Int J Hypertens [JOURNAL]
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200 papers
Combination of and in Gastrointestinal Microbiota Related to Bile-Acid Metabolism as a Biomarker for Hypertensive Nephropathy.
Li X, Wang L, Ma S … +3 more , Lin S, Wang C, Wang H
Int J Hypertens · 2022 · PMID 35620320 · Full text
The human microbiome is a mixed group of microorganisms, which individually consists of 10-100 trillion symbiotic microbial cells. The relationship between gastrointestinal microbiota and blood pressure has been verified...
The human microbiome is a mixed group of microorganisms, which individually consists of 10-100 trillion symbiotic microbial cells. The relationship between gastrointestinal microbiota and blood pressure has been verified and the intestinal microbiota of chronic kidney disease (CKD) patients in the distribution of bacterial species is different from the flora of people with no CKD. The purpose of this research is to study the different intestinal microbiota of hypertensive patients with and without nephropathy and to find possible biomarkers of hypertensive nephropathy (H-CKD). The subjects of this research were divided into three groups, healthy control group, hypertension group, and hypertensive nephropathy group. Sequencing, bioinformatics, and statistical analysis were performed on the 16S rRNA gene of the subjects' stool samples. This research study showed the differences of intestinal flora as biomarkers in hypertension patients with and without nephropathy; it investigated the relationship of the differences in the intestinal microbiota with bile-acid metabolism; it also explored bile-acid metabolism mechanism of intestinal microbiota differences in hypertension with or without nephropathy. In summary, the difference in the combination of and in the gastrointestinal microbiota is related to bile-acid metabolism in hypertensive patients and can be one of the factors causing CKD. It is the first time to report such a biomarker or pathogenic factor of H-CKD in the world.
Comparative Efficacy of Antihypertensive Agents in Flow-Mediated Vasodilation of Patients with Hypertension: Network Meta-Analysis of Randomized Controlled Trial.
Ding H, Liu S, Zhao KX … +3 more , Pu J, Xie YF, Zhang XW
Int J Hypertens · 2022 · PMID 35535214 · Full text
Hypertension induces both structural and functional changes in blood vessels, thereby increasing endothelial dysfunction, which in turn, contributes to an increase in blood pressure. A popular and widely used noninvasive...
Hypertension induces both structural and functional changes in blood vessels, thereby increasing endothelial dysfunction, which in turn, contributes to an increase in blood pressure. A popular and widely used noninvasive tool, flow-mediated dilation (FMD), is used to examine peripheral artery endothelium-dependent dilation. This study aimed to compare the efficacies of different classes of antihypertensive agents based on their effects on FMD. PubMed, Embase, and Cochrane Library were queried till November 1, 2020. Comparative studies on the efficacies of two or more antihypertensive agents or placebos for hypertensive patients were included. The outcomes were variations in mean systolic and diastolic blood pressure. Two reviewers independently reviewed and filtered the literature and extracted the data; the Cochrane "risk of bias" method was used to evaluate the methodological quality of the randomized controlled trials. A network meta-analysis was performed using Stata 15.0 software with a total of 49 studies. Subgroup analysis based on age and duration of treatments was performed. As compared to the placebo group, patients receiving the antihypertensive drugs exhibited significantly enhanced FMD (ARB + CCB: 4.01%, 95% CI, 0.92-7.11%, < 0.001; ACEI + ARB: 2.81%, 95% CI, 1.19-4.43%, < 0.001; ACEI: 2.55%, 95% CI, 1.34-3.77%, < 0.001; ARB: 2.22%, 95% CI, 1.05-3.38%, < 0.001; -blocker: 2.23%, 95% CI, 0.93-3.52%, < 0.001). In the SUCRA curve for network meta-analysis, the combination of CCB and ARB was found to be the most effective in increasing FMD (SUCRA = 89.0%), followed by ACEI monotherapy (SUCRA = 74.2%). ARB combined with CCB was superior in improving the endothelial function measured as the FMD; ACEI monotherapy was the most effective treatment among the antihypertension medications. There were no significant differences between antihypertensive drug-based monotherapies.
Self-Monitoring Home Blood Pressure in Community-Dwelling Older People: Age Differences in White-Coat and Masked Phenomena and Related Factors-The SONIC Study.
Tuo J, Godai K, Kabayama M … +14 more , Akagi Y, Akasaka H, Takami Y, Takeya Y, Yamamoto K, Sugimoto K, Yasumoto S, Masui Y, Arai Y, Ikebe K, Gondo Y, Ishizaki T, Rakugi H, Kamide K
Int J Hypertens · 2022 · PMID 35535213 · Full text
Some studies reported that home blood pressure (HBP) monitoring was conducted by community-dwelling older people themselves, but there have been few studies on HBP including very old populations aged over 90 years old. T...
Some studies reported that home blood pressure (HBP) monitoring was conducted by community-dwelling older people themselves, but there have been few studies on HBP including very old populations aged over 90 years old. Thus, the aim of the present study was to clarify the current situation of white-coat and masked phenomena defined by on-site and home BP measurements in community-dwelling old and oldest-old populations. The study subjects were 380 participants from the SONIC study, a cohort study of a community-dwelling old population, who measured their HBP in a series of 3-5 days by themselves and brought their HBP records to the venue on the survey day. Study participants' characteristics were as follows: female, 185 (48.7%); male, 195 (51.3%); 70s, 95 (25.0%); 80s, 245 (64.5%); and 90s, 40 (10.5%). A total of 344 (90.5%) participants had hypertension. A total of 291 (76.6%) hypertensive participants taking antihypertensive medication were analyzed in the present study. Regarding the types of hypertension defined by home and on-site BP, they showed white-coat phenomenon, 183 (48.2%); masked phenomenon, 115 (30.3%); sustained hypertension, 130 (34.2%); and normotension, 82 (21.6%). On comparison of age groups, there was a tendency for the white-coat phenomenon to be common in young-old people in their 70s and the masked phenomenon to be common in very old people in their 90s. Therefore, since the detection of white-coat and masked phenomena is closely associated with appropriate BP management, it is very important for community-dwelling older populations to self-monitor HBP.
Factors Affecting ICU Stay and Length of Stay in the ICU in Patients with HELLP Syndrome in a Tertiary Referral Hospital.
Ağaçayak E, Bugday R, Peker N … +4 more , Deger U, Ölmez Kavak G, Evsen MS, Gul T
Int J Hypertens · 2022 · PMID 35479732 · Full text
OBJECTIVE: The study aimed to compare patients with HELLP syndrome who require intensive care and who do not require intensive care and evaluate the factors affecting the length of stay in the intensive care unit. METHOD...
OBJECTIVE: The study aimed to compare patients with HELLP syndrome who require intensive care and who do not require intensive care and evaluate the factors affecting the length of stay in the intensive care unit. METHODS: Patients were divided into two groups as follows: requiring intensive care (group 1) and not requiring intensive care (group 2). The data of both groups were compared in terms of demographic characteristics, transfusion amounts, length of stay in the intensive care unit, maternal complications, and mortality. RESULTS: 14032 births in a tertiary center between 2011 and 2018 were evaluated in this study. During the study period, 342 patients were diagnosed with HELLP, and 32 (9.4%) of these were followed up in the intensive care unit. The length of stay in the intensive care unit was determined as 8.1 (7.2) days on average. Fresh frozen plasma, erythrocyte suspension, apheresis, and random thrombocyte transfusion were observed to be significantly more in group 1 patients. In the regression analysis, the most effective factor was found to be erythrocyte suspension and the length of stay in the intensive care unit was significantly longer in patients who had erythrocyte suspension transfusion. The receiver operating characteristic curve showed that the area under the curve value for erythrocyte transfusion was 70.6%. When the cutoff value of erythrocyte suspension was 450 (95% CI: 365-681) ml, the sensitivity was 43.8% and the specificity was 91.6%. CONCLUSION: We think that physicians should be careful that maternal morbidity and mortality may increase as the need for erythrocyte suspension transfusion increases in patients with HELLP syndrome. Minimum transfusion to hemodynamically stable patients can be more suitable in terms of morbidity and mortality in managing patients with HELLP syndrome requiring erythrocyte suspension transfusion. Precautions and measures should be taken in this regard.
Evaluation of Relationship between Serum Liver Enzymes and Hypertension: A Cross-Sectional Study Based on Data from Rafsanjan Cohort Study.
Khalili P, Abdollahpoor S, Ayoobi F … +4 more , Vakilian A, Hakimi H, Rajabi Z, Jamali Z
Int J Hypertens · 2022 · PMID 35464126 · Full text
BACKGROUND: Hypertension as a major risk factor for cardiovascular diseases is among the leading causes of death worldwide. The relationship between elevated serum levels of liver enzymes and hypertension has been report...
BACKGROUND: Hypertension as a major risk factor for cardiovascular diseases is among the leading causes of death worldwide. The relationship between elevated serum levels of liver enzymes and hypertension has been reported in limited studies, and to the best of our knowledge, there are no previous reports in the literature on this issue in the southeast of Iran. Our investigation aimed at evaluating the relation between ALT, AST, GGT, and ALP with hypertension in the Rafsanjan Cohort Study, a city in Kerman Province, Iran. METHODS: In this cross-sectional study, we used data obtained from the Rafsanjan Cohort Study (RCS), as a part of the prospective epidemiological research studies in Iran (PERSIAN). The association of the liver enzymes levels with hypertension was investigated using the multivariable logistic regression models. RESULTS: Among 9930 participants, the mean age (±SD) was 49.94 (±9.56) years, and 46.56% were men. The odds of abnormal blood pressure significantly increased along with the higher levels of ALT, GGT, and ALP which remained significant only for ALP after adjustment for all confounding variables in both males and females (OR in males: 1.36, 95% CI = 1.09-1.69, OR in females: 1.25, 95% CI = 1.01-1.54). In subjects with normal levels of ALT, AST, GGT, and ALP, dose-response increases were observed for abnormal blood pressure in both genders. Finally, we found that, among liver enzymes, only elevated ALP was significantly correlated with the odds of stage 1 hypertension and stage 2 hypertension for both genders. CONCLUSIONS: In subjects with normal levels of ALT, AST, GGT, and ALP, dose-response increases were observed for abnormal blood pressure in both genders. Increased serum ALP activity was positively associated with increased odds of hypertension in males and females. Therefore, increased ALP could be an early indicator of hypertension.
Association of MTHFR Polymorphisms with H-Type Hypertension: A Systemic Review and Network Meta-Analysis of Diagnostic Test Accuracy.
Kong Y, Zheng J, Li L … +2 more , Lu L, Wang J
Int J Hypertens · 2022 · PMID 35360528 · Full text
PURPOSE: An association between MTHFR polymorphisms and H-type hypertension (H-HTN) has been investigated by epidemiological studies, but results have been inconsistent. Thus, a systematic assessment of the association w...
PURPOSE: An association between MTHFR polymorphisms and H-type hypertension (H-HTN) has been investigated by epidemiological studies, but results have been inconsistent. Thus, a systematic assessment of the association was performed based on a literature review and pooled analysis, to provide stronger evidence on the effects of single nucleotide polymorphisms on H-HTN risk. METHODS: Three investigators independently retrieved relevant studies in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Database, and China Biomedical Literature Database (CBM). A fixed or random effects model was selected to calculate pooled odds ratio (OR) and 95% confidence intervals (CIs). A network meta-analysis of diagnostic test and Thakkinstian's algorithm were used to select the most appropriate genetic model, along with false-positive report probability (FPRP) for noteworthy associations. All data were processed using Stata 15.0 and Meta-Disc. RESULTS: A total of 14 studies involving 1759 cases and 1581 controls for MTHFR were included in our meta-analysis. In a direct meta-analysis, we found that MTHFR C667T rs1801133 significantly increased the risk of H-HTN susceptibility except for an overdominant model. However, MTHFR A1298C rs1801131 polymorphism had no significant correlation with H-HTN risk. Besides, MTHFR C667T rs1801133 is a potential diagnostic biomarker for estimating H-HTN risk. The results indicated that the dominant model was an optimal diagnosis model for excluding diseases, which could reduce a missed diagnosis rate and further improve the accuracy of disease diagnosis. CONCLUSION: The present result suggests that MTHFR C667T rs1801133 polymorphism is associated with H-HTN risk and may act as a promising predictive biomarker for H-HTN risk. However, further well-designed studies are warranted to confirm these results.
The Association of Serum Anti-Lysosomal-Associated Membrane Protein-2 Antibody with Vasculitis Combined with Hypertension.
Zhu B, Cai X, Zhu Q … +5 more , Wu T, Liu S, Liu S, Hong J, Li N
Int J Hypertens · 2022 · PMID 35356030 · Full text
The aim of this study was to explore the association of serum anti-lysosomal-associated membrane protein-2 (anti-LAMP-2) antibody with vasculitis combined with hypertension (VAS-HTN). A total of 51 VAS-HTN patients, 46 e...
The aim of this study was to explore the association of serum anti-lysosomal-associated membrane protein-2 (anti-LAMP-2) antibody with vasculitis combined with hypertension (VAS-HTN). A total of 51 VAS-HTN patients, 46 essential hypertension (EH) patients, and 46 healthy controls (HC) were included in the study. Serum anti-LAMP-2 antibody levels are increased in VAS-HTN patients as compared with EH and HC (all < 0.05). Serum anti-LAMP-2 antibody levels were significantly higher in active stage patients than those in non-active stage patients and HC (all < 0.05). The correlation analysis showed a significant positive correlation between serum anti-LAMP-2 antibody levels and the Birmingham Vasculitis Activity Score (BVAS) and hypersensitive C-reactive protein (Hs-CRP) (all < 0.05). Among the subsets of VAS-HTN, the levels of serum anti-LAMP-2 antibody were remarkably higher in all VAS-HTN subsets compared with HC (all < 0.05). More interestingly, the levels of serum anti-LAMP-2 antibody were remarkably increased in polyarteritis nodosa (PAN) patients compared with ANCA-associated vasculitis and Takayasu arteritis patients (all < 0.05). In addition, there was a significant positive correlation between serum anti-LAMP-2 antibody levels and BAVS and Hs-CRP in PAN patients (all < 0.05). Multivariate logistic regression analysis showed that the anti-LAMP-2 antibody was independently associated with VAS-HTN. The levels of serum anti-LAMP-2 antibody were remarkably increased in VAS-HTN patients compared to EH and HC and might reflect the disease activity. The anti-LAMP-2 antibody may be a potential biomarker for diagnosis and estimating the disease activity in VAS-HTN.
Association of AGTR1 A1166C and CYP2C9∗3 Gene Polymorphisms with the Antihypertensive Effect of Valsartan.
Liu Y, Kong X, Jiang Y … +5 more , Zhao M, Gao P, Cong X, Cao Y, Ma L
Int J Hypertens · 2022 · PMID 35345577 · Full text
BACKGROUND: The differences in the antihypertensive treatment with angiotensin type II receptor blockers (ARBs) may be attributed to polymorphisms in genes involving drug-targeted receptor and drug metabolism. The presen...
BACKGROUND: The differences in the antihypertensive treatment with angiotensin type II receptor blockers (ARBs) may be attributed to polymorphisms in genes involving drug-targeted receptor and drug metabolism. The present study aimed to investigate whether the antihypertensive effect of the ARB drug valsartan was associated with angiotensin II type 1 receptor () gene polymorphism (A1166 C) and cytochrome P450 enzyme 2C9 () gene polymorphism (∗3). METHODS: 281 patients with hypertension who received valsartan monotherapy in the past month were included in this retrospective study. Polymerase chain reaction-melting curve analysis was performed to genotype the and gene polymorphisms. Based on the systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the time of visit, the patients were divided into well-controlled group ( = 144, SBP/DBP <140/90 mmHg) and poorly controlled group ( = 137, SBP/DBP ≥140/90 mmHg). RESULTS: Older age, decreased history of drinking, a higher proportion of mild-to-moderate hypertension, lower alanine aminotransferase levels, and higher high-density lipoprotein cholesterol levels were observed in the well-controlled group than the poorly controlled group. Higher frequencies of the C allele and AC + CC genotype of A1166C were detected in the well-controlled than the poorly controlled patients ( = 0.005 and = 0.006). After adjustment for demographic and environmental factors, the CC + AC genotype of A1166C was markedly linked to better hypertension control with valsartan treatment compared to the AA genotype (odds ratio: 2.836, 95% confidence interval: 1.199-6.705, = 0.018). No significant difference was observed in the allele or genotype distribution of ∗3 polymorphism between well-controlled and poorly controlled patients. CONCLUSIONS: The current data suggested that the A1166 C polymorphism may be associated with the antihypertensive effect of valsartan, and carriers with AC and CC genotypes may have a better antihypertensive efficacy response to valsartan treatment.
Prevalence of Cardiovascular Disease Risk Factors in the Women Population Covered by Health Centers in Ardabil.
Avesta L, Rasoolzadeh S, Naeim M … +1 more , Kamran A
Int J Hypertens · 2022 · PMID 35321055 · Full text
OBJECTIVE: This study aimed to determine the prevalence of cardiovascular risk factors in the population of women aged 30 to 60 years covered by health centers in Ardabil. METHODS: This retrospective descriptive-analytic...
OBJECTIVE: This study aimed to determine the prevalence of cardiovascular risk factors in the population of women aged 30 to 60 years covered by health centers in Ardabil. METHODS: This retrospective descriptive-analytical study was conducted on 1006 women aged 30 to 60 years who were covered by Ardabil comprehensive urban health service centers, and they were selected by using the multistage random sampling method. In the first stage, health centers in Ardabil were divided into five geographical areas, and the population covered by each of the five areas was calculated. In the second stage, the number of samples was allocated as a quota in the regions, and in the third stage, in proportion to the population covered by each center in Ardabil, the samples were selected. Women with one of the conditions of pregnancy, lactation, history of kidney disease, known diabetes under medication, history of hepatitis, history of cardiovascular surgery, and history of cancer were excluded from the research process. RESULTS: The average activity of individuals was 24.42 minutes per day. The mean intake of fruits and vegetables was 1.9 ± 0.9 and 2.1 ± 1.07 unit/day, respectively, and meat was 286.6 ± 174.6 grams per week. The mean of HDL, LDL, TG, cholesterol, and FBS were 43.6 ± 10.4, 101.28 ± 26.3, 159.89 ± 54.01, 185.99 ± 37.9, and 94.62 ± 13.3 mg/dl, respectively. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 108.14 and 68.26 mmHg, respectively. CONCLUSIONS: Abdominal obesity (waist above 88), obesity and overweight (high body mass index), high triglycerides, high cholesterol, and LDL and HDL outside the proper range were the most important and risk factors for cardiovascular disease among women.
Association between Quantitative Classification of Renal Surface Nodularity and Early Renal Injury in Patients with Arterial Hypertension.
Zhou J, Ding J, Chen J … +3 more , Wu Q, Xiang D, Xing W
Int J Hypertens · 2022 · PMID 35284141 · Full text
BACKGROUND: This study sought to explore the association between quantitative classification of renal surface nodularity (qRSN) based on computed tomography (CT) imaging and early renal injury (ERI) in patients with arte...
BACKGROUND: This study sought to explore the association between quantitative classification of renal surface nodularity (qRSN) based on computed tomography (CT) imaging and early renal injury (ERI) in patients with arterial hypertension. METHODS: A total of 143 patients with a history of hypertension were retrospectively enrolled; clinical information (age, sex, hypertension grade, and hypertension course), laboratory tests, and qRSN were collected or assessed. The subjects were divided into an ERI group ( = 60) or a control group (CP, = 83) according to ERI diagnosis based on the following criteria: cystatin C > 1.02 mg/L. Univariate analysis and multiple logistic regression were used to assess the association between ERI and qRSN. A receiver operating characteristic curve (ROC) was performed to compare multiple logistic regression models with or without qRSN for differentiating the ERI group from the control group. RESULTS: In univariate analysis, hypertension grade, hypertension course, triglycerides (TG), and qRSN were related to ERI in patients with arterial hypertension (all < 0.1), with strong interrater agreement of qRSN. Multiple logistic regression analysis showed an area under the ROC curve of 0.697 in the model without qRSN and 0.790 in the model with qRSN, which was significantly different ( = 2.314, =0.021). CONCLUSION: CT imaging-based qRSN was associated with ERI in patients with arterial hypertension and may be an imaging biomarker of early renal injury.
Plasma and Urinary Levels of Nerve Growth Factor Are Elevated in Primary Hypertension.
Tomoda F, Nitta A, Sugimori H … +2 more , Koike T, Kinugawa K
Int J Hypertens · 2022 · PMID 35284140 · Full text
Nerve growth factor (NGF) is the main neurotrophic factor that can control sympathetic nerve innervation and sympathetic neural activity in cardiovascular organs. Although NGF overproduction and its influences on the sym...
Nerve growth factor (NGF) is the main neurotrophic factor that can control sympathetic nerve innervation and sympathetic neural activity in cardiovascular organs. Although NGF overproduction and its influences on the sympathetic nervous system have been shown in hypertensive animals, NGF status and its association with sympathetic nerve activity have not yet been explored in human hypertension. In the present study, therefore, plasma and urinary levels of NGF and those of catecholamines (i.e., indices for NGF status and sympathoadrenal activity, respectively) were compared between 83 untreated primary hypertensives without apparent cardiovascular damages and 81 healthy normotensive subjects. Plasma and urinary levels of NGF were significantly greater in the hypertensive group (311 ± 158 pg/mL and 72.7 ± 54.0 ng/g of Cr) than in the normotensive group (168 ± 188 pg/mL and 54.5 ± 38.8 ng/g of Cr) ( < 0.05 for each measurement), even if the baseline differences of age and gender between the groups were adjusted. Similarly, plasma and urinary levels of catecholamines were significantly higher in the hypertensive group than in the normotensive group except for plasma noradrenaline. In addition, despite no significant correlations between plasma levels of NGF and catecholamines in both groups, urinary NGF significantly correlated positively with both urinary noradrenaline and urinary adrenaline in the hypertensive group ( = 0.259, =0.018 and = 0.232, =0.035), but not in the normotensive group ( = 0.115, =0.307 and = -0.018, =0.871). On the contrary, plasma and urinary levels of NGF as well as those of catecholamines did not associate with any systemic hemodynamic indices such as blood pressure and pulse rate in either group. Thus, primary hypertension was characterized by the enhancements of both NGF status and sympathoadrenal activity and the positive relationship between them. Our data indicate that enhanced NGF status and subsequent NGF-induced sympathoadrenal overactivity could occur in primary hypertension.
Skipping Breakfast Is Associated with Hypertension in Adults: A Meta-Analysis.
Li Z, Li H, Xu Q … +1 more , Long Y
Int J Hypertens · 2022 · PMID 35284139 · Full text
Previous studies evaluating the association between skipping breakfast and hypertension in adult population showed inconsistent results. We performed a meta-analysis to systematically evaluate the association. Observatio...
Previous studies evaluating the association between skipping breakfast and hypertension in adult population showed inconsistent results. We performed a meta-analysis to systematically evaluate the association. Observational studies which evaluated the relationship between skipping breakfast and hypertension in adult population with multivariate analyses were identified by systematic search of PubMed, Embase, and Web of Science databases. A random-effect model which incorporated the potential intrastudy heterogeneity was used for the meta-analysis. A total of six observational studies with 14189 adults were included, and 3577 of them were breakfast skippers. Pooled results showed that skipping breakfast was independently associated with hypertension in these populations (adjusted odds ratio (OR): 1.20, 95% confidence interval: 1.08 to 1.33, < 0.001) with no significant heterogeneity ( = 0%). Sensitivity by excluding one study at a time showed consistent results (OR: 1.18 to 1.22, all <0.01). Subgroup analyses showed that the association between skipping breakfast and hypertension in adults was consistent in the general population and in patients with type 2 diabetes, in studies from different countries, in cohort and cross-sectional studies, in breakfast skippers defined as taking breakfast ≤3 days/week and as self-reported habitual breakfast skipping, and in studies with and without adjustment of body mass index (for subgroup difference, all >0.10). In conclusion, skipping breakfast is associated with hypertension in the adult population.
A Retrospective, Observational, EMR-Based Real-World Evidence Study to Assess the Incidence of Pedal Edema in Essential Hypertensive Patients on Amlodipine or Cilnidipine.
Dalal J, Sawhney JP, Jayagopal PB … +7 more , Hazra PK, Khan MY, Gaurav K, Pinto C, Mane A, Rao S, Jain M
Int J Hypertens · 2022 · PMID 35251710 · Full text
INTRODUCTION: Calcium channel blockers have pedal edema as one of the confining factors of treatment. A real-world study may help evident reality of the situation in regular Indian clinical practice. The aim of the study...
INTRODUCTION: Calcium channel blockers have pedal edema as one of the confining factors of treatment. A real-world study may help evident reality of the situation in regular Indian clinical practice. The aim of the study is to assess effectiveness and incidence of pedal edema in essential hypertensive patients treated with amlodipine or cilnidipine monotherapy. METHODS: Retrospective EMR data of adult essential hypertensive patients, prescribed amlodipine ( = 800) or cilnidipine ( = 800) as monotherapy, were analyzed. Incidence of pedal edema from baseline visit was analyzed in terms of dose and duration of treatment. The changes in systolic (SBP) and diastolic blood pressure (DBP) from baseline and proportion of patients achieving target BP goals were assessed. RESULTS: In amlodipine and cilnidipine groups, mean changes in SBP and DBP from baseline to end of the study period were 28.4 and 15.1 mmHg and 24.3 and 13.5 mmHg, respectively ( value <0.05). More than 50% of patients in both groups achieved BP goal at the end of the study ( value 0.266). In amlodipine group, total 23.9% reported pedal edema, while in cilnidipine, 27.6% ( value 0.0863). At the end of the study, 3.5% and 8.2% of patients remain with pedal edema, respectively, in both groups ( <0.005). CONCLUSION: Amlodipine demonstrated greater BP reduction at a lower average dose, better efficacy, and tolerability in terms of pedal edema count as a lesser number of patients reported edema at the end of the study and a higher percentage of patients continued the prescribed baseline dosage regimen as compared to cilnidipine. Thus, the study established amlodipine as an effective and well-tolerated antihypertensive for Indians.
Association between Particulate Matter Pollution Concentration and Hospital Admissions for Hypertension in Ganzhou, China.
Li C, Zhou X, Huang K … +2 more , Zhang X, Gao Y
Int J Hypertens · 2022 · PMID 35223092 · Full text
Fine particulate matter (PM) and respirable particulate matter (PM) are two major air pollutants with toxic effects on the cardiovascular system. Hypertension, as a chronic noncommunicable cardiovascular disease, is also...
Fine particulate matter (PM) and respirable particulate matter (PM) are two major air pollutants with toxic effects on the cardiovascular system. Hypertension, as a chronic noncommunicable cardiovascular disease, is also a risk factor for several diseases. We applied generalized linear models with a quasi-Poisson link to assess the effect of air pollution exposure on the number of daily admissions for patients with hypertension. In addition, we established a two-pollutant model to evaluate PM and PM hazard effect stability by adjusting the other gaseous pollutants. Results showed that during the study period, 24 h mean concentrations of ambient PM and PM at 38.17 and 59.84 g/m, respectively, and a total of 2,611 hypertension hospital admissions were recorded. Air pollution concentrations significantly affected the number of hospitalizations for hypertension approximately 2 months after exposure. For each 10 g/m increase in PM and PM in single-pollutant models, the number of hospitalizations for hypertension increased by 7.92% (95% CI: 5.48% to 10.42%) and 4.46% (95% CI: 2.86% to 5.65%), respectively, at the lag day with the strongest effect. NO, O, CO, and SO had different significant effects on the number of hospitalizations over the same time period, and PM and PM still showed robust significant effects after adjustment of gas pollutants through a two-pollutant model. These findings may contribute to a better understanding of the health effects of ambient particulate matter.
The Magnitude of Salt Intake Behaviors and Its Predictors among Saqez Urban Population of Kurdistan District in Iran: A Cross-Sectional Study.
Khoram K, Asghari-Jafarabadi M, Ebrahimi-Mamagani M … +2 more , Shokrvash B, Hariri-Akbari M
Int J Hypertens · 2022 · PMID 35198241 · Full text
BACKGROUND: Controlling and reducing salt intake are one of the solutions to overcome hypertension. This study aimed at determining the predictors related to salt control methods in Saqez urban population. METHODS AND MA...
BACKGROUND: Controlling and reducing salt intake are one of the solutions to overcome hypertension. This study aimed at determining the predictors related to salt control methods in Saqez urban population. METHODS AND MATERIALS: In the present cross-sectional study, the sample population was randomly selected through cluster sampling. Data collection was performed using valid questionnaires, demographic, family economic status, knowledge, perception, intention, salt intake behaviors, and salt control methods, along with measuring body mass index (BMI) and hypertension levels. Descriptive, analytical statistical methods and multivariate logistic regression analysis were used to determine the predictors of desirable salt control methods. The variables of sex, age, family economic status, knowledge, perception, perceived social support, self-efficacy, and intention were analyzed as independent variables. Data analysis was performed using SPSS software version 24 at a significance level of 0.05. RESULTS: Out of 766 participants, 73% were women, with mean (M) 32.83, standard deviation (SD) 9.52 years, and 77.2% were married. There were significant sex differences in employment (=0.01) and economic status (=0.016). The M (SD) of blood pressure (systolic/diastolic) was 110.65 (0.0212) (=0.441). The salt intake control methods between men and women did not show significant differences (=0.368). Among totally 88.5%, 87.7% men and 88.9% women followed desirable behaviors. The predictors that determine the adoption of salt control methods were sex (man) (OR = 0.71, 95% CI (0.38-1.29)), age (OR = 1.02, 95% CI = (0.99-1.05)), SES/FAS (medium, high level) (OR = 1.37, 95% CI = (0.754-2.47); OR = 0.46, 95% CI = (0.047-4.55)), blood pressure (OR = 1.33, 95% CI = (0.16-11.23)), knowledge (have) (OR = 1.01, 95% CI = (0.39-1.63)), intent to reduce salt (OR = 1.047, 95% CI = (1.03-1.06)), perceived salt reduction importance (OR = 1.02, 95% CI = (1.01-1.04)), perceived emotional support (health staff) (OR = 1.02, 95% CI = (1.01-1.04)), media (OR = 1.01, 95% CI = 0.99-1.02), perceived practical support (spouse) (OR = 1.02, 95% CI = 0.99-1.04)), and perceived self-efficacy (OR = 1.01, 95% CI = (0.99-1.03)). CONCLUSION: The support of health staff and spouse seems to be effective in controlling the salt intake behaviors of healthy individuals. In parallel with the development and change of people's lifestyles, new approaches (legal and services) for salt control based on the support of media and social media were expected.
Effect of Presence versus Absence of Hypertension on Admission Heart Rate-Associated Cardiovascular Risk in Patients with Acute Coronary Syndrome.
Xia Y, Wang Z, Gao F … +5 more , Yang L, Liang J, Shi D, Zhou Y, Ma X
Int J Hypertens · 2022 · PMID 35198240 · Full text
BACKGROUND AND AIMS: Heart rate (HR) and hypertension are both important risk factors for adverse cardiovascular (CV) events in patients with established coronary artery disease (CAD). We sought to evaluate whether hyper...
BACKGROUND AND AIMS: Heart rate (HR) and hypertension are both important risk factors for adverse cardiovascular (CV) events in patients with established coronary artery disease (CAD). We sought to evaluate whether hypertension can modify the effect of admission HR on adverse CV events in patients with acute coronary syndrome (ACS). METHODS: A total of 1056 patients with ACS undergoing percutaneous coronary intervention (PCI) were analyzed. All patients were classified into three groups according to the tertiles of admission HR (T1: ≤66 bpm, = 369; T2: 67-73 bpm, = 322; and T3: ≥74 bpm, = 365). The primary endpoint was defined as major adverse CV events (MACEs), including all-cause death, stroke, myocardial infarction, or unplanned repeat revascularization. The multivariate Cox regression model was performed to evaluate the association of admission HR with MACE stratified by hypertension. RESULTS: During the median follow-up of 30 months, a total of 232 patients developed at least one event. After adjusting for other covariates, elevated admission HR was significantly associated with an increased risk of MACE only in patients with hypertension (when T1 was taken as a reference, the adjusted HR of T2 was 1.143 [95% CI: 0.700-1.864] and that of T3 was 2.062 [95% CI: 1.300-3.270]); however, in patients without hypertension, admission HR was not associated with the risk of MACE (when T1 was taken as a reference, the adjusted HR of T2 was 0.744 [0.406-1.364] and that of T3 was 0.614 [0.342-1.101]) (=0.025 for interaction). CONCLUSIONS: In patients with ACS undergoing PCI, the association of elevated admission HR with an increased risk of MACE was present in individuals with hypertension but not in those without hypertension. This finding suggests a potential benefit of HR control for ACS patients when they concomitantly have hypertension.
Serum Fibroblast Growth Factor 21 Level Is Associated with Aortic Stiffness in Patients on Maintenance Hemodialysis.
Chiu LT, Hung CD, Lin L … +2 more , Lin YL, Hsu BG
Int J Hypertens · 2022 · PMID 35186330 · Full text
BACKGROUND: Fibroblast growth factor 21 (FGF-21) is a hormone that regulates glucose and lipid metabolism. High serum FGF-21 levels are associated with carotid atherosclerosis and coronary artery disease. This cross-sect...
BACKGROUND: Fibroblast growth factor 21 (FGF-21) is a hormone that regulates glucose and lipid metabolism. High serum FGF-21 levels are associated with carotid atherosclerosis and coronary artery disease. This cross-sectional study aimed to assess the relationship between serum FGF-21 levels and carotid-femoral pulse wave velocity (cfPWV) in patients on maintenance hemodialysis (HD). METHODS: Blood samples and baseline characteristics were collected from 130 HD patients. Serum FGF-21 concentrations were measured with an enzyme-linked immunosorbent assay kit. Aortic stiffness was defined as a carotid-femoral pulse wave velocity (cfPWV) of more than 10 m/s. RESULTS: Of the 130 HD patients, aortic stiffness was diagnosed in 54 (41.5%). Serum FGF-21 levels were significantly higher in those with aortic stiffness than those without ( < 0.001). The FGF-21 level was independently associated with aortic stiffness (odds ratio (OR): 1.008; 95% CI: 1.003-1.012; =0.001) after adjusting for diabetes mellitus, age, hypertension, C-reactive protein, and body weight in multivariable logistic regression analysis. Multivariable forward stepwise linear regression analysis also confirmed that the logarithmically transformed FGF-21 level ( = 3.245, 95% CI: 1.593-4.987, < 0.001) was an independent predictor of cfPWV values. The area under the receiver operating characteristic (ROC) curve predicting aortic stiffness by the serum FGF-21 level was 0.693 (95% CI: 0.606-0.771, < 0.001). CONCLUSIONS: Serum FGF-21 level positively correlates with cfPWV and is also an independent predictor of aortic stiffness in maintenance HD patients.
Human Gut Microbes Associated with Systolic Blood Pressure.
Joishy TK, Jha A, Oudah M … +4 more , Das S, Adak A, Deb D, Khan MR
Int J Hypertens · 2022 · PMID 35154822 · Full text
Emerging studies have revealed a strong link between the gut microbiome and several human diseases. Since human gut microbiome mirrors variations in lifestyle and environment, whether associations between disease conditi...
Emerging studies have revealed a strong link between the gut microbiome and several human diseases. Since human gut microbiome mirrors variations in lifestyle and environment, whether associations between disease conditions and gut microbiome are consistent across populations-particularly in communities practicing traditional subsistence strategies whose microbiomes differ markedly from industrialists-remains unknown. Cardiovascular diseases are the leading cause of mortality in India affecting 55 million people, and high blood pressure is one of the primary risk factors for cardiovascular diseases. We examined associations between gut microbiome and blood pressure along with 14 other variables associated with lifestyle, dietary habits, disease conditions, and clinical blood markers in the three Assamese populations. Our analysis reveals a robust link between the gut microbiome diversity and composition and systolic blood pressure. Moreover, several genera previously associated with hypertension in non-Indian populations were also associated with systolic blood pressure in this cohort and these genera were predictors of elevated blood pressure in these populations. These findings confer opportunities to design personalized, preventative, and targeted interventions harnessing the gut microbiome to tackle the burden of cardiovascular diseases in India.
Comparative Assessment of the Utility of Anthropometric and Bioelectrical Impedance Indices as Potential Predictors of Hypertension within a Ghanaian Adult Population: A Cross-Sectional Study.
Boakye AA, Adedia D, Hunkpe GK … +4 more , Ampomah Carr RA, AdanusahAll VFA, Agbenyo BS, Duedu KO
Int J Hypertens · 2022 · PMID 35127158 · Full text
BACKGROUND: Hypertension is an important public health concern that is claiming millions of lives worldwide. In sub-Saharan African countries, where some of the highest prevalence rates are being recorded, sufficient att...
BACKGROUND: Hypertension is an important public health concern that is claiming millions of lives worldwide. In sub-Saharan African countries, where some of the highest prevalence rates are being recorded, sufficient attention has not been given to its control. OBJECTIVE: The aim of this study was to determine the association and predictive potential of different anthropometric and bioelectrical impedance analysis (BIA) measures for hypertension. METHODS: A total of 812 individuals (204 men and 608 women) were enrolled, and their blood pressure measurement was determined. Direct anthropometric measures (weight, height, waist circumference (WC), and hip circumference) and derived anthropometric measures (body mass index, conicity index, abdominal volume index (AVI), and body adiposity index) were determined. BIA indices investigated included visceral fat level (VF), percentage body fat (%BF), resting metabolic rate (RMR), and skeletal muscle mass. RESULTS: A prevalence of 31.28% was observed for hypertension in the total study population, with males having a slightly higher prevalence than females. Except for the skeletal muscle mass, all the other indices measured showed an increasing trend from normotension to prehypertension and hypertension. Age and visceral fat level showed the highest correlation with systolic blood pressure for both genders. Receiver operator characteristic analysis showed that age was the best predictor of hypertension in both genders, whereas, in predicting prehypertension, RMR was the best predictor in males, and WC was the best predictor in females. VF, WC, and AVI were other good predictors of hypertension in this study population. However, BMI and % BF had a low predictive value for hypertension. CONCLUSION: The result of this study shows that within this study population in addition to age, measures of central obesity rather than general obesity are the likely drivers of the hypertension epidemic; thus, measures aimed at controlling central obesity may offer some therapeutic and preventive advantage.
The Prevalence and Associated Factors of Hypertension among HIV Patients.
Mbuthia GW, Magutah K, McGarvey ST
Int J Hypertens · 2021 · PMID 35111340 · Full text
BACKGROUND: The dual burden of cardiovascular diseases and Human Immunodeficiency Virus (HIV) in sub-Saharan Africa is of public health concern. Persons living with HIV are 1.5-2 times more likely to develop CVD risk fac...
BACKGROUND: The dual burden of cardiovascular diseases and Human Immunodeficiency Virus (HIV) in sub-Saharan Africa is of public health concern. Persons living with HIV are 1.5-2 times more likely to develop CVD risk factors compared to the noninfected individuals. Hypertension is a major risk factor leading to the rising CVD epidemic in SSA. However, the burden of hypertension among HIV patients in Kenya is not well documented. OBJECTIVE: This study determined the prevalence and the associated factors of hypertension among HIV patients receiving regular care at Thika Level 5 Hospital Comprehensive Care Clinic (CCC), within metropolitan Nairobi, Kenya. METHODS: The current cross-sectional study involved review of patients' records/charts. Charts for adult patients seen in the last 6 months at Thika Level 5 Hospital CCC were included in the study. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg on two different readings one month apart, while overweight/obesity was defined as body mass index (BMI) ≥ 25 kg/m. RESULTS: In a sample of 939 HIV patients, the majority, 68.8% (646), were female. The patients' ages ranged from 18 to 84 years with a median age of 44 (IQR 37-51) years. The mean BMI was higher for females (25.8 kg/m) compared to that of males (23.1 kg/m). However, the prevalence of hypertension was higher among males (25.3%) compared to females (16.9%). Age >40 years (AOR = 2.80, ≤ 0.001), male sex (AOR = 2.10; =0.04), history of alcohol consumption (AOR = 2.56, ≤ 0.001), and being overweight/obese (AOR = 2.77 ≤ 0.001) were significantly associated with hypertension. The antiretroviral (ARV) regimen and, additionally, the duration of antiretroviral therapy had no association with being hypertensive. CONCLUSION: The prevalence of hypertension is high among HIV patients. Traditional cardiovascular risk factors were associated with hypertension, but no association was observed with ART regime or duration of ARV use. There is a need to integrate hypertension management into regular HIV care.
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