzubur, Alen; Durak, Azra; Kulic, Mehmed; Naser, Nura

2016-07-27

The term masked hypertension (MH) should be used for untreated individuals who have normal office blood pressure but elevated ambulatory blood pressure. For treated patients, this condition should be termed masked uncontrolled hypertension (MUCH). Masked uncontrolled hypertension (MUCH) has gone unrecognized because few studies have used 24-h ABPM to determine the prevalence of suboptimal BP control in seemingly well-treated patients, and there are few such studies in large cohorts of treated patients attending usual clinical practice. This is important because masked hypertension is associated with a high risk of cardiovascular events. This study was conducted to obtain more information about the association between hypertension and other CV risk factors, about office and ambulatory blood pressure (BP) control as well as on cardiovascular (CV) risk profile in treated hypertensive patients, also to define the prevalence and characteristics of masked uncontrolled hypertension (MUCH) among treated hypertensive patients in routine clinical practice. In this study 2514 male and female patients were included during a period of 5 years follow up. All patients have ambulatory blood pressure monitoring (ABPM) for at least 24h. We identified patients with treated and controlled BP according to current international guidelines (clinic BP, 140/90mmHg). Cardiovascular risk assessment was based on personal history, clinic BP values, as well as target organ damage evaluation. Masked uncontrolled hypertension (MUCH) was diagnosed in these patients if despite controlled clinic BP, the mean 24-h ABPM average remained elevated (24-h systolic BP ≥130mmHg and/or 24-h diastolic BP ≥80mmHg). Patients had a mean age of 60.2+10 years, and the majority of them (94.6%) were followed by specialist physicians. Average clinic BP was 150.4+16/89.9+12 mmHg. About 70% of patients displayed a very high-risk profile. Ambulatory blood pressure monitoring (ABPM) was performed in all recruited

Football as a treatment for hypertension in untrained 30-55-year-old men: a prospective randomized study

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Andersen, Lars Juel; Randers, Morten Bredsgaard; Westh, K.

2010-01-01

The present study investigated whether football has favorable effects in the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men. Twenty-five untrained males aged 31-54 year with mild-to-moderate hypertension were randomized to a football training group (FTG, two 1-h.......p.m.), whereas no change was observed for DAG. After 3 months, FTG had higher (Pattractive non-pharmacological supplement...... to the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men....

Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy

DEFF Research Database (Denmark)

Behrens, Ida; Basit, Saima; Melbye, Mads

2017-01-01

Objectives To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time.Design Nationwide register based cohort study.Setting Denmark.Populations 482 972 primiparous women with a first l...

A quality improvement plan for hypertension control: the INCOTECA Project (INterventions for COntrol of hyperTEnsion in CAtalonia).

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Vallès-Fernandez, Roser; Rosell-Murphy, Magdalena; Correcher-Aventin, Olga; Mengual-Martínez, Lucas; Aznar-Martínez, Núria; Prieto-De Lamo, Gemma; Franzi-Sisó, Alícia; Puig-Manresa, Jordi; Ma Bonet-Simó, Josep

2009-03-25

Different studies have shown insufficient blood pressure (BP) control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT) with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. multicentric study quasi-experimental before - after with control group. The non-randomised allocation of the intervention will be done at PHCT level. 18 PHCT in the Barcelona province (Spain). all patients with a diagnosis of hypertension (population based study). patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure). The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non-normally distributed variables. Significance level (alpha) will be set at improvement plan might benefit the coordination of different professionals of

A quality improvement plan for hypertension control: the INCOTECA Project (INterventions for COntrol of hyperTEnsion in CAtalonia

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Vallès-Fernandez Roser

2009-03-01

Full Text Available Abstract Background Different studies have shown insufficient blood pressure (BP control in hypertensive patients. Multiple factors influence hypertension management, and the quality of primary care is one of them. We decided therefore to evaluate the effectiveness of a quality improvement plan directed at professionals of Primary Health Care Teams (PHCT with the aim to achieve a better control of hypertension. The hypothesis of the study is that the implementation of a quality improvement plan will improve the control of hypertension. The primary aim of this study will be to evaluate the effectiveness of this plan. Methods and design Design: multicentric study quasi-experimental before – after with control group. The non-randomised allocation of the intervention will be done at PHCT level. Setting: 18 PHCT in the Barcelona province (Spain. Sample: all patients with a diagnosis of hypertension (population based study. Exclusion criteria: patients with a diagnosis of hypertension made later than 01/01/2006 and patients younger than 18 years. Intervention: a quality improvement plan, which targets primary health care professionals and includes educational sessions, feedback to health professionals, audit and implementation of recommended clinical practice guidelines for the management of hypertensive patients. Measurements: age, sex, associated co-morbidity (diabetes mellitus type I and II, heart failure and renal failure. The following variables will be recorded: BP measurement, cardiovascular risk and antihypertensive drugs used. Results will be measured before the start of the intervention and twelve months after the start of the study. Dependent variable: prevalence of hypertensive patients with poor BP control. Analysis: Chi-square test and Student's t-test will be used to measure the association between independent qualitative and quantitative variables, respectively. Non-parametric tests will be used for the analysis of non

An ethnobotanical study of medicinal plants administered for the treatment of hypertension.

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Baharvand-Ahmadi, Babak; Bahmani, Mahmoud; Tajeddini, Pegah; Rafieian-Kopaei, Mahmoud; Naghdi, Nasrollah

2016-01-01

The incidence of cardiovascular diseases (CVDs) is very high in human societies and their prevention and treatment are the most important priority in many countries. Hypertension makes an important contribution to the development of CVDs. This study aimed to collect the ethno-medicinal knowledge of the traditional healers of Shiraz on medicinal plants used in the treatment of hypertension. Ethno-medicinal data were collected from September 2012 to July 2013 through direct interview. Twenty-five healers were interviewed using semi-structured questionnaires and their traditional ethno-medicinal knowledge was recorded. Questionnaires were included apothecary personal information, plant local name, plant parts used, method of preparation, season of harvest and traditional use. Data collected from surveys and interviews were transferred to Microsoft Excel 2007 and analyzed. Analysis of data showed that, 27 medicinal plants from 22 families are used for the treatment of hypertension. The families with most antihypertensive species were Apiaceae (8%), Rosaceae (8%) and Papaveraceae (8%). The most frequently used plant parts were leaves (36%) followed by fruits (30%), aerial part (17%) and branches (7%). The most frequently used preparation method was decoction (95%). Borago officinalis (51.85%), Berberis vulgaris (51.58%) had the highest frequency of mention. The ethno-medicinal survey of medicinal plants recommended by traditional healers for the treatment of hypertension provides new areas of research on the antihypertensive effect of medicinal plants. In the case of safety and effectiveness, they can be refined and processed to produce natural drugs.

Associations between thoracic radiographic changes and severity of pulmonary arterial hypertension diagnosed in 60 dogs via Doppler echocardiography: A retrospective study.

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Adams, Dustin S; Marolf, Angela J; Valdés-Martínez, Alejandro; Randall, Elissa K; Bachand, Annette M

2017-07-01

Doppler echocardiography is a noninvasive method for estimating and grading pulmonary arterial hypertension. No current literature associates significance of radiographic findings with severity of pulmonary arterial hypertension. We hypothesized that the number and conspicuity of radiographic findings suggestive of pulmonary arterial hypertension would be greater based on the severity of pulmonary arterial hypertension. Dogs with pulmonary arterial hypertension and normal control dogs were included in this retrospective, case control study. Three radiologists blinded to echocardiographic results scored thoracic radiographs for right ventricular and main pulmonary artery enlargement and pulmonary lobar artery enlargement, tortuosity, and blunting by multiple methods. Presence or absence of each finding was scored in an additive fashion and averaged for each grade of pulmonary arterial hypertension severity. Seventy-one dogs (60 dogs with pulmonary arterial hypertension and 11 control dogs) of which some had multiple studies were included: 20 mild, 21 moderate, 25 severe, and 11 absent pulmonary arterial hypertension. The following radiographic findings were significantly associated with increasing pulmonary arterial hypertension severity: right ventricular enlargement by "reverse D" and "3/5-2/5 cardiac ratio" methods, main pulmonary artery enlargement, and caudal lobar artery enlargement by the "3rd rib" method. Mean scores for severe pulmonary arterial hypertension and normal dogs were significantly different (P-value < 0.0001). Mean scores between different pulmonary arterial hypertension grades increased with severity but were not statistically significant. Individually and in combination, radiographic findings performed poorly in differentiating severity of pulmonary arterial hypertension. Findings indicated that thoracic radiographs should be utilized in conjunction with Doppler echocardiography in a complete diagnostic work-up for dogs with suspected

White Coat Hypertension and Masked Hypertension Among Omani Patients Attending a Tertiary Hospital for Ambulatory Blood Pressure Monitoring

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Khamis Al-Hashmi

2015-03-01

Full Text Available Objectives: Our study aimed to estimate the rate of white coat hypertension (WCH and effect, and masked hypertension in patients attending a tertiary care hospital for 24 hour ambulatory blood pressure monitoring (24-h ABPM. Methods: A total of 231 adult patients were referred to the Department of Clinical Physiology at Sultan Qaboos University Hospital, Muscat, for ABPM, between January 2010 and June 2012. The following data were gathered and analyzed: demographic data, clinic blood pressure (BP measurements, and 24-h BP profile from ABPM. Thirty-two patients were excluded and the final analysis included 199 patients. Results: There were 105 (52.8% women and 94 (47.2% men studied. The mean age of patients was 46±15 years and most patients were overweight with a mean BMI of 29.6±5kg/m2. Around half of patients (53.8% were on one or more antihypertensive medications. WCH was found in 10.6% and white coat effect was found in 16% of patients. The majority of patients (57% with WCH were aged 40 years or above. Masked hypertension was present in 6% of patients and masked uncontrolled hypertension in 8.5% of patients. Conclusions: Our study showed that WCH and effect, and masked hypertension are common in hypertensive patients. Identifying these patients will have an impact on their management. However, the results of the study should be interpreted within the context of its limitations. Prospective randomized community and hospital-based studies should be conducted to estimate the true prevalence in the general population as well as in hypertensive patients.

Stress-sensitive arterial hypertension, haemodynamic changes and brain metabolites in hypertensive ISIAH rats: MRI investigation.

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Seryapina, A A; Shevelev, O B; Moshkin, M P; Markel, A L; Akulov, A E

2017-05-01

What is the central question of this study? Stress-sensitive arterial hypertension is considered to be controlled by changes in central and peripheral sympathetic regulating mechanisms, which eventually result in haemodynamic alterations and blood pressure elevation. Therefore, study of the early stages of development of hypertension is of particular interest, because it helps in understanding the aetiology of the disease. What is the main finding and its importance? Non-invasive in vivo investigation in ISIAH rats demonstrated that establishment of sustainable stress-sensitive hypertension is accompanied by a decrease in prefrontal cortex activity and mobilization of hypothalamic processes, with considerable correlations between haemodynamic parameters and individual metabolite ratios. The study of early development of arterial hypertension in association with emotional stress is of great importance for better understanding of the aetiology and pathogenesis of the hypertensive disease. Magnetic resonance imaging (MRI) was applied to evaluate the changes in haemodynamics and brain metabolites in 1- and 3-month-old inherited stress-induced arterial hypertension (ISIAH) rats (10 male rats) with stress-sensitive arterial hypertension and in control normotensive Wistar Albino Glaxo (WAG) rats (eight male rats). In the 3-month-old ISIAH rats, the age-dependent increase in blood pressure was associated with increased blood flow through the renal arteries and decreased blood flow in the lower part of the abdominal aorta. The renal vascular resistance in the ISIAH rats decreased during ageing, although at both ages it remained higher than the renal vascular resistance in WAG rats. An integral metabolome portrait demonstrated that development of hypertension in the ISIAH rats was associated with an attenuation of the excitatory and energetic activity in the prefrontal cortex, whereas in the WAG rats the opposite age-dependent changes were observed. In contrast, in the

[Cardiovascular risk profile of uncontrolled hypertensive patients. The Control-Project study].

