Integrated Blood Pressure Control[JOURNAL]
Sun
166 papers
Erratum: Burden of Undiagnosed Hypertension Among Adults in Urban Communities of Southwest Ethiopia [Corrigendum].
Integr Blood Press Control · 2021 · PMID 34168493 · Full text
[This corrects the article DOI: 10.2147/IBPC.S293251.].
[This corrects the article DOI: 10.2147/IBPC.S293251.].
Factors Associated with Early Postoperative Results of Total Anomalous Pulmonary Venous Connection Repair: Findings from Retrospective Single-Institution Data in Vietnam.
Hung DQ, Huy DX, Vo HL … +1 more , Hien NS
Integr Blood Press Control · 2021 · PMID 34103983 · Full text
INTRODUCTION: There are scanty reports of the risk factors for pulmonary hypertensive crisis and low cardiac output syndrome after the operative repair of total anomalous pulmonary venous connection (TAPVC). We aim to ev...
INTRODUCTION: There are scanty reports of the risk factors for pulmonary hypertensive crisis and low cardiac output syndrome after the operative repair of total anomalous pulmonary venous connection (TAPVC). We aim to evaluate early surgical outcomes of TAPVC and risk factors for pulmonary hypertensive crisis and low cardiac output syndrome. METHODS: We conducted a retrospective medical record review for all patients undergoing operative repair of TAPVC within 5 years. Outcome variables included pulmonary hypertensive crisis, low cardiac output syndrome and early mortality. RESULTS: Of 58 patients, we documented 77.59% supracardiac, 20.69% cardiac and 1.72% mixed site of connection. About 86.21% patients underwent elective surgery, and 13.79% patients required emergency surgery. Incidence rates were 27.59% for pulmonary hypertensive crisis and 6.90% for low cardiac output syndrome. Body weight below 6 kg, pneumonia, tachycardia, hepatomegaly, preoperative pulmonary congestion on chest x-ray, preoperative elevated mean pulmonary artery pressure, preoperative pulmonary venous obstruction, emergency surgery and prolonged aortic cross-clamping time were significant risk factors for postoperative pulmonary hypertensive crisis. Significant risk factors for postoperative low cardiac output syndrome included pneumonia, prolonged duration of preoperative mechanical ventilation and prolonged aortic cross-clamping time. CONCLUSION: The early outcome of surgical repair of TAPVC was acceptable, with 96.55% survival rate. This current analysis suggests that a thorough evaluation of all preoperative and operative characteristics is imperative to achieve best medical and surgical outcomes.
Burden of Undiagnosed Hypertension among Adults in Urban Communities of Southwest Ethiopia.
Mogas SB, Tesfaye T, Zewde B … +6 more , Tesfaye Y, Kebede A, Tadesse M, Gudina EK, Tamiru D, Dadi LS
Integr Blood Press Control · 2021 · PMID 34054307 · Full text
BACKGROUND: Hypertension (HTN) is the leading risk factor for mortality due to cardiovascular diseases, it accounts for 7% of global disability adjusted life years. In 2015, it was estimated that around 1.13 billion adul...
BACKGROUND: Hypertension (HTN) is the leading risk factor for mortality due to cardiovascular diseases, it accounts for 7% of global disability adjusted life years. In 2015, it was estimated that around 1.13 billion adults had HTN globally with a high prevalence in low and middle-income countries where the health system is weak to diagnose, treat, and control HTN. Most people with HTN are asymptomatic and go undiagnosed for years. Therefore, the aim of this study was to assess the burden of undiagnosed HTN among adults in urban communities of Southwest Ethiopia. METHODS: A community-based cross-sectional study involving 915 adults from June 17 to July 27, 2019 was performed. WHO STEPS questionnaire was used to collect data, and the collected data were entered using Epi Data version 3.1and analyzed using SPSS version 20, respectively. Binary logistic regression was used to check for a possible association between outcome and independent factors. -value <0.05 and 95% CI were used on multivariable logistic regression analysis as threshold for significant statistical association. RESULTS: Undiagnosed HTN in the study area was 21.2% (194). Age (AOR=1.04, 95% CI=1.02-1.05), BMI with overweight (AOR=2.52, 95% CI=1.35-4.71), triglyceride (AOR=1.83, 95% CI=1.29-2.59), and waist to hip ratio (AOR=1.62, 95% CI=1.03-2.54) were factors significantly associated with HTN. CONCLUSION: As compared to studies performed before, the risk of undiagnosed HTN in the current study was high. Age, BMI, triglyceride, and waist to hip ratios were found to be the significant factors for it. Preventing the risk factors and screening of HTN should be promoted for early detection, prevention, and treatment of the burden of the disease on the population.
The Role of Health Care Quality in Hypertension Self-Management: A Qualitative Study of the Experience of Patients in a Public Hospital, North-West Ethiopia.
Hussien M, Muhye A, Abebe F … +1 more , Ambaw F
Integr Blood Press Control · 2021 · PMID 33948092 · Full text
PURPOSE: Hypertension is becoming a global epidemic in all population groups. For its effective management and control, patients should have enhanced self-management skills and get adequate support from care providers. A...
PURPOSE: Hypertension is becoming a global epidemic in all population groups. For its effective management and control, patients should have enhanced self-management skills and get adequate support from care providers. Although the quality of health care is critical in enhancing self-management behaviors of patients with hypertension, the issue has not been fully explored in the Ethiopian context. Therefore, the purpose of this study was to explore the experience of hypertensive patients on the quality of health care and the self-management practice in a public hospital in North-west Ethiopia. PATIENTS AND METHODS: This qualitative study involves a phenomenological approach. Participants were hypertension patients who are on treatment follow-up. They were recruited purposively with maximum variation approach. Eleven in-depth interviews and two key informant interviews were undertaken using a semi-structured interview guide with hypertensive patients and nurses respectively. Interviews were audio recorded, transcribed verbatim, translated into English, and then analyzed thematically by the investigators. RESULTS: The analysis identified two main themes and seven sub-themes. The first theme "experience in self-management practice" describes medication adherence, lifestyle modification, and self-monitoring of blood pressure. The second theme "experience in the quality of health care" discusses access to health services, patient-centered care, behavior of health care providers, and time and patient flow management. CONCLUSION: The self-management practice of hypertensive patients is sub-optimal. Although several individual patient issues were identified, facility-level problems are mainly responsible for poor self-management practice. The main facility-level barriers, as reported by participants, include shortage of medicines, high cost of medicines, busyness of doctors due to high patient load, lack of appropriate education and counseling services, poor patient-provider interaction, and long waiting times. Intervention areas should focus on providing appropriate training for health care providers to enhance the patient-provider relationship. Improving the supply of hypertensive medications is also paramount for better medication adherence.
Prevalence of Hypertension and Its Associated Factors Among Adults in Areka Town, Wolaita Zone, Southern Ethiopia.
Anjulo U, Haile D, Wolde A
Integr Blood Press Control · 2021 · PMID 33758539 · Full text
BACKGROUND: Hypertension is an emerging public health problem in many low- and middle-income countries including Ethiopia. However, there are limited studies and data are scarce in these countries, particularly in Ethiop...
BACKGROUND: Hypertension is an emerging public health problem in many low- and middle-income countries including Ethiopia. However, there are limited studies and data are scarce in these countries, particularly in Ethiopia. Thus, the aim of this study was to assess the prevalence of hypertension and its associated factors in this study area. METHODS: A community-based cross-sectional study was conducted in Areka town. Multi-stage sampling technique was used to select 581 adults. Information on socio-demographic data, behavioral and dietary habits, and family history of hypertension were collected using face-to-face interview. Measurements of weight, height, and blood pressure were taken using digital weighing scale, Stadio-meter, and digital sphygmomanometer respectively. Data were entered and cleaned in Epi-Data version 3.1, and exported to SPSS version 20 for analysis. Binary logistic regressions were done and odds ratios with 95% confidence intervals were calculated to identify associated factors. RESULTS: The overall prevalence of hypertension among the study participants was 19.1% (95% CI: 15.9-22.4). Out of these, more than half (57.3%) of the cases were newly screened for hypertension. In a multivariate logistic regression analysis; history of perceived childhood obesity (AOR:2.8 (95% CI:1.6,5.1)), age 55 years and above (AOR=8.90, 95% CI: 3.77-21.02), family history of hypertension (AOR= 2.57, 95% CI: 1.17-5.64), fatty meat intake (AOR=1.96, 95% CI: 1.05-3.65), eating vegetables less than two days per week (AOR=2.81, 95% CI: 1.24-6.37) and being obese (AOR=11.59, 95% CI: 4.7-27.62) were associated factors of developing hypertension. CONCLUSION: The study revealed that the prevalence was found to be high among adults indicating the hidden burden of the problem in the area. Therefore, the health systems need to develop strategies for community-based screening, strategies that focus on life cycle-based approach because childhood and adolescence are crucial times for the prevention of NCDs including hypertension. Health education on eating behavior and life style modifications to maintain normal body weight are recommended.
Risk Factors and Comorbidities in Young Indian Patients with Hypertension: REAL YOUNG (Hypertension) Study.
Desai N, Unni G, Agarwala R … +5 more , Salagre S, Godbole S, Dengra A, Abhyankar MV, Revankar S
Integr Blood Press Control · 2021 · PMID 33664586 · Full text
PURPOSE: To analyze the risk factors and comorbidities among the young Indian adults with hypertension. PATIENTS AND METHODS: This was a retrospective, multicentric real-world study which included patients diagnosed with...
PURPOSE: To analyze the risk factors and comorbidities among the young Indian adults with hypertension. PATIENTS AND METHODS: This was a retrospective, multicentric real-world study which included patients diagnosed with and receiving treatment for hypertension. Data were collected from the medical records of clinics/hospitals across 623 study sites in India. Patients of either sex and aged 18-45 years were included. Demographic details (age, sex, anthropometric measurement), medical and family history, sedentary lifestyle, smoking status and alcohol consumption data were extracted. Descriptive and comparative analysis (Mann-Whitney and chi-squared test) was done. RESULTS: Out of 15,006 young patients diagnosed with hypertension (men=63.6%), 65.7% belonged to the age group of >35-45 years. The median body mass index was 27.0 kg/m. Patients diagnosed with only hypertension were 29.1% while other predominant comorbidities with hypertension were diabetes mellitus (42.4%) and dyslipidemia (7.8%). Hypertension with diabetes mellitus were prevalent in the age group of >35-45 years (43.8%). More than half of the patients with hypertension (n=7656) had a sedentary lifestyle. Overall, 35.6%, 47.3%, and 56.7% of the patients were alcoholic, smokers (present and former), and had a family history of hypertension, respectively. CONCLUSION: The results showed that among the young population, hypertension was common in the age group of >35-45 years and diabetes mellitus and dyslipidemia were common comorbidities. Family history, sedentary lifestyle, smoking, alcohol consumption, and body mass index may also contribute to hypertension.
Are Community Health Center Patients Interested in Self-Measured Blood Pressure Monitoring (SMBP) - And Can They Do It?
Roy D, Meador M, Sasu N … +2 more , Whelihan K, Lewis JH
Integr Blood Press Control · 2021 · PMID 33603456 · Full text
INTRODUCTION: Self-measured blood pressure monitoring (SMBP) helps diagnose and manage hypertension from outside the clinic, which has implications for patient empowerment and outcomes, continuity of care, and resilience...
INTRODUCTION: Self-measured blood pressure monitoring (SMBP) helps diagnose and manage hypertension from outside the clinic, which has implications for patient empowerment and outcomes, continuity of care, and resilience in care communities catering to vulnerable populations. METHODS: We instituted a protocol for SMBP among hypertensive patients at 9 community health centers in 3 states and administered questionnaires to patients before and after the protocol was instituted to assess knowledge and engagement with disease management, beliefs and attitudes towards, and experience doing SMBP. Questionnaires included 16 items designed to evaluate patient perceptions and beliefs about SMBP. These included a series of questions using a 5-point Likert scale, binary questions related to their perceived ability to comply with specific SMBP guidelines and open-ended questions to obtain descriptions of experiences with SMBP. RESULTS: The pre-questionnaire was completed by 478 patients and the post-questionnaire was completed by 372. Seventy-seven percent of respondents knew their ideal blood pressure and their engagement with blood pressure management increased significantly (p=0.0024) after completing the protocol. Additionally, 85% of respondents said that they had a positive experience doing SMBP. Open-ended responses revealed insight regarding why patients chose to do SMBP and factors patients appreciated about SMBP. DISCUSSION: When trained properly and supported, community health center patients are capable of and motivated to perform accurate SMBP. Our study provides evidence that health center patients can follow detailed SMBP protocols and monitor their own blood pressure from the safety of their homes, which is critical to their care continuum, particularly in days of a pandemic.
Evidence of Nonadherence in Cases of Pseudoresistant Hypertension.
Zanatta JMM, Cosenso-Martin LN, da Silva Lopes V … +5 more , Roma Uyemura JR, Polegati Santos AM, Paz Landim MI, Yugar-Toledo JC, Vilela-Martin JF
Integr Blood Press Control · 2021 · PMID 33603455 · Full text
Resistant hypertension (RH) is characterized by the use of three or more antihypertensive drugs without reaching the goal of controlling blood pressure (BP). For a definitive diagnosis of RH, it is necessary to exclude c...
Resistant hypertension (RH) is characterized by the use of three or more antihypertensive drugs without reaching the goal of controlling blood pressure (BP). For a definitive diagnosis of RH, it is necessary to exclude causes of pseudoresistance, including the white-coat effect, errors in BP measurement, secondary hypertension, therapeutic inertia, and poor adherence to lifestyle changes and pharmacological treatment. Herein, we report the history of a patient with long-standing uncontrolled BP, even when using seven antihypertensive drugs. Causes of secondary hypertension that justified the high BP levels were investigated, in addition to the other causes of pseudo-RH. In view of the difficult-to-control BP situation, it was decided to hospitalize the patient for better investigation. After 5 days, he had BP control with practically the same medications previously used. Finally, all factors related to the presence of pseudo-RH are discussed, especially poor adherence to treatment. Poor adherence to antihypertensive treatment is common in daily medical practice, and its investigation is of fundamental importance for better management of BP.
Blood Pressure Control with Reference to Intensive Blood Pressure Targets Among Hypertension Patients on Chronic Follow-Up at Dessie Referral Hospital, Northeast Ethiopia.
Bogale K, Aderaw A
Integr Blood Press Control · 2021 · PMID 33519231 · Full text
BACKGROUND: Hypertension is a risk factor for heart, brain, kidney, and other diseases. It is also the major cause of premature death. Thus, it is important to prevent, treat, and control hypertension and to reduce the r...
BACKGROUND: Hypertension is a risk factor for heart, brain, kidney, and other diseases. It is also the major cause of premature death. Thus, it is important to prevent, treat, and control hypertension and to reduce the risk of cardiovascular disease. OBJECTIVE: To determine the level of blood pressure control and associated factors based on the new intensive blood pressure goals (<130/80 mmHg). METHODS: A cross-sectional study design was used to assess the level of blood pressure control and associated factors from February 15 to April 15, 2019. Two hundred and sixteen patients were selected through a systematic sampling technique. RESULTS: From 203 hypertension patients incorporated in the study, 102 (50.2%) were females. The mean age of patients documented during the last date of follow-up was 55.2 (SD=±14.47). About 51.2% of patients were less than 5 years from the day of diagnosis of hypertension. The majority of the study participants (111, 54.7%) were using two antihypertensives. The most common anti-hypertensive medication was hydrochlorothiazide (HCT), at 25 (12.3%). The most common combination drug therapy used was the combination of HCT and calcium channel blockers, at 62 (30.5%). Heart failure (22, 20.8%), stroke (18, 16.98%), and dyslipidemia (17, 16.04%) were the top three comorbidities. Based on the new intensive targets of blood pressure control (<130/80 mmHg), the blood pressure was controlled for only 25 (12%) patients. CONCLUSION: The level of blood pressure control for hypertensive patients on chronic follow-up at Dessie Referral Hospital was very poor.
Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania.
Chuwa G, Chillo P
Integr Blood Press Control · 2020 · PMID 33380824 · Full text
BACKGROUND: Hypertension is a major risk factor for cardiovascular morbidity and mortality. Increasingly, evidence suggests that 24-hour ambulatory blood pressure (BP) monitoring (ABPM) is more accurate than clinic BP in...
BACKGROUND: Hypertension is a major risk factor for cardiovascular morbidity and mortality. Increasingly, evidence suggests that 24-hour ambulatory blood pressure (BP) monitoring (ABPM) is more accurate than clinic BP in predicting cardiovascular risk. However, this association has not been widely studied in subSaharan Africa, especially in Tanzania. AIM: To explore the relationship between 24-hour ABPM profiles and cardiovascular risk factors in comparison with clinic BP among Muhimbili University of Health and Allied Sciences (MUHAS) employees. METHODS: A descriptive cross-sectional study was conducted from October 2018 to February 2019. Socio-demographic and cardiovascular risk information was gathered. We used an automated ABPM device to record 24-hour ambulatory BP. Correlation between BP profiles and cardiovascular risk factors was done using Pearson's correlation coefficient, and independent factors for hypertension were determined using logistic regression analysis. -value of <0.05 was considered statistically significant. RESULTS: In total, 390 employees participated. Their mean age was 40.5 ± 8.9 years, and 53.6% were men. The mean office systolic and diastolic BP were 126±12 mmHg and 78±13 mmHg, respectively, while the corresponding values for mean 24-hour ABPM were 122±14 and 75±10 mmHg. The prevalence of hypertension was 23.1%. The prevalence of white coat hypertension was 16.2%, while masked hypertension and nocturnal non-dipping were present in 11.5 and 66.7%, respectively. Overall, the mean 24-hour systolic BP showed the strongest correlations with cardiovascular risk factors while mean office systolic BP showed least. Independent associated factors of hypertension were male gender, age ≥40 years, family history of hypertension, central obesity, raised cholesterol and uric acid levels, all p<0.01. CONCLUSION: Compared to office BP, ABPM measurements had stronger correlations with cardiovascular risk factors in this population, and therefore likely to reflect true BP. ABPM has revealed high proportion of masked, white coat and nocturnal non-dipping, supporting use of ABPM to detect these clinically important BP profiles.
Peri-Procedural Blood Pressure Changes and Their Relationship with MACE in Patients Undergoing Percutaneous Coronary Intervention: A Cross-Sectional Study.
Labib S, Kassem HH, Kandil H
Integr Blood Press Control · 2020 · PMID 33335422 · Full text
BACKGROUND: Peri-procedural blood-pressure (BP) changes were investigated and correlated to Major adverse cardiovascular events (MACE) as predictor of outcome for patients undergoing percutaneous coronary intervention (P...
BACKGROUND: Peri-procedural blood-pressure (BP) changes were investigated and correlated to Major adverse cardiovascular events (MACE) as predictor of outcome for patients undergoing percutaneous coronary intervention (PCI); whether acute coronary syndrome (Unstable angina, or MI; STEMI or NSTEMI) or scheduled for elective PCI. METHODS: Resting BP in the 204 recruited patients undergoing PCI throughout 2018 was measured thrice - in the ward before transferring to the cardiac catheterization lab (cath lab), in the cath lab, and after transfer to the recovery room. Patients were categorized based on their systolic and diastolic BP peri-procedural difference as systolic (SBP): with a large difference (>20 mmHg, n=47), with a small difference (≤20 mmHg, n=157) (shock patients excluded); diastolic (DBP): with a large difference (>10 mmHg, n=65), and with a small difference (≤10 mmHg, n=139). The primary end-points were MACE including all-cause mortality, non-fatal myocardial infarction, and stroke during the hospital stay. The Mann-Whitney U and Chi-square tests were used to analyze the data accordingly (p<0.005). RESULTS: Within the category of MACE, cardiac mortality was the only adverse cardiac event encountered in the study sample. Cardiac mortality was significantly higher in both the large SBP-difference group versus the other group (10.6% vs 0.6%, p=0.003) and the large DBP-difference group versus the small-difference group (7.7% vs 0.7%, p=0.013). CONCLUSION: Peri-procedural systolic and diastolic BP differences, greater than 20 mmHg and 10 mmHg, respectively, correlated with MACE in all patients undergoing PCI.
Anthropometric Indexes for Predicting High Blood Pressure in Vietnamese Adults: A Cross-Sectional Study.
Nguyen Minh Q, Nguyen Vo MH
Integr Blood Press Control · 2020 · PMID 33293857 · Full text
BACKGROUND: The rate of hypertension and obesity is increasing in Vietnamese society. This study aimed to focus on assessing the relationship between anthropometric indexes (body mass index (BMI), waist-to-height ratio (...
BACKGROUND: The rate of hypertension and obesity is increasing in Vietnamese society. This study aimed to focus on assessing the relationship between anthropometric indexes (body mass index (BMI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR)) and high blood pressure to determine which is the best predictor for high blood pressure among adults over 18 years in Vietnam. METHODS: A cross-sectional study of 1636 people was conducted. People who were over 18 years old, healthy or had hyperlipidemia and on the treatment were recruited. Patients with cancer, heart disease, diabetes, kidney disease, and hypertension were excluded. Information on demographics, smoking and drinking habits, weight, height, waist circumference, and blood pressure was collected. Areas under receiver operating characteristic curves (AUCs) were examined to determine the predictability of anthropometric indicators for high blood pressure in men and women. Logistic regression analysis, stratified by gender, was performed to examine the association between anthropometric indexes and high blood pressure. RESULTS: In this study, the percentage of people with high blood pressure was 10.51%. The AUC for the WHtR was significantly greater than for the BMI for both genders. Logistic regression demonstrated that only WHtR had a significant positive association with high blood pressure among women. The optimal WHtR cut-off value for predicting high blood pressure in men and women were 0.47 and 0.50, respectively. CONCLUSION: Among the indicators analyzed in this study, WHtR was the best for the predicting of the presence of high blood pressure, in both men and women. However, WHtR could only explain the changes of high blood pressure in women.
Prevalence of Hypertension and Its Associated Factors Among Gimbi Town Residents, Ethiopia: A Community-Based Cross-Sectional Study.
Yadecha B, Tekle F, Fetensa G … +2 more , Habte A, Zeleke B
Integr Blood Press Control · 2020 · PMID 33273852 · Full text
BACKGROUND: Globally, sixty-two percent of cerebrovascular disease and forty-nine percent of ischemic heart disease are attributable to increased blood pressure. Half of the patients with stroke and heart disease were du...
BACKGROUND: Globally, sixty-two percent of cerebrovascular disease and forty-nine percent of ischemic heart disease are attributable to increased blood pressure. Half of the patients with stroke and heart disease were due to hypertension. OBJECTIVE: This study aimed to identify prevalence of hypertension and its associated factors in Gimbi town, Ethiopia. METHODS: We conducted a community-based cross-sectional study from May to June 2017 on 471 participants in Gimbi town, western Ethiopia. A systematic sampling method was used to recruit study participants. Data collectors used structured questionnaires to gather data through face to face interview. The standardized procedure followed to measure blood pressure and anthropometric measurements by trained extension health workers. We entered data into Epi-data and exported to SPSS version 20.00 for analysis. Variables having a P-value less than or equal to 0.05 were declared as statistically significant in multivariable analysis. RESULTS: Four hundred seventy-one participants were included with a response rate of 98.85%, and 248 (52.6%) were female. The prevalence of isolated systolic and diastolic hypertension was 9.55% and 9.3%, respectively. Of 157 (33.5%) hypertensive participants, 117 (24.8%) were newly diagnosed. Age 35-55 [AOR: 2.335 95% CI (1.360-4.009)], ≥55 [(AOR: 3.566 95% CI (1.288-9.876))], occupation, government employee [(AOR: 3.072 95% CI (1.458-6.474))], merchants [(AOR: 3.177 95% CI (1.290-7.824))], ever alcohol drinker [(AOR: 2.333 95% CI (1.320-4.122))], and family history of hypertension [(AOR: 6.642 95% CI (4.068-10.843))] were found to be predictor variables for hypertension. CONCLUSION: The findings of this study indicated a hidden high prevalence of hypertension indicating the need for stakeholders' collaboration to design and implement a mobile blood pressure screening programs at the community level.
Matrix Metalloproteinases and Hypertension-Mediated Organ Damage: Current Insights.
Bisogni V, Cerasari A, Pucci G … +1 more , Vaudo G
Integr Blood Press Control · 2020 · PMID 33173330 · Full text
Matrix metalloproteinases (MMPs) are important extracellular enzymes involved in many physiological and pathological processes. Changes in the activity and concentration of specific MMPs, as well as the unbalance with th...
Matrix metalloproteinases (MMPs) are important extracellular enzymes involved in many physiological and pathological processes. Changes in the activity and concentration of specific MMPs, as well as the unbalance with their inhibitors (tissue inhibitors of metalloproteinases - TIMPs), have been described as a part of the pathogenic cascade promoted by arterial hypertension. MMPs are able to degrade various protein substrates in the extracellular matrix, to influence endothelial cells function, vascular smooth muscle cells migration, proliferation and contraction, and to stimulate cardiomyocytes changes. All these processes can be activated by chronically elevated blood pressure values. Animal and human studies demonstrated the key function of MMPs in the pathogenesis of hypertension-mediated vascular, cardiac, and renal damage, besides age and blood pressure values. Thus, the role of MMPs as biomarkers of hypertension-mediated organ damage and potential pharmacological treatment targets to prevent further cardiovascular and renal complications in hypertensive population is increasingly supported. In this review, we aimed to describe the main scientific evidence about the behavior of MMPs in the development of vascular, cardiac, and renal damage in hypertensive patients.
Adherence to Lifestyle Modifications and Associated Factors Among Adult Hypertensive Patients Attending Chronic Follow-Up Units of Dessie Referral Hospital, North East Ethiopia, 2020.
Andualem A, Gelaye H, Damtie Y
Integr Blood Press Control · 2020 · PMID 33122940 · Full text
BACKGROUND: Hypertension is a major health problem throughout the world which affects over one billion people due to severe complications and inadequate control. Even though lifestyle modification is one of the most effe...
BACKGROUND: Hypertension is a major health problem throughout the world which affects over one billion people due to severe complications and inadequate control. Even though lifestyle modification is one of the most effective ways to prevent and control hypertension, only little emphasis has been given for it compared with treating hypertension with medication. Therefore, the aim of this study was to assess adherence to lifestyle modifications and associated factors among hypertensive patients attending Dessie referral hospital. MATERIALS AND METHODS: Institutional-based cross-sectional study design was conducted among 301 hypertensive patients during May and June, 2020. The study participants were selected with a convenient sampling technique due to the COVID-19 pandemic. Data were collected using pre-tested and structured face to face interviewer-administered questionnaire and checked, cleaned and entered into Epi data version 4.4 and exported to SPSS version 25.0 software for analysis. The associations between independent variables and dependent variable were analyzed using binary logistic regression models. RESULTS: A total of 301 respondents participated in the study yielding a response of 100%. The overall adherence in this study was only 23.6%. Independent predictors of adherence to lifestyle modifications were divorced (AOR=0.35; 95% CI (0.13-0.94)) and widowed (AOR=0.27; 95% CI (0.10-0.75)), secondary school education (AOR=4.85; 95% CI (1.54-15.22)), no regular income (AOR=0.22; 95% CI (0.08-0.65)) or monthly income of ≥3000 ETB (AOR=5.58; 95% CI (2.46-12.66)), having co-morbidities (AOR=2.37; CI (1.23-4.57)), good knowledge about the disease (AOR=1.83; CI (0.92-3.65)) and good self-efficacy (AOR=3.64; CI (1.75-7.55)). CONCLUSION AND RECOMMENDATIONS: The overall adherence to recommended lifestyle modifications was very low. The independent predictors were marital status, educational level, monthly income, having co-morbidities, knowledge and self-efficacy. Therefore, multifaceted and collaborative implementation of strategies about lifestyle modifications for hypertension prevention and control are needed to address barriers at the patient, provider, system and community levels.
Epidemiology of Hypertension in Ethiopia: A Systematic Review.
Legese N, Tadiwos Y
Integr Blood Press Control · 2020 · PMID 33116810 · Full text
BACKGROUND: Hypertension is one of the leading causes of disease in the world. This study is a systematic review paper, intended to provide compressive evidence on the prevalence, distribution, determinants, and burden o...
BACKGROUND: Hypertension is one of the leading causes of disease in the world. This study is a systematic review paper, intended to provide compressive evidence on the prevalence, distribution, determinants, and burden of hypertension in Ethiopia. METHODS: A quantitative epidemiological literature review was conducted by searching different articles in different databases, including PubMed, Cochrane, and Google scholar. The search involved population-based, hospital-based, and institution-based studies on hypertension conducted in Ethiopia. All data were extracted independently by two reviewers using data collection formats. Finally, this review included 22 studies. RESULTS: Different studies reported varied prevalence of hypertension because of the differences in participant's mean ages, source population, and study settings. Population-based studies revealed the prevalence of hypertension to be 9.3-30.3%, institution-based studies revealed 7-37%, whereas hospital-based studies revealed 13.2-18.8%. In studies included in this review, about 37-78% of hypertensive patients were not aware of their blood pressure condition. There was a high prevalence of hypertension in urban residents, and different factors were associated with hypertension, including being overweight, family history of hypertension, age, sex, diabetes mellitus, alcohol intake, physical inactivity, and obesity. CONCