International Journal Of Hypertension[JOURNAL]
Sun
200 papers
Preference for Stronger Taste Associated with a Higher Risk of Hypertension: Evidence from a Cross-Sectional Study in Northwest China.
Liu H, Wang Y, Zhang B … +7 more , Huo Y, Cao S, Liu J, Zeng L, Yan H, Dang S, Mi B
Int J Hypertens · 2022 · PMID 36457645 · Full text
BACKGROUND: Dietary modulation is a primary lifestyle approach for reducing the risk of hypertension. However, evidence of the potential role that a dietary taste preference plays in the risk of hypertension remains limi...
BACKGROUND: Dietary modulation is a primary lifestyle approach for reducing the risk of hypertension. However, evidence of the potential role that a dietary taste preference plays in the risk of hypertension remains limited. METHODS: A cross-sectional analysis was conducted based on the Shaanxi baseline survey of the Regional Ethnic Cohort Study. We used self-reported salt consumption and intensity preferences for sourness and spiciness to calculate the taste preference score, which was categorized into bland, moderate, and strong. A generalized linear mixed model and quantile regression were performed to estimate associations between taste preferences and hypertension/blood pressure. RESULTS: Among 27,233 adults, 72.2% preferred a moderate taste and 21.4% preferred a strong taste. Compared with a bland taste, a stronger taste preference might be associated with a higher risk of hypertension (adjusted OR for a moderate taste = 1.25, 95% CI: 1.06, 1.49; adjusted OR for a strong taste = 1.41, 95% CI: 1.15, 1.71; = 0.002), especially in females (adjusted OR for a moderate taste = 1.43, 95% CI: 1.24, 1.66; adjusted OR for a strong taste = 1.55, 95% CI: 1.32, 1.83; < 0.001). Quantile regression showed that the taste preference was positively associated with diastolic blood pressure (DBP) ( - ) in females, with an average increase of 3.31 mmHg for a strong taste ( = 3.31, < 0.001) and 1.77 mmHg for a moderate taste ( = 1.77, = 0.008). CONCLUSIONS: A preference for stronger multitastes of salty, sour, and spicy might be associated with a higher risk of hypertension, especially in females. This relationship possibly occurs through increasing DBP. Dietary modulation with the promotion of a bland taste is encouraged.
Hypertensive Response to Exercise in Athletes: Unremarkable Finding or Relevant Marker for Future Cardiovascular Complications?
Würzburger L, Wiech P, Rossi VA … +4 more , Neunhäuserer D, Caselli S, Schmied CM, Niederseer D
Int J Hypertens · 2022 · PMID 36420357 · Full text
BACKGROUND: In the general population, hypertensive response to exercise (HRE) predicts new-onset resting hypertension or other cardiovascular diseases. METHODS: PubMed was searched for English articles published between...
BACKGROUND: In the general population, hypertensive response to exercise (HRE) predicts new-onset resting hypertension or other cardiovascular diseases. METHODS: PubMed was searched for English articles published between January 1st 2000 and April 30th 2020. Additional studies were identified via reference lists of included studies. 92 papers were selected for full text analysis, finally 30 studies were included. RESULTS: The results from 5 follow-up studies suggested an association between HRE and the risk of developing hypertension, while 10 studies reported a link with adverse cardiovascular events in the general population. Another study showed an association between HRE and future hypertension in athletes after a follow-up of 7 years. HRE in athletes was associated with left ventricular hypertrophy in three studies. Two other studies showed a link between HRE and focal myocardial fibrosis in triathletes and myocardial injury, respectively. One study found lower Apoliprotein-1 serum levels in athletes with HRE leading to a higher risk for cardiovascular disease. Only in one study no association with cardiovascular dysfunction in athletes with HRE was found. CONCLUSIONS: Based on current evidence, HRE is not a normal finding in athletes. If detected, it should be interpreted as a risk factor for future cardiovascular complications. Future research should address the adequate follow-up and management of athletes with HRE.
Influence of AGTR1 and ABCB1 Gene Polymorphism on the Curative Effect of Irbesartan.
Wang Q, You L, Li Z … +3 more , Zhang L, Li X, Yang X
Int J Hypertens · 2022 · PMID 36404948 · Full text
The interindividual heterogeneity in response to the antihypertensive effect of irbesartan has received considerable attention because of gene polymorphism. In this study, we investigated the new combinational influences...
The interindividual heterogeneity in response to the antihypertensive effect of irbesartan has received considerable attention because of gene polymorphism. In this study, we investigated the new combinational influences of AGTR1 and ABCB1 gene polymorphism on the therapeutic effect of irbesartan among Chinese hypertensive patients. A total of 353 samples including 168 normal people and 185 hypertensive patients were adopted, and genotypes comprise ABCB1 (CC, CT, and TT) and AGTR1 (AA and AC) in this study. The results of multiple linear regression models showed that no statistically significant differences were observed in blood pressure change following irbesartan administration in each genotype from either ABCB1 (CC, CT, and TT) or AGTR1 (AA and AC). However, spline smoothing analysis demonstrated that the blood pressure therapeutic responses of irbesartan presented a noticeable difference among different ABCB1 genotypes when irbesartan doses reached over 300 ng/mL. Eventually, we assumed that the different drug responses of irbesartan among various AGTR1 genotypes were due to the diversity of the irbesartan-conjugated protein, which is responsible for crossing-coupled intracellular G-protein-coupled receptors (GPCRs).
Mortality in Elderly Patients Taking Furosemide: Prospective Cohorts Study.
Rodríguez-Molinero A, Miñarro A, Narvaiza L … +12 more , Gálvez-Barrón C, Gonzalo León N, Valldosera E, De Mingo E, Macho O, Aivar D, Pinzón E, Alba A, Passarelli J, Stasi N, Collado I, Banegas JR
Int J Hypertens · 2022 · PMID 36345286 · Full text
OBJECTIVES: Low blood pressure (BP) has been proposed as a risk factor of death in elderly patients. However, this association could be partially accounted for by the deleterious effects of BP-lowering drugs. We analyzed...
OBJECTIVES: Low blood pressure (BP) has been proposed as a risk factor of death in elderly patients. However, this association could be partially accounted for by the deleterious effects of BP-lowering drugs. We analyzed whether these drugs are associated to an increased risk of death in elderly patients taking multiple potential confounders into account. DESIGN: This is a prospective cohort study. Probabilistic sample of 772 community-dwelling patients aged >65 years living in Spain, who were appointed for an initial clinical visit and followed up through telephone calls 4, 6, 9, 12, and 60 months afterwards. METHODS: At baseline visit, BP was measured using standardized methods, and BP medications and risk factors of death in elderly patients (BMI, oxygen saturation, toxic habits, comorbidity, muscular strength, and functional and cognitive capacity) were collected. During the follow-up, the vital status of patients and the date of death were ascertained. RESULTS: During a median 5-year follow-up, 226 all-cause deaths occurred among the 686 participants included in the analysis. In a Cox regression model that included all the BP drug classes, diuretics and nitrites were significantly associated with mortality ( < 0.005). Within diuretics, furosemide was found to be responsible for the association of the group. In multivariable Cox regression models adjusted for BP and the rest of the mortality risk factors, furosemide remained as the only BP drug that was independently associated with mortality (hazard ratio 2.34; < 0.01). CONCLUSIONS: Furosemide was prospectively associated with increased mortality in older people. If confirmed, this drug should be taken into account by prescribers and considered a confounder in BP studies.
Syndecan-4 is More Sensitive in Detecting Hypertensive Left Ventricular Diastolic Dysfunction in 2K2C Rats.
Dai W, Liu Y, Yao F … +4 more , Li W, Liu J, Li C, Liu D
Int J Hypertens · 2022 · PMID 36248198 · Full text
OBJECTIVE: The aim of this study was to investigate the changes of syndecan-4 (SDC-4) during the hypertensive period in two kidney-two clip (2K2C) hypertension rats and compare them to brain natriuretic peptide (BNP) and...
OBJECTIVE: The aim of this study was to investigate the changes of syndecan-4 (SDC-4) during the hypertensive period in two kidney-two clip (2K2C) hypertension rats and compare them to brain natriuretic peptide (BNP) and the echocardiographic parameters for diastolic function evaluation in the rat model of 2K2C hypertension. METHODS: A total of 36 Sprague-Dawley (SD) rats were used in this study. Hypertension was induced in 21 by 2K2C surgery, and 15 were sham-operated. Both the 2K2C hypertension group ( = 21) and the sham-operated group ( = 15) were equally divided into 3 subgroups according to the schedules (week 4, week 8, and week 12). Serum SDC-4 and BNP were detected by ELISA, and echocardiography indexes were acquired. RESULTS: The level of SDC-4 and cardiac fibrosis increased gradually as the experiment was processed, and BNP, Tei index, and E/E' followed to be raised as high blood pressure was maintained after four weeks in the 2K2C hypertension rats. In the earlier 4 weeks, only SDC-4 and cardiac fibrosis were significantly increased in 2K2C hypertensive rats in comparison with normotensive rats. And it was shown that SDC-4 was positively correlated with BNP level during the entire study ( = 0.762, < 0.01). CONCLUSION: SDC-4 increases gradually during the process of diastolic dysfunction in 2K2C hypertensive rats. SDC-4 is the earliest biomarker reflecting diastolic dysfunction in this model, superior to E/E' and the Tei index. Our results indicate that serum SDC-4 could act as an early biomarker to show diastolic dysfunction.
Trajectories of Blood Pressure in Patients with Established Coronary Artery Disease over 20 years.
Jankowski P, Kozieł P, Bilo G … +4 more , Pinkas J, Czarnecka D, Kawecka-Jaszcz K, Pająk A
Int J Hypertens · 2022 · PMID 36225816 · Full text
OBJECTIVE: To evaluate changes in blood pressure (BP) values in patients with established coronary artery disease (CAD) over 20 years (1997-2017). MATERIALS AND METHODS: Consecutive patients aged <71 years and hospitaliz...