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Márquez-Contreras, Emilio; Coca, Antonio; de la Figuera von Wichmann, Mariano; Divisón, Juan Antonio; Llisterri, José Luis; Sobrino, Javier; Filozof, Claudia; Sánchez-Zamorano, Miguel Angel; Grigorian Shamagian, Lilian

2007-01-27

To assess absolute cardiovascular risk and co-morbidities in uncontrolled hypertensive patients (blood pressure [BP]>or=140/90 mmHg or>or=130/80 mmHg in diabetics) attending Primary Care Physicians in Spain, and to determine the attitudes of these physicians towards this problem. Cross-sectional, multicenter study involving 356 general practitioners around Spain. Absolute cardiovascular risk was assessed according to ESH-ESC 2003 Guidelines in a sample of 1,710 patients. Two hundred ninety seven patients were excluded by several reasons and a total of 1,413 hypertensive patients were valuable (mean age: 65.3+/-11.4 years; 56.7% women). Normal BP values (or=180/110 mmHg) by 7.9%. Associated cardiovascular risk factors were observed in 96.0% of patients (95% CI=94.7-97.2%), target organ damage in 34.5% (95% CI=31.6-36.5%), and cardiovascular clinical disease in 36.0% (95% CI=33.5-38.5%). According to ESH-ESC 2003 Guidelines 34.0% (CI=31.5-38.2%) were at very-high risk; 29.4% (95% CI=26.4-32.8%) at high risk; 30.4% (95% CI=27.2-33.7%) at moderate risk and 5.4% (95% CI=3.9-7.2%) at low risk of cardiovascular disease. Despite the high absolute risk, physicians did not do any therapeutic change in 30.4% (95% CI=28.2-33.5%) of uncontrolled hypertensive patients. Most of them (64.26%) considered that bad compliance to life style changes was the reason for inadequate BP control. The most frequent measure introduced was the association of additional drugs. Absolute cardiovascular risk in uncontrolled hypertensive patients attending Primary Care Physicians in Spain is very relevant. Sixty-five percent of these patients are at high or very high risk with a high prevalence of target organ damage or associated cardiovascular clinical disease. Therapeutic attitudes towards these patients are still very conservative although they are improving compared with previous studies.

Masked Uncontrolled Hypertension in CKD.

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Agarwal, Rajiv; Pappas, Maria K; Sinha, Arjun D

2016-03-01

Masked uncontrolled hypertension (MUCH) is diagnosed in patients treated for hypertension who are normotensive in the clinic but hypertensive outside. In this study of 333 veterans with CKD, we prospectively evaluated the prevalence of MUCH as determined by ambulatory BP monitoring using three definitions of hypertension (daytime hypertension ≥135/85 mmHg; either nighttime hypertension ≥120/70 mmHg or daytime hypertension; and 24-hour hypertension ≥130/80 mmHg) or by home BP monitoring (hypertension ≥135/85 mmHg). The prevalence of MUCH was 26.7% by daytime ambulatory BP, 32.8% by 24-hour ambulatory BP, 56.1% by daytime or night-time ambulatory BP, and 50.8% by home BP. To assess the reproducibility of the diagnosis, we repeated these measurements after 4 weeks. Agreement in MUCH diagnosis by ambulatory BP was 75-78% (κ coefficient for agreement, 0.44-0.51), depending on the definition used. In contrast, home BP showed an agreement of only 63% and a κ coefficient of 0.25. Prevalence of MUCH increased with increasing clinic systolic BP: 2% in the 90-110 mmHg group, 17% in the 110-119 mmHg group, 34% in the 120-129 mmHg group, and 66% in the 130-139 mmHg group. Clinic BP was a good determinant of MUCH (receiver operating characteristic area under the curve 0.82; 95% confidence interval 0.76-0.87). In diagnosing MUCH, home BP was not different from clinic BP. In conclusion, among people with CKD, MUCH is common and reproducible, and should be suspected when clinic BP is in the prehypertensive range. Confirmation of MUCH diagnosis should rely on ambulatory BP monitoring. Copyright © 2016 by the American Society of Nephrology.

Literacy and motivation for the prevention and control of hypertension among female community health volunteers: a qualitative study from Nepal

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Dinesh Neupane

2015-12-01

Full Text Available Background: The prevalence of hypertension is increasing in Nepal. Thus, there is a need for a programme to improve primary healthcare. One possibility is to assign prevention, diagnosis, and treatment of hypertension to female community health volunteers (FCHVs. Objective: To assess literacy and motivation to be involved in a hypertension prevention and control programme in Nepal among FCHVs. Design: Five focus group discussions (FGDs were conducted with a total of 69 FCHVs in Lekhnath municipality, Kaski district, Nepal. Seven themes were developed on the basis of data collection: 1 knowledge about hypertension; 2 risk factors of hypertension; 3 prevention and control of hypertension; 4 access to treatment for hypertension in the community; 5 learning about blood pressure measurement; 6 ability to raise blood pressure awareness in the community; 7 possible challenges for their future involvement. Data were analysed using the thematic analysis approach. Results: FCHVs have some knowledge about diagnosis, risk factors, and complications of hypertension. General unanimity was observed in the understanding that hypertension and risk factors needed to be addressed. The willingness of FCHVs to contribute to prevention, control, and management was strong, and they were confident that with some basic training they could obtain skills in hypertension management. Conclusions: Despite limited knowledge about hypertension, FCHVs expressed willingness and readiness to be trained in hypertension management. This study supports the possibility of involving FCHVs in prevention and control of hypertension in Nepal.

OBESITY IS ASSOCIATED WITH HYPERTENSION IN ADOLESCENTS

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Hendy Hendy

2014-12-01

Full Text Available Obesity has become a global issue. Previous studies in Bali reveal an increase in the proportionof obesity in adolescents. Obesity causes hypertension; hence there should also be an increase inthe prevalence of hypertension as well in Bali. Hypertension in obese adolescents could be causedby various factors, hence identification of the risks factors is crucial as a preventive approach.The aim of this study was to prove an association between obesity and hypertension in adolescents,and to look for the risk factors. We used an analitical cross sectional design conducted to 12-14years old samples. We took body weight, height, waist circumference, hip circumference, andblood pressure measurements with appropriate devices and asked for information regarding lifestyle and familial history by a questionnare filled in by the samples. The association of obeseadolescents with hypertension and their risk factors was analyzed by Chi-square and multivariatetests. A total of 225 subjects from Santo Yoseph junior high school students, west Denpasar,Bali, met the inclusion criteria. The proportion of obese subjects in this study was 25.7%. Wefound that proportion in familial history of obesity was greater in obese than non-obese subjects(70.7 % vs 41.3%. Logistic regression test revealed that obese subjects with hypertension had abody mass index (BMI > 30 with odds ratio of 7.3 (CI 95% = 1.8 to 28.8 and P = 0.005. Weconcluded that there was an association between obesity and adolescents with hypertension,and BMI > 30 could be a risk factor for obese adolescents with hypertension.

Drug Resistant Hypertension - No SIMPLE Way Out

OpenAIRE

Janusz Skrzypecki; Marcin Ufnal

2015-01-01

Hypertension poses growing challenge for health policy-makers and doctors worldwide. Recently published results of Symplicity-III trial (HTN-3), the first blinded, randomized, multicenter study on the efficacy of renal denervation for the treatment of resistant hypertension did not show a significant reduction of BP in patients with resistant hypertension 6 months after renal-artery denervation, as compared with controls. In this paper we review clinical and experimental studies on renal dene...

Diet quality is associated with obesity and hypertension in Australian adults: a cross sectional study

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Katherine M. Livingstone

2016-10-01

Full Text Available Abstract Background Poor diet, characterized by a low diet quality score, has been associated with greater prevelence of obesity and hypertension. However, the evidence is inconsistent across diet quality scores and by sex. The aim was to investigate the relationship between diet quality and obesity and hypertension. Methods Adults (n = 4908; age 45.2 ± 0.24 years were included from the cross-sectional Australian Health Survey 2011–2013. Two 24-h dietary recalls were used to derive the dietary guideline index (DGI and recommended food score (RFS. Logistic regression investigated relationships between diet quality score and odds ratio of obesity, hypertension and obesity-associated hypertension. Results In the highest tertile of DGI, but not RFS, individuals were less likely to be obese (men: OR 0.64, CI: 0.45, 0.92, P-trend = 0.014; women: 0.68, 0.48, 0.96, P-trend = 0.025 and to have central adiposity (men: 0.68, 0.48, 0.97, P-trend = 0.030; women: 0.53, 0.37, 0.77, P-trend = 0.001 compared with the lowest tertile. Men, but not women, in the highest tertile of DGI and RFS were less likely to be hypertensive (DGI: 0.56, 0.37, 0.85, P-trend = 0.006; RFS: 0.62, 0.41, 0.94, P-trend = 0.021 compared with the lowest tertile. In men with obesity, but not normal weight men or women, those in the highest tertile of DGI were less likely to be hypertensive (0.53, 0.36, 0.78, P-trend = 0.001 compared with the highest tertile. Conclusions Higher diet quality, as estimated using DGI, was associated with lower odds ratio of obesity in men and women. Odds ratio of hypertension was lower in men, but not women, with a high diet quality score compared with a low score, while obesity-associated hypertension was only associated with diet quality score in men with obesity. Longitudinal studies are needed to evaluate whether diet quality predicts risk of obesity and hypertension.

Primary hypertension among a population of Nigerian secondary school adolescents: Prevalence and correlation with anthropometric indices: A cross-sectional study.

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Uwaezuoke, S N; Okoli, C V; Ubesie, A C; Ikefuna, A N

2016-01-01

To assess the prevalence of primary hypertension and its correlation with anthropometric indices among a population of Nigerian adolescents. A cross-sectional study of secondary school adolescents aged 10-19 years in Enugu, Nigeria, using multi-staged sampling method. Anthropometry and blood pressures were measured using standardized instruments. Data analysis was with the Statistical Package for Social Sciences (SPSS) Version 20.0 (Chicago, IL, USA). A total of 2419 adolescents (mean age, 14.80 ± 2.07 years) were included in the study. Prevalence of hypertension was 10.7%. Systolic and diastolic hypertension were observed in 232 (9.6%) and 85 (3.5%) of the participants, respectively. Forty-two of the 137 obese (30.7%) compared to 158 among the 1777 (7.7%) with normal body mass index (BMI) (P hypertension. Waist circumference (r = 0.37) and BMI (r = 0.37) significantly and positively correlated with systolic hypertension. Obese and overweight adolescents had higher prevalence of primary hypertension than their counterparts with normal BMI.

The Cost-Effectiveness of Low-Cost Essential Antihypertensive Medicines for Hypertension Control in China: A Modelling Study.

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Dongfeng Gu

2015-08-01

cardiovascular disease for secondary prevention was projected to be cost saving in the main simulation and 100% of probabilistic simulation results. Treating all hypertension for primary and secondary prevention would prevent about 800,000 cardiovascular disease events annually (95% uncertainty interval, 0.6 to 1.0 million and was borderline cost-effective incremental to treating only cardiovascular disease and stage two patients (2015 Int$13,000 per QALY gained [95% uncertainty interval, Int$10,000 to Int$18,000]. Of all one-way sensitivity analyses, assuming adherence to taking medications as low as 25%, high Shanghai drug costs, or low medication efficacy led to the most unfavorable results (treating all hypertension, about Int$47,000, Int$37,000, and Int$27,000 per QALY were gained, respectively. The strengths of this study were the use of a recent Chinese national health survey, vital statistics, health care costs, and cohort study outcomes data as model inputs and reliance on clinical-trial-based estimates of coronary heart disease and stroke risk reduction due to antihypertensive medication treatment. The limitations of the study were the use of several sources of data, limited clinical trial evidence for medication effectiveness and harms in the youngest and oldest age groups, lack of information about geographic and ethnic subgroups, lack of specific information about indirect costs borne by patients, and uncertainty about the future epidemiology of cardiovascular diseases in China.Expanded hypertension treatment has the potential to prevent about 800,000 cardiovascular disease events annually and be borderline cost-effective in China, provided low-cost essential antihypertensive medicines programs can be implemented.

Procollagen type III amino terminal peptide and myocardial fibrosis: A study in hypertensive patients with and without left ventricular hypertrophy.

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dos Santos Moreira, Carlos; Serejo, Fátima; Alcântara, Paula; Ramalhinho, Vítor; Braz Nogueira, J

2015-05-01

An exaggerated accumulation of type I and type III fibrillar collagens occurs throughout the free wall and interventricular septum of patients with primary hypertension and left ventricular hypertrophy (LVH). In the present study the serum concentration of procollagen type III amino terminal peptide (PIIIP) was measured to determine the value of this peptide as a potential marker of ventricular fibrosis in hypertensive patients, particularly those with LVH. The study population consisted of patients with never-treated mild to moderate essential hypertension and 30 normotensive control subjects. Clinical, echocardiographic, electrocardiographic and biochemical parameters were assessed in all patients. Heart rate, body mass index and levels of blood pressure were increased in hypertensives, particularly those with LVH, compared to normotensive controls. Posterior wall thickness, left ventricular (LV) mass and LV mass index, and serum PIIIP concentration were also increased in hypertensives, with significant differences between the two hypertensive groups. The ratio between maximal early and late transmitral flow velocity measured during diastole was lower in hypertensives, particularly those with LVH, than in normotensive controls. The increase in PIIIP indicates that type III collagen synthesis increases in hypertensives, particularly those with LVH, implying that alterations in the heart in hypertension are the result not solely of hypertrophied LV muscle, but also of increased collagen deposition within the ventricular wall and around the coronary vessels. Thus, measurement of serum PIIIP could be a practical and useful tool in the non-invasive assessment of myocardial remodeling in hypertension. Copyright © 2014 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

SYSTOLIC HYPERTENSION. IMPACT ON CEREBROVASCULAR DISEASE

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Juan Eloy Cruz Quesada

2011-08-01

Full Text Available Background: Atherosclerosis is a multifactor process in which several risk factors are involved. It is the leading cause of death and morbidity in hospital admitted patients, and it may cause a marked decrease in blood flow to all organs of the body.Objective: To determine the impact of systolic hypertension on cerebrovascular disease.Methods: A cross-sectional, observational and analytical study was conducted in 59 death patients who suffered from hypertension. Cerebral arteries were analyzed and atherosclerotic lesion and its variety were quantified by using the atherometric system. The different types of hypertension were considered. Statistical (central tendency measures and comparative (comparison test based on Student’s arithmetic t-test procedures were used.Results: Recent strokes were more frequent in systodiastolic hypertensive patients. There was no significant difference in the injury onset age for both sexes, but women with systolic hypertension were significantly more damaged (from a morphometric point of view. Significant correlation for both groups of hypertensive patients was observed between type of stroke and atherometric system variables.Conclusions: Systolic hypertension is an important factor in the genesis of cerebrovascular disease and is associated with the progression of atherosclerotic plaque.

The study of risk in pulmonary arterial hypertension

Directory of Open Access Journals (Sweden)

Gerald Simonneau

2012-09-01

Full Text Available A growing body of published evidence exists on the risk factors for disease progression in pulmonary arterial hypertension (PAH. The Scientific Steering Committee for the Study of Risk in PAH was established to bring together leading clinical and statistical experts in PAH and risk modelling, for the purpose of advancing the understanding of the risk of development and progression of PAH. Herein, we discuss the impact of this information on three key areas: 1 clinical decision-making; 2 policy and reimbursement; and 3 future trials and research.

Hypertensive Crisis

Science.gov (United States)

... Artery Disease Venous Thromboembolism Aortic Aneurysm More Hypertensive Crisis: When You Should Call 9-1-1 for ... Nov 13,2017 A hypertensive ( high blood pressure ) crisis is when blood pressure rises quickly and severely ...

Orthostatic hypertension: profile of a Nigerian population ...

African Journals Online (AJOL)

Background: The aim of this study was to determine the prevalence, age, sex distribution and blood pressure (BP) pattern of patients with orthostatic hypertension in a cohort of hypertensives. Method: A total of 179 patients on follow-up treatment in a hypertension clinic were assessed for age, sex and BP in the seated ...

Intraerythrocytic 2,3-diphosphoglycerate concentration in hypertensive subjects before and following control by anti hypertensive treatment.

Science.gov (United States)

Kasparian, H; Konstantopoulos, K; Tassiopoulos, S; Papadogiannis, D; Karadzas, N; Tassiopoulos, T

1997-09-01

We measured the 2,3-diphosphoglycerate inraerythrocytic concentration in 24 normal controls and in 24 hypertensives before and following drug therapy. In hypertensives the 2,3-diphosphoglycerate concentration was higher than that of the controls (14.96 mumol/g Hb vs 13.26 mumol/g Hb respectively); the difference is statistically significant (p levels in the patients studied do not seem to differ statistically from those of the controls. This may be a consequence of lower cardiac output in hypertension which results to a lower tissue perfusion, leading to an increased concentration of deoxygenated haemoglobin in the vein blood. Measurement of 2,3-diphosphoglucerate may prove of value in estimating tissue perfusion in hypertension.

Significance of White-Coat Hypertension in Older Persons With Isolated Systolic Hypertension

Science.gov (United States)

Franklin, Stanley S.; Thijs, Lutgarde; Hansen, Tine W.; Li, Yan; Boggia, José; Kikuya, Masahiro; Björklund-Bodegård, Kristina; Ohkubo, Takayoshi; Jeppesen, Jørgen; Torp-Pedersen, Christian; Dolan, Eamon; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Imai, Yutaka; Wang, Jiguang; Ibsen, Hans; O’Brien, Eoin; Staessen, Jan A.

2013-01-01

The significance of white-coat hypertension in older persons with isolated systolic hypertension remains poorly understood. We analyzed subjects from the population-based 11-country International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes database who had daytime ambulatory blood pressure (BP; ABP) and conventional BP (CBP) measurements. After excluding persons with diastolic hypertension by CBP (≥90 mm Hg) or by daytime ABP (≥85 mm Hg), a history of cardiovascular disease, and persons hypertension. During a median follow-up of 10.6 years, there was a total of 655 fatal and nonfatal cardiovascular events. The analyses were stratified by treatment status. In untreated subjects, those with white-coat hypertension (CBP ≥140/hypertension, the cardiovascular risk was similar in elevated conventional and normal daytime systolic BP as compared with those with normal conventional and normal daytime BPs (adjusted hazard rate: 1.10 [95% CI: 0.79–1.53]; P=0.57). However, both treated isolated systolic hypertension subjects with white-coat hypertension (adjusted hazard rate: 2.00; [95% CI: 1.43–2.79]; Phypertension who have their ABP normalized on antihypertensive therapy but with residual white-coat effect by CBP measurement have an entity that we have termed, “treated normalized hypertension.” Therefore, one should be cautious in applying the term “white-coat hypertension” to persons receiving antihypertensive treatment. PMID:22252396

Plasma proteome analysis in patients with pulmonary arterial hypertension: an observational cohort study.

Science.gov (United States)

Rhodes, Christopher J; Wharton, John; Ghataorhe, Pavandeep; Watson, Geoffrey; Girerd, Barbara; Howard, Luke S; Gibbs, J Simon R; Condliffe, Robin; Elliot, Charles A; Kiely, David G; Simonneau, Gerald; Montani, David; Sitbon, Olivier; Gall, Henning; Schermuly, Ralph T; Ghofrani, H Ardeschir; Lawrie, Allan; Humbert, Marc; Wilkins, Martin R

2017-09-01

Idiopathic and heritable pulmonary arterial hypertension form a rare but molecularly heterogeneous disease group. We aimed to measure and validate differences in plasma concentrations of proteins that are associated with survival in patients with idiopathic or heritable pulmonary arterial hypertension to improve risk stratification. In this observational cohort study, we enrolled patients with idiopathic or heritable pulmonary arterial hypertension from London (UK; cohorts 1 and 2), Giessen (Germany; cohort 3), and Paris (France; cohort 4). Blood samples were collected at routine clinical appointment visits, clinical data were collected within 30 days of blood sampling, and biochemical data were collected within 7 days of blood sampling. We used an aptamer-based assay of 1129 plasma proteins, and patient clinical details were concealed to the technicians. We identified a panel of prognostic proteins, confirmed with alternative targeted assays, which we evaluated against the established prognostic risk equation for pulmonary arterial hypertension derived from the REVEAL registry. All-cause mortality was the primary endpoint. 20 proteins differentiated survivors and non-survivors in 143 consecutive patients with idiopathic or heritable pulmonary arterial hypertension with 2 years' follow-up (cohort 1) and in a further 75 patients with 2·5 years' follow-up (cohort 2). Nine proteins were both prognostic independent of plasma NT-proBNP concentrations and confirmed by targeted assays. The functions of these proteins relate to myocardial stress, inflammation, pulmonary vascular cellular dysfunction and structural dysregulation, iron status, and coagulation. A cutoff-based score using the panel of nine proteins provided prognostic information independent of the REVEAL equation, improving the C statistic from area under the curve 0·83 (for REVEAL risk score, 95% CI 0·77-0·89; parterial hypertension in cohort 3 (p=0·0133). The protein panel was validated in 93 patients

Neurocognitive Function in Children with Primary Hypertension

Science.gov (United States)

Lande, Marc B.; Batisky, Donald L.; Kupferman, Juan C.; Samuels, Joshua; Hooper, Stephen R.; Falkner, Bonita; Waldstein, Shari R.; Szilagyi, Peter G.; Wang, Hongyue; Staskiewicz, Jennifer; Adams, Heather R.

2016-01-01

Objective To compare neurocognitive test performance of children with primary hypertension to that of normotensive controls. Study design Seventy-five children (10-18 years of age) with newly diagnosed, untreated hypertension and 75 frequency matched normotensive controls had baseline neurocognitive testing as part of a prospective multicenter study of cognition in primary hypertension. Subjects completed tests of general intelligence, attention, memory, executive function, and processing speed. Parents completed rating scales of executive function and the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (PSQ-SRBD). Results Hypertension and control groups did not differ significantly in age, sex, maternal education, income, race, ethnicity, obesity, anxiety, depression, cholesterol, glucose, insulin, and C-reactive protein. Subjects with hypertension had higher PSQ-SRBD scores (p = 0.04) and triglycerides (p = 0.037). Multivariate analyses showed that hypertension was independently associated with worse performance on the Rey Auditory Verbal Learning Test (List A Trial 1, p = 0.034; List A Total, p = 0.009; Short delay recall, p = 0.013), CogState Groton Maze Learning Test delayed recall (p = 0.002), Grooved Pegboard dominant hand (p = 0.045), and Wechsler Abbreviated Scales of Intelligence Vocabulary (p = 0.016). Results indicated a significant interaction between disordered sleep (PSQ-SRBD score) and hypertension on ratings of executive function (p = 0.04), such that hypertension heightened the association between increased disordered sleep and worse executive function. Conclusions Youth with primary hypertension demonstrated significantly lower performance on neurocognitive testing compared with normotensive controls, in particular, on measures of memory, attention, and executive functions. PMID:27692987

Association between Polyphenol Intake and Hypertension in Adults and Older Adults: A Population-Based Study in Brazil.

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Andreia Machado Miranda

Full Text Available Hypertension is an important risk factor for cardiovascular disease, and diet has been identified as a modifiable factor for preventing and controlling hypertension. Besides, epidemiological studies have suggested an inverse association between polyphenol intake and cardiovascular diseases. The aim of this study was to evaluate the association between the intake of polyphenols and hypertension in a general population of Sao Paulo.Data came from the 'Health Survey of Sao Paulo (ISA-Capital' among 550 adults and older adults in Sao Paulo, Brazil. Diet was assessed by two 24-hour dietary recalls (24HR. Usual intakes were calculated using the Multiple Source Method. Polyphenol intake was calculated by matching food consumption data from the 24HR with the Phenol-Explorer database. The associations between the hypertension and tertiles of the total and classes of polyphenols intake were tested by multivariate logistic regression analysis.After multivariate adjustment for potential confounding factors the findings showed an inverse and linearly association between the hypertension and highest tertiles of tyrosols (OR = 0.33; 95%CI 0.18, 0.64, alkylphenols (OR = 0.45; 95%CI 0.23, 0.87, lignans (OR = 0.49; 95%CI 0.25, 0.98, as well as stilbenes (OR = 0.60; 95%CI 0.36, 0.98, and other polyphenols (OR = 0.33; 95%CI 0.14, 0.74. However, total polyphenol intake, and phenolic acids were significantly associated only in the middle tertile with hypertension and flavonoids were not significant associated.There is an inverse and linearly association between the highest tertile of some classes of polyphenols, such as, tyrosols, alkylphenols, lignans, stilbenes, other polyphenols and hypertension.

The effect of educational programs on hypertension management.

Science.gov (United States)

Babaee Beigi, Mohammad Ali; Zibaeenezhad, Mohammad Javad; Aghasadeghi, Kamran; Jokar, Abutaleb; Shekarforoush, Shahnaz; Khazraei, Hajar

2014-09-01

Hypertension is the main risk factor for cardiovascular diseases and stroke. Blood pressure control is a challenge for healthcare providers and the rate of blood pressure control is not more than 50% worldwide. The present study aimed to determine the effectiveness of a short-term educational program on the level of knowledge, lifestyle changes, and blood pressure control among hypertensive patients. This quasi-experimental study was conducted on the hypertensive patients attending Shiraz Healthy Heart House. In this study, 112 patients were selected via systematic random sampling. The study data were collected using a data gathering form which consisted of baseline characteristics and measurements of blood pressure. Multivariate analyses were used to assess the relationship between education and hypertension. At baseline, the scores of aware, treated, and controlled hypertensive patients were 21%, 20%, and 12%, respectively. However, these measures were increased to 92%, 95%, and 51%, respectively at the end of the study. The mean knowledge scores improved from 2.77 ± 2.7 to 7.99 ± 1.78 after 3 months (P lifestyle scores changed from 3.15 ± 1.52 to 4.53 ± 1.23 (P lifestyle habits of the patients with hypertension.

Dietary pattern, lifestyle and nutritional status of hypertensive ...

African Journals Online (AJOL)

Inappropriate eating habits and sedentary lifestyle predispose to hypertension. This study assessed dietary pattern, lifestyle and nutritional status of hypertensive outpatients attending Cardiology Clinic of University College Hospital, Ibadan. This research was descriptive and cross-sectional, including 92 hypertensive ...

Association of Parental Hypertension With Arterial Stiffness in Nonhypertensive Offspring

DEFF Research Database (Denmark)

Andersson, Charlotte; Quiroz, Rene; Enserro, Danielle

2016-01-01

High arterial stiffness seems to be causally involved in the pathogenesis of hypertension. We tested the hypothesis that offspring of parents with hypertension may display higher arterial stiffness before clinically manifest hypertension, given that hypertension is a heritable condition. We compa......, in this community-based sample of young, nonhypertensive adults, we observed greater arterial stiffness in offspring of parents with hypertension. These observations are consistent with higher vascular stiffness at an early stage in the pathogenesis of hypertension.......High arterial stiffness seems to be causally involved in the pathogenesis of hypertension. We tested the hypothesis that offspring of parents with hypertension may display higher arterial stiffness before clinically manifest hypertension, given that hypertension is a heritable condition. We...... compared arterial tonometry measures in a sample of 1564 nonhypertensive Framingham Heart Study third-generation cohort participants (mean age: 38 years; 55% women) whose parents were enrolled in the Framingham Offspring Study. A total of 468, 715, and 381 participants had 0 (referent), 1, and 2 parents...

Hypertension Canada's 2016 Canadian Hypertension Education Program Guidelines for Blood Pressure Measurement, Diagnosis, Assessment of Risk, Prevention, and Treatment of Hypertension.

Science.gov (United States)

Leung, Alexander A; Nerenberg, Kara; Daskalopoulou, Stella S; McBrien, Kerry; Zarnke, Kelly B; Dasgupta, Kaberi; Cloutier, Lyne; Gelfer, Mark; Lamarre-Cliche, Maxime; Milot, Alain; Bolli, Peter; Tremblay, Guy; McLean, Donna; Tobe, Sheldon W; Ruzicka, Marcel; Burns, Kevin D; Vallée, Michel; Prasad, G V Ramesh; Lebel, Marcel; Feldman, Ross D; Selby, Peter; Pipe, Andrew; Schiffrin, Ernesto L; McFarlane, Philip A; Oh, Paul; Hegele, Robert A; Khara, Milan; Wilson, Thomas W; Penner, S Brian; Burgess, Ellen; Herman, Robert J; Bacon, Simon L; Rabkin, Simon W; Gilbert, Richard E; Campbell, Tavis S; Grover, Steven; Honos, George; Lindsay, Patrice; Hill, Michael D; Coutts, Shelagh B; Gubitz, Gord; Campbell, Norman R C; Moe, Gordon W; Howlett, Jonathan G; Boulanger, Jean-Martin; Prebtani, Ally; Larochelle, Pierre; Leiter, Lawrence A; Jones, Charlotte; Ogilvie, Richard I; Woo, Vincent; Kaczorowski, Janusz; Trudeau, Luc; Petrella, Robert J; Hiremath, Swapnil; Drouin, Denis; Lavoie, Kim L; Hamet, Pavel; Fodor, George; Grégoire, Jean C; Lewanczuk, Richard; Dresser, George K; Sharma, Mukul; Reid, Debra; Lear, Scott A; Moullec, Gregory; Gupta, Milan; Magee, Laura A; Logan, Alexander G; Harris, Kevin C; Dionne, Janis; Fournier, Anne; Benoit, Geneviève; Feber, Janusz; Poirier, Luc; Padwal, Raj S; Rabi, Doreen M

2016-05-01

Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force provides annually updated, evidence-based recommendations to guide the diagnosis, assessment, prevention, and treatment of hypertension. This year, we present 4 new recommendations, as well as revisions to 2 previous recommendations. In the diagnosis and assessment of hypertension, automated office blood pressure, taken without patient-health provider interaction, is now recommended as the preferred method of measuring in-office blood pressure. Also, although a serum lipid panel remains part of the routine laboratory testing for patients with hypertension, fasting and nonfasting collections are now considered acceptable. For individuals with secondary hypertension arising from primary hyperaldosteronism, adrenal vein sampling is recommended for those who are candidates for potential adrenalectomy. With respect to the treatment of hypertension, a new recommendation that has been added is for increasing dietary potassium to reduce blood pressure in those who are not at high risk for hyperkalemia. Furthermore, in selected high-risk patients, intensive blood pressure reduction to a target systolic blood pressure ≤ 120 mm Hg should be considered to decrease the risk of cardiovascular events. Finally, in hypertensive individuals with uncomplicated, stable angina pectoris, either a β-blocker or calcium channel blocker may be considered for initial therapy. The specific evidence and rationale underlying each of these recommendations are discussed. Hypertension Canada's Canadian Hypertension Education Program Guidelines Task Force will continue to provide annual updates. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Work-related maternal risk factors and the risk of pregnancy induced hypertension and Preeclampsia during pregnancy. The generation R study

NARCIS (Netherlands)

J.J. Nugteren (Jaap); C.A. Snijder (Claudia); A. Hofman (Albert); V.W.V. Jaddoe (Vincent); E.A.P. Steegers (Eric); A. Burdorf (Alex)

2012-01-01

textabstractObjective: To study the associations between physically demanding work and occupational exposure to chemicals and hypertensive disorders during pregnancy within a large birth cohort study, the Generation R Study. Methods: Associations between occupational characteristics and hypertensive

Cervical Spondylosis and Hypertension

OpenAIRE

Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

2015-01-01

Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully w...

Endothelial nitric oxide synthase gene polymorphisms and cardiovascular damage in hypertensive subjects: an Italian case-control study

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Pizzo Federica

2008-05-01

Full Text Available Abstract Background Nitric oxide (NO synthesized by endothelial nitric oxide synthase (eNOS plays an important role in regulation of endothelial function and in the control of blood pressure. However, the results from some studies on the association between three clinically relevant eNOS gene polymorphisms (G894T, T786C and intron 4b/a and essential hypertension are unclear. We designed a case-control study to evaluate the influence of eNOS polymorphisms on target organ damage in 127 hypertensives and 67 normotensives. Clinical evaluation, biochemical parameters, Urinary Albumin Excretion (UAE and echocardiogram were performed to characterize target organ damage. eNOS polymorphism were recognized by PCR method. Results The distribution of eNOS genotypes was similar in hypertensives and normotensives but 4aa was present in the 2.5% of hypertensives and completely absent in normotensives. Subjects with 4bb, G894T, and T786C genotypes showed an increased prevalence of target organ damage. Moreover prevalence of G894T and introne 4 variants was significantly higher in hypertensives than in normotensives both with cardiovascular damage. Logistic regression analysis didn't show any association between eNOS polymorphisms, Body Mass Index (BMI, hypertension, gender and cardiovascular damage. Only the age (OR 1.11; IC 95% 1.06–1.18 was predictive of cardiovascular damage in our population. Conclusion Our results seem to indicate a lack of association with eNOS variants and cardiovascular damage onset.

Cognitive impairment and hypertension in older adults living in extreme poverty: a cross-sectional study in Peru.

Science.gov (United States)

Lazo-Porras, Maria; Ortiz-Soriano, Victor; Moscoso-Porras, Miguel; Runzer-Colmenares, Fernando M; Málaga, German; Jaime Miranda, J

2017-10-26

Previous studies have shown that hypertension is a risk factor for cognitive impairment, but whether this association is also present in extremely poor populations in Low Middle Income Countries settings remains to be studied. Understanding other drivers of cognitive impairment in this unique population also merits attention. We performed a secondary analysis using data from the "Encuesta de Salud y Bienestar del Adulto Mayor", a regional survey conducted in an extremely poor population of people older than 65 years old from 12 Peruvian cities in 2012. The outcome variable was cognitive impairment, determined by a score of ≤7 in the modified Mini-Mental State Examination. The exposure was self-reported hypertension status. Variables such as age, gender, controlled hypertension, education level, occupation, depression and area of living (rural/urban) were included in the adjusted analysis. We used Poisson regression with robust variance to calculate prevalence ratios (PR) and 95% confidence interval (95% CI) adjusting for confounders. Data from 3842 participants was analyzed, 51.8% were older than 70 years, and 45.6% were females. The prevalence of cognitive impairment was 1.7% (95% CI 1.3%-2.1%). There was no significant difference on the prevalence of cognitive impairment between the group of individuals with hypertension in comparison with those without hypertension (PR = 0.64, 95% CI 0.33-1.23). The association described between hypertension and cognitive impairment was not found in a sample of extremely poor Peruvian older adults.

Utilities of Patients with Hypertension in Northern Vietnam

NARCIS (Netherlands)

Nguyen, Thi-Phuong-Lan; Krabbe, Paul F. M.; Nguyen, Thi-Bach-Yen; Schuiling-Veninga, Catharina C. M.; Wright, E. Pamela; Postma, Maarten J.

2015-01-01

Objectives The study aims to inform potential cost-effectiveness analysis of hypertension management in Vietnam by providing utilities and predictors of utilities in patients with hypertension. Methods Hypertensive patients up to 80 years old visiting the hospital were invited to participate in a

A randomized controlled trial of community health workers using patient stories to support hypertension management: Study protocol.

