International Journal Of Hypertension[JOURNAL]
Sun
200 papers
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.
Serum Calprotectin Level as an Inflammatory Marker in Newly Diagnosed Hypertensive Patients.
Bayrakci N, Ozkan G, Kara SP … +2 more , Yilmaz A, Guzel S
Int J Hypertens · 2022 · PMID 35096423 · Full text
BACKGROUND: Hypertension is one of the leading causes of cardiovascular mortality. Although the pathogenetic process involved is not yet fully understood, the disease involves endothelial damage and inflammation. Calprot...
BACKGROUND: Hypertension is one of the leading causes of cardiovascular mortality. Although the pathogenetic process involved is not yet fully understood, the disease involves endothelial damage and inflammation. Calprotectin is an inflammatory marker that rises in parallel with disease activity in conditions such as systemic inflammatory diseases, infection, and atherosclerosis. The purpose of this study was to evaluate inflammation through serum calprotectin levels in newly diagnosed primary hypertension patients. METHODS: Forty-nine newly diagnosed hypertensive patients and 38 healthy adults were included in the study. Patients' office blood pressure values, biochemical findings, and demographic characteristics were recorded. Serum calprotectin levels were measured using ELISA. Parameters affecting serum calprotectin levels and determinants of hypertension were evaluated. RESULTS: Serum calprotectin levels were 242.8 (72.4-524) ng/mL in the control group and 112.6 (67.4-389.8) ng/mL in the hypertensive patient group, the difference being statistically significant (=0.001). There was no correlation between serum calprotectin levels and other parameters (blood pressure values, age, gender, serum creatinine, uric acid, and calcium levels) in the hypertensive group. A lower serum calprotectin level was found to be independently related to hypertension ( = -0.009, =0.005). Serum calprotectin at a cutoff level of 128.6 ng/mL differentiated hypertensives from healthy controls with a sensitivity of 69.4% and specificity of 68.4% (AUC = 0.767). CONCLUSIONS: The results of this study were the opposite of our hypothesis that a higher calprotectin level may reflect subclinical endothelial damage in newly diagnosed hypertensive patients. Further comparative studies involving patients at different stages of hypertension may contribute to clarifying the relationship between calprotectin and hypertension. We conclude that molecular studies seem essential for understanding the place of calprotectin in hypertension-associated inflammation, a complex process.
Involvement of Neuropeptide Y within Paraventricular Nucleus in Electroacupuncture Inhibiting Sympathetic Activities in Hypertensive Rats.
Zhang Q, Tan Y, Wen X … +1 more , Li F
Int J Hypertens · 2022 · PMID 35087687 · Full text
Although electroacupuncture (EA) has been used to decrease the blood pressure (BP) clinically, the underlying mechanisms are not clearly clarified. This study aimed to assess the hypothesis that EA treatment exerts a hyp...
Although electroacupuncture (EA) has been used to decrease the blood pressure (BP) clinically, the underlying mechanisms are not clearly clarified. This study aimed to assess the hypothesis that EA treatment exerts a hypotensive action via suppressing sympathetic activities and modulating neuropeptide Y (NPY) function within the paraventricular nucleus (PVN) of hypertensive rats. Male Sprague-Dawley rats were selected for the experiment, and the hypertensive models were established by the two-kidney, one-clip (2K1C) method. Then, the rats were randomly assigned to the sham group, 2K1C group, 2K1C plus EA group, and 2K1C plus sham EA group. EA treatment at the acupoints ST36 and ST40 overlying the peroneal nerves was given once a day for 30 days. The radiotelemetry system was applied to collect the arterial BP recordings. Power spectral analyses of BP variability, BP responses to ganglionic blockade, and plasma levels of norepinephrine and epinephrine were performed to assess the changes in sympathetic nerve activity. Real-time PCR and Western blots were carried out to examine the expression of NPY system in the PVN. The responses of PVN microinjection with NPY Y1R antagonist BIBO3304 were detected to check the endogenous NPY tone. The results showed that the enhanced arterial BP and sympathetic activities were effectively reduced by 30 days of EA treatment, and baroreflex sensitivity was improved in 2K1C hypertensive rats. The level of NPY mRNA and protein expression in the PVN was markedly upregulated by EA treatment in 2K1C rats. In addition, the pressor responses of PVN microinjection with NPY Y1R antagonist BIBO3304 in 2K1C models were remarkably augmented by the EA stimulation. Our results indicate that the increased NPY expression and function in the PVN induced by EA treatment contribute to antihypertensive and sympathetic suppression on hypertensive rats. The findings may elucidate the underlying mechanisms of the acupuncture to be a potential therapeutic strategy against hypertension.