OBJECTIVE: To evaluate changes in blood pressure (BP) values in patients with established coronary artery disease (CAD) over 20 years (1997-2017). MATERIALS AND METHODS: Consecutive patients aged <71 years and hospitalized for acute coronary syndrome or myocardial revascularization procedures were recruited and interviewed 6-18 months after their discharge from the hospital. BP was measured in 1997-1998, 1999-2000, 2006-2007, 2011-2013, and 2016-2017. The same five hospitals took part in the surveys at each time point. RESULTS: We examined 412 patients in 1997-1998, 427 in 1999-2000, 422 in 2006-2007, 462 in 2011-2013, and 272 in 2016-2017. The proportion of patients with BP at the recommended goal was 49.2% in 1997-98, 44.5% in 1999-2000, 44.7% in 2006-07, 51.1% in 2011-13, and 58.8% in 2016-17 ( < 0.001). Mean systolic and diastolic BP decreased significantly independent of age, sex, and education (systolic BP: 137.9 ± 21.4 mmHg in 1997-98, 139.5 ± 21.6 mmHg in 1999-2000, 136.1 ± 20.3 mmHg in 2006-07, 134.8 ± 22.0 mmHg in 2011-13, and 134.2 ± 18.6 mmHg in 2016-17, < 0.001; diastolic BP: 83.4 ± 11.0 mmHg in 1997-98, 84.8 ± 12.0 mmHg in 1999-2000, 85.2 ± 11.0 mmHg in 2006-07, 80.9 ± 12.5 mmHg in 2011-13, and 81.1 ± 10.4 mmHg in 2016-17; < 0.001). CONCLUSION: The analysis of five multicenter surveys provides evidence of a decrease in BP in patients with established CAD over two decades. This trend is independent of age, sex, and the education level of the patients.
Fibrosis-4 Index Is Closely Associated with Arterial Damage and Future Risk of Coronary Heart Disease in Type 2 Diabetes.
Watanabe K, Takakubo N, Saigusa T … +7 more , Nagasawa A, Yamana M, Ojima M, Kameda W, Susa S, Ishizawa K, Ishihara H
Int J Hypertens · 2022 · PMID 36225815 · Full text
This study evaluated the association between fibrosis-4 (FIB 4) index and arterial damage or future risk of coronary heart disease (CHD) in type 2 diabetes. The study subjects were 253 patients with type 2 diabetes. The...
This study evaluated the association between fibrosis-4 (FIB 4) index and arterial damage or future risk of coronary heart disease (CHD) in type 2 diabetes. The study subjects were 253 patients with type 2 diabetes. The FIB4 index, as a marker of hepatic fibrosis based on age, aspartate aminotransferase and alanine aminotransferase levels, and platelet count, was calculated for all subjects. Carotid intima-media thickness (IMT), carotid artery calcification (CAC), and aortic arch calcification (AAC) grade (0-2) were assessed as atherosclerotic variables. The Suita score was calculated as the future risk of coronary heart disease (CHD). We assessed whether the FIB4 index was associated with both atherosclerotic variables and the Suita score. FIB4 index was significantly associated with IMT ( = 0.241, < 0.001) and Suita score ( = 0.291, < 0.001). Subjects with CAC showed a significantly higher FIB4 index score compared to subjects without (1.70 ± 0.74 and 1.24 ± 0.69, respectively, < 0.001), whereas the FIB4 index was significantly elevated with a higher grade of AAC (1.24 ± 0.74, 1.56 ± 0.66, and 1.79 ± 0.71, respectively, < 0.001). Linear regression analysis adjusted for clinical characteristics indicated that the FIB4 index was positively associated with IMT, Suita score, CAC, and AAC grade ( = 0.241, =0.004; = 2.994, < 0.001; = 0.139, =0.001; and = 0.265, < 0.001, respectively). FIB4 index is closely associated with arterial damage and future risk of CHD in type 2 diabetes.
Association of H-Type Hypertension with miR-21, miR-29, and miR-199 in Kazahks of Xinjiang, China.
He X, Ma R, Li Y … +7 more , Wang H, Yan Y, Mao Y, Liao S, Sun X, Guo S, Guo H
Int J Hypertens · 2022 · PMID 36200021 · Full text
OBJECTIVE: This study aims to analyze the expressions of miR-21, miR-29, and miR-199 in the serum of the patients with H-type hypertension among Kazakhs. Then, we analyzed the effect of MTHFR 677C > T polymorphism on the...
OBJECTIVE: This study aims to analyze the expressions of miR-21, miR-29, and miR-199 in the serum of the patients with H-type hypertension among Kazakhs. Then, we analyzed the effect of MTHFR 677C > T polymorphism on the association between the above miRNA and H-type hypertension. METHOD: In this study, the expression of miR-21, miR-29, and miR-199 was quantitatively measured in 120 serum samples and then stratified according to the C677T polymorphism to analyze the relationship between target miRNAs and HHcy. RESULTS: The expression of miR-21/-29 in the hypertension group was higher than the normal group ( < 0.001). And the expression of miR-199 was higher in the hcy group than in the normal group ( < 0.001). In the CC and CT genotypes of MTHFR 677C > T, the expression of miR-21 was lower in the HHcy patients than in the normal individuals ( = 0.005 and = 0.001) and miR-199 was significantly higher in the HHcy patients than in the normal ones ( = 0.002 and = 0.048). No such difference was found in the TT genotype. Logistic regression analysis showed that after adjusting for sex, age, BMI, systolic blood pressure, diastolic blood pressure, and MTHFRC677 T gene polymorphism, miR-21 was negatively correlated with hcy (OR = 0.222, 95% CI (0.101-0.485), < 0.001) and miR-199 was positively correlated with hcy (OR = 1.823,95%CI (1.272∼2.614), = 0.001). CONCLUSION: miR-21, miR-29, and miR-199 are associated with H-type hypertension in the Kazakhs, especially hyperhomocysteinemia. And these three miRNAs may serve as biomarkers to provide clues to the potential pathogenesis of H-type hypertension.
Genetic Polymorphism rs7412 T/T Genotype May Be a Risk Factor for Essential Hypertension among Hakka People in Southern China.
Rao H, Wu H, Yu Z … +1 more , Huang Q
Int J Hypertens · 2022 · PMID 36158751 · Full text
OBJECTIVE: One of the causes of hypertension is a genetic factor. The purpose of this study was to look at the relationship between apolipoprotein E (APOE) and methylenetetrahydrofolate reductase (MTHFR) polymorphisms an...
OBJECTIVE: One of the causes of hypertension is a genetic factor. The purpose of this study was to look at the relationship between apolipoprotein E (APOE) and methylenetetrahydrofolate reductase (MTHFR) polymorphisms and essential hypertension in the Hakka population. METHODS: The study included 2,850 patients with hypertension and 2,034 controls. rs429358, rs7412, and rs1801133 were genotyped by polymerase chain reaction (PCR)-microarray. The differences in these polymorphisms between the two groups were analyzed. RESULTS: The genotype and allele frequency of and polymorphisms did not differ significantly between hypertensive patients and controls. Patients with hypertension who were rs429358C/C homozygous had higher TG, TC, LDL-C, and Apo-B levels, whereas patients with the T/T genotype had higher HDL-C levels. Patients with hypertension who were rs7412T/T homozygous had higher TG and TC levels and lower LDL-C and Apo-B levels. Homocysteine (Hcy) levels in patients with CC, CT, and TT genotypes were increased, while patients with the TT genotype and T allele had higher Hcy levels than those of patients with other genotypes and the C allele. The rs7412T/T genotype in the co-dominant model ( rs7412T/T vs. C/C) (gender-, age-, smoking-, and drinking-adjusted OR 2.682, 95% CI, 1.072-6.710, =0.035) was a significant risk factor for hypertension. The rs429358 and rs1801133 genotypes in co-dominant, dominant, and recessive models were not significant risk factors for hypertension. CONCLUSIONS: It supports that polymorphisms are related to hypertension in the Hakka population. Specifically, the rs7412T/T genotype may be a risk factor for hypertension.
Predictors of Nonadherence to Medications among Hypertensive Patients in Ghana: An Application of the Health Belief Model.
Atibila F, Donkoh ET, Ruiter R … +2 more , Kok G, Hoor GT
Int J Hypertens · 2022 · PMID 36059589 · Full text
INTRODUCTION: Hypertension (HPT) is recognized as a significant public health problem worldwide from a health and economic perspective. This study determined predictors of nonadherence to HPT medications in Ghana using t...
INTRODUCTION: Hypertension (HPT) is recognized as a significant public health problem worldwide from a health and economic perspective. This study determined predictors of nonadherence to HPT medications in Ghana using the health belief model. METHODS: A cross-sectional descriptive survey employing a quantitative approach was conducted among HPT patients who routinely attend clinics at selected hospitals in the Brong Ahafo region of Ghana. Respondents ( = 399) were recruited using a multistage sampling technique. RESULTS: The prevalence of nonadherence was 63.7% ( = 254). Nonadherence to hypertension medication was associated with lower education status (=0.009). In logistic regression analysis, patients with high "perceived susceptibility" and "perceived severity" were more likely to forfeit their HPT medication schedules, while patients with high "perceived barriers" and "cues to action" were less likely to skip their medication. CONCLUSION: The present study suggests a plausible path to improving medication adherence in this population. Given the high prevalence of nonadherence, policymakers need to urgently design tailor-made health promotion interventions to ensure optimal health outcomes.
Evaluation of Psychological Distress, Self-Care, and Medication Adherence in Association with Hypertension Control.
Eghbali M, Akbari M, Seify K … +9 more , Fakhrolmobasheri M, Heidarpour M, Roohafza H, Afzali M, Mostafavi-Esfahani FS, Karimian P, Sepehr A, Shafie D, Khosravi A
Int J Hypertens · 2022 · PMID 36059588 · Full text
BACKGROUND: Most of the patients with hypertension (HTN) who undergo medical therapy unaccompanied by psychological and behavioral interventions may not achieve their goal in HTN treatment. Self-care is a key factor in c...
BACKGROUND: Most of the patients with hypertension (HTN) who undergo medical therapy unaccompanied by psychological and behavioral interventions may not achieve their goal in HTN treatment. Self-care is a key factor in controlling HTN. Given that depression, stress, and anxiety are the most psychological disorders in chronic illnesses. Their impact on self-care, quality of life, and HTN control must be studied more. METHODS: We analyzed the difference in medication adherence in 252 patients with low vs. high psychological distress. Also, patients with controlled and uncontrolled HTN were compared according to their psychological distress scores. We further assessed the relation of psychological distress, self-care, and medication adherence with patients' demographic characteristics. RESULTS: 61.3% of our participants were female with a mean age of 60.6 ± 11.35 and male participants had a mean age of 60.5 ± 11.55. The psychological distress score was significantly higher in women with uncontrolled HTN ( value = 0.044). Also, individuals with controlled HTN tend to have a higher medication adherence score ( value = 0.01) and higher self-care score ( value = 0.033). Hypertensive females had a higher psychological distress score (3.35 ± 2.05) and a lower self-care score (64.05 ± 8.16). There was a positive relationship between age and drug adherence. The self-care score was higher (65.95 ± 7.88) in patients having lower psychological distress levels. CONCLUSION: A lower psychological distress score can result in better self-care, enhancing the probability of better HTN control; thus, psychological interventions may be necessary for the treatment of HTN. However, more studies are needed to assess the effectiveness of this intervention.
A Prediction Nomogram Combining Epworth Sleepiness Scale and Other Clinical Parameters to Predict Obstructive Sleep Apnea in Patients with Hypertension.
Wang L, Sun D, Xie J … +3 more , Zhang L, Lao D, Xu S
Int J Hypertens · 2022 · PMID 36034887 · Full text
BACKGROUND: Obstructive sleep apnea (OSA) is common in patients with hypertension. Nonetheless, OSA is underdiagnosed despite considerable evidence of the association between OSA and adverse health outcomes. This study d...
BACKGROUND: Obstructive sleep apnea (OSA) is common in patients with hypertension. Nonetheless, OSA is underdiagnosed despite considerable evidence of the association between OSA and adverse health outcomes. This study developed and validated a clinical nomogram to predict OSA in patients with hypertension based on the Epworth Sleepiness Scale (ESS) score and OSA-related parameters. METHODS: A total of 347 hypertensive patients with suspected OSA were retrospectively enrolled and randomly assigned to a training set and a validation set at 70 : 30 ( = 242/N = 105) ratio. OSA was diagnosed through sleep monitoring and was defined as an apnea-hypopnea index ≥5 events/h. Using the least absolute shrinkage and selection operator regression model, we identified potential predictors of OSA and constructed a nomogram model in the training set. The predictive performance of the nomogram was assessed and validated by discrimination and calibration. The nomogram was also compared with ESS scores according to decision curve analysis (DCA), integrated discrimination index (IDI), and net reclassification index (NRI). RESULTS: ESS scores, body mass index, neck circumference, snoring, and observed apnea predicted OSA are considered. The nomogram showed similar discrimination between the training set (AUC: 0.799, 95% CI: 0.743-0.847) and validation set (AUC: 0.766, 95% CI: 0.673-0.843) and good calibration in the training (=0.925 > 0.05) and validation (=0.906 > 0.05) sets. Compared with the predictive value of the ESS, the nomogram was clinically useful and significantly improved reclassification accuracy (NRI: 0.552, 95% CI: 0.282-0.822, < 0.001; IDI: 0.088, 95% CI: 0.045-0.133, < 0.001) at a probability threshold of >42%. CONCLUSIONS: We developed a novel OSA prediction nomogram based on ESS scores and OSA-related parameters. This nomogram may help improve clinical decision-making, especially in communities and primary clinics, where polysomnography is unavailable.
Present Evidence of Determinants to Predict the Efficacy of Renal Denervation.
Zhou H, Xu Y, Chen W … +5 more , Wang L, Du H, Liu H, Ling Z, Yin Y
Int J Hypertens · 2022 · PMID 35992203 · Full text
Sympathetic overactivation is one of the main contributors to development and progress of hypertension. Renal denervation (RDN) has been evidenced by series of clinical trials for its efficacy and safety to treat overact...
Sympathetic overactivation is one of the main contributors to development and progress of hypertension. Renal denervation (RDN) has been evidenced by series of clinical trials for its efficacy and safety to treat overactivated sympathetic nervous system induced diseases. However, the results were inconsistent and not all patients benefited from RDN. Appropriate patient selection and intraoperative factors to improve the efficacy of RDN need to be solved urgently. Over the decade, research studies on the correlations between indicators and the antihypertensive effects have been conducted and made a fairly well progress. Herein, we comprehensively reviewed the research studies on how to make RDN more predictable or improve the efficacy of RDN and summarized these potential indicators or devices which might be applied in clinical settings.
Electrocardiography in Hypertensive Patients without Cardiovascular Events: A Valuable Predictor Tool?
Ricardo Pires J, Teixeira M, Ferreira F … +3 more , Viseu I, Afreixo V, Neves C
Int J Hypertens · 2022 · PMID 35912335 · Full text
BACKGROUND: Hypertension is an important risk factor of cardiovascular (CV) disease. An early diagnosis of target organ damage could prevent major CV events. Electrocardiography (ECG) is a valuable clinical technique, wi...
BACKGROUND: Hypertension is an important risk factor of cardiovascular (CV) disease. An early diagnosis of target organ damage could prevent major CV events. Electrocardiography (ECG) is a valuable clinical technique, with wide availability and high specificity, used in evaluation of hypertensive patients. However, the use of ECG as a predictor tool is controversial given its low sensitivity. This study aims to characterise ECG features in a hypertensive population and identify ECG abnormalities that could predict CV events. METHODS: We studied 175 hypertensive patients without previous CV events during a follow-up mean of 4.0 ± 2.20 years. ECGs and pulse wave velocity were performed in all patients. Clinical characteristics and ECG abnormalities were evaluated and compared between the patients as they presented CV events. RESULTS: Considering the 175 patients (53.14% male), the median age was 62 years. Median systolic blood pressure was 140 mmHg and diastolic blood pressure was 78 mmHg. Median PWV was 9.8 m/s. Of the patients, 39.4% were diabetic, 78.3% had hyperlipidaemia, and 16.0% had smoking habits. ECG identified left ventricular (LV) hypertrophy in 29.71% of the patients, and a LV strain pattern was present in 9.7% of the patients. Twenty-nine patients (16.57%) had a CV event. Comparative analyses showed statistical significance for the presence of a LV strain pattern in patients with CV events (=0.01). Univariate and multivariate analysis confirmed that a LV strain pattern was an independent predictor of CV event (HR 2.66, 95% IC 1.01-7.00). In the survival analysis, the Kaplan-Meier curve showed a worse prognosis for CV events in patients with a LV strain pattern (=0.014). CONCLUSION: ECG is a useful daily method to identify end-organ damage in hypertensive patients. In our study, we also observed that it may be a valuable tool for the prediction of CV events.
Blood Pressure Trajectories for 16 Years and the Development of Left Ventricular Hypertrophy and Increased Left Atrial Size: The Korean Genome and Epidemiology Study.
Kim SH, Lee JM, Lee SK … +2 more , Shin C, Park JH
Int J Hypertens · 2022 · PMID 35898962 · Full text
BACKGROUND: Elevated single blood pressure (BP) measurement can be associated with the development of hypertension-mediated target organ damage including left ventricular hypertrophy (LVH) and left atrial (LA) enlargemen...
BACKGROUND: Elevated single blood pressure (BP) measurement can be associated with the development of hypertension-mediated target organ damage including left ventricular hypertrophy (LVH) and left atrial (LA) enlargement (LAE). However, long-term patterns of BP and their effects on LVH and LAE are poorly understood. We evaluated the association between the BP trajectories and the presence of LVH and LAE. METHODS: We analyzed a total of 2,565 participants (1,267 males, 47.8 ± 6.7 years old) from the first biennial examination (2001-2002) of the Korean Genome and Epidemiology Study. The presence of LVH and LAE was identified by echocardiography performed at the 8 biennial examination (2015-2016). Latent mixture modeling was used to identify trajectories in mid-BP ((systolic BP + diastolic BP)/2) over time. Linear logistic regression was used for assessing BP trajectories with the outcomes. RESULTS: We identified 4 distinct mid-BP trajectories: group 1 (lowest, 20.9%, = 536), group 2 (36.2%, = 928), group 3 (32.3%, = 828), and group 4 (highest, 10.6%, = 273). Compared with the lowest group, trajectories with elevated mid-BP had greater odds ratios having LVH and LAE by multivariable-adjusted regression models. Adjusted odd ratios for LVH were 2.033 (95% CI = 1.462-2.827, < 0.001) for group 2, 3.446 (95% CI = 2.475-4.797, < 0.001) for group 3, and 4.940 (95% CI = 3.318-7.356, < 0.001) for group 4. Adjusted odd ratios for LAE were 1.200 (95% CI = 0.814-1.769, = 0.358) for group 2, 1.599 (95% CI = 1.084-2.360, = 0.018) for group 3, and 1.944 (95% CI = 1.212-3.118, = 0.006) for group 4. CONCLUSIONS: Higher long-term mid-BP was an independent risk factor of cardiac structural changes such as LVH and LAE among middle-aged population.
Adherence to Self-Care among Patients with Hypertension in Ethiopia: A Systematic Review and Meta-Analysis.
Edmealem A, Ademe S, Gedamu S
Int J Hypertens · 2022 · PMID 35879985 · Full text
BACKGROUND: Self-care adherence for hypertensive patients is a cornerstone for the control of it and prevention of its complications. However, there are inconsistent findings for self-care adherence of hypertensive patie...
BACKGROUND: Self-care adherence for hypertensive patients is a cornerstone for the control of it and prevention of its complications. However, there are inconsistent findings for self-care adherence of hypertensive patients in Ethiopia. Thus, this systematic review and meta-analysis was done to determine the pooled estimate self-care adherence. METHODS: This systematic review and meta-analysis was reported based on the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. An intensive search of online databases such as PubMed (MEDLINE), CINHAL, Google Scholar, and advanced Google search was made to access both published and unpublished articles that report self-care adherence among hypertensive patients in Ethiopia. The pooled estimate was done with STATA version 11 metan commands in a 95% confidence interval. The presence of heterogeneity and publication bias were detected by I and Egger's test, respectively. A random-effect model was obtained, and subgroup analysis was done for the management of heterogeneity. RESULT: A total of 24 articles with a total of 7224 participants were included in the final systematic review and meta-analysis. The pooled estimate of overall self-care adherence among hypertensive patients was 36.98% (95% CI: 27.13-46.83). In subgroup analysis, the highest overall self-care adherence was observed in the Amhara region at 53% (95% CI: 46.54, 59.47). The pooled estimate of self-care dimensions such as medication adherence, low-salt diet, physical activity, smoking abstinence, alcohol abstinence, and weight management was 62.71%, 65.96%, 47.28%, 92.53%, 67.59%, and 52.54%, respectively. CONCLUSION: The pooled estimate of good self-care adherence among hypertensive patients was low. From the dimensions of self-care, the lowest level was in physical activity and the highest level was in smoking abstinence. Comparing all regions, the lowest level of overall self-care adherence was observed in Addis Ababa, Tigray region, and South Nations and Nationalities of Ethiopia. Screening of adherence to self-care and health education should be provided to every patient during every visit.
Emergent Anthropometric Indices in Differential Prediction of Prehypertension and Hypertension in Mexican Population: Results according to Age and Sex.
Zaragoza-García O, Gutiérrez-Pérez IA, Delgado-Floody P … +4 more , Parra-Rojas I, Jerez-Mayorga D, Campos-Jara C, Guzmán-Guzmán IP
Int J Hypertens · 2022 · PMID 35844253 · Full text
BACKGROUND: Hypertension (HTN) is recognized as a significant public health problem in the world. The objective of this study is to evaluate emergent anthropometric indices as predictors of preHTN and HTN according to ag...
BACKGROUND: Hypertension (HTN) is recognized as a significant public health problem in the world. The objective of this study is to evaluate emergent anthropometric indices as predictors of preHTN and HTN according to age and sex in a sample of Mexican adults. METHODS: A cross-sectional study was conducted in 1,150 participants aged 18-80 years old. Anthropometric data and blood pressure measurements were analyzed. Comparisons between men and women were carried out by independent analysis. Cutoff points for each emergent anthropometric index were obtained using the values' upper second and third tertiles. Logistic regression models and receiver operating characteristics curve analyses were used to assess the association and the predictive value of several emergent anthropometric indices with the presence of preHTN and HTN. RESULTS: The prevalence of preHTN and HTN was 29.74% and 14.35%, respectively. In a logistic regression analysis adjusted by age and sex, the body roundness index (BRI) (OR = 2.08, < 0.001) and conicity index (CI) (OR = 1.37, =0.044) were associated with preHTN, while CI (OR = 2.47, < 0.001) and waist to height squared (W/Ht) (OR = 2.19, < 0.001) were associated with HTN. Furthermore, in both sexes, BRI was the main predictor of preHTN (AUC: 0.634 and 0.656, respectively). Particularly, according to sex and age range, the predictive emergent anthropometric indices in men were the body shape index (ABSI) and waist to height cubic (W/Ht) (AUC = 0.777 and 0.771, respectively), whereas in women, the predictors were CI and ABSI (AUC = 0.737 and 0.729, respectively). In men ≤40 years old, central body fat indices were predictors of preHTN and HTN, but in men >40 years old, the predictor indices were W/Ht and W/Ht. In women ≤40 years, the pulse mass index (PMI) was the best main predictor (AUC = 0.909) of HTN. CONCLUSION: CI, PMI, W/Ht, W/Ht, and ABSI could represent differential predictors of preHTN and HTN between men and women according to age range.
Gender Differences in Cardiovascular Risk Factors, Clinical Presentation, and Outcome of Patients Admitted with a Hypertensive Crisis at the Buea Regional Hospital, Cameroon.
Nkoke C, Jingi AM, Noubiap JJ … +6 more , Teuwafeu D, Nkouonlack C, Gobina R, Djibrilla S, Abas A, Dzudie A
Int J Hypertens · 2022 · PMID 35801166 · Full text
BACKGROUND: Several recent studies have shown differences in the risk profile and outcome of cardiovascular diseases between men and women, with a dearth of data from African populations. This study aimed to examine gend...
BACKGROUND: Several recent studies have shown differences in the risk profile and outcome of cardiovascular diseases between men and women, with a dearth of data from African populations. This study aimed to examine gender differences in a group of patients from Cameroon hospitalized with a hypertensive crisis. METHODS: We conducted a cross-sectional study from June 2018 until June 2019. The criteria to define a hypertensive crisis (HC) were systolic and/or diastolic blood pressure should be ≥180/110 mmHg. We compared the clinical presentation and outcome of males versus females. RESULTS: Out of the 1536 patients admitted, 95 (6.2%) had an HC. There were 49 (51.6%) men. There was no significant age difference between men and women (52.7 years vs. 49.3 years, = 0.28). Alcohol consumption ( < 0.0001), previous stroke ( = 0.04), and smoking ( = 0.03) were significantly higher in men compared to women. Men had a higher proportion of psychomotor agitation ( = 0.05). There was an equal proportion of men and women with hypertensive emergencies. Although acute left ventricular failure was most frequent in women (46.4% vs 42.9%), cerebral infarction (14.3% vs 17.9%), and acute coronary syndrome (0% vs 7.1%) were higher in men, the differences were not statistically significant (all > 0.05). Case fatality was also higher in men compared to women but the difference was not statistically significant. CONCLUSIONS: Men admitted for an HC had a significantly higher cardiovascular risk burden and higher psychomotor agitation. However, there were no significant differences in the types of hypertensive emergencies and outcomes between men and women.
High Sucrose Ingestion during a Critical Period of Vessel Development Promotes the Synthetic Phenotype of Vascular Smooth Muscle Cells and Modifies Vascular Contractility Leading to Hypertension in Adult Rats.
Castrejón-Téllez V, Rubio-Ruiz ME, Cano-Martínez A … +4 more , Pérez-Torres I, Del Valle-Mondragón L, Carreón-Torres E, Guarner-Lans V
Int J Hypertens · 2022 · PMID 35774422 · Full text
Cardiometabolic diseases, including hypertension, may result from exposure to high sugar diets during critical periods of development. Here, we studied the effect of sucrose ingestion during a critical period (CP) betwee...
Cardiometabolic diseases, including hypertension, may result from exposure to high sugar diets during critical periods of development. Here, we studied the effect of sucrose ingestion during a critical period (CP) between postnatal days 12 and 28 of the rat on blood pressure, aortic histology, vascular smooth muscle phenotype, expression of metalloproteinases 2 and 9, and vascular contractility in adult rats and compared it with those of adult rats that received sucrose for 6 months and developed metabolic syndrome (MS). Blood pressure increased to a similar level in CP and MS rats. The diameter of lumen, media, and adventitia of aortas from CP rats was decreased. Muscle fibers were discontinuous. There was a decrease in the expression of alpha-actin in CP and MS rat aortas, suggesting a change to the secretory phenotype in vascular smooth muscle. Metalloproteinases 2 and 9 were decreased in CP and MS rats, suggesting that phenotype remains in an altered steady stationary state with little interchange of the vessel matrix. Aortic contraction to norepinephrine did not change, but aortic relaxation was diminished in CP and MS aortas. In conclusion, high sugar diets during the CP increase predisposition to hypertension in adults.
Comparison of Blood Pressure Variability between 24 h Ambulatory Monitoring and Office Blood Pressure in Diabetics and Nondiabetic Patients: A Cross-Sectional Study.
Rouxinol-Dias AL, Gonçalves ML, Ramalho D … +3 more , Silva J, Barbosa L, Polónia J
Int J Hypertens · 2022 · PMID 35774421 · Full text
BACKGROUND: Evidence regarding blood pressure (BP) variability (BPV) and its independent association with adverse outcomes has grown. Diabetic patients might have increased BPV, but there is still an evidence gap regardi...
BACKGROUND: Evidence regarding blood pressure (BP) variability (BPV) and its independent association with adverse outcomes has grown. Diabetic patients might have increased BPV, but there is still an evidence gap regarding relation between BPV and type 2 diabetes beyond mean values of BP. OBJECTIVE: To examine the relationship between 24 h ambulatory BP monitoring (ABPM, short-term variability) and visit-to-visit in-office BPV (OBP, long-term variability), in diabetics () and nondiabetics (ND), and to explore BPV relation with estimated glomerular filtration rate (eGFR), and pulse wave velocity (PWV) as indicators of target organ lesion. MATERIALS AND METHODS: We conducted a single-center cross-sectional study in an outpatient BP unit, including adult patients consecutively admitted from 1999 to 2019. Multivariate was performed to compare BPV between and ND adjusted for clinical variables. Pearson's correlation was performed to evaluate relation of BPV with eGFR and PWV. RESULTS: A total of 1123 patients with ABPM and OBP measurements were included. Values of eGFR and PWV were worse in than in ND. Measurements of OBPV did not differ between groups. Of ABPM BPV, the coefficient of variation and standard deviation for daytime systolic BP were higher in compared to ND, but only in ND did BPV correlated with both eGFR and PWV. CONCLUSION: We found that diabetes is associated with higher variability of daytime BP than nondiabetics along with worse damage of vascular and renal function. However, in contrast to nondiabetics, in diabetics eGFR and PWV may not be dependent on BP variability, suggesting that other mechanisms might explain more rigorously the greater damage of target organ lesion markers.
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