Science.gov (United States)

Hargraves, J Lee; Bonollo, Debra; Person, Sharina D; Ferguson, Warren J

2018-04-12

Uncontrolled hypertension is a significant public health problem in the U.S. with about one half of people able to keep blood pressure (BP) under control. Uncontrolled hypertension leads to increased risk of stroke, heart attack, and death. Furthermore, the social and economic costs of poor hypertension control are staggering. People living with hypertension can benefit from additional educational outreach and support. This randomized trial conducted at two Community Health Centers (CHCs) in Massachusetts assessed the effect of community health workers (CHWs) assisting patients with hypertension. In addition to the support provided by CHWs, the study uses video narratives from patients who have worked to control their BP through diet, exercise, and better medication adherence. Participants enrolled in the study were randomly assigned to immediate intervention (I) by CHWs or a delayed intervention (DI) (4 to 6 months later). Each participant was asked to meet with the CHW 5 times (twice in person and three times telephonically). Study outcomes include systolic and diastolic BP, diet, exercise, and body mass index. CHWs working directly with patients, using multiple approaches to support patient self-management, can be effective agents to support change in chronic illness management. Moreover, having culturally appropriate tools, such as narratives available through videos, can be an important, cost effective aid to CHWs. Recruitment and intervention delivery within a busy CHC environment required adaptation of the study design and protocols for staff supervision, data collection and intervention delivery and lessons learned are presented. Clinical Trials.gov registration submitted 8/17/16: Protocol ID# 5P60MD006912-02 and Clinical trials.gov ID# NCT02874547 Community Health Workers Using Patient Stories to Support Hypertension Management. Copyright © 2018. Published by Elsevier Inc.

Epidemiology and management of hypertension among Bedouins in Northern Jordan.

Science.gov (United States)

Jaddou, Hashem Y; Bateiha, Anwar M; Al-Khateeb, Mohammed S; Ajlouni, Kamel M

2003-05-01

To estimate the magnitude of hypertension, and its levels of awareness and control of hypertension among a community of Jordanian aborigines in Northern Jordan; and to compare the study findings with findings from other Jordanian communities. A systematic sample of 50% of all households of Qafqafa, Northern Jordan was selected and all members of the selected households were included in the study at Qafqafa Health Center, Qafqafa, Jordan. A structured questionnaire was administered to all study participants and measurement of blood pressure was performed according to a preset criteria. Data on 366 subjects included in the sample were collected during the months of April and May 2002. A total of 40 subjects or 10.9% were suffering from hypertension. Prevalence rate of hypertension was significantly lower than the 16.1% and 16.3% prevalence rates reported from other more modernized Jordanian communities. Logistic regression analysis indicated that hypertension was positively associated with masculinity, age, illiteracy, obesity, and with positive family history of hypertension. No association was detected between hypertension and each of smoking, Diabetes mellitus, and total serum cholesterol. This study showed that one-half (47.5%) of hypertensives were unaware of their diagnosis and more than one-half (57.1%) of those aware of their diagnosis did not achieve control of their hypertension. Population of the study community has significantly lower levels of hypertension than both semi-urban and recently urbanized Jordanian communities, and much of the rise in blood pressure levels is attributed to environmental factors. Moreover, hypertension management programs in Jordan are far below the optimal standards.

Study of intrarenal vasculature in cases of primary and secondary hypertension (by metallic impregnation technique on whole kidney section

Directory of Open Access Journals (Sweden)

Mittal B

1992-10-01

Full Text Available Study of intrarenal vasculature was carried out by using the metallic impregnation technique on whole kidney sections in 31 [corrected] cases of (primary and secondary hypertension and 10 normal controls. Distinct patterns of intrarenal vasculature were noted in controls and in cases of hypertension. Gradual tapering of vessels, absence of tortuosity and good peripheral vascularisation were noted in controls. Abrupt tapering, tortuosity of vessels and poor peripheral vascularisation were noted in hypertensive cases. In essential hypertension moderate to severe changes of dilatation of the segmental and/or arcuate arteries was noted. The degree of dilatation was related to the level of systolic BP rather than diastolic in cases of essential hypertension. Secondary hypertension even if severe, rarely showed significant dilatation lesions. Avascular zones and conglomeration of vessels at poles was seen only in cases of pyelonephritis. This helped in distinguishing these, from cases of glomerulonephritis.

Education and hypertension: impact on global cardiovascular risk.

Science.gov (United States)

Di Chiara, Tiziana; Scaglione, Alessandra; Corrao, Salvatore; Argano, Christiano; Pinto, Antonio; Scaglione, Rosario

2017-10-01

Improving cardiovascular risk prediction continues to be a major challenge and effective prevention of cardiovascular disease. Accordingly, several studies have recently reported on the role of cardiovascular risk education. This study was designed to evaluate the impact of education on global cardiovascular risk in hypertensive patients. The study population consisted of 223 consecutive hypertensive outpatients. Their educational status was categorized according to the number of years of formal education as follows: (1) low education (less than 10 years) and (2) medium-high education (10-15 years). In both groups, cardiometabolic comorbidities, global cardiovascular risk and echocardiographic measurements were analysed. Less educated hypertensive subjects were characterized by a significantly higher prevalence of patients with metabolic syndrome (MetS) (p educated hypertensive subjects. In the same subjects, a significant increase in microalbuminuria (MA) (p education (r = -0.45; p Education was independently (p education may be considered the best predictor of global cardiovascular risk in hypertensives and thus has to be evaluated in the strategies of hypertension and cardiovascular risk management.

RENAL DENERVATION IN RESISTANT ARTERIAL HYPERTENSION

OpenAIRE

V. A. Sulimov; A. V. Rodionov; A. A. Svetankova; I. E. Deneka

2015-01-01

A new method of non-drug treatment of resistant hypertension – renal denervation is considered. General information about resistant hypertension, method of renal denervation, the results of clinical studies on efficacy and safety, as well as own clinical case are presented.

Effect of shift work on hypertension: cross sectional study.

Science.gov (United States)

Yeom, Jeong Han; Sim, Chang Sun; Lee, Jiho; Yun, Seok Hyeon; Park, Sang Jin; Yoo, Cheol-In; Sung, Joo Hyun

2017-01-01

The need of efficient resource management and full-time accessibility to resources has increased with the development of industry, resulting in the increase of shift workers. Previous researches of past decades show that there are various health effects on shift workers. However, the definition and the form of shift work have varied from each research and occupational harmful factors except for shift work have not been excluded completely in previous researches. Therefore, in this research, we tried to find out the effect of shift work focusing on the hypertension. To complement previously mentioned weakness of other researches, we performed our research on participants to whom we could minimize other risk factors excluding shift work. This research examined 1,953 petrochemical plant male workers (shift work 1,075, day worker 878) who did medical checkup from 1st Jan. 2014 to 31th Dec. 2014 in a general hospital located in Ulsan, based on their medical records and questionnaires. With the questionnaire, we found out their basic information including age, social status, occupational history, and we took their physical measurements. Compared to day workers, shift workers' odds ratio of developing hypertension was 1.31 (95% CI 0.98-1.75). After adjusting confounding variables, adjusted odds ratio for entire subjects was 1.51 (95% CI 1.11-2.06). Also, for subjects who were in continuous service for over 20 years, odds ratio was 1.51 (95% CI 1.08-2.11). Shift workers had a higher chance of hypertension than day workers do. Particularly, the longer the workers work continuously, the risk of hypertension getting higher.

Association of blood glucose level and hypertension in Elderly Chinese Subjects: a community based study.

Science.gov (United States)

Yan, Qun; Sun, Dongmei; Li, Xu; Chen, Guoliang; Zheng, Qinghu; Li, Lun; Gu, Chenhong; Feng, Bo

2016-07-13

There is a scarcity of epidemiological researches examining the relationship between blood pressure (BP) and glucose level among older adults. The objective of the current study was to investigate the association of high BP and glucose level in elderly Chinese. A cross-sectional study of a population of 2092 Chinese individuals aged over 65 years was conducted. Multiple logistic analysis was used to explore the association between hypertension and hyperglycemia. Independent risk factors for systolic and diastolic BP were analyzed using stepwise linear regression. Subjects in impaired fasting glucose group (IFG) (n = 144) and diabetes (n = 346), as compared with normal fasting glucose (NFG) (n = 1277), had a significant higher risk for hypertension, with odds ratios (ORs) of 1.81 (95 % CI, 1.39-2.35) (P = 0.000) and 1.40 (95 % CI, 1.09-1.80) (P = 0.009), respectively. Higher fasting plasma glucose (FPG) levels in the normal range were still significantly associated with a higher prevalence of hypertension in both genders, with ORs of 1.24 (95 % CI, 0.85-1.80), R (2) = 0.114, P = 0.023 in men and 1.61 (95 % CI, 1.12-2.30), R (2) = 0.082, P = 0.010 in women, respectively, when compared with lower FPG. Linear regression analysis revealed FPG was an independent factor of systolic and diastolic BP. Our findings suggest that hyperglycemia as well as higher FPG within the normal range is associated with a higher prevalence of hypertension independent of other cardiovascular risk factors in elderly Chinese. Further studies are needed to explore the relationship between hyperglycemia and hypertension in a longitudinal setting.

Heart Disease, Hypertension, Gestational Diabetes Mellitus, and Preeclampsia/Eclampsia in Mothers With Juvenile Arthritis: A Nested Case-Control Study.

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Feldman, Debbie E; Vinet, Évelyne; Bérard, Anick; Duffy, Ciarán; Hazel, Beth; Meshefedjian, Garbis; Sylvestre, Marie-Pierre; Bernatsky, Sasha

2017-02-01

To determine whether women with a history of juvenile arthritis are at higher risk for heart disease and hypertension and for developing adverse maternal outcomes: gestational diabetes mellitus, maternal hypertension, and preeclampsia/eclampsia. We designed a nested case-control study from a cohort of first-time mothers with prior physician billing codes suggesting juvenile arthritis, and a matched comparison group without juvenile arthritis. For the nested case-control design, we selected 3 controls for each case for the outcomes of heart disease (n = 403), prepregnancy hypertension (n = 66), gestational diabetes mellitus (n = 285), maternal hypertension (n = 561), and preeclampsia/eclampsia (n = 236). We used conditional logistic regression, adjusting for maternal age and education. Having juvenile arthritis was associated with heart disease (odds ratio [OR] 2.44 [95% confidence interval (95% CI) 1.15-5.15]) but not with gestational hypertension, diabetes mellitus, or preeclampsia/eclampsia. All 66 cases of prepregnancy hypertension had juvenile arthritis. Having prepregnancy hypertension was strongly associated with preeclampsia/eclampsia (OR 8.05 [95% CI 2.69-24.07]). Women with a history of juvenile arthritis had a higher risk of heart disease. This risk signals the potential importance of cardiac prevention strategies in juvenile arthritis. As this was a retrospective study, it was not possible to correct for some relevant potential confounders. Further studies should assess the impact of medications, disease severity, and other factors (e.g., obesity) on cardiac outcomes in juvenile arthritis. © 2016, American College of Rheumatology.

Hypertension in women.

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Pimenta, Eduardo

2012-02-01

Hypertension is an important modifiable risk factor for cardiovascular (CV) morbidity and mortality, and a highly prevalent condition in both men and women. However, the prevalence of hypertension is predicted to increase more among women than men. Combined oral contraceptives (COCs) can induce hypertension in a small group of women and, increase CV risk especially among those with hypertension. Both COC-related increased CV risk and blood pressure (BP) returns to pretreatment levels by 3 months of its discontinuation. The effects of menopause and hormone replacement therapy (HRT) on BP are controversial, and COCs and HRT containing the new generation progestin drospirenone are preferred in women with established hypertension. Despite the high incidence of cancer in women, CV disease remains the major cause of death in women and comparable benefit of antihypertensive treatment have been demonstrated in both women and men.

Adherence treatment factors in hypertensive African American women

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Marie N Fongwa

2008-02-01

Full Text Available Marie N Fongwa1, Lorraines S Evangelista1, Ron D Hays2, David S Martins3, David Elashoff4, Marie J Cowan1, Donald E Morisky51University of California Los Angeles School of Nursing, Los Angeles, CA, USA; 2University of California Los Angeles School of Medicine, Division of General Internal Medicine and Health Services Research, Los Angeles, CA, USA; 3To Help Everyone Clinic Inc. Los Angeles, CA, USA; 4University of California Los Angeles Public Health, Los Angeles, CA, USA; 5University of California Los Angeles School of Public Health, CA, USABackground: Hypertension among African American women is of epidemic proportions. Nonadherence to treatment contributes to uncontrolled blood pressure in this population. Factors associated with adherence to treatment in African American women are unknown. The purpose of this study was to identify factors associated with adherence to hypertension treatment in African American women.Methods: Five audio-taped focus groups were conducted with hypertensive African American women, 35 years and older receiving treatment for hypertension from an inner-city free clinic. All transcripts from the tapes were analyzed for content describing adherence to treatment factors.Findings: Factors associated with adherence to treatment in hypertensive African American women were in three main categories including: beliefs about hypertension, facilitators of adherence to treatment, and barriers to adherence to treatment.Implications: The study supports the need for education on managing hypertension and medication side effects, early screening for depression in hypertensive African Americans, development of culturally sensitive hypertension educational material, and formation of support groups for promoting adherence to treatment among African American women with hypertension.Keywords: adherence, African American, hypertension treatment factors

Knowledge of Hypertensive Patients With or Without HIV on ...

African Journals Online (AJOL)

Purpose: The study assessed the knowledge of both HIV and non-HIV hypertensive patients on hypertension and the role of pharmacists in their pharmaceutical care. Methods: The study was conducted at the hypertension and HIV clinics in government hospitals in Dar es Salaam, Tanzania. Patients were interviewed using ...

Hypertension and Spina Bifida

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SBA National Resource Center: 800-621-3141 Hypertension A disease that often goes undetected. What is hypertension? Hypertension, also called high blood pressure , is a condition in which the arteries of ...

Revisiting essential hypertension--a "mechanism-based" approach may argue for a better definition of hypertension.

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Calò, L A

2009-08-01

Several major overarching themes have recently emerged in our understanding of the pathophysiology of hypertension which may allow to revisit essential hypertension with an eye towards the possibility of adopting a more rational "mechanistic-based" definition of hypertension and moving away from the unsatisfactory "essential" label for hypertension from unknown cause. As our understanding of the biochemical and physiological mechanisms that control blood pressure rapidly evolves, the "essential" label of hypertension is losing both value as well as utility as it will describe an increasingly small number of hypertensive patients. This paper uses some recently identified pathways central to hypertension and uses this understanding of pathophysiology to argue for a better definition of hypertension.

Calcium fractions in aortic segments from hypertensive rabbits

International Nuclear Information System (INIS)

Tomera, J.F.; Harakal, C.

1982-01-01

The rate constants (-k) of Ca 2 + from cellular compartments of intact smooth muscle cells of thoracic aorta of normotensive, renal hypertensive, and cadmium hypertensive rabbits were studied by 45 Ca efflux and by employing norepinephrine (NE, 5.9 X 10(-7) M). Tissues from hypertensive animals showed an increased rate of release of 45 Ca over a 5-h unloading period when compared to normotensive controls. Three exchangeable compartments were found to contribute to the total kinetic efflux curve for all groups. The Ca 2 + fraction in compartments I and II showed an increased rate of Ca 2 + release for the hypertensive subgroups. Although the rates were slowed for tissues treated with NE prior to efflux, the rates of the hypertensive subgroups were increased compared to the normotensive group. Pretreatment of aortic segments with NE caused an overall increase in 45 Ca activity of the incubation medium and may explain the slowed rates attained in the efflux analyses. Influx studies showed that tissues from hypertensive animals had a greater uptake of 45 Ca than did the normotensive controls. Such data may represent a larger exchangeable component in aortae from the hypertensive subgroups. These findings indicate differences in the rates of Ca 2 + release from intact smooth muscle cells of hypertensive rabbits

Hypertension in Pregnancy and Future Cardiovascular Event Risk in Siblings

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Turner, Stephen T.; Mosley, Thomas H.; Kardia, Sharon L.R.; Hanis, Craig L.; Milic, Natasa M.; Garovic, Vesna D.

2016-01-01

Hypertension in pregnancy is a risk factor for future hypertension and cardiovascular disease. This may reflect an underlying familial predisposition or persistent damage caused by the hypertensive pregnancy. We sought to isolate the effect of hypertension in pregnancy by comparing the risk of hypertension and cardiovascular disease in women who had hypertension in pregnancy and their sisters who did not using the dataset from the Genetic Epidemiology Network of Arteriopathy study, which examined the genetics of hypertension in white, black, and Hispanic siblings. This analysis included all sibships with at least one parous woman and at least one other sibling. After gathering demographic and pregnancy data, BP and serum analytes were measured. Disease-free survival was examined using Kaplan–Meier curves and Cox proportional hazards regression. Compared with their sisters who did not have hypertension in pregnancy, women who had hypertension in pregnancy were more likely to develop new onset hypertension later in life, after adjusting for body mass index and diabetes (hazard ratio 1.75, 95% confidence interval 1.27–2.42). A sibling history of hypertension in pregnancy was also associated with an increased risk of hypertension in brothers and unaffected sisters, whereas an increased risk of cardiovascular events was observed in brothers only. These results suggest familial factors contribute to the increased risk of future hypertension in women who had hypertension in pregnancy. Further studies are needed to clarify the potential role of nonfamilial factors. Furthermore, a sibling history of hypertension in pregnancy may be a novel familial risk factor for future hypertension. PMID:26315531

Streptozotocin-induced diabetes mellitus in spontaneously hypertensive rats: a pathophysiological model for the combined effects of hypertension and diabetes

NARCIS (Netherlands)

Pijl, A. J.; van der Wal, A. C.; Mathy, M. J.; Kam, K. L.; Hendriks, M. G.; Pfaffendorf, M.; van Zwieten, P. A.

1994-01-01

The present study was undertaken to investigate the combined effects of hypertension and streptozotocin-induced diabetes mellitus in the rat. Accordingly, four groups of rats were studied: Wistar Kyoto rats (WKY), diabetic WKY, spontaneously hypertensive rats (SHR) and diabetic SHR, respectively.

Efficacy of moxibustion for pre- or stage I hypertension: study protocol for a pilot randomized controlled trial

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Shin Kyung-Min

2012-10-01

Full Text Available Abstract Background Hypertension is a risk factor for cardiovascular disease, and the prevalence of hypertension tends to increase with age. Current treatments for hypertension have adverse side effects and poor adherence. The purpose of this study is to evaluate the effects of moxibustion on blood pressure in individuals with pre- or stage I hypertension. Methods/design Forty-five subjects with pre- or stage I hypertension will be randomized into three groups: treatment group A (2 times/week, treatment group B (3 times/week, and the control group (non-treated group. The inclusion criteria will be as follows: (1 aged between 19 and 65 years; (2 prehypertension or stage I hypertension (JNC 7, Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; (3 the participants are volunteers and written consent obtained. The participants in the treatment group A will undergo indirect moxibustion 2 times per week for 4 weeks, and the participants in the treatment group B will undergo indirect moxibustion 3 times per week for 4 weeks. The participants in the control group (non-treated group will maintain their current lifestyle, including diet and exercise. The use of antihypertensive medication is not permitted. The primary endpoint will be a change in patient blood pressure. The secondary endpoints will be the body mass index, lipid profile, EuroQol and Heart Rate Variability. The data will be analyzed with the Student’s t-test and analysis of variance (ANOVA (p Discussion The results of this study will help to establish the optimal approach for the care of adults with pre- or stage I hypertension. Trial registration Clinical Research Information Service KCT0000469

Hypertension and Diabetes Mellitus: Coprediction and Time Trajectories.

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Tsimihodimos, Vasilis; Gonzalez-Villalpando, Clicerio; Meigs, James B; Ferrannini, Ele

2018-03-01

Type 2 diabetes mellitus and hypertension overlap in the population. In many subjects, development of diabetes mellitus is characterized by a relatively rapid increase in plasma glucose values. Whether a similar phenomenon occurs during the development of hypertension is not known. We analyzed the pattern of blood pressure (BP) changes during the development of hypertension in patients with or without diabetes mellitus using data from the MCDS (Mexico City Diabetes Study; a population-based study of diabetes mellitus in Hispanic whites) and in the FOS (Framingham Offspring Study, a community-based study in non-Hispanic whites) during a 7-year follow-up. Diabetes mellitus at baseline was a significant predictor of incident hypertension (in FOS, odds ratio, 3.14; 95% confidence interval, 2.17-4.54) independently of sex, age, body mass index, and familial diabetes mellitus. Conversely, hypertension at baseline was an independent predictor of incident diabetes mellitus (in FOS, odds ratio, 3.33; 95% CI, 2.50-4.44). In >60% of the converters, progression from normotension to hypertension was characterized by a steep increase in BP values, averaging 20 mm Hg for systolic BP within 3.5 years (in MCDS). In comparison with the nonconverters group, hypertension and diabetes mellitus converters shared a metabolic syndrome phenotype (hyperinsulinemia, higher body mass index, waist girth, BP, heart rate and pulse pressure, and dyslipidemia). Overall, results were similar in the 2 ethnic groups. We conclude that (1) development of hypertension and diabetes mellitus track each other over time, (2) transition from normotension to hypertension is characterized by a sharp increase in BP values, and (3) insulin resistance is one common feature of both prediabetes and prehypertension and an antecedent of progression to 2 respective disease states. © 2018 American Heart Association, Inc.

Clinical study on the factors affecting the post-partum recovery of patients with hypertensive pregnancy disorders at a Chinese hospital.

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Wei, Jun; Wang, Yan; Xu, Jiayuan; Zhang, Chunfang; Zhou, Helen; Liu, Guoli

2017-03-01

The aim of this study was to investigate the post-partum recovery of blood pressure (BP) in women with hypertensive disorders of pregnancy (HDP) and to evaluate HDP risk factors. A total of 124 patients with gestational hypertension (n = 63) or pre-eclampsia (n = 61) who gave birth at Peking University People's Hospital between January and December 2013 were included in this study. The recorded clinical and laboratory parameters included the patients' general information, maternal pre-pregnancy body mass index, gestational weight gain, gestational age at onset and delivery, delivery mode and time taken for BP to return to normal level. Logistic regression analysis was performed to evaluate the influence of various risk factors on post-partum BP recovery. The mean interval for BP normalization was 24.1 ± 22.8 days (median, 7 days). Forty-six percent of the patients recovered from hypertension within three days, and 75% recovered within six weeks of delivery. About 90% of the patients required 60 days for BP to normalize after delivery. After adjusting for confounding factors, post-partum recovery from hypertension was found to be influenced by hypertension severity, maternal serum albumin level, a family history of hypertension and gestational week at delivery. The BP of the majority of the patients with gestational hypertension or pre-eclampsia returned to normal within 60 days of delivery. Hypertension severity, maternal serum albumin level, a family history of family hypertension and gestational week at delivery influenced the time required for BP normalization. © 2016 Japan Society of Obstetrics and Gynecology.

Adrenal Mass Causing Secondary Hypertension.

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Robinson, Darlene Y

2015-11-01

Most hypertensive patients have essential (primary) hypertension; only 5% to 10% have a secondary cause. Two clinical characteristics suggestive of secondary hypertension are early onset (hypertension (>180/110 mm Hg). When faced with these findings, clinicians should consider a secondary cause of hypertension. A 22-year-old woman being evaluated for asthma exacerbation in the emergency department was noted to have severe persistent hypertension. Additional evaluation revealed severe hypokalemia, metabolic alkalosis, and hypernatremia. The patient was admitted to the hospital for blood pressure management, electrolyte replacement, and further evaluation of presumed hyperaldosteronism. Diagnostic imaging revealed a large adrenal mass. Surgical resection was performed, leading to a diagnosis of hyperaldosteronism caused by adrenal carcinoma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Secondary hypertension is far less common than essential hypertension; however, considering the large volume of patients seen in emergency departments, it is likely that some will have secondary hypertension. Emergency physicians should be aware of the clinical characteristics that suggest secondary hypertension so that the appropriate diagnostic and treatment pathways can be pursued. Copyright © 2015 Elsevier Inc. All rights reserved.

