International Journal Of Hypertension[JOURNAL]
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200 papers
Impact of Renin-Angiotensin-Aldosterone System (RAAS) Gene Polymorphism in Essential Hypertension and Antihypertensive Drug Therapy: A Review.
Adhikari A, Sharma C, Lhamu Sherpa M … +3 more , Karaunakran G, Dhakal M, Sharma A
Int J Hypertens · 2025 · PMID 40342617 · Full text
Genetic, demographic and environmental factors all play a role in the frequency of an intricate multifactorial condition known as hypertension. Approximately 30% and 50% of BP fluctuation are influenced by genetic variab...
Genetic, demographic and environmental factors all play a role in the frequency of an intricate multifactorial condition known as hypertension. Approximately 30% and 50% of BP fluctuation are influenced by genetic variability. Many genetic studies have confirmed the link between genetic variability and susceptibility to essential hypertension; hence, identifying genes associated with essential hypertension susceptibility will aid in understanding the pathophysiology and their influence on how an individual responds towards the antihypertensive therapy. There are also controversial results highlighted in some reports. This review summarises genetic variants of the renin-angiotensin-aldosterone system (RAAS), angiotensinogen (AGT) (M235T), angiotensin converting enzyme (ACE) (insertion/deletion), angiotensin II type 1 receptor (AT1R) (A1166C) and aldosterone synthase (C344T) that are known and might contribute towards the pathophysiology of essential hypertension. Furthermore, the review highlights the response of certain RAAS gene polymorphisms (renin, ACE and AT1R genes) to antihypertensive drugs.
Analysis of Adherence Status and Influencing Factors Among Middle-Aged and Elderly Hypertension Patients in Rural Areas of Northeast China.
Lu X, Wang J, Chen S … +2 more , Lv L, Yu J
Int J Hypertens · 2025 · PMID 40322455 · Full text
Hypertension remains a major public health challenge globally, with suboptimal adherence to treatment and lifestyle modifications exacerbating cardiovascular risks. This study evaluates multidimensional adherence (medica...
Hypertension remains a major public health challenge globally, with suboptimal adherence to treatment and lifestyle modifications exacerbating cardiovascular risks. This study evaluates multidimensional adherence (medication, diet, and behavior) and its determinants among hypertensive patients in rural Northeast China. A cross-sectional study enrolled 6352 adults aged ≥ 40 years with diagnosed and poorly controlled hypertension from rural villages across five cities (Benxi, Chaoyang, Dandong, Donggang, and Fuxin) in Liaoning Province, Northeast China, using multistage cluster sampling. Adherence was assessed via standardized questionnaires, with logistic regression analyzing sociodemographic, clinical, and behavioral predictors. Medication adherence was reported by 73.7% of participants, while dietary and behavioral adherence rates were 10.5% and 29.3%, respectively. Ethnic disparities emerged, with Han Chinese exhibiting lower medication adherence (aOR = 0.485, 95% CI: 0.377-0.624). Cohabiting with children enhanced dietary adherence (aOR = 2.184, 95% CI: 1.854-2.573), whereas widowed status reduced both dietary (aOR = 0.698, 95% CI: 0.528-0.924) and behavioral adherence (aOR = 0.726, 95% CI: 0.595-0.887). Higher hypertension knowledge scores positively influenced all adherence domains ( < 0.05). Adherence among rural hypertensive patients is multidimensional, shaped by cultural, socioeconomic, and behavioral factors. Targeted interventions addressing dietary sodium reduction, family-based support, and health literacy improvement are urgently needed. This study underscores the importance of integrating region-specific strategies into hypertension management programs to mitigate cardiovascular morbidity in high-risk populations.
Self-Care Behaviors and Associated Factors Among Hypertensive Patients at Dessie Referral Hospital, Northeast Ethiopia.
Muhe A, Kahissay MH, Ali MK … +2 more , Cunningham SA, Habte BM
Int J Hypertens · 2025 · PMID 40313352 · Full text
Hypertension poses a significant global health challenge, leading to serious health conditions and premature death. Effective blood pressure control is often hindered by patients' nonadherence to self-care behaviors. Thi...
Hypertension poses a significant global health challenge, leading to serious health conditions and premature death. Effective blood pressure control is often hindered by patients' nonadherence to self-care behaviors. This study evaluates these behaviors and their influencing factors among hypertensive patients at Dessie Referral Hospital, Ethiopia. Conducted from October 20 to November 30, 2019, this mixed-methods study involved 370 hypertensive patients from the hospital's outpatient clinic. Data were collected via structured questionnaires and analyzed using multivariable logistic regression. Additionally, 14 in-depth interviews provided qualitative insights, analyzed thematically. Only 29.4% of patients fully adhered to self-care recommendations. Urban dwellers showed 70% less adherence than rural counterparts. Adherence varied with the duration since diagnosis, with medium-duration patients being less likely to adhere. Interviews revealed personal strategies for managing diet, exercise, medication, and lifestyle, highlighting the struggle with adherence and innovative solutions to challenges. Adherence to self-care among hypertensive patients is alarmingly low, influenced by diagnosis duration, residency, and BMI. Addressing hindrances like living conditions, work, cultural norms, and peer influence is vital. Healthcare providers must focus on education that promotes behavior change and support. Patient engagement in self-care is essential. Future research should investigate healthcare organizational and provider influences. Implementing these strategies could markedly improve hypertension management and patient outcomes.
Association Between Ultra-Processed Food Consumption and Hypertension Incidence: Findings From RaNCD Cohort Project.
Amirian P, Zarpoosh M, Pasdar Y
Int J Hypertens · 2025 · PMID 40265039 · Full text
Ultra-processed food (UPF) consumption is increasing rapidly due to large-scale food production. Being a public health issue, hypertension is affecting 1.28 billion adults globally. This study investigates the link betwe...
Ultra-processed food (UPF) consumption is increasing rapidly due to large-scale food production. Being a public health issue, hypertension is affecting 1.28 billion adults globally. This study investigates the link between UPF consumption and hypertension. We included 8150 participants at the risk of hypertension in the final analysis. UPF consumption was assessed using data from the available Food Frequency Questionnaire (FFQ), and the amount of UPF consumption of each participant in a day was assessed. Cox proportional models with covariates including age, sex, residence type, marital status, socioeconomic status, physical activity, familial history of hypertension, and fasting blood sugar were used to assess the association between UPF consumption and hypertension in the main model and sensitivity analysis. Age, residence type, and the third tertile of UPF interacted with time in our model, which was addressed accordingly. The mean participant age was 46.25 years (47.58% male) with a mean follow-up of 7.65 years. The mean daily UPF intake was 88.07 g. During follow-up, 862 hypertension cases were recorded. After adjusting the main model for confounders, the hazard ratios for the second and third tertiles of UPF consumption were 1.13 (95% CI, value) (0.96-1.32, 0.13) and 0.65 (95% CI, value) (0.46-0.91, 0.01), respectively, compared to the first tertile. We found significant association between the third tertile of UPF intake and hypertension; moreover, we identified significant associations between hypertension incidence and some demographic factors, warranting further investigation.
MicroRNA-34a Mediates the Aldosterone-Induced Acceleration of Endothelial Senescence.
Jia M, Lin L, Yang B … +4 more , Yu H, Zhong S, Xu X, Song X
Int J Hypertens · 2025 · PMID 40226530 · Full text
Inappropriate aldosterone production relative to sodium status is known to induce arterial hypertension and cause detrimental effects on endothelium and vascular remodeling. This study investigated whether microRNAs (miR...
Inappropriate aldosterone production relative to sodium status is known to induce arterial hypertension and cause detrimental effects on endothelium and vascular remodeling. This study investigated whether microRNAs (miRs) serve as key mediators of aldosterone's effects on endothelial dysfunction. Using human umbilical vein endothelial cells (HUVECs) as a model system, we demonstrated that aldosterone treatment suppressed cellular proliferation and migration while promoting senescence. Mechanistically, we observed that aldosterone exposure significantly upregulated miR-34a expression in HUVECs. The functional significance of miR-34a was confirmed when specific inhibitors reversed aldosterone's antiproliferative and prosenescence effects. To elucidate the underlying molecular pathway, we performed comprehensive biological analyses, which revealed that miR-34a target genes were predominantly associated with the Notch signaling pathway. Western blot analysis further validated that miR-34a promotes senescence in HUVECs through negative regulation of NOTCH1. Collectively, our findings identify miR-34a as a crucial mediator of aldosterone-induced endothelial cell senescence via the NOTCH1 signaling pathway, suggesting its potential as a therapeutic target for aldosterone-related vascular diseases.
Contribution of Body Composition Measures to the Increased Left Ventricular Mass Index in Young Adult Black and White Females.
Sill J, Woo JG, Urbina EM
Int J Hypertens · 2025 · PMID 40190451 · Full text
We aimed to determine the contribution of various types of body composition measures to the increased left ventricular mass index (LVMI) in young adult females. Data from the National Growth and Health Study (NGHS), inc...
We aimed to determine the contribution of various types of body composition measures to the increased left ventricular mass index (LVMI) in young adult females. Data from the National Growth and Health Study (NGHS), including dual-energy x-ray absorptiometry (DEXA), magnetic resonance imaging (MRI), and echocardiogram, were analyzed ( = 589, 54.8% Black, mean age: 24.9 ± 0.7 years). Logistic and linear regressions were conducted to assess for the contribution of fat mass (FM) and fat-free mass (FFM) by DEXA and subcutaneous abdominal adipose tissue (SAT) mass and visceral adipose tissue (VAT) volume by MRI in relation to the increased LVMI or left ventricular hypertrophy (LVH; LVMI ≥ 38.6 g/m). FM ( ± SE: 0.025 ± 0.002, < 0.01, adjusted = 0.313), FFM (0.059 ± 0.003, < 0.01, adjusted = 0.374), SAT (0.054 ± 0.005, < 0.01, adjusted = 0.291), and VAT (0.194 ± 0.019, < 0.01, adjusted = 0.256) were each significantly associated with the increased LVMI, with FFM having the greatest association. Black race was associated with the increased LVMI in models involving individual fat mass types (0.055 ± 0.020, < 0.01 for FM; 0.054 ± 0.021, = 0.01 for SAT; 0.119 ± 0.021, < 0.01 for VAT). In logistic models considering all mass types, FFM (OR [95% CI]: 1.62 [1.46-1.79], < 0.01) and systolic blood pressure (SBP) (1.04 [1.01-1.07], < 0.01) were significant contributors to LVH (area under the receiver-operator characteristic curve 0.847), and only FFM was a significant contributor in the corresponding linear regression ( ± SE: 0.059 ± 0.003, < 0.01, adjusted = 0.374). FFM had the greatest association with LVH and LVMI, confirming previously published data. Through the use of MRI, we found that neither subtype of abdominal fat mass (SAT and VAT) better explained the variance in LVMI than FFM.
Predicting Factors Associated With Uncontrolled Hypertension Using Machine Learning Methods: A Cross-Sectional Study in Western Iran.
Cheraghi Z, Doosti-Irani M, Sohrabi M … +1 more , Doosti-Irani A
Int J Hypertens · 2025 · PMID 40012844 · Full text
Uncontrolled hypertension is a major public health issue globally. This study aimed to uncover the factors contributing to uncontrolled hypertension using machine learning techniques. In this study, 303 adults with hyper...
Uncontrolled hypertension is a major public health issue globally. This study aimed to uncover the factors contributing to uncontrolled hypertension using machine learning techniques. In this study, 303 adults with hypertension were included in this cross-sectional study. Data were collected using the Standard Health Literacy Questionnaire. Uncontrolled hypertension was defined as systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg on both days. Data were analyzed using percentages and chi-square tests. Four machine learning algorithms were employed in this study. The efficacy of these algorithms was assessed using several performance metrics, including accuracy, positive predictive value, sensitivity, _Score, and the area under the receiver operating characteristic (ROC) curve (AUC). The analyses were performed utilizing Python version 3.8. Of the four models evaluated, logistic regression exhibited the highest accuracy at 75.4% and the greatest AUC at 0.87. According to the logistic regression algorithm, individuals who did not adhere to their treatment had a significantly lower likelihood of having uncontrolled hypertension (OR = 0.17, value < 0.001). Number of children (OR = 0.44, < 0.001), physical activity (OR = 0.94, < 0.001), and health literacy (OR = 0.29, = 0.10) were all associated directly, and salt intake (OR = 9.60, < 0.001) was associated inversely with the odds of having uncontrolled hypertension. Based on variable importance analysis, low physical activity was identified as the most important variable, followed by weak health literacy and nonadherence to drug treatment. Factors such as age, duration of hypertension, chronic disease, and salt consumption were also significant. Adherence to treatment, physical activity, health literacy, and salt intake play crucial roles in uncontrolled hypertension. Interventions targeting these factors could help in managing and preventing uncontrolled hypertension.
Effect of Hydrogen Sulfide on Sympathoinhibition in Obese Pithed Rats and Participation of K Channel.
Gomez CB, Sánchez-López A, Carvajal K … +1 more , Centurión D
Int J Hypertens · 2024 · PMID 39530003 · Full text
Elevated blood pressure is the leading metabolic risk factor in attributable deaths, and hydrogen sulfide (HS) regulates vascular tone and blood pressure. Thus, this study aims to evaluate the mechanism by which NaHS (HS...
Elevated blood pressure is the leading metabolic risk factor in attributable deaths, and hydrogen sulfide (HS) regulates vascular tone and blood pressure. Thus, this study aims to evaluate the mechanism by which NaHS (HS donor) produces inhibition of the vasopressor sympathetic outflow in obese rats. For that purpose, animals were fed a high-fat diet (HFD) (60% calories from fat) for 12 weeks. They were anesthetized, pithed, and cannulated to evaluate the role of the potassium channel on NaHS-induced sympathoinhibition. Animals received selective electrical stimulation of the vasopressor sympathetic outflow, an intravenous (i.v.) administration of (1) tetraethylammonium (TEA, non-selective K channel blocker, 16.5 mg/kg), (2) 4-aminopyridine (4-AP, K channel blocker, 5 mg/kg), (3) barium chloride (BaCl, K channel blocker, 65 g/kg), (4) saline solution (vehicle of TEA, 4-AP, and BaCl, 1 mL/kg), (5) glibenclamide (K channel blocker, 10 mg/kg), and (6) glibenclamide vehicle (DMSO + glucose 10% + NaOH, 1 mL/kg), and then a 310 g/kg·min NaHS i.v. continuous infusion. We observed that (1) NaHS produced inhibition of the vasopressor sympathetic outflow and (2) the sympathoinhibitory effect by NaHS was reversed by the K channel blocker, BaCl, in obese rats. The above data suggest that the potassium channel could be involved in the sympathoinhibition induced by NaHS.
Identifying Who Benefits the Most from a Community Health Worker-Led Multicomponent Intervention for Hypertension.
Pan M, Beratarrechea A, Poggio R … +7 more , He H, Chen CS, Chen J, Irazola V, Rubinstein A, He J, Mills KT
Int J Hypertens · 2024 · PMID 39319334 · Full text
BACKGROUND: Uncontrolled hypertension is a major public health challenge in low- and middle-income countries. The Hypertension Control Program in Argentina (HCPIA) showed that a community health worker-led multicomponent...
BACKGROUND: Uncontrolled hypertension is a major public health challenge in low- and middle-income countries. The Hypertension Control Program in Argentina (HCPIA) showed that a community health worker-led multicomponent intervention was effective for blood pressure (BP) reduction in resource-limited settings, but whether the intervention was equally effective across participant subgroups is unknown. OBJECTIVE: To identify participants who benefit the most from the HCPIA BP control intervention. METHODS: This secondary analysis used data from HCPIA, a successful 18-month cluster-randomized trial in 18 health centers with 1,432 low-income hypertensive patients in Argentina. Fifteen baseline characteristics were used to define subgroups. The proportion of controlled BP (<140/90 mmHg) was estimated using generalized linear mixed models with arm-by-subgroup interaction terms. The distribution of trial BP response among intervention patient subgroups was assessed. RESULTS: Participants were 53.0% female, a mean age of 56 years, and 17.4% controlled BP at baseline. After the intervention, 72.9% of intervention and 52.2% of control participants had controlled BP. The intervention was more effective in physically inactive patients (OR = 2.76, 95% CI: 1.82 and 4.21; for interaction = 0.04), moderately active patients (OR = 3.08, 95% CI: 1.90 and 4.99; for interaction = 0.03), and those with uncontrolled BP at baseline (OR = 2.77, 95% CI: 2.15 and 3.57; for interaction = 0.05). Among intervention participants, 20.2% had no BP response (BP change < -4 mmHg), 41.3% had a moderate BP response (BP change: -4 mmHg to -24 mmHg), and 38.5% had a high BP response (BP change > -24 mmHg). Women (=0.01), those who were physically inactive (=0.03), and those not taking antihypertensive medications at baseline (=0.001) had the greatest BP response. CONCLUSION: The effect of the intervention was consistent across many subgroups with some key groups showing a particularly strong intervention effect. These findings could be useful for planning future hypertension control programs in low- and middle-income countries.
Platelet Indices and Hypertension: Results from Shahedieh Cohort Study, Yazd, Iran.
Shakeri Shamsi F, Taheri Soodejani M
Int J Hypertens · 2024 · PMID 39220598 · Full text
INTRODUCTION: Hypertension is one of the most important diseases worldwide. In this study, we aim to demonstrate the relationship between platelet indices and hypertension. MATERIALS AND METHODS: We studied 9448 people i...
INTRODUCTION: Hypertension is one of the most important diseases worldwide. In this study, we aim to demonstrate the relationship between platelet indices and hypertension. MATERIALS AND METHODS: We studied 9448 people in the age range of 30 to 70 years. We assessed their hypertension status, platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), smoking, cardiovascular disease history, diabetes status, body mass index, and creatinine levels. Hypertension status was assessed qualitatively. All platelet indices were categorized by quartiles. We then used logistic regression to predict the relationship between these indices and hypertension. RESULTS: PDW index and hypertension had a statistically significant relationship in the second quartile (16.2 fL < PDW ≤ 16.7 fL) in 30 to 40 years old (AOR: 0.225, 95% CI: 0.063-0.806), in the fourth quartile in 50 to 60 years old (AOR = 1.532, 95% CI: 1.048-2.238), and in all the quartiles of the age range of over 60 years. PLT index had a positive relationship (AOR = 3.147, 0.95% CI: 1.163-8.516) in 30 to 40 years old in the fourth quartile vs. the first quartile. A positive relationship was obtained in the third and fourth quartiles of PLT and the age range of 40 to 50 years, respectively (AOR = 2.063, 0.95% CI: 1.162-3.662) and (AOR = 2.204, 0.95% CI: 1.220-3.981). CONCLUSION: According to the results of this study, some platelet indices could be correlated with hypertension, so we may be able to reduce the burden of this disease.
Effects of Renal Denervation on Ouabain-Induced Hypertension in Rats.
Tang M, Hu J, Li W … +4 more , Zhang N, Ning S, Yan Y, Cui Z
Int J Hypertens · 2024 · PMID 38957519 · Full text
BACKGROUND: Ouabain, a Na, K-ATPase inhibitor, is elevated in hypertensive patients. Evidence suggests ouabain contributes to hypertension mainly through activation of the sympathetic nervous system (SNS). Renal nerves p...
BACKGROUND: Ouabain, a Na, K-ATPase inhibitor, is elevated in hypertensive patients. Evidence suggests ouabain contributes to hypertension mainly through activation of the sympathetic nervous system (SNS). Renal nerves play a vital role in the regulation of SNS activity, so we hypothesize that renal denervation may attenuate the development of ouabain-induced hypertension. METHODS AND RESULTS: Forty Sprague-Dawley rats were divided into following groups ( = 10 each): control group (sham surgery plus intraperitoneal saline injection), RDN group (renal denervation (RDN) plus intraperitoneal saline injection), ouabain group (sham surgery plus intraperitoneal ouabain injection), and ouabain + RDN group (RDN plus intraperitoneal ouabain injection). After eight weeks, compared with the control group, rats in the ouabain group exhibited elevated blood pressure ( < 0.05), increased plasma epinephrine, norepinephrine, angiotensin II, and aldosterone levels ( < 0.05). These indexes could be significantly ameliorated by RDN. RDN also reduced the thickening of aortic tunica media and downregulated the expression of proliferating cell nuclear antigen (PCNA) in the thoracic aorta induced by ouabain. Masson staining and echocardiography showed that myocardial fibrosis and increased left ventricular mass in the ouabain group could be attenuated by RDN. CONCLUSIONS: The present study reveals that renal nerves play an important role in the development of ouabain-induced hypertension. RDN could inhibit the pressor effect and the myocardial remodeling induced by ouabain potentially via inhibiting catecholamine release and vascular smooth muscle cell proliferation. Clinical studies are needed to explore whether RDN may exhibit better antihypertensive effects on hypertensive patients with high plasma ouabain levels as compared to those with normal plasma ouabain levels.
Traditional Cardiovascular Risk Factors Associated with Diagonal Earlobe Crease (Frank Sign) in Mexican Adults: Aging, Obesity, Arterial Hypertension, and Being Male Are the Most Important.
Molina-Gallardo R, Aurelien-Cabezas NS, Tiburcio-Jimenez D … +8 more , Plata-Florenzano JE, Guzman-Esquivel J, Rodriguez-Sanchez IP, Martinez-Fierro ML, Molina-Osorio R, De-la-Madrid-Cernas AA, Barriguete-Melendez JA, Delgado-Enciso I
Int J Hypertens · 2024 · PMID 38948003 · Full text
INTRODUCTION: Cardiovascular risk factors such as obesity, type 2 diabetes, hypertension, smoking, and dyslipidemia enfold heart disease morbimortality. Diagonal earlobe crease has been proposed as a prognostic marker of...
INTRODUCTION: Cardiovascular risk factors such as obesity, type 2 diabetes, hypertension, smoking, and dyslipidemia enfold heart disease morbimortality. Diagonal earlobe crease has been proposed as a prognostic marker of extension and severity of illness in patients with acute coronary syndrome. But its usefulness remains unclear in patients with or without coronary disease. METHODS: A case-control study was carried out on a total of 805 patients with and without cardiovascular risk factors or acute coronary syndrome. Univariate and multivariate binary logistic regression analyses were used to determine the probability of having diagonal earlobe crease with the presence of cardiovascular risk factors and acute coronary syndrome. Data were summarized as odds ratio with 95% confidence intervals and values. RESULTS: An unadjusted (univariate) analysis showed that being male, being older than 55 years, obesity, type 2 diabetes mellitus, arterial hypertension, smoking, and dyslipidemia, as well as having acute coronary syndrome, were associated with the presence of diagonal earlobe crease. The multivariate analysis showed that men (OR 1.6, 95% IC 1.1-2.4, =0.007), being over 55 years old (OR 4.8, 95% IC 3.2-7.2, < 0.001), being obese (OR 2.1, 95% IC 1.4-3.1, < 0.001), having arterial hypertension (1.5, 95% IC 1.1-2.3, =0.025), or suffering from acute coronary syndrome (OR 5.3, 95% IC 2.5-11.1, < 0.001), were independent factors associated with diagonal earlobe crease. The rest of cardiovascular risk factors were not relevant in the multivariate model. CONCLUSIONS: In Mexican adults, having an acute coronary syndrome is not the only factor associated with diagonal earlobe crease but also being a man, older than 55 years, having high blood pressure and obesity. Diagonal earlobe crease may simply be caused by changes in the skin and connective tissues of the ears because of the aging process, obesity, and/or being male. These factors, by themselves, enfold cardiovascular risk due to well-known pathophysiological causes.
Effect of Yogurt Intake Frequency on Blood Pressure: A Cross-Sectional Study.
Li X, Zhao Z, Na L … +4 more , Cui W, Che X, Chang J, Xue X
Int J Hypertens · 2024 · PMID 38737523 · Full text
Yogurt consumption is a significant factor in reducing the risk of hypertension and preventing cardiovascular diseases. Although increasing evidence has emerged regarding the potential benefits of probiotics in hypertens...
Yogurt consumption is a significant factor in reducing the risk of hypertension and preventing cardiovascular diseases. Although increasing evidence has emerged regarding the potential benefits of probiotics in hypertension, there is a lack of large, cross-sectional studies assessing the association between yogurt intake and blood pressure parameters. We aimed to evaluate the association between yogurt intake frequency and blood pressure. A cross-sectional study was designed using data from the National Health and Nutrition Examination Survey from 2003 to 2004 and 2005 to 2006. We included 3, 068 adults with blood pressure data and yogurt intake data. Multivariate regression analyses revealed significant inverse associations between yogurt and systolic blood pressure ( < 0.05), diastolic blood pressure ( < 0.05), and mean arterial pressure ( < 0.05) in nonhypertensive participants ( = 1 822) but not in hypertensive participants ( = 1 246). Furthermore, a high frequency of yogurt intake prevented hypertension; however, no additional antihypertensive effects were observed in patients already diagnosed with hypertension.
An Assessment of the Prevalence and Risk Factors of Hypertensive Crisis in Patients Who Visited the Emergency Outpatient Department (EOPD) at Adama Hospital Medical College, Adama, Oromia, Ethiopia: A 6-Month Prospective Study.
Abebe AT, Kebede YT, Mohammed BD
Int J Hypertens · 2024 · PMID 38711482 · Full text
BACKGROUND: Over 1 billion people worldwide suffer from the common chronic medical condition of hypertension. A hypertensive crisis occurs when blood pressure exceeds 180/110 mmHg. Depending on whether the target organ i...
BACKGROUND: Over 1 billion people worldwide suffer from the common chronic medical condition of hypertension. A hypertensive crisis occurs when blood pressure exceeds 180/110 mmHg. Depending on whether the target organ is harmed, the situation may be presented as a hypertensive emergency or urgency. OBJECTIVE: To assess the prevalence and risk factors of patients with hypertensive crises who visited the Emergency Outpatient Department (EOPD) at Adama Hospital Medical College in Adama, Oromia, Ethiopia, between January 01 and August 31, 2021, G.C. . A cross-sectional, prospective study on the hypertensive crisis was conducted at Adama Hospital Medical College from January 01 to August 31, 2021, G.C. The data were collected using a standardized questionnaire, validated for completeness, and analyzed using SPSS. The findings were tabulated, and conclusions and recommendations were conveyed. RESULT: Out of 9,082 patients who visited the EOPD during the six-month period, 444 individuals with hypertensive crises were identified, representing a prevalence of 4.9%. Of these, 56.8% were men, resulting in a : ratio of 1.31 : 1. Those between the ages of 66 and 75 were the most affected. At presentation, 91.0% of the study participants were known hypertensive patients. Among the known hypertensive patients, the majority (34.9%) were known to have been hypertensive for 5-10 years. Of the known hypertensive patients, 48.6% were found to be adherent. Hypertensive urgency was discovered to be far more common than hypertensive emergencies (63.5% vs. 36.5%). Headache was the most common presenting symptom, and most patients (36.5%) presented to the health setup in less than 24 hours. The main risk variables identified were drug discontinuation, family history of hypertension, salt consumption, and alcohol usage. The main excuse for the lack of adherence was the cost of the medications. More than half of the patients do not have any additional comorbidities, and of those who do, diabetes mellitus is the most prevalent. A stroke was identified as a major complication. . Hypertensive crises are one of the most prevalent reasons for EOPD admission and are linked to significant consequences. At presentation, most of the study subjects were known hypertension patients. Diabetes mellitus was discovered to be a comorbid condition in one-quarter of them. Although more than half of the patients had improved, the death rate still remained high. Infrastructure and capacity building to provide hospitals with the requisite baseline investigations are among the government's recommendations. Health practitioners are expected to make improvements, such as by educating the public about the need for lifestyle changes and evaluating and managing any hypertension problems.
Blood Pressure Control and Associated Factors among Hypertension Comorbid Type 2 Diabetic Patients in Southeast Ethiopia.
Desta F, Mengesha S, Belayneh F … +5 more , Woldeyohannes D, Tekalegn Y, Zenbaba D, Sahiledengle B, Hailu D
Int J Hypertens · 2024 · PMID 38655153 · Full text
BACKGROUND: Hypertension is the main contributor to the morbidity and mortality of patients with cardiovascular disease. Even though hypertension is very common in comorbid type 2 diabetic patients, it is frequently over...
BACKGROUND: Hypertension is the main contributor to the morbidity and mortality of patients with cardiovascular disease. Even though hypertension is very common in comorbid type 2 diabetic patients, it is frequently overlooked. This study aimed to assess blood pressure control and its associated factors among hypertension comorbid type 2 diabetic patients in Bale Zone public hospitals in Southeast Ethiopia. METHODS AND MATERIALS: A hospital-based cross-sectional study design was conducted among hypertension comorbid type 2 diabetic patients. The data were collected using an interviewer-administered structured questionnaire and a review of the medical charts of patients. A simple random sampling technique was used to select the study participants. The bivariate and multivariate logistic regression analyses were performed to assess the association between blood pressure control and its associated factors. Independent variables that showed a < 0.25 in the bivariate analysis was included in the multivariate analysis. Finally, variables with a < 0.05 were declared statistically significant factors. RESULTS: The total number of participants in the study was 378. The overall magnitude of uncontrolled hypertension among hypertension comorbid diabetic patients was found to be 82.5% (95% CI: 78.7%, 86.4%). Nonadherence to antihypertensive medication (AOR = 2.45, 95% CI: 1.11, 5.39, = 0.027), duration of hypertension >10 years (AOR = 5.2, 95% CI: 1.27, 21.38, = 0.022), participants who attended secondary education (AOR = 3.2, 95% CI: 1.18, 8.87, = 0.023), and being obese (AOR = 4.1, 95% CI: 1.24, 13.49, = 0.021) were significantly associated with uncontrolled hypertension. CONCLUSION: Uncontrolled hypertension was found to be high among hypertension comorbid type 2 diabetic patients. Patients' adherence to antihypertensive medication, physical activity, and alcohol abstinence should be maximized. Loss of weight is also crucial, as is the early detection and management of comorbidities.
Pharmacogenomics of Hypertension in Africa: Paving the Way for a Pharmacogenetic-Based Approach for the Treatment of Hypertension in Africans.
Katsukunya JN, Soko ND, Naidoo J … +8 more , Rayner B, Blom D, Sinxadi P, Chimusa ER, Dandara M, Dzobo K, Jones E, Dandara C
Int J Hypertens · 2023 · PMID 38633331 · Full text
In Africa, the burden of hypertension has been rising at an alarming rate for the last two decades and is a major cause for cardiovascular disease (CVD) mortality and morbidity. Hypertension is characterised by elevated...
In Africa, the burden of hypertension has been rising at an alarming rate for the last two decades and is a major cause for cardiovascular disease (CVD) mortality and morbidity. Hypertension is characterised by elevated blood pressure (BP) ≥ 140/90 mmHg. Current hypertension guidelines recommend the use of antihypertensives belonging to the following classes: calcium channel blockers (CCB), angiotensin converting inhibitors (ACEI), angiotensin receptor blockers (ARB), diuretics, -blockers, and mineralocorticoid receptor antagonists (MRAs), to manage hypertension. Still, a considerable number of hypertensives in Africa have their BP uncontrolled due to poor drug response and remain at the risk of CVD events. Genetic factors are a major contributing factor, accounting for 20% to 80% of individual variability in therapy and poor response. Poor response to antihypertensive drug therapy is characterised by elevated BPs and occurrence of adverse drug reactions (ADRs). As a result, there have been numerous studies which have examined the role of genetic variation and its influence on antihypertensive drug response. These studies are predominantly carried out in non-African populations, including Europeans and Asians, with few or no Africans participating. It is important to note that the greatest genetic diversity is observed in African populations as well as the highest prevalence of hypertension. As a result, this warrants a need to focus on how genetic variation affects response to therapeutic interventions used to manage hypertension in African populations. In this paper, we discuss the implications of genetic diversity in genes, and chromosome 12q loci on hypertension susceptibility and response to antihypertensive therapy. We show that African populations are poorly explored genetically, and for the few characterised genes, they exhibit qualitative and quantitative differences in the profile of pharmacogene variants when compared to other ethnic groups. We conclude by proposing prioritization of pharmacogenetics research in Africa and possible adoption of pharmacogenetic-guided therapies for hypertension in African patients. Finally, we outline the implications, challenges, and opportunities these studies present for populations of non-European descent.
Awareness of Hypertension, Hypercholesterolemia, and Diabetes Mellitus and Associated Characteristics in Russian Adults.
Sahatqija F, Hunsberger M, Cook S … +4 more , Kholmatova K, Shapkina M, Malyutina S, Kudryavtsev AV
Int J Hypertens · 2024 · PMID 38567246 · Full text
Russia has higher cardiovascular disease (CVD) mortality compared to other European countries. The major CVD risk factors are age, male sex, and three conditions, namely hypertension, hypercholesterolemia, and diabetes m...
Russia has higher cardiovascular disease (CVD) mortality compared to other European countries. The major CVD risk factors are age, male sex, and three conditions, namely hypertension, hypercholesterolemia, and diabetes mellitus (DM). This study aimed to assess awareness of these three conditions among Russian adults ( = 3803) and the associated socio-demographic, lifestyle, and health characteristics. We used cross-sectional data from a randomly drawn population-based sample of Russians aged 35-69 years, who participated in the Know Your Heart (KYH) study conducted in Arkhangelsk and Novosibirsk between 2015-2018. Participants' self-reported awareness of hypertension, hypercholesterolemia, and DM was assessed against the measures at the KYH health check (blood pressure, cholesterol, HbA1c and/or use of medication for each condition). Prevalence estimates for the awareness were age- and sex-standardized to the Standard European Population. Socio-demographic, lifestyle, and health-related correlates of the awareness were investigated using logistic regression modelling. Among participants with hypertension ( = 2206), hypercholesterolemia ( = 3171), and DM ( = 329) recorded at a health check, 79%, 45%, and 61% self-reported these conditions, respectively. Higher awareness of hypercholesterolemia and hypertension was associated with older age, female sex, nonsmoking status, obesity, and history of CVD diagnoses. Low household income and history of CVD diagnoses were associated with being aware of DM. The awareness rates of hypertension were relatively high, whereas awareness rates of hypercholesterolemia and DM were relatively low. CVD prevention and early intervention could be improved in Russia through increasing the awareness of the risk factors.
Epidemiology and Risk Factors for Orthostatic Hypotension and Its Severity in Residents Aged > 60 years: A Cross-Sectional Study.
Yang M, Peng R, Wang Z … +4 more , Li M, Song Y, Niu J, Ji Y
Int J Hypertens · 2024 · PMID 38445022 · Full text
This cross-sectional study investigated the epidemiology and risk factors associated with orthostatic hypotension (OH) and its severity in older adults residing in the Jizhou community of Tianjin and the Jimei community...
This cross-sectional study investigated the epidemiology and risk factors associated with orthostatic hypotension (OH) and its severity in older adults residing in the Jizhou community of Tianjin and the Jimei community of Xiamen. The study, conducted from March to September 2019, involved adults aged over 60. A comprehensive questionnaire survey was administered, resulting in the enrolment of 4383 older adults. The overall prevalence of OH was found to be 11.7% (516 out of 4383). Notably, a significant gender difference was observed, with a prevalence of 10% among males (194 out of 1926) and 13.1% among females (322 out of 2457) (=0.002). Among individuals with OH, 332 exhibited mild symptoms, 64 had moderate OH, 58 had severe OH cases, and 50 have very severe OH. Multivariable logistic regression analysis revealed that being female, widowed, engaging in general social activities, and a history of hypertension, migraines, heart disease, cerebrovascular disease, and mental health conditions (anxiety and depression) were independently associated with OH. Ordinal logistic regression analysis further confirmed that hypertension, migraine, and a history of general anesthesia surgery were independently associated with the severity of OH. This study highlights a relatively high prevalence of OH among older adults in the Jizhou community of Tianjin and the Jimei community of Xiamen, China. The identified risk factors, particularly social activities, and hypertension, significantly influence the severity of OH. Further examination is required to corroborate these findings and investigate potential interventions.
Lipid Horizons: Recent Advances and Future Prospects in LBDDS for Oral Administration of Antihypertensive Agents.
Preeti, Sambhakar S, Malik R … +7 more , Bhatia S, Harrasi AA, Saharan R, Aggarwal G, Kumar S, Sehrawat R, Rani C
Int J Hypertens · 2024 · PMID 38410720 · Full text
The lipid-based drug delivery system (LBDDS) is a well-established technique that is anticipated to bring about comprehensive transformations in the pharmaceutical field, impacting the management and administration of dr...
The lipid-based drug delivery system (LBDDS) is a well-established technique that is anticipated to bring about comprehensive transformations in the pharmaceutical field, impacting the management and administration of drugs, as well as treatment and diagnosis. Various LBDDSs verified to be an efficacious mechanism for monitoring hypertension systems are SEDDS (self-nano emulsifying drug delivery), nanoemulsion, microemulsions, vesicular systems (transferosomes and liposomes), and solid lipid nanoparticles. LBDDSs overcome the shortcomings that are associated with antihypertensive agents because around fifty percent of the antihypertensive agents experience a few drawbacks including short half-life because of hepatic first-pass metabolism, poor aqueous solubility, low permeation rate, and undesirable side effects. This review emphasizes antihypertensive agents that were encapsulated into the lipid carrier to improve their poor oral bioavailability. Incorporating cutting-edge technologies such as nanotechnology and targeted drug delivery, LBDDS holds promise in addressing the multifactorial nature of hypertension. By fine-tuning drug release profiles and enhancing drug uptake at specific sites, LBDDS can potentially target renin-angiotensin-aldosterone system components, sympathetic nervous system pathways, and endothelial dysfunction, all of which play crucial roles in hypertension pathophysiology. The future of hypertension management using LBDDS is promising, with ongoing reviews focusing on precision medicine approaches, improved biocompatibility, and reduced toxicity. As we delve deeper into understanding the intricate mechanisms underlying hypertension, LBDDS offers a pathway to develop next-generation antihypertensive therapies that are safer, more effective, and tailored to individual patient needs.
Da-Chuan-Xiong Decoction Ameliorates Sodium Sensitivity and Plasma Norepinephrine via Attenuation of Brain Oxidative Stress in the DOCA-Salt Hypertensive Rats.
Zhang Q, Li H, Zhao S … +2 more , Li F, Tan Y
Int J Hypertens · 2024 · PMID 38344148 · Full text
BACKGROUND: Da-Chuan-Xiong Decoction (DCXD) is an aqueous extract from a classic Chinese herbal formula composed of dried rhizomes of Ligusticum chuanxiong Hort and Bl. in the mass ratio of 4 : 1. It has been long used...
BACKGROUND: Da-Chuan-Xiong Decoction (DCXD) is an aqueous extract from a classic Chinese herbal formula composed of dried rhizomes of Ligusticum chuanxiong Hort and Bl. in the mass ratio of 4 : 1. It has been long used to treat chronic cardiovascular disease caused by blood stasis and wind pathogen in the clinic. This experimental study aimed to investigate the blood pressure (BP)-lowering effect of DCXD treatment on hypertension and underlying mechanisms. METHODS: Male Sprague-Dawley rats were used in the experiment, and the hypertensive models were created by administering deoxycorticosterone acetate (DOCA) in conjunction with a high salt intake in uninephrectomized rats. DCXD was administered to hypertensive rats by oral gavage daily at a dose of 5 g/kg or 2.5 g/kg bodyweight for 28 days. The brain sodium sensitivity, ENaC function, superoxide anion level, NADPH oxidase activity, and expression of ENaC, p67phox, p47phox, and Rac1 in the paraventricular nucleus were assessed by using the appropriate methods. RESULTS: The 28 days of DCXD (5 g/kg) treatment significantly reduced the increased BP effectively, inhibited the enhanced heart index, kidney index, and 24 h urinary protein, and improved the progressive pathological changes of heart and kidney, which was comparable to that of the positive control amlodipine. DCXD treatment also caused a marked reduction in plasma norepinephrine and induced a significant improvement in brain sodium sensitivity and ENaC function in DOCA-salt hypertensive rats. Rats in DCXD-treated groups also exhibited decreased superoxide anion levels and NADPH oxidase activity in the paraventricular nucleus. The level of ENaC, p67phox, and Rac1 protein expression in the paraventricular nucleus was significantly downregulated by DCXD treatment in DOCA-salt hypertensive rats. CONCLUSIONS: These findings indicate that the depressor action and sympathetic inhibition of DCXD on salt-sensitive hypertension may be by ameliorating brain sodium sensitivity, modulating ENaC function, and inhibiting the expression of ENaC and NADPH oxidase in the hypothalamic paraventricular nucleus.
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