The Effects of Different Classes of Antihypertensive Drugs on Patients with COVID-19 and Hypertension: A Mini-Review.
Nozari F, Hamidizadeh N
Int J Hypertens · 2022 · PMID 35075396 · Full text
Hypertension is a major risk factor for cardiovascular disease. Previous studies showed that patients with hypertension are at an increased risk of developing severe COVID-19 infection. Therefore, proper blood pressure c...
Hypertension is a major risk factor for cardiovascular disease. Previous studies showed that patients with hypertension are at an increased risk of developing severe COVID-19 infection. Therefore, proper blood pressure control in hypertensive patients with COVID-19 is of great importance. In this review, we discussed the effects of different classes of antihypertensive drugs on patients with hypertension and COVID-19.
Patients with Dipper and Nondipper High-Normal Blood Pressure Were Associated with Left Ventricular Mass.
Xiao FK, Li P, Han ZY … +3 more , Jing L, Hua S, Zhao LS
Int J Hypertens · 2021 · PMID 35070446 · Full text
PURPOSE: High-normal blood pressure has been suggested to associate with target organ damage and higher left ventricular mass index (LVMI). Our aim is to find the association between people with high-normal blood pressur...
PURPOSE: High-normal blood pressure has been suggested to associate with target organ damage and higher left ventricular mass index (LVMI). Our aim is to find the association between people with high-normal blood pressure and their left ventricular mass index. MATERIALS AND METHODS: Given a total of 181 people with office blood pressure, 24-hour ambulatory blood pressure monitoring, 35 of them are normotensive (BP < 130/85 mm Hg), and 146 people with high-normal blood pressure (BP 130-139/85-89 mm Hg), divide the high-normal blood pressure group into dipper and nondipper according to their ABPM in 24 hours. All of them were performed with echocardiography to calculate LVMI. RESULTS: After adjusting for potential confounding factors, mean systolic blood pressure (BP) of the nondipper group is (119 + 9) mmHg in 24 h, which is significantly higher ( < 0.05) than in the dipper group (116 + 11) mmHg, indicating the mean systolic BP is associated with the dipper type ( < 0.05); furthermore, the higher nocturnal blood pressure is associated with the nondipper group significantly ( < 0.05), and LVMI ((121 ± 11) g/m) of the nondipper group is also significantly higher than in the dipper group's LVMI ((108 ± 12) g/m) ( < 0.05). The multivariate linear regression analyses revealed significant and independent associations of LVMI with these factors: triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL-C), and coefficient of variation of systolic and diastolic blood pressure in 24 hours. CONCLUSION: After multiple relevant clinical confounding factors were adjusted, patients with dipper and nondipper high-normal blood pressure had higher LVMI. Abnormalities in circadian blood pressure variability may be associated with the left ventricular hypertrophy.
A Prospective Study of Azilsartan Medoxomil in the Treatment of Patients with Essential Hypertension and Type 2 Diabetes in Asia.
Deerochanawong C, Chang KC, Woo YC … +2 more , Lai WT, Chutinet A
Int J Hypertens · 2022 · PMID 35036003 · Full text
This phase 4 study evaluated the efficacy and safety of azilsartan medoxomil (AZL-M) in patients with essential hypertension and type 2 diabetes mellitus (T2DM) in Hong Kong, Taiwan, and Thailand. This was a prospective,...
This phase 4 study evaluated the efficacy and safety of azilsartan medoxomil (AZL-M) in patients with essential hypertension and type 2 diabetes mellitus (T2DM) in Hong Kong, Taiwan, and Thailand. This was a prospective, multicenter, single-arm, open-label study with patients aged 18-75 years with T2DM and essential hypertension and on stable treatment for T2DM. Patients with uncontrolled hypertension were treated with AZL-M 40 mg daily, with the option to uptitrate to 80 mg at 6 weeks. In all, 380 of the 478 patients screened in Hong Kong, Taiwan, and Thailand were enrolled. At week 6, 97 patients (25.5%) were titrated up to AZL-M 80 mg based on BP readings. At 12 weeks, 54.8% of patients reached the blood pressure (BP) goal of <140/85 mm Hg by trough sitting clinic BP (primary endpoint), and 62.8% and 27.0% achieved a BP of <140/90 mm Hg and <130/80 mm Hg, respectively. The efficacy of AZL-M over 12 weeks was also seen in different age and body mass index groups. The incidence of treatment emergent adverse events (TEAEs) was 12.9% before 6 weeks and 16.1% after 6 weeks, and they were mostly mild in severity. The most frequent TEAE was dizziness (4.7%). The incidence of TEAEs leading to study drug discontinuation (4.5%) and drug-related TEAEs (5.0% before 6 weeks; 3.9% after 6 weeks) was low. In patients with essential hypertension and T2DM in Asia, treatment with AZL-M indicated a favorable efficacy and safety profile in achieving target BP.