Left atrial volume index is an independent predictor of hypertensive response to exercise in patients with hypertension.

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Lee, Sang-Eun; Youn, Jong-Chan; Lee, Hye Sun; Park, Sungha; Lee, Sang-Hak; Cho, In-Jeong; Shim, Chi Young; Hong, Geu-Ru; Choi, Donghoon; Kang, Seok-Min

2015-02-01

A hypertensive response to exercise (HRE) is known to be associated with higher risk of heart failure and future cardiovascular events in patients with hypertension. Left atrial volume index (LAVI) is associated with the diastolic dysfunction, indicating exercise intolerance. Therefore, we investigated whether LAVI is relevant to HRE during cardiopulmonary exercise test (CPET). We studied 118 consecutive hypertensive patients (61 men, 57±11 years) and 45 normotensive control subjects (16 men, 54±8 years). Clinical characteristics, CPET, echocardiographic and laboratory findings were assessed at the time of enrollment. HRE was defined as maximum systolic blood pressure (SBP)⩾210 mm Hg in men and ⩾190 mm Hg in women. HRE was more prevalent in hypertensive patients compared with normotensive control subjects (50.8% vs. 20.0%, PHRE in normotensive control subjects, as were baseline SBP and LAVI in hypertensive group. In multivariate analysis, LAVI was found to be an independent predictor of HRE in hypertensive patients (P=0.020) but not in normotensive control subjects (P=0.936) when controlled for age, sex, body mass index and peak oxygen consumption. Higher LAVI, reflecting the duration and severity of increased left atrial pressure is independently associated with HRE in hypertensive patients, but not in normotensive control subjects.

Intracranial Hypertension Research Foundation

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... PARTNERSHIPS Meet our Fundraising Partners Tweet Welcome Intracranial hypertension (IH) is the general term for the neurological ... high. (Old names for IH include Benign Intracranial Hypertension and Pseudotumor Cerebri). The Intracranial Hypertension Research Foundation ...

HIV and Pulmonary Hypertension

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... What do I need to know about pulmonary hypertension in connection with HIV? Although pulmonary hypertension and ... Should an HIV patient be tested for pulmonary hypertension? HIV patients know that medical supervision is critical ...

Dietary pattern and other lifestyle factors as potential contributors to hypertension prevalence in Arusha City, Tanzania: a population-based descriptive study

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L. K. Katalambula

2017-08-01

Full Text Available Abstract Background High blood pressure is increasing worldwide, disproportionately so in developing countries. Inadequate health care systems and adoption of unhealthy lifestyles have been linked to this emergent pattern. To better understand this trend, it is imperative we measure prevalence of hypertension, and examine specific risk factors, at a local level. This study provides a cross-sectional view of urban residents of Arusha City to determine prevalence and associated risk factors. Methods Blood pressure was measured using a digital sphygmomanometer. Interviews were conducted using the WHO STEPwise survey questionnaire to assess lifestyle factors. Dietary intake information was collected by a standardized Food Frequency Questionnaire (FFQ. Descriptive statistics were used to analyze demographic characteristics. Means and standard deviations were calculated for continuous variables and percentages for categorical variables. Pearson’s Chi Square (χ 2 tests were used to determine significant risk factors for hypertension, and multivariate log binomial regression was used to reveal potential predictors of hypertension. Dietary patterns were analyzed by principal component analysis. Results Approximately 45% of the study population was found to be hypertensive. The mean arterial blood pressure (MABP of the sample was 102.3 mmHg (SD = 18.3. Mean systolic and diastolic blood pressure were 136.3 (SD = 30.5 and 85.3 (SD = 16.1 mmHg, respectively. Through multivariate analysis, age and body mass index were found to be independently, positively, associated with hypertension. Adherence to ‘healthy’ dietary pattern was negatively independently associated with hypertension. Conclusions With nearly half of participants being hypertensive, this study suggests that hypertension is a significant health risk in Arusha, Tanzania. Obesity, healthy diet, and age were found to be positively associated with hypertension risk. This study did not

Dietary pattern and other lifestyle factors as potential contributors to hypertension prevalence in Arusha City, Tanzania: a population-based descriptive study.

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Katalambula, L K; Meyer, D N; Ngoma, T; Buza, J; Mpolya, E; Mtumwa, A H; Petrucka, P

2017-08-16

High blood pressure is increasing worldwide, disproportionately so in developing countries. Inadequate health care systems and adoption of unhealthy lifestyles have been linked to this emergent pattern. To better understand this trend, it is imperative we measure prevalence of hypertension, and examine specific risk factors, at a local level. This study provides a cross-sectional view of urban residents of Arusha City to determine prevalence and associated risk factors. Blood pressure was measured using a digital sphygmomanometer. Interviews were conducted using the WHO STEPwise survey questionnaire to assess lifestyle factors. Dietary intake information was collected by a standardized Food Frequency Questionnaire (FFQ). Descriptive statistics were used to analyze demographic characteristics. Means and standard deviations were calculated for continuous variables and percentages for categorical variables. Pearson's Chi Square (χ 2 ) tests were used to determine significant risk factors for hypertension, and multivariate log binomial regression was used to reveal potential predictors of hypertension. Dietary patterns were analyzed by principal component analysis. Approximately 45% of the study population was found to be hypertensive. The mean arterial blood pressure (MABP) of the sample was 102.3 mmHg (SD = 18.3). Mean systolic and diastolic blood pressure were 136.3 (SD = 30.5) and 85.3 (SD = 16.1) mmHg, respectively. Through multivariate analysis, age and body mass index were found to be independently, positively, associated with hypertension. Adherence to 'healthy' dietary pattern was negatively independently associated with hypertension. With nearly half of participants being hypertensive, this study suggests that hypertension is a significant health risk in Arusha, Tanzania. Obesity, healthy diet, and age were found to be positively associated with hypertension risk. This study did not establish any significant association between increased blood

Hypertension in Hypothyroidism; a Rare Association in Childhood

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Bushra Minhaji

2017-08-01

Full Text Available The association of hypothyroidism with hypertension is an uncommon phenomenon.   Hypertension adds to cardiovascular risk in any population and hypertension due to hypothyroidism is reversible with hormonal replacement. Although there are various case studies exists in adults but such reports are rare in children.

The interaction effect of effort-reward imbalance and overcommitment on hypertension among Chinese workers: findings from SHISO study.

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Xu, Weixian; Yu, Haiyi; Hang, Juan; Gao, Wei; Zhao, Yiming; Guo, Lijun

2013-12-01

No previous studies investigated the interaction of effort-reward imbalance (ERI) and overcommitment on blood pressure. Our aim was to investigate associations of ERI and overcommitment (and their interaction) with blood pressure and hypertension within a Chinese population. Seven hundred thirty-four participants from the Stress and Health in Shenzhen Workers study completed a demographics, job stressor and risk factor questionnaire, and their blood pressure was measured by mercury sphygmomanometers. Risk factors for blood pressure were analyzed by multiple linear regression and risk factors for hypertension by Poisson regression. Overcommitment was associated with diastolic blood pressure after adjustment for confounders and ERI among men (β = 0.17, P controlling for overcommitment, ERI remained significantly associated with hypertension risk (PR = 2.38, 95% CI 1.53-3.71). When high overcommitment and high ERI was combined, hypertension risk was highest (adjusted PR = 2.99, 95% CI 1.82-4.91, adjusted synergy index 5.85). The interaction was significant when it was tested by an interaction term in the regression (P < 0.001). The interaction effect of overcommitment and ERI on hypertension was independent and synergistic. © 2013 Wiley Periodicals, Inc.

Cognitive impairment and hypertension in older adults living in extreme poverty: a cross-sectional study in Peru

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Maria Lazo-Porras

2017-10-01

Full Text Available Abstract Background Previous studies have shown that hypertension is a risk factor for cognitive impairment, but whether this association is also present in extremely poor populations in Low Middle Income Countries settings remains to be studied. Understanding other drivers of cognitive impairment in this unique population also merits attention. Methods We performed a secondary analysis using data from the “Encuesta de Salud y Bienestar del Adulto Mayor”, a regional survey conducted in an extremely poor population of people older than 65 years old from 12 Peruvian cities in 2012. The outcome variable was cognitive impairment, determined by a score of ≤7 in the modified Mini-Mental State Examination. The exposure was self-reported hypertension status. Variables such as age, gender, controlled hypertension, education level, occupation, depression and area of living (rural/urban were included in the adjusted analysis. We used Poisson regression with robust variance to calculate prevalence ratios (PR and 95% confidence interval (95% CI adjusting for confounders. Results Data from 3842 participants was analyzed, 51.8% were older than 70 years, and 45.6% were females. The prevalence of cognitive impairment was 1.7% (95% CI 1.3%–2.1%. There was no significant difference on the prevalence of cognitive impairment between the group of individuals with hypertension in comparison with those without hypertension (PR = 0.64, 95% CI 0.33–1.23. Conclusions The association described between hypertension and cognitive impairment was not found in a sample of extremely poor Peruvian older adults.

Hypertension and obstructive sleep apnea

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Phillips CL

2013-05-01

Full Text Available Craig L Phillips,1–3 Denise M O'Driscoll4,51Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, Sydney, Australia; 2National Health and Medical Research Council Center for Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia; 3Discipline of Sleep Medicine, Sydney Medical School, University of Sydney, Sydney, Australia; 4Monash Lung and Sleep, Monash Medical Centre, Monash University, Melbourne, Australia; 5Department of Medicine, Southern Clinical School, Monash University, Melbourne, AustraliaAbstract: Obstructive sleep apnea (OSA is increasingly being recognized as a major health burden with strong focus on the associated cardiovascular risk. Studies from the last two decades have provided strong evidence for a causal role of OSA in the development of systemic hypertension. The acute physiological changes that occur during apnea promote nocturnal hypertension and may lead to the development of sustained daytime hypertension via the pathways of sympathetic activation, inflammation, oxidative stress, and endothelial dysfunction. This review will focus on the acute hemodynamic disturbances and associated intermittent hypoxia that characterize OSA and the potential pathophysiological mechanisms responsible for the development of hypertension in OSA. In addition the epidemiology of OSA and hypertension, as well as the role of treatment of OSA, in improving blood pressure control will be examined.Keywords: obstructive sleep apnea, hypertension, intermittent hypoxia, ambulatory blood pressure, sympathetic activation

RENAL DENERVATION IN RESISTANT ARTERIAL HYPERTENSION

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V. A. Sulimov

2013-01-01

Full Text Available A new method of non-drug treatment of resistant hypertension – renal denervation is considered. General information about resistant hypertension, method of renal denervation, the results of clinical studies on efficacy and safety, as well as own clinical case are presented.

RENAL DENERVATION IN RESISTANT ARTERIAL HYPERTENSION

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V. A. Sulimov

2015-09-01

Full Text Available A new method of non-drug treatment of resistant hypertension – renal denervation is considered. General information about resistant hypertension, method of renal denervation, the results of clinical studies on efficacy and safety, as well as own clinical case are presented.

Toward a definition of masked hypertension and white-coat hypertension among hemodialysis patients.

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Agarwal, Rajiv; Sinha, Arjun D; Light, Robert P

2011-08-01

Among people with essential hypertension, ambulatory BP measurement is superior to BP obtained in the clinic in predicting cardiovascular outcomes. In part, this is because it can detect white-coat hypertension and masked hypertension. Whether the same is true for hemodialysis patients is not known. Using a threshold of 140/80 mmHg for median midweek dialysis-unit BP and 135/85 mmHg for 44-hour ambulatory BP, we defined four categories of BP: sustained normotension (SN), white-coat hypertension (WCH), masked hypertension (MHTN), and sustained hypertension (SHTN). Among 355 long-term hemodialysis patients, the prevalence of SN was 35%, WCH 15%, MHTN 15%, and SHTN 35%. Over a mean follow-up of 29.6 (SD 21.7) months, 102 patients died (29%), yielding a crude mortality rate of 121/1000 patient-years. Unadjusted and multivariate-adjusted analyses showed increasing all-cause mortality with increasing severity of hypertension (unadjusted hazard ratios from SN, WCH, MHTN, SHTN: 1, 1.12, 1.70, 1.80, respectively [P for trend hypertension population, MHTN and WCH have prognostic significance. The prognostic value of BP obtained in the dialysis unit can be refined with ambulatory BP monitoring.

Drug Resistant Hypertension - No SIMPLE Way Out

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Janusz Skrzypecki

2015-02-01

Full Text Available Hypertension poses growing challenge for health policy-makers and doctors worldwide. Recently published results of Symplicity-III trial (HTN-3, the first blinded, randomized, multicenter study on the efficacy of renal denervation for the treatment of resistant hypertension did not show a significant reduction of BP in patients with resistant hypertension 6 months after renal-artery denervation, as compared with controls. In this paper we review clinical and experimental studies on renal denervation. In order to identify causes of inconsistent results in renal denervation studies we look at basic science support for renal denervation and at designs of clinical trials.

Renal sympathetic denervation attenuates hypertension and vascular remodeling in renovascular hypertensive rats.

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Li, Peng; Huang, Pei-Pei; Yang, Yun; Liu, Chi; Lu, Yan; Wang, Fang; Sun, Wei; Kong, Xiang-Qing

2017-01-01

results suggest a possible clinical efficacy of RSD for renovascular hypertension. The effects of renal sympathetic denervation (RSD) on hypertension, cardiac function, vascular fibrosis, and renal apoptosis were studied in the 2K1C rat model. Results showed that RSD attenuated hypertension, improved vascular remodeling, and reduced vascular fibrosis through decreased sympathetic activity in the 2K1C rat model, but it did not change the kidney size, renal apoptosis, or renal caspase-3 expression. These results could suggest possible clinical efficacy of RSD for renovascular hypertension. Copyright © 2017 the American Physiological Society.

Are low wages risk factors for hypertension?

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Leigh, J Paul; Du, Juan

2012-12-01

Socio-economic status (SES) is strongly correlated with hypertension. But SES has several components, including income and correlations in cross-sectional data need not imply SES is a risk factor. This study investigates whether wages-the largest category within income-are risk factors. We analysed longitudinal, nationally representative US data from four waves (1999, 2001, 2003 and 2005) of the Panel Study of Income Dynamics. The overall sample was restricted to employed persons age 25-65 years, n = 17 295. Separate subsamples were constructed of persons within two age groups (25-44 and 45-65 years) and genders. Hypertension incidence was self-reported based on physician diagnosis. Our study was prospective since data from three base years (1999, 2001, 2003) were used to predict newly diagnosed hypertension for three subsequent years (2001, 2003, 2005). In separate analyses, data from the first base year were used to predict time-to-reporting hypertension. Logistic regressions with random effects and Cox proportional hazards regressions were run. Negative and strongly statistically significant correlations between wages and hypertension were found both in logistic and Cox regressions, especially for subsamples containing the younger age group (25-44 years) and women. Correlations were stronger when three health variables-obesity, subjective measures of health and number of co-morbidities-were excluded from regressions. Doubling the wage was associated with 25-30% lower chances of hypertension for persons aged 25-44 years. The strongest evidence for low wages being risk factors for hypertension among working people were for women and persons aged 25-44 years.

A STUDY OF THE ANTIOXIDANT EFFECTS OF IRANIAN CAPTOPRIL ON PATIENTS WITH HYPERTENSION AND HEART FAILURE

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Sedighe Asgari

2010-12-01

Full Text Available Abstract INTRODUCTION: Myocardial ischemia, cerebral ischemia and myocardial infarction are the most important complications of hypertension and atherosclerotic disease in developing countries. Angiotensin converting enzyme (ACE inhibitors are among the drugs used to treat hypertension and heart failure. Captopril is an ACE-inhibitor which also has antioxidant properties. This study was conducted to assess the antioxidant effects of Iranian Captopril on malondialdehyde (MDA, conjugated dienes (CD and serum antioxidant capacity before and after treatment. methods: This interventional prospective single-blind study was conducted on 34 mildly hypertensive individuals and 34 patients with stage I and II heart failure. MDA, CD and serum antioxidant capacity were measured in all samples. The patients were then given 50 mg Captopril tablets 2-3 times daily. The measurements were repeated 1.5 months later. results: Comparison of mean MDA, CD and serum antioxidant capacity in hypertensive patients and patients with heart failure before and after drug administration revealed no significant difference in any of the parameters studied. Discussion: Existing evidence is suggestive of the strong antioxidative properties of Captopril in vitro, although these effects have not been borne out by some studies. In the present study, comparison of MDA, CD and serum antioxidants before and after the period of treatment with Iranian Captopril did not reveal any statistically significant difference.Keywords • Antioxidant • ACE inhibitor • High blood pressure • Heart failure • Clinical trial

Is white-coat hypertension a harbinger of increased risk?

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Kollias, Anastasios; Ntineri, Angeliki; Stergiou, George S

2014-09-01

White-coat hypertension is defined by elevated office and normal out-of-office blood pressure (home or ambulatory) in untreated subjects. This condition is common in clinical practice and requires appropriate work-up for detection and management. Many studies have examined the relationship between white-coat hypertension and cardiovascular risk but with marked heterogeneity in the definitions and methodology applied. Thus, the results have been inconsistent leading to confusion in scientific research and clinical practice. Some but not all the relevant studies suggested that white-coat hypertension is associated with subclinical target-organ damage, yet the cross-sectional design of these studies and the fact that these indices are only surrogate end points do not allow firm conclusions to be drawn. In recent years, longitudinal studies have examined the prognostic significance of white-coat hypertension in terms of cardiovascular morbidity and mortality. Most of them indicate that white-coat hypertensive compared with normotensive subjects present a moderate-in most cases not significant-increase in risk. Meta-analyses of raw data from large databases, such as the International Database on Ambulatory blood pressure and Cardiovascular Outcomes (IDACO) and the International Database on HOme blood pressure in relation to Cardiovascular Outcomes (IDHOCO) allowed separate powered analyses in untreated subjects and provided a clearer picture regarding the modest risk associated with white-coat hypertension, especially in the long term. White-coat hypertension is regarded as an intermediate phenotype between normotension and hypertension associated with increased risk of developing sustained hypertension, and therefore requires regular follow-up using nonpharmacological measures.

[The magnetotherapy of hypertension patients].

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Ivanov, S G; Smirnov, V V; Solov'eva, F V; Liashevskaia, S P; Selezneva, L Iu

1990-01-01

A study was made of the influence of the constant MKM2-1 magnets on patients suffering from essential hypertension. Continuous action of the magnetic field, created by such magnets, on the patients with stage II essential hypertension was noted to result in a decrease of arterial pressure without the occurrence of any side effects and in a simultaneous reduction of the scope of drug administration. Apart from that fact, magnetotherapy was discovered to produce a beneficial effect on the central hemodynamics and microcirculation. The use of the MKM2-1 magnets may be regarded as a feasible method of the treatment of essential hypertension patients at any medical institution.

Hypertension in Pregnancy and Future Cardiovascular Event Risk in Siblings.

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Weissgerber, Tracey L; Turner, Stephen T; Mosley, Thomas H; Kardia, Sharon L R; Hanis, Craig L; Milic, Natasa M; Garovic, Vesna D

2016-03-01

Hypertension in pregnancy is a risk factor for future hypertension and cardiovascular disease. This may reflect an underlying familial predisposition or persistent damage caused by the hypertensive pregnancy. We sought to isolate the effect of hypertension in pregnancy by comparing the risk of hypertension and cardiovascular disease in women who had hypertension in pregnancy and their sisters who did not using the dataset from the Genetic Epidemiology Network of Arteriopathy study, which examined the genetics of hypertension in white, black, and Hispanic siblings. This analysis included all sibships with at least one parous woman and at least one other sibling. After gathering demographic and pregnancy data, BP and serum analytes were measured. Disease-free survival was examined using Kaplan-Meier curves and Cox proportional hazards regression. Compared with their sisters who did not have hypertension in pregnancy, women who had hypertension in pregnancy were more likely to develop new onset hypertension later in life, after adjusting for body mass index and diabetes (hazard ratio 1.75, 95% confidence interval 1.27-2.42). A sibling history of hypertension in pregnancy was also associated with an increased risk of hypertension in brothers and unaffected sisters, whereas an increased risk of cardiovascular events was observed in brothers only. These results suggest familial factors contribute to the increased risk of future hypertension in women who had hypertension in pregnancy. Further studies are needed to clarify the potential role of nonfamilial factors. Furthermore, a sibling history of hypertension in pregnancy may be a novel familial risk factor for future hypertension. Copyright © 2016 by the American Society of Nephrology.

White coat effect and masked uncontrolled hypertension in treated hypertensive-diabetic patients: Prevalence and target organ damage.

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Leiria, Liana F; Severo, Mateus D; Ledur, Priscila S; Becker, Alexandre D; Aguiar, Fernanda M; Massierer, Daniela; Freitas, Valéria C; Schaan, Beatriz D; Gus, Miguel

2015-09-01

The association between hypertensive phenotypes of controlled hypertension (CH), white-coat effect (WCE), masked uncontrolled hypertension (MUH) and sustained hypertension (SH) with target organ damage have not been clearly established in diabetic hypertensive treated patients. The present study aims to evaluate the prevalence of the four phenotypes considering the current cut-off points for office and 24 h-ambulatory blood pressure monitoring (ABPM) and the association with left ventricle hypertrophy (LVH), diastolic function and nephropathy. Cross-sectional study with 304 patients on anti-hypertensive treatment aged 57.6 ± 6.1 years, who were submitted to ABPM and echocardiography. They were classified into CH (normal office BP and ABPM), WCE (high office BP and normal ABPM), MUH (normal office BP and high ABPM), and SH (high office BP and ABPM). Median HbA1c and diabetes duration were 7.9% (6.8-9.2), and 10 years (5-16), respectively. Prevalences of CH, WCE, MUH and SH were 27.3%, 17.1%, 18.8%, and 36.8%. MUH prevalence was higher than previously described. There was a significant increasing trend across the four groups in variables related to LVH (P ABPM beyond the traditional cardiovascular risk stratification tools has limitations, but is still useful in high-risk patients. Longitudinal studies could better evaluate the role of the use of ABPM in this scenario. Cut-off points for normality of office and ABPM influence the prevalences of WCH and MUH. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Surgical Treatment of Cervical Spondylotic Myelopathy Associated Hypertension--A Retrospective Study of 309 Patients.

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Ze-qun Li

Full Text Available Hypertension is the most prevalent cardiovascular disease, and various risk factors are known to be involved in it. Cervical spondylotic myelopathy (CSM is the most common non-traumatic cause of myelopathy, which displays neurological symptoms and may induce systemic symptoms. To date, it is still unknown whether CSM is associated with hypertension, and if so, whether the decompression operations can attenuate CSM associated hypertension. Here, a total of 309 patients with CSM who received anterior or posterior decompression surgery were enrolled as subjects. Blood pressure measurements were performed before and within one week after the surgery. Among the 309 subjects, 144 (46.6% of them exhibited hypertension before surgery, a significantly higher ratio than that of the whole population. One week after surgery, blood pressure of 106 (73.6% patients turned back to normal. Blood pressure of another 37(25.7% patients decreased with different degrees, although still higher than normal. Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure. We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well. Collectively, compression of spinal cord in CSM patients might be associated with hypertension, and decompression surgery largely attenuated this type of hypertension. These findings prove CSM to be a potential associated factor of high blood pressure and may shed light on therapies of hypertension in clinics.