Int J Hypertens [JOURNAL]
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200 papers
Factors Affecting Hypertensive Treatment Adherence: Development and Preliminary Validation of a New Scale.
Dehghan M, Dehghan Nayeri N
Int J Hypertens · 2021 · PMID 33824763 · Full text
DESIGN: A sequential exploratory mixed method study was used. METHODS: After item generation using a qualitative study and literature review, the psychometric properties of the scale were evaluated. Face, content, and co...
DESIGN: A sequential exploratory mixed method study was used. METHODS: After item generation using a qualitative study and literature review, the psychometric properties of the scale were evaluated. Face, content, and construct validity, Cronbach's alpha, and test-retest reliability were used to validate the scales. RESULTS: Data analysis showed that the scale had acceptable face and content validity. The scale had excellent stability (intraclass correlation = 0.89) and good acceptability of internal consistency ( = 0.71). The exploratory factor analysis showed that the scale consisted of five subscales which were meaningful. CONCLUSION: Psychometric properties of the scale achieved the standard level, and it was sufficient to recommend for general use in future measures of caring in nursing.
The Effect of Chronic and Inhospital Exposure to Renin-Angiotensin System Inhibitors on the Outcome and Inflammatory State of Coronavirus Disease 2019 Adult Inpatients.
Gaspar P, Parreira I, Antunes Meireles P … +5 more , Bessa F, Dias Silva V, Abrantes AM, Pais de Lacerda A, Mota C
Int J Hypertens · 2021 · PMID 33824762 · Full text
BACKGROUND: Controversies exist about the effect of renin-angiotensin system inhibitors (RASi) on coronavirus disease 2019 (COVID-19) outcome. The inhospital use of RASi and its effect on inflammatory sate are still poor...
BACKGROUND: Controversies exist about the effect of renin-angiotensin system inhibitors (RASi) on coronavirus disease 2019 (COVID-19) outcome. The inhospital use of RASi and its effect on inflammatory sate are still poorly studied during the COVID-19 pandemic. OBJECTIVES: We aimed to compare the impact of previous and inhospital RASi exposure on the outcome and inflammatory response of COVID-19 patients. METHODS: Single-centre, ambispective analysis of hospitalized adult COVID-19 patients at Hospital de Santa Maria, Lisbon, between March and August 2020 was performed. We excluded asymptomatic patients and those admitted due to another disease. The primary outcome was inhospital all-cause mortality. Illness severity was assessed based on the development of acute respiratory distress syndrome/acute lung injury (ARDS/ALI), intensive care unit (ICU) admission, and need for invasive mechanical ventilation (IMV). We used C-reactive protein (CRP), ferritin, and interleukin 6 (IL-6) as surrogate markers of the inflammatory response. RESULTS: From a total of 432 patients, 279 were selected, among whom 133 (47.7%) were receiving a RASi. Chronic treatment with RASi was not associated with the risk of death (OR 1.24, 95% CI 0.66-2.31, =0.500), ARDS/ALI development (OR 1.12, 95% CI 0.67-1.86, =0.676), ICU admission (OR 1.11, 95% CI 0.67-1.84, = 0.686), and IMV need (OR 1.03, 95% CI 0.58-1.84, =0.917) in a univariable and multivariable analysis. Inhospital RASi withdrawing was associated with the risk of death (OR 4.38, 95% CI 1.11-17.21, =0.035) and ARDS/ALI development (OR 4.33, 95% CI 1.49-12.6, =0.007), the latter remaining significant after adjustment. Previous exposure to RASi was associated with lower CRP levels at admission (=0.018). IL-6 levels were significantly higher in those patients whose RASi were stopped (=0.024). CONCLUSION: Previous and inhospital exposure to RASi was not associated with mortality nor severity of COVID-19. This study supports current guidance on RASi management during the COVID-19 pandemic.
Trends in the Prevalence, Awareness, Treatment, and Control of Hypertension in Nepal between 2000 and 2025: A Systematic Review and Meta-Analysis.
Dhungana RR, Pandey AR, Shrestha N
Int J Hypertens · 2021 · PMID 33747559 · Full text
BACKGROUND: Understanding the burden and trend of hypertension and the associated care cascade can provide direction to the development of interventions preventing and controlling hypertension. This study aimed to assess...
BACKGROUND: Understanding the burden and trend of hypertension and the associated care cascade can provide direction to the development of interventions preventing and controlling hypertension. This study aimed to assess prevalence and trends of hypertension and its awareness, treatment, and control in Nepal. METHODS: We systematically searched CINAHL, Embase, ProQuest, PubMed, Web of Science, WorldCat, and government and health agency-owned websites to identify studies reporting prevalence of hypertension, awareness, treatment, and control in Nepal between 2000 and 2020. We applied the random-effects model to compute the pooled prevalence in the overall population and among subgroups in each 5-year interval period between 2000 and 2020. We used linear meta-regression analysis to predict hypertension from 2000 to 2025. RESULTS: We identified 23 studies having a total of 84,006 participants. The pooled prevalence of hypertension, awareness, treatment, and control for 2016-2020 was 32% (95% CI: 23-40%), 50% (95% CI: 30-69%), 27% (95% CI: 19-34%), and 38% (95% CI: 28-48%), respectively. The prevalence of hypertension varied by age, gender, education, and geographical area. Hypertension increased by 6 percentage points (pp), awareness increased by 12 pp, treatment increased by 11 pp, and control increased by 3 pp over the 20 years studied. Since 2000, the rate of increment of hypertension has been 3.5 pp per decade, where 44.7% of men are expected to suffer from hypertension by 2025. CONCLUSION: The markedly increased prevalence of hypertension and relatively poor progress in hypertension awareness, treatment, and control in Nepal suggest that there is a need for hypertension preventive approaches as well as strategies to optimize hypertension care cascade.
Relation between Blood Pressure Variability within a Single Visit and Stroke.
Ma W, Yang Y, Qi L … +5 more , Zhang B, Meng L, Zhang Y, Li M, Huo Y
Int J Hypertens · 2021 · PMID 33747558 · Full text
Blood pressure variability (BPV) has been identified as an important risk factor for cardiovascular events. The white coat effect (WCE), which is measured as the first systolic blood pressure (SBP) measurement minus the...
Blood pressure variability (BPV) has been identified as an important risk factor for cardiovascular events. The white coat effect (WCE), which is measured as the first systolic blood pressure (SBP) measurement minus the mean of the second and third measurements, is a BPV indicator within a single visit. In total, 2,972 participants who had three measurements of BP within a single visit were included. The participants were divided into three groups based on their WCE percentiles: Group 1 (WCE, 2.5-97.5th percentiles of WCE), Group 2 (WCE, 0-2.4th percentiles of WCE), and Group 3 (WCE, 97.6-100th percentiles of WCE). A multiple logistic regression model was used to analyze the relationship between WCE and stroke after adjusting for cardiovascular disease risk factors. Compared with the WCE group, the OR for stroke in the WCE group was 2.78 (95% CI: 1.22, 6.36, =0.015). After adjusting for cardiovascular factors, OR increased to 3.12 (95% CI: 1.22, 7.96, =0.017). The OR of WCE for stroke was 0.93 (95%CI: 0.87, 0.99, =0.036). BPV within a single visit is associated with stroke. The value and direction of the change may be important as well.
Association of the Risk of Osteoarthritis and Hypertension in the Korean Adult Population Aged 40-59 in Pre- and Postmenopausal Women: Using Korea National Health and Nutrition Examination Survey 2012-2016 Data.
Ryu M, Ha JS, Lee S … +3 more , Baek WC, Kimm H, Gym H
Int J Hypertens · 2021 · PMID 33708440 · Full text
PURPOSE: Previous studies reported the relation of osteoarthritis (OA) and hypertension (HTN) mostly in postmenopausal women. This study aimed to identify the association between OA and HTN in pre- and postmenopausal wom...
PURPOSE: Previous studies reported the relation of osteoarthritis (OA) and hypertension (HTN) mostly in postmenopausal women. This study aimed to identify the association between OA and HTN in pre- and postmenopausal women. METHODS: We used data of 4,627 middle-aged (40-59 years) women from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2012 to 2016. Chi-square and -test compared the characteristics of the participants. Binomial logistic regression was used to identify an association between OA and HTN under controlling covariates such as age, tobacco smoking, alcohol consumption, and obesity. RESULTS: There were 1,859 participants with non-OA and menopause, 104 with OA and nonmenopause, and 375 with OA and menopause, respectively. The number of women with OA and HTN was 129. OA was significantly associated with HTN diagnosis in postmenopausal women under controlling covariates (odds ratio: 1.408, 95% CI: 1.092-1.815, =0.008). However, this relationship was weakened in premenopausal women (odds ratio: 1.651, 95% CI: 0.950-2.869, =0.075). CONCLUSION: In conclusion, women with HTN showed a distinct association with OA than the normotensives, and this relationship was more apparent among postmenopausal women. Further research is needed for a preventive approach.
Sex Differences in the Renal Vascular Responses of AT and Mas Receptors in Two-Kidney-One-Clip Hypertension.
Pezeshki Z, Nematbakhsh M
Int J Hypertens · 2021 · PMID 33688433 · Full text
BACKGROUND: The prevalence and severity of hypertension, as well as the activity of the systemic and local renin angiotensin systems (RASs), are gender related, with more symptoms in males than in females. However, the u...
BACKGROUND: The prevalence and severity of hypertension, as well as the activity of the systemic and local renin angiotensin systems (RASs), are gender related, with more symptoms in males than in females. However, the underlying mechanisms are not well understood. In this study, we investigated sex differences in renal vascular responses to angiotensin II (Ang II) administration with and without Ang II type 1 and Mas receptor (ATR and MasR) antagonists (losartan and A779) in the 2K1C rat model of renovascular hypertension. METHODS: Male and female 2K1C rats were divided into 8 experimental groups (4 of each sex) treated with vehicle, losartan, A779, or A779+losartan. Responses of mean arterial pressure (MAP), renal blood flow (RBF), and renal vascular resistance (RVR) to Ang II were determined. RESULTS: In both sexes, the basal MAP, RBF, and RVR were not significantly different between the four groups during the control period. The Ang II administration decreased RBF and increased RVR in a dose-related manner in both sexes pretreated with vehicle or A779 ( < 0.0001), but in vehicle pretreated groups, RBF and RVR responses were different between male and female rats ( < 0.05). ATR blockade increased RBF and decreased RVR responses to Ang II, and no difference between the sexes was detected. Coblockades of ATR and MasR receptors increased RBF response to Ang II significantly in males alone but not in females ( =0.04). CONCLUSION: The impact of Ang II on RBF and RVR responses seems to be gender related with a greater effect on males, and this sex difference abolishes by Mas receptor blockade. However, the paradoxical role of dual losartan and A779 may provide the different receptor interaction in RAS between male and female rats.
Positive Associations between Adipocyte Fatty Acid-Binding Protein Level and Central Arterial Stiffness in Peritoneal Dialysis Patients.
Sung CH, Hsu BG, Tasi JP … +2 more , Wang CH, Kuo CH
Int J Hypertens · 2021 · PMID 33628486 · Full text
BACKGROUND: Adipocyte fatty acid-binding protein (A-FABP) plays essential roles in lipolysis, insulin resistance, and atherosclerosis. This study aimed to evaluate the relationship between serum A-FABP levels and carotid...
BACKGROUND: Adipocyte fatty acid-binding protein (A-FABP) plays essential roles in lipolysis, insulin resistance, and atherosclerosis. This study aimed to evaluate the relationship between serum A-FABP levels and carotid-femoral pulse wave velocity (cfPWV) in peritoneal dialysis (PD) patients. METHODS: This study obtained fasting blood samples from 76 PD patients. A validated tonometry system was used to measure cfPWV. Patients with cfPWV values >10 m/s were classified into the high arterial stiffness group, whereas patients with values ≤10 m/s were classified into the low arterial stiffness group, according to the ESH-ESC 2013 guidelines. Serum A-FABP levels were measured using a commercial enzyme-linked immunosorbent assay kit. RESULTS: Twenty-five (32.9%) of the 76 PD patients were classified in the high arterial stiffness group. Compared with the patients in the low arterial stiffness group, the high arterial stiffness group was older ( = 0.002) and had a longer PD vintage ( = 0.011), higher diastolic blood pressure (DBP, = 0.036), higher fasting glucose levels ( = 0.012), higher serum C reactive protein levels ( = 0.001), and higher serum A-FABP levels ( < 0.001). A multivariate logistic regression analysis of the factors significantly associated with central arterial stiffness revealed that A-FABP (odds ratio (OR): 1.165, 95% confidence interval (CI): 1.056-1.284, = 0.002), age (OR: 1.423, 95% CI: 1.153-1.757, = 0.001), PD vintage (OR: 1.049, 95% CI: 1.015-1.085, = 0.005), and DBP (OR: 1.152, 95% CI: 1.033-1.285, = 0.011) were independent predictors of central arterial stiffness in PD patients. Furthermore, serum A-FABP levels ( = 0.476, adjusted change: 0.197, < 0.001) were significantly positively correlated with cfPWV according to the multivariable forward stepwise linear regression analysis. CONCLUSIONS: A-FABP levels are an independent marker of central arterial stiffness in PD patients.
The Prevalence and Risk Factors of Hypertension among the Urban Population in Southeast Asian Countries: A Systematic Review and Meta-Analysis.
Mohammed Nawi A, Mohammad Z, Jetly K … +4 more , Abd Razak MA, Ramli NS, Wan Ibadullah WAH, Ahmad N
Int J Hypertens · 2021 · PMID 33628485 · Full text
The trend of global prevalence for hypertension has been dramatically increasing for the past two decades in Southeast Asian countries. A systematic review aiming to assess the prevalence of hypertension and its risk fac...
The trend of global prevalence for hypertension has been dramatically increasing for the past two decades in Southeast Asian countries. A systematic review aiming to assess the prevalence of hypertension and its risk factors among the urban population in Southeast Asian countries was conducted. We performed database searches of PubMed and Web of Science and performed meta-analysis to determine the pooled prevalence estimate. The overall pooled prevalence estimate of hypertension for Southeast Asian urban population was 33.82%. Among this, 33.98% of hypertension was reported in the community and 32.45% among adolescents in school. The common risk factors that we found were male, ethnicity, education and socioeconomic level, body mass index, waist circumference, smoking, and dyslipidaemia. The review indicates an urgent need for primary and secondary prevention activities. Therefore, a multisectoral and intersectoral approach and collaboration should be undertaken to improve the overall health outcomes of all populations in all Southeast Asian countries.
Individual and Obstetric Risk Factors of Preeclampsia among Singleton Pregnancy in Hospitals of Southern Ethiopia.
Tessema KF, Gebremeskel F, Getahun F … +2 more , Chufamo N, Misker D
Int J Hypertens · 2021 · PMID 33575039 · Full text
BACKGROUND: Preeclampsia is the second most common problem that causes maternal morbidity and complication in low-income countries. In contrast to death due to other direct causes, preeclampsia-related death is appeared...
BACKGROUND: Preeclampsia is the second most common problem that causes maternal morbidity and complication in low-income countries. In contrast to death due to other direct causes, preeclampsia-related death is appeared to be connected with multiple factors; yet, factors have paucity and are limited. Considering the clinical significance, this study aimed to identify that individual and obstetric factors of preeclampsia can be an input for disease identification involving clinicians in southern Ethiopia. METHODS: A case-control study was conducted among mothers with a singleton pregnancy who attended perinatal care in all six public hospitals in the provinces around the Omo stream. A sample size of 487 women with a singleton pregnancy (163 cases and 326 controls) was involved in the study. All cases were enrolled, while controls were selected consecutively using a random sampling technique. Data were gathered using a structured questionnaire and data extraction sheet. Descriptive data were presented using percentages and numbers. Multivariable logistic regression analysis was carried out to identify factors at a value of less than 0.05. RESULTS: There was a statistically significant association between the family history of hypertension (AOR = 2.42, 95% CI: 1.16-5.05), no pregnancy interval (AOR = 1.62; 95% CI: 1.03-2.55), and normal body mass index (AOR = 0.42, 95% CI: 0.21-0.87) and the occurrence of preeclampsia. CONCLUSION: Primary relatives with a history of chronic hypertension and no pregnancy interval were identified as risk factors of preeclampsia, while having a normal body mass index was found to be a protective factor of preeclampsia occurrence. To improve early detection and timely management of preeclampsia, the clinician should give attention to women who have no previous childbirth and whose close relatives had a history of chronic hypertension, as well as working on the protective factor is recommended.
Higher Apnea-Hypopnea Index (AHI) and Oxygen Desaturation Index (ODI) Were Independently Associated with Increased Risks of Hypertension in Patients with T2DM: A Cross-Sectional Study.
Su W, Chen G, Ma D … +7 more , Zeng J, Yan F, Lin X, Xu Z, Yang S, Li Z, Liu C
Int J Hypertens · 2021 · PMID 33552598 · Full text
OBJECTIVE: The current study aimed to explore the relationship between OSAS and hypertension and whether polysomnography (PSG) indices were independently associated with hypertension in patients with type 2 diabetes (T2D...
OBJECTIVE: The current study aimed to explore the relationship between OSAS and hypertension and whether polysomnography (PSG) indices were independently associated with hypertension in patients with type 2 diabetes (T2DM). METHODS: This study recruited 316 T2DM patients. Multivariable logistic regression analyses were performed to determine the independent association of apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) with hypertension with adjustment for potential confounders. RESULTS: Among 316 patients, 130 (41.1%) and 204 (64.6%) had hypertension and OSAS, respectively. T2DM patients with hypertension showed significantly increased levels of AHI ((median (interquartile range)): 17.2 (5.7-34.9) vs. 5.7 (2.1-17.3) events/hour, < 0.001), nonrapid eye movement AHI (NREM-AHI) (17.6 (5.5-36.5) vs. 5.2 (2.2-16.6) events/hour, < 0.001), ODI (48.4 (21.9-78.0) vs. 22.6 (10.8-48.1) events/hour, < 0.001), and severities of OSAS and decreased levels of lowest SaO ((mean ± standard deviation): 74.0 ± 10.4 vs. 77.3 ± 9.8, = 0.004). Multivariable logistic regression analysis showed that higher levels of AHI, NREM-AHI, and ODI were significantly associated with increased risks of hypertension, and the adjusted odds ratios (ORs) with 95% CI were 1.026 (1.008-1.044, = 0.004), 1.026 (1.009-1.044, = 0.003), and 1.005 (1.001-1.010, = 0.040), respectively. Compared with non-OSAS, severe OSAS was significantly associated with the risk of hypertension with the adjusted OR (95% CI) of 3.626 (1.609-8.172, = 0.002), but associations of rapid eye movement AHI (REM-AHI) and lowest SaO with hypertension were not statistically significant. CONCLUSION: Increased AHI, NREM-AHI, ODI, and severities of OSAS were significantly associated with higher risks of hypertension in T2DM patients. Detection and treatment of OSAS are needed to prevent hypertension in T2DM patients.
May Measurement Month 2017-2019: A Community-Wide Opportunistic Blood Pressure Screening Campaign in Hong Kong.
Li JTS, Lam ASM, Tomlinson B … +1 more , Lee VWY
Int J Hypertens · 2021 · PMID 33532095 · Full text
INTRODUCTION: Hypertension is a modifiable risk factor for multiple cardiovascular diseases. Early identification and intervention of new cases are crucial to improve patients' outcomes. May Measurement Month (MMM) is an...
INTRODUCTION: Hypertension is a modifiable risk factor for multiple cardiovascular diseases. Early identification and intervention of new cases are crucial to improve patients' outcomes. May Measurement Month (MMM) is an annual global synchronised blood pressure (BP) screening campaign. Participants can have their BP measured at the screening sites. It may be a possible way to identify undiagnosed hypertensive patients in the population. METHODS: It was a cross-sectional study of BP among Hong Kong adults. Multiple screening sites were set in local community pharmacies and on the campus of the Chinese University of Hong Kong. Participants were asked to fill in a questionnaire regarding their demographics, medical history, and social history. Then, they took at least one BP reading using an automated sphygmomanometer after sitting at for 5 minutes. Up to three BP readings were taken and recorded for each participant, with one-minute intervals between readings. RESULTS: A total of 3224 adults participated in MMM between 2017 and 2019. The average BP among the 3224 participants was 139.8/75.5 mmHg. The prevalence of hypertension was 2282 (70.8%), of which 635 (27.8%) were undiagnosed before MMM. Among the 1647 participants previously diagnosed with hypertension, 1007 (61.1%) had uncontrolled hypertension. CONCLUSION: A high number of cases can be identified with untreated, or treated but uncontrolled, hypertension from MMM. Citizens should be encouraged to check BP regularly and take follow-up actions if hypertension is suspected.
Analyzing Trio-Anthropometric Predictors of Hypertension: Determining the Susceptibility of Blood Pressure to Sexual Dimorphism in Body Stature.
Kenneth EU, Chinedu UG, Christian AO … +2 more , Ezeonu PO, Obaje SG
Int J Hypertens · 2021 · PMID 33532094 · Full text
BACKGROUND: Several studies had suggested that complex body stature could be a risk factor of hypertension. OBJECTIVES: We aim to correlate body mass index (BMI), waist-hip ratio (WHR), and waist-height ratio (WHtR) of r...
BACKGROUND: Several studies had suggested that complex body stature could be a risk factor of hypertension. OBJECTIVES: We aim to correlate body mass index (BMI), waist-hip ratio (WHR), and waist-height ratio (WHtR) of rural dwellers in Afikpo community, Ebonyi State, Nigeria, with blood pressure parameters. Furthermore, we aim to ascertain how each of the anthropometric variables affects blood pressure in men and women, respectively. MATERIALS AND METHODS: A sample of 400 (200 males and 200 females) adults aged 18-89 years were selected for the correlation cross-sectional study. Data for weight, height, waist, and hip circumferences were collected by means of anthropometric measurement protocol with the aid of a calibrated flexible tape and health scale and mercury sphygmomanometer for measurement of blood pressure. A participant was classified as being hypertensive if systolic blood pressure (SBP) was >140 mmHg and diastolic blood pressure (DBP) >90 mmHg. Pulse pressure was recorded as the numeric difference of SBP and DBP. RESULTS: The result revealed that male BMI and WHR were higher than those of females while female WHtR was higher than that of males ( < 0.01). The prevalence of hypertension failed to correlate with sex among participants in the study ( = 0.567; < 0.05). Variation in SBP and DBP of both sexes was dependent on BMI, WHtR, and waist and hip circumference, but not on WHR. The SBP of both sexes and female pulse pressure did correlate with age ( < 0.001). Waist circumference, BMI, and WHtR correctly predicted the variations in SBP, DBP, and pulse pressure. CONCLUSION: The strength of association of BMI, WHtR, and waist girth with SBP and DBP of both sexes was robust and similar, but inconsistent with WHR. Thus, a simple estimation of the trio-anthropometric predictors could serve as a means for routine check or preliminary diagnosis of a patient with hypertension.
Factors Affecting Hypertension in the Adult Population of the Marmara Region, Turkey: A Descriptive Field Study.
Göktaş O, Şentürk T, Ersoy C
Int J Hypertens · 2020 · PMID 33520303 · Full text
INTRODUCTION: Hypertension is an increasingly prevalent global public health problem. Nutritional culture and lifestyle are among the factors related to hypertension. The aim of this study was to evaluate the prevalence...
INTRODUCTION: Hypertension is an increasingly prevalent global public health problem. Nutritional culture and lifestyle are among the factors related to hypertension. The aim of this study was to evaluate the prevalence and influential factors of hypertension in the adult population of the Marmara region, Turkey. METHODS: The study was conducted in 10 provinces in the Marmara region between June 01, 2018, and November 30, 2018. Participants included 2353 patients over 18 years of age diagnosed with hypertension by any of the 30 family physicians working in the Family Health Centers in these provinces. After the participants provided written consent, a survey consisting of 25 questions was administered by their family physicians. SPSS 25.0 (IBM Corporation, Armonk, New York, United States) was used for all statistical analysis calculations. RESULTS: The patients included 1449 females (61.6%) and 904 males (38.4%). Among the respondents, 1555 (73.1%) had primary hypertension etiology and 572 (26.9%) had secondary etiology. While 1614 patients (68.6%) did not exercise at all, 739 patients (31.4%) reported exercising; 1026 patients (43.9%) did not restrict salt in their diet; and 1134 patients (48.2%) had a family history of hypertension. CONCLUSION: Since individual and environmental factors affect the etiology of hypertension, it is recommended that family physicians address these factors first as part of a holistic approach for hypertension prevention, diagnosis, treatment, and follow-up.
Long-Term Risk of Progression to Sustained Hypertension in White-Coat Hypertension with Normal Night-Time Blood Pressure Values.
Faria J, Mesquita Bastos J, Bertoquini S … +2 more , Silva J, Polónia J
Int J Hypertens · 2020 · PMID 33489356 · Full text
BACKGROUND: The long-term prognosis and transition towards sustained ambulatory hypertension (SHT) of white-coat hypertension (WCHT) remain uncertain particularly in those with both normal nighttime and daytime blood pre...
BACKGROUND: The long-term prognosis and transition towards sustained ambulatory hypertension (SHT) of white-coat hypertension (WCHT) remain uncertain particularly in those with both normal nighttime and daytime blood pressure (BP) values. Different classification criteria and the use of antihypertensive drugs may contribute to conflicting results. We prospectively evaluated for a 7.1 year transition to SHT in 899 nondiabetic subjects free from cardiovascular (CV) events: normotensive (NT) ( = 344; 52, 9% female; ageing 48 ± 14 years); untreated WCHT (UnWCHT = 399; 50, 1% female; ageing 51 ± 14 years); and treated WCHT with antihypertensive drugs after baseline (TxWCHT = 156; 54, 4% female; ageing 51 ± 15 years). All underwent 24 h ambulatory BP monitoring (24 h-ABPM) at baseline, at 30 to 60 months, and at 70 to 120 months thereafter. WCHT was at baseline (with no treatment) as office BP ≥ 140/or 90 mm·Hg, daytime BP < 135/85 mm·Hg, and nighttime BP < 120/70 mm·Hg. Development of SHT was considered if daytime BP ≥ 135/or 85 mm Hg and/or nighttime BP ≥ 120/or 70 mm·Hg. RESULTS: Baseline metabolic parameters did not differ among groups. At 30-60 months and at the end of follow-up, development of SHT occurred, respectively, in NT (3.8% ( = 13) and 9.6% ( = 33)) and in UnWCHT (10.1% ( = 40) and 16.5% ( = 66)) ( < 0.009). The mean annual increase of average 24 h-systolic BP was 0.48 + 0.93 in NT and 0.73 + 1.06 in UnWCHT, whereas annual SBP in office increased in NT by 1.2 + 0.95 but decreased in UnWCHT by 1.36 + 1.35 mm Hg ( < 0.01). CONCLUSION: Untreated WCHT patients exhibit a faster and a higher risk of developing SHT compared to NT with TxWCHT assuming an intermediate position between them.
Arterial Hypertension as a Risk Comorbidity Associated with COVID-19 Pathology.
Kamyshnyi A, Krynytska I, Matskevych V … +2 more , Marushchak M, Lushchak O
Int J Hypertens · 2020 · PMID 33489355 · Full text
Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is an ongoing global public health challenge. Current clinical data suggest that, in COVI...
Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is an ongoing global public health challenge. Current clinical data suggest that, in COVID-19 patients, arterial hypertension (AH) is one of the most common cardiovascular comorbidities; it can worsen outcomes and increase the risk of admission to intensive care unit (ICU). The exact mechanisms through which AH contributes to the poor prognosis in COVID-19 are not yet clear. The putative relationship between AH and COVID-19 may be linked to the role of angiotensin-converting enzyme 2 (ACE2), a key element of the AH pathophysiology. Another mechanism connecting AH and COVID-19 is the dysregulation of the immune system resulting in a cytokine storm, mediated by an imbalanced response of T helper cells subtypes. Therefore, it is essential to optimize blood pressure control in hypertensive patients and monitor them carefully for cardiovascular and other complications for the duration of COVID-19 infection. The question whether AH-linked ACE2 gene polymorphisms increase the risk and/or worsen the course of SARS-CoV-2 infection should also receive further consideration.
Effects of L-/N-Type Calcium Channel Blockers on Angiotensin II-Renin Feedback in Hypertensive Patients.
Kawabata Y, Soeki T, Ito H … +13 more , Matsuura T, Kusunose K, Ise T, Yamaguchi K, Tobiume T, Yagi S, Fukuda D, Yamada H, Wakatsuki T, Kitani M, Kawano K, Taketani Y, Sata M
Int J Hypertens · 2020 · PMID 33489354 · Full text
OBJECTIVES: Cilnidipine, an L-/N-type calcium channel blocker (CCB), has unique organ-protective properties due to suppression of hyperactivity in the sympathetic nervous system and renin-angiotensin system (RAS). In thi...
OBJECTIVES: Cilnidipine, an L-/N-type calcium channel blocker (CCB), has unique organ-protective properties due to suppression of hyperactivity in the sympathetic nervous system and renin-angiotensin system (RAS). In this study, we hypothesized that cilnidipine might exert a renoprotective effect by suppressing the RAS. METHODS: A total of 25 hypertensive patients receiving a RAS inhibitor were randomly assigned to a cilnidipine ( = 12) or amlodipine ( = 13) group. The effects of cilnidipine on proteinuria and angiotensin II-renin feedback were assessed. RESULTS: After 6 months of treatment, both systolic and diastolic blood pressures were significantly reduced to a similar extent in both groups. The urine albumin-to-creatinine ratio was significantly lower in the cilnidipine group ( < 0.05) than in the amlodipine group. Amlodipine increased plasma angiotensin I and angiotensin II levels ( < 0.05), whereas cilnidipine did not. Interestingly, the cilnidipine group had a higher ratio of angiotensin-(1-7) (Ang-(1-7)) to angiotensin II in plasma than the amlodipine group ( < 0.05). CONCLUSIONS: The L-/N-type CCB cilnidipine, but not amlodipine, decreased urinary albumin excretion in hypertensive patients. Cilnidipine also increased the ratio of Ang-(1-7) to angiotensin II in plasma, which might be one factor underlying its beneficial effects.
Assessment of Plasma Sodium to Potassium Ratio, Renal Function, Markers of Oxidative Stress, Inflammation, and Endothelial Dysfunction in Nigerian Hypertensive Patients.
Ekun OA, Daniel F, Adebola P … +7 more , Ajibare A, Ekun OO, Omogoroye OO, Ilori OS, Oluwasayo BJ, Oshundun MF, Oyegbami SR
Int J Hypertens · 2020 · PMID 33489353 · Full text
BACKGROUND: This study investigated plasma sodium/potassium ratio, markers of oxidative stress, renal function, and endothelial dysfunction in hypertensive Nigerians. MATERIALS AND METHODS: Five hundred forty-nine volunt...
BACKGROUND: This study investigated plasma sodium/potassium ratio, markers of oxidative stress, renal function, and endothelial dysfunction in hypertensive Nigerians. MATERIALS AND METHODS: Five hundred forty-nine volunteers consisting of three hundred and twenty-four hypertensive and two hundred twenty-five controls participated in this study. Blood samples were collected from the participants and were analyzed for electrolytes, markers of oxidative stress, endothelial dysfunction, renal function, and inflammation, using ion-selective electrodes, spectrophotometric, and enzyme-linked immunosorbent assay methods, respectively. RESULTS: The mean systolic blood pressure, mean diastolic blood pressure, mean arterial blood pressure, and body mass index (BMI) were significantly elevated among the hypertensive group when compared with control ( < 0.001). The mean sodium increased, while potassium and bicarbonate (HCO ) decreased ( < 0.001) in hypertensive volunteers. The sodium-potassium ratio (Na/K) and urea were raised ( < 0.001) in the hypertensive group when compared with the control. Glutathione, superoxide dismutase, nitric oxide (NO), and catalase were significantly reduced ( < 0.001) while malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), and ferritin were raised significantly ( < 0.001) in hypertensive participants. The odds of hypertension and its complications increased ( < 0.001) with an increase in BMI, Na/K, hs-CRP, MDA, and ferritin and a decrease in estimated glomerular filtration rate (eGFR), glutathione, superoxide dismutase, and catalase. CONCLUSION: An increase in Na/K, urea, hs-CRP, ferritin, MDA, and BMI and a decrease in eGFR, glutathione, and superoxide dismutase were associated with an increased risk of hypertension complication. Abnormal values of markers of oxidative stress, inflammation, and endothelial function could impact deleterious effects on the cardiovascular system among hypertensive Nigerians. A decreased bicarbonate possibly suggests an occult acid-base imbalance among hypertensive volunteers.
p38/JNK Is Required for the Proliferation and Phenotype Changes of Vascular Smooth Muscle Cells Induced by in Essential Hypertension.
Hu C, Zuo K, Li K … +12 more , Gao Y, Chen M, Hu R, Liu Y, Chi H, Wang H, Qin Y, Liu X, Zhong J, Cai J, Yang X, Li J
Int J Hypertens · 2020 · PMID 33381308 · Full text
AIM: Hypertension is a complicated disorder with multifactorial etiology and high heritability. Our previous work has identified as a novel susceptibility gene for the development of essential hypertension, accompanied...
AIM: Hypertension is a complicated disorder with multifactorial etiology and high heritability. Our previous work has identified as a novel susceptibility gene for the development of essential hypertension, accompanied with activation of p38/JNK. Yet, little evidence has been reported whether p38/JNK contributed directly to -induced vascular remodeling and exploring the potential mechanism of in vascular smooth muscle cells (VSMCs). METHODS: We evaluated the contribution of on proliferation, migration, and phenotype changes of VSMCs and further explored the critical role of p38 and JNK signaling pathway underlying. RESULTS: In transgenic rats, we found that the elevated blood pressure, increased left ventricular hypertrophy, and thickened vascular media layer were significantly relieved by both p38 and JNK inhibitors. Meanwhile, increased cell proliferation, advanced cell cycle progression, greater migratory capability, and synthetic phenotype were observed in overexpressed VSMCs, which could be blocked by either p38 or JNK inhibitor. CONCLUSIONS: Our findings pinpointed that p38 and JNK were required for the proliferation and phenotype changes of VSMCs induced by in hypertension. These novel findings yield new insights into the genetic and biological basis of hypertension and are fundamental for further studies to explore the intervention strategies targeting and p38/JNK to counteract the progression of hypertension.
Adherence to Antihypertensive Treatment and Associated Factors in Central Ethiopia.
G/Tsadik D, Berhane Y, Worku A
Int J Hypertens · 2020 · PMID 33149946 · Full text
BACKGROUND: Adherence to treatment is a primary determinant of treatment success. Nonadherence attenuates clinical benefits to the recipients of the treatment. However, monitoring adherence to long treatment regimens is...
BACKGROUND: Adherence to treatment is a primary determinant of treatment success. Nonadherence attenuates clinical benefits to the recipients of the treatment. However, monitoring adherence to long treatment regimens is not given due emphasis in low-income contexts. This study aimed to assess adherence to antihypertensive treatment and factors associated with it in Central Ethiopia. METHOD: This is an institution-based cross-sectional study conducted in 4 public hospitals in Central Ethiopia from December 4, 2016, to September 25, 2017. The Morisky Medication Adherence Scale (MMAS-8) was used to assess the level of adherence. The Revised Illness Perception Questionnaire (IPQ-R) was used to assess illness perception. The MMAS-8 score ranges from 0 to 8, a score of 8 reflects high adherence, 6 to 7 medium adherence, and <6 low adherence. RESULTS: A total of 989 hypertensive patients participated in the study, of which 36.0% were assessed to have high adherence, 31.7% medium adherence, and 32.3% low adherence. We found that treatment adherence was significantly and positively associated with having family support (AOR: 1.65; 95% CI = 1.23, 2.22), high perception about consequences of hypertension (AOR: 1.51; 95% CI = 1.17, 1.95), and high perception about the severity of the disease (AOR: 1.42; 95% CI = 1.09, 1.86). CONCLUSION: The treatment adherence to antihypertensive medications is low in Central Ethiopia. Engaging family members in the treatment plan and improving patients' understanding of the illness are critical in achieving high adherence to medication in this context.
Aliskiren Reduces the Adrenal Zona Glomerulosa Apoptosis and Autophagy in Wistar Rats with 2K1C Hypertension.
de Matos VS, do Nascimento ALR, Pereira PG … +10 more , Rabelo K, Andrade CBV, Moraes ACN, Salata C, Araújo VHVO, Ciambarella BT, Bonfim Vieira A, Alves LL, da Silva JFR, de Carvalho JJ
Int J Hypertens · 2020 · PMID 33145109 · Full text
Hypertension is a disease classified as primary or secondary, manifested not only by elevation of blood pressure but also involved in structural and functional changes of target organs. Renal artery stenosis is a leading...
Hypertension is a disease classified as primary or secondary, manifested not only by elevation of blood pressure but also involved in structural and functional changes of target organs. Renal artery stenosis is a leading factor of secondary hypertension, and its progress is associated with overactivation of the renin-angiotensin-aldosterone system (RAAS). Aliskiren is a renin inhibiting drug that suppresses RAAS and culminates in decreased renin release, plasma angiotensin II concentration, and inhibition of aldosterone secretion. In this sense, the aim of the present study was to analyze the structural and ultrastructural morphophysiology of the adrenal glomerular zone, after treatment with aliskiren in Wistar rats with 2K1C hypertension. Parameters as structure and ultrastructure of the adrenal glomerular zone, cellular apoptosis, nuclear cell proliferation, and AT1 receptor expression were analyzed by immunostaining and electron microscopy. Our results showed that the hypertensive animals treated with aliskiren presented a reestablishment of AT1 receptor expression and decrease in apoptosis and autophagy. In addition, treatment with aliskiren improves the cell aspects in the adrenal glomerular zone, evidenced by ultrastructural analysis through preserved nuclei and well-developed mitochondria. Therefore, our evidence suggests that aliskiren has a beneficial effect on the adrenal glomerular zone remodeling in animals with renovascular hypertension.
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