Relationship between Insulin Secretion and Arterial Stiffness in Essential Hypertension.
Sun Y, Zhu Y, Zhang L … +6 more , Lu Y, Liu Y, Zhang Y, Song W, Jiang Y, Cheng Y
Int J Hypertens · 2021 · PMID 34976408 · Full text
The study aims to explore the relationship between plasma insulin secretion and arterial stiffness in nondiabetic essential hypertensive patients. A total of 730 nondiabetic essential hypertensive patients registered bet...
The study aims to explore the relationship between plasma insulin secretion and arterial stiffness in nondiabetic essential hypertensive patients. A total of 730 nondiabetic essential hypertensive patients registered between January 2016 and October 2020 were enrolled. A two-hour oral glucose tolerance test (OGTT) was performed to detect the levels of C-peptide and blood glucose at 0 hours and 2 hours, as well as the difference between C-peptide (Δ C-peptide) and blood glucose (Δ blood glucose) over the same period. Patients were divided into two groups: the normal glucose tolerance (NGT) group ( = 322) and the impaired glucose tolerance (IGT) group ( = 408). A multiple linear regression analysis was used to evaluate the association between brachial-ankle pulse wave velocity (baPWV) and the other factors. 0 h C-peptide, 2 h C-peptide, and Δ C-peptide were found to be higher in the IGT group. baPWV was positively linear correlated with 2 h C-peptide ( = 0.086, =0.020) and Δ C-peptide ( = 0.115, =0.002). baPWV remained independently associated with 0 h C-peptide, 2 h C-peptide, and Δ C-peptide, after adjusting by age, gender, smoking, body mass index (BMI), high-density lipoprotein (HDL), cholesterol, systolic blood pressure (SBP), and triglycerides (TG). Our data shows that higher endogenous insulin secretion might play an important role in the progression of arterial stiffness in nondiabetic essential hypertensive patients.
The Bidirectional Signal Communication of Microbiota-Gut-Brain Axis in Hypertension.
Wang X, Chen Z, Geng B … +1 more , Cai J
Int J Hypertens · 2021 · PMID 34970454 · Full text
Hypertension is a critical risk factor of cardiovascular diseases. A new concept of microbiota-gut-brain axis has been established recently, mediating the bidirectional communication between the gut and its microbiome an...
Hypertension is a critical risk factor of cardiovascular diseases. A new concept of microbiota-gut-brain axis has been established recently, mediating the bidirectional communication between the gut and its microbiome and the brain. Alterations in bidirectional interactions are believed to be involved in the blood pressure regulation. Neuroinflammation and increased sympathetic outflow act as the descending innervation signals from the brain. Increased sympathetic activation plays a recognized role in the genesis of hypertension. The present evidence demonstrates that gut dysbiosis is associated with central nervous system neuroinflammation. However, how the gut influences the brain remains unclear. We reviewed the roles of neuroinflammation and gut microbiota and their interactions in the pathogenesis of hypertension and described the ascending signaling mechanisms behind the microbiota-gut-brain axis in detail. Additionally, the innovative prohypertensive mechanisms of dietary salt through the microbiota-gut-brain axis are summarized. The bidirectional communication mechanisms were proposed for the first time that the descending signals from the brain and the ascending connections from the gut form a vicious circle of hypertension progression, acting as a premise for hypertension therapy.
Association between rs20456 and rs6930913 of Kinesin-Like Family 6 and Hypertension in a Chinese Cohort.
Chen YL, Zheng LQ, Li TJ … +4 more , Sun ZQ, Hao Y, Wu BG, Sun YX
Int J Hypertens · 2021 · PMID 34961832 · Full text
This study aimed to investigate the relationship between kinesin-like family 6 (KIF6) polymorphisms and hypertension in a northeast Chinese cohort. In this study, two single nucleotide polymorphisms of KIF6 (rs20456 and...
This study aimed to investigate the relationship between kinesin-like family 6 (KIF6) polymorphisms and hypertension in a northeast Chinese cohort. In this study, two single nucleotide polymorphisms of KIF6 (rs20456 and rs6930913) and their haplotype were analyzed in 382 hypertension patients and 378 controls with SHEsis analysis platform, and the gene-environmental interactions were evaluated with logistic regression analysis. After adjusting for confounding factors, significantly lower risk of hypertension was observed in participants with genotype TC (0.416 (CI 0.299-0.578), < 0.001) and CC (0.577 (0.389-0.857), =0.007) of rs20456 compared with TT. For rs6930913, allele T (0.522 (0.386-0.704), < 0.001), genotype TT (0.325 (0.205-0.515), < 0.001), and genotype CT (0.513 (0.379-0.693), < 0.001) were significantly associated with lower risk of hypertension than allele C and CC genotype, respectively. Gene-environment analyses confirmed the significant influence on hypertension by the interactions between genotypes distribution in rs20456 (CT: =0.036, TT: =0.022) and smoking status. No interactions were found between smoking and rs6930913, except those with dominant or recessive genetic models (both =0.006). There were no interactions between KIF6 and overweight (all > 0.05). Haplotype analyses showed that CC (=0.005) and TC (=0.001) of rs20456 and rs6930913 were significantly associated with a statistically increased risk of hypertension. The false-positive report probability (FPRP) analysis was used to verify significant findings. In conclusions, KIF6 might affect the susceptibility of hypertension. The allele C (rs20456) and allele T (rs690913) were inclined to protect individuals from hypertension both in genotype and haplotype analyses.
Association between ZFHX3 and PRRX1 Polymorphisms and Atrial Fibrillation Susceptibility from Meta-Analysis.
Wu L, Chu M, Zhuang W
Int J Hypertens · 2021 · PMID 34950514 · Full text
BACKGROUND: Atrial fibrillation (AF) is a common, sustained cardiac arrhythmia. Recent studies have reported an association between ZFHX3/PRRX1 polymorphisms and AF. In this study, a meta-analysis was conducted to confir...
BACKGROUND: Atrial fibrillation (AF) is a common, sustained cardiac arrhythmia. Recent studies have reported an association between ZFHX3/PRRX1 polymorphisms and AF. In this study, a meta-analysis was conducted to confirm these associations. . The PubMed, Embase, and Wanfang databases were searched, covering all publications before July 20, 2020. RESULTS: Overall, seven articles including 3,674 cases and 8,990 healthy controls for ZFHX3 rs2106261 and 1045 cases and 1407 controls for PRRX1 rs3903239 were included. The odds ratio (OR) (95% confidence interval (CI)) was used to assess the associations. Publication bias was calculated using Egger's and Begg's tests. We found that the ZFHX3 rs2106261 polymorphism increased AF risk in Asians (for example, allelic contrast: OR [95% CI]: 1.39 [1.31-1.47], < 0.001). Similarly, strong associations were detected through stratified analysis using source of control and genotype methods (for example, allelic contrast: OR [95% CI]: 1.51 [1.38-1.64], < 0.001 for HB; OR [95% CI]: 1.31 [1.21-1.41], < 0.001 for PB; OR [95% CI]: 1.55 [1.33-1.80], < 0.001 for TaqMan; and OR [95% CI]: 1.31 [1.21-1.41], < 0.001 for high-resolution melt). In contrast, an inverse relationship was observed between the PRRX1 rs3903239 polymorphism and AF risk (C-allele T-allele: OR [95% CI]: 0.83 [0.77-0.99], =0.036; CT TT: OR [95% CI]: 0.79 [0.67-0.94], =0.006). No obvious evidence of publication bias was observed. CONCLUSIONS: In summary, our study suggests that the ZFHX3 rs2106261 and PRRX1 rs3903239 polymorphisms are associated with AF risk, and larger case-controls must be carried out to confirm the abovementioned conclusions.
Hypertension May Reduce the Infection Risk but Increase the Severity of COVID-19: Based on the Current Data in China.
Li B, Zeng L, Sun N … +7 more , Zhao Y, Zhao F, Bian H, Yi W, Yang J, Li B, Su G
Int J Hypertens · 2021 · PMID 34938578 · Full text
Increasing evidence has shown an unusual relationship between hypertension and COVID-19, which may not be as simple as previously thought. The purpose of our study was to determine the association of hypertension with th...
Increasing evidence has shown an unusual relationship between hypertension and COVID-19, which may not be as simple as previously thought. The purpose of our study was to determine the association of hypertension with the onset and development of COVID-19. A meta-analysis was performed to summarize the prevalence of hypertension in COVID-19 patients, as well as the usage of ACEIs/ARBs. Metaregression analyses were used to evaluate the association of hypertension with disease severity and mortality. PubMed and Google Scholar were searched for relevant studies. A total of 42 studies including 14138 patients were enrolled in the study. The proportion of hypertension in COVID-19 patients in China was 17.7% according to the enrolled studies, while it was 6.0% in a study containing 72314 confirmed cases, which are both much lower than in the general population. All of the data from the 11 provinces in China showed the same tendency. The proportions of hypertension were higher in severe/ICU patients and nonsurvivors than in nonsevere/ICU patients and survivors. The metaregression analyses suggested that both disease severity and risk of death were associated with the incidence of hypertension. A total of 27.6% of COVID-19 patients with hypertension received ACEI/ARB therapy. The proportion of deaths in COVID-19 patients with hypertension treated with ACEIs/ARBs was significantly lower than that in nonuse patients treated with ACEIs/ARBs. In conclusion, hypertension may reduce the infection risk of COVID-19 but increase the risk of developing worse clinical outcomes. The use of ACEIs/ARBs may benefit COVID-19 patients with hypertension.
C-Reactive Protein Levels in relation to Incidence of Hypertension in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey.
Chen B, Cui Y, Lei M … +5 more , Xu W, Yan Q, Zhang X, Qin M, Xu S
Int J Hypertens · 2021 · PMID 34925916 · Full text
OBJECTIVE: To explore the association between high sensitivity C-reactive protein (hs-CRP) levels and incident hypertension, as well as the association between hs-CRP levels and related covariates, in a Chinese adult pop...
OBJECTIVE: To explore the association between high sensitivity C-reactive protein (hs-CRP) levels and incident hypertension, as well as the association between hs-CRP levels and related covariates, in a Chinese adult population. METHODS: This study was based on the China Health and Nutrition Survey, a continuing open, large-scale prospective cohort study. Adult participants who were free of hypertension were included at baseline survey in 2009 and were followed up in 2015 (follow-up rate: 77.45%). The hs-CRP was measured using the immunoturbidimetric method and divided into three groups: low-risk group (0 ≤ hs-CRP <1 mg/L), average-risk group (1 ≤ hs-CRP <3 mg/L), and high-risk group (3 ≤ hs-CRP ≤10 mg/L). Definite diagnosis of hypertension in the follow-up survey in 2015 was the endpoint event of this study. The areas under the curve (AUC) of the receiver operating characteristic (ROC) curve analyses were used to evaluate the predictive value of the hs-CRP. RESULTS: 3794 participants were finally included as study sample, of whom 912 developed hypertension during a 6-year follow-up period (incidence: 24.1%). The incidences of hypertension in hs-CRP low-risk, average-risk, and high-risk groups were 17.6% (200/1135), 25.9% (521/2015), and 29.7% (191/644), respectively. Spearman's correlation analyses showed that there was significant positive correlation between hs-CRP levels and waist circumference, total triglycerides, total cholesterol, age, body mass index, and homeostasis model assessment of insulin resistance index. Stepwise regression analyses showed that participants in the hs-CRP high-risk group had a 46.2% higher risk of developing hypertension compared with those in the hs-CRP low-risk group (odds ratio: 1.462, 95% confidence interval: 1.018-2.101). Baseline systolic and diastolic blood pressure levels and waist circumference contributed the most to the development of hypertension with of 0.076, 0.052, and 0.039, respectively, while hs-CRP had lower area under the curve (AUC) for hypertension, adding baseline BP and WC to the prediction model increased the AUC to 0.708 (95% CI: 0.681-0.735). CONCLUSION: This study revealed a weak positive association between CRP levels and future incidence of hypertension in the Chinese population. The combination of hs-CRP with baseline BP and waist circumference (WC) had a higher predictive value for hypertension (AUC: 0.708), but the predictive value was still limited.
Effects of Posttrial Antihypertensive Drugs on Morbidity and Mortality: Findings from 15-Year Passive Follow-Up after ALLHAT Ended.
Du XL, Simpson LM, Tandy BC … +2 more , Bettencourt J, Davis BR
Int J Hypertens · 2021 · PMID 34925915 · Full text
BACKGROUND: Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) ended in 2002, but it is important to study its long-term outcomes during the posttrial period by incorporating posttrial a...
BACKGROUND: Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) ended in 2002, but it is important to study its long-term outcomes during the posttrial period by incorporating posttrial antihypertensive medication uses in the analysis. PURPOSES: The primary aim is to explore the patterns of antihypertensive medication use during the posttrial period from Medicare Part-D data over the 11-year period from 2007 to 2017. The secondary aim is to examine the potential effects of these posttrial antihypertensive medications on the observed mortality and morbidity benefits. METHODS: This is a posttrial passive follow-up study of ALLHAT participants in 567 US centers in 1994-1998 with the last date of active in-trial follow-up on March 31, 2002, by linking with their Medicare and National Death Index data through 2017 among 8,007 subjects receiving antihypertensive drugs (3,637 for chlorthalidone, 2,189 for amlodipine, and 2,181 for lisinopril). Outcomes included posttrial antihypertensive drug use, all-cause mortality, and cardiovascular disease (CVD) mortality. RESULTS: Of 8007 subjects, 3,637 participants were initially randomized to diuretic (chlorthalidone). The majority (67.9%) of them still received diuretics in 2007, and 52.7%, 47.2%, and 44.0% received -blockers, angiotensin-converting enzyme (ACE) inhibitors, and calcium channel blockers (CCBs), respectively. Compared to participants who received diuretic-based antihypertensives, those who received CCB had a nonsignificantly higher risk of all-cause mortality (1.17, 0.99-1.37), whereas those who received ACE/ARB (angiotensin receptor blockers) had a significantly higher risk of all-cause mortality (1.26, 1.09-1.45). For the combined fatal or nonfatal hospitalized events, the risk of CVD was significantly higher in patients receiving CCB (1.30, 1.04-1.61) and ACE/ARB (1.49, 1.22-1.81) as compared to patients receiving diuretics. CONCLUSION: After the conclusion of the ALLHAT, almost all patients switched to combination antihypertensive therapies, independently by the original drug class, and the combination therapies (mostly based on diuretics) reduced the incidence of major cardiovascular outcomes and mortality.
Association of Obesity and Hypertension: A Cohort Study in China.
Li X, Niu H, Bai X … +2 more , Wang Y, Wang W
Int J Hypertens · 2021 · PMID 34925914 · Full text
The prevalence of general and central obesity has increased rapidly in China for decades, while little is known on obesity-normal weight-central obesity (NWCO) in China. In this study, we aim to depict the trend of the t...
The prevalence of general and central obesity has increased rapidly in China for decades, while little is known on obesity-normal weight-central obesity (NWCO) in China. In this study, we aim to depict the trend of the three kinds of obesity and to explore their associations with hypertension in a cohort study in China. We used data from eight waves of the China Health and Nutrition Survey (CHNS) in 1993, 1997, 2000, 2004, 2006, 2009, 2011, and 2015 for analysis. The Cochran-Armitage test was used for trend of the three kinds of obesity or hypertension. Mixed logistic regression was used to explore their relationship. In this study, we found the prevalence of general obesity increased from 20.81% in 1993 to 50.57% in 2015 in China, which was from 19.23% to 56.15% for central obesity and from 27.20% to 49.07% for NWCO, respectively. Males had the highest increase among all the subgroups. The RR for hypertension and general obesity was 3.71 (95%CI: 3.26-4.22), 3.62 (95%CI 3.19-4.12) for central obesity, and 1.60 (95%CI 1.23-2.06) for NWCO after adjusted for age, sex, education, smoking, alcohol drinking, marriage status, urbanicity and income. Both prevalence of obesity and hypertension have increased significantly in China for the two decades. The general obesity was most likely to develop hypertension compared to central or NOCWO in this study.
Disturbances of the Gut Microbiota, Sleep Architecture, and mTOR Signaling Pathway in Patients with Severe Obstructive Sleep Apnea-Associated Hypertension.
Ko CY, Su HZ, Zhang L … +1 more , Zeng YM
Int J Hypertens · 2021 · PMID 34888100 · Full text
Intermittent hypoxia and sleep fragmentation are pathophysiological processes involved in obstructive sleep apnea (OSA) which affect gut microbiota, sleep architecture, and mTOR signaling pathway. However, the involvemen...
Intermittent hypoxia and sleep fragmentation are pathophysiological processes involved in obstructive sleep apnea (OSA) which affect gut microbiota, sleep architecture, and mTOR signaling pathway. However, the involvement of these elements in the pathogenesis mechanism of OSA-associated hypertension remains unclear. Therefore, this study investigated whether the OSA-associated hypertension mechanism is regulated by the gut microbiota and mTOR signaling pathway. Patients were diagnosed by polysomnography; their fecal samples were obtained and analyzed for their microbiome composition by 16S ribosomal RNA pyrosequencing and bioinformatics analysis. Transcript genes on fasting peripheral blood mononuclear cells (PBMCs) were examined using Illumina RNA-sequencing analysis. Totally, we enrolled 60 patients with severe OSA [without hypertension ( = 27) and with hypertension ( = 33)] and 12 controls (neither OSA nor hypertension). Results revealed that severe-OSA patients with hypertension had an altered gut microbiome, decreased short-chain fatty acid-producing bacteria ( < 0.05), and reduced arginine and proline metabolism pathways (=0.001), compared with controls; also, they had increased stage N1 sleep and reduced stages N2 and N3 sleep accompanied by repeated arousals ( < 0.05). Analysis of PBMCs using the Kyoto Encyclopedia of Genes and Genomes database showed that the mTOR signaling pathway (=0.006) was the most important differential gene-enriched pathway in severe-OSA patients with hypertension. Our findings extend prior work and suggest a possibility that the regulation of the mTOR signaling pathway is involved in developing OSA-associated hypertension through its interaction with the disturbance of the gut microbiome and sleep architecture.
Considering Psychosocial Factors When Investigating Blood Pressure in Patients with Short Sleep Duration: A Propensity Score Matched Analysis.
Qian N, Yang D, Li H … +8 more , Ding S, Yu X, Fan Q, Yu Z, Ye S, Yu H, Wang Y, Pan X
Int J Hypertens · 2021 · PMID 34888099 · Full text
Few studies have considered psychosocial characteristics when investigating the associations between sleep duration and blood pressure (BP). In this study, we took propensity score matching (PSM) to adjust for psychosoci...
Few studies have considered psychosocial characteristics when investigating the associations between sleep duration and blood pressure (BP). In this study, we took propensity score matching (PSM) to adjust for psychosocial characteristics when comparing BP between individuals with short sleep duration and those with normal sleep duration. A total of 429 participants were included. 72 participants with sleep duration ≤6 h and 65 participants with sleep duration >6 h were matched after PSM. We compared office BP, 24-hour BP, and prevalence of hypertension in the populations before and after PSM, respectively. In the unmatched population, participants with sleep duration ≤6 h were observed with higher office diastolic BP (DBP) and 24-h systolic BP (SBP)/DBP (all < 0.05). In the matched populations, the differences between the two groups (sleep duration ≤6 h vs. sleep duration >6 h) in office DBP (88.4 ± 10.9 vs. 82.5 ± 11.1 mm Hg; =0.002), 24-h SBP (134.7 ± 12.0 vs. 129.3 ± 11.6 mm Hg; =0.009), and 24-h DBP (83.4 ± 9.9 vs. 78.1 ± 10.1 mm Hg; =0.002) become more significant. Participants with sleep duration ≤6 h only show higher prevalence of hypertension based on 24-h BP data, while analysis after PSM further revealed that these with sleep duration ≤6 h presented about 20% higher prevalence of elevated BP up to office diagnosed hypertension threshold. Therefore, psychosocial characteristics accompanied with short sleep duration should be fully valued in individuals at risks for elevated BP. This trial is registered with NCT03866226.
Sympathetic Nerve Activity and Baroreflex are Strongly Altered in a Context of Severe Hypertension Using the Spontaneously Hypertensive Rat Model Associated with Chronic Reduction of Nitric Oxide.
Vayssettes-Courchay C, Melka J, Philouze C … +1 more , Harouki N
Int J Hypertens · 2021 · PMID 34868673 · Full text
The aim of our study is to investigate the sympathetic output and baroreflex via renal sympathetic nerve activity (RSNA) recording in a model of severe hypertension which exhibits arterial, cardiac, and renal damages, th...
The aim of our study is to investigate the sympathetic output and baroreflex via renal sympathetic nerve activity (RSNA) recording in a model of severe hypertension which exhibits arterial, cardiac, and renal damages, the spontaneously hypertensive rat (SHR) under lowered NO bioavailability. SHR are treated from 18 to 20 weeks of age with a low dose of L-NAME, a NO synthase inhibitor, in drinking water (SHRLN) and compared to SHR and normotensive Wistar Kyoto (WKY) rats. After the two-week treatment, rats are anesthetized for RSNA, mean blood pressure (MBP), and heart rate (HR) recording. MBP is higher in SHR than in WKY and higher in SHRLN than in SHR. Compared to WKY, SHR displays an alteration in the baroreflex with a displacement of the sympathoinhibition curve to highest pressures; this displacement is greater in SHRLN rats. The bradycardic response is reduced in SHRLN compared to both SHR and WKY. In hypertensive rats, SHR and SHRLN, basal RSNA is modified, the maximal amplitude of burst is reduced, but minimal values are increased, indicating an increased basal RSNA with reduced bursting activity. The temporal correlation between RSNA and HR is preserved in SHR but altered in 10 SHRLN out of 10. The RSNA inhibition triggered by the Bezold-Jarisch reflex activation is not modified in hypertensive rats, SHR or SHRLN, in contrast to that triggered by the baroreflex. Histological analysis of the carotid bifurcation does not reveal any abnormality in SHRLN at the level of the carotid sinus. In conclusion, data indicate that the sympathetic outflow is altered in SHRLN with a strong reduction of the baroreflex sympathoinhibition and suggest that its central pathway is not involved. These additional results on SHRLN also confirm the usefulness of this model of severe hypertension with multiple target organ damages.
Prevalence of Erectile Dysfunction and Associated Factors among Hypertensive Patients Attending Governmental Health Institutions in Gondar City, Northwest Ethiopia: A Cross-Sectional Study.
Abuhay DA, Gela YY, Getu AA
Int J Hypertens · 2021 · PMID 34868672 · Full text
INTRODUCTION: Erectile dysfunction is a common sexual problem affecting men with hypertension. It may result in withdrawal from sexual engagement, decreased work productivity, psychosocial problems including poor self-es...
INTRODUCTION: Erectile dysfunction is a common sexual problem affecting men with hypertension. It may result in withdrawal from sexual engagement, decreased work productivity, psychosocial problems including poor self-esteem and depression, and reduction in quality of life for both the affected men and their female partners. OBJECTIVE: This study was aimed to determine the prevalence of erectile dysfunction and associated factors among hypertensive patients attending governmental health institutions in Gondar city, Northwest Ethiopia. MATERIALS AND METHODS: An institutional-based cross-sectional study was conducted on 423 hypertensive men randomly selected using a systematic random sampling technique. Erectile dysfunction was assessed using the International Index of Erectile Function-5 tool. Sociodemographic, clinical, and behavioral factors were also collected using pretested interviewer-administered questionnaires. Data were entered into EpiData version 4.6 and analyzed using Stata-14. Binary logistic regression was performed to identify factors associated with erectile dysfunction. The level of significance was computed at a value ≤ 0.05. RESULTS: The mean age of the study participants was 58.84 ± 13.52 years. The prevalence of erectile dysfunction among hypertensive men was 46.34% (95% CI: 41.61, 51.12). About 28% of them had a mild form of erectile dysfunction while nearly 6% had severe forms. Age above 60 years (AOR = 3.8, 95% CI: 1.62, 6.55), stage II hypertension (AOR = 3.5, 95% CI: 1.63, 5.74), hypertension duration >10 years (AOR = 2.5, 95% CI:1.12, 4.19), comorbidity (AOR = 1.7, 95% CI: 1.04, 3.15), depression (AOR = 2.35, 95% CI: 1.31, 4.21), and being physically active (AOR = 0.48, 95% CI: 0.28, 0.83) were factors significantly associated with erectile dysfunction. CONCLUSION: Nearly half of the study participants had some form of erectile dysfunction, indicating the presence of a high burden of the problem. Assessment of hypertensive men for erectile dysfunction should be part of routine medical care.
Irisin Is Correlated with Blood Pressure in Obstructive Sleep Apnea Patients.
Wang X, Zhang Z, Lan X … +4 more , Fu K, Xu G, Zhao J, Yuan H
Int J Hypertens · 2021 · PMID 34804606 · Full text
BACKGROUND: Despite approximately 95% primary cases of hypertension, secondary hypertension seems to be common with resistant forms. Notably, obstructive sleep apnea (OSA) is known as a common cause of secondary hyperten...
BACKGROUND: Despite approximately 95% primary cases of hypertension, secondary hypertension seems to be common with resistant forms. Notably, obstructive sleep apnea (OSA) is known as a common cause of secondary hypertension and has a major characteristic of obesity. Irisin acts as a link between muscles and adipose tissues in obesity, playing an essential role in human blood pressure (BP) regulation. However, whether irisin is associated with secondary hypertension caused by OSA and how it takes effect essentially have not been elucidated. PURPOSE: To investigate the changes of irisin and its relationship with BP in OSA. METHODS: 72 snoring patients finished Epworth Sleep Scale (ESS) evaluation before polysomnography (PSG). BP was the average of three brachial BP values by mercury sphygmomanometer. Serum irisin level was determined by enzyme-linked immunosorbent assay (ELISA). Results were analyzed by SPSS software. RESULTS: Irisin was higher in the severe and quite severe group than that in control and nonsevere groups ( < 0.05). For BP, significant differences were found between the control group and the other three groups ( < 0.05) and between the quite severe and the other three groups ( ≤ 0.001). Positive correlations were found between irisin and apnea-hypopnea index (AHI), AHI and BP, and irisin level and BP. Negative correlations were between irisin and SpO nadir and SpO nadir and BP. Positive correlation still existed between AHI and irisin even after adjusting for some obesity-related variables. CONCLUSIONS: Irisin may serve as a potential biomarker for severity of OSA independently of obesity and imply the development of hypertension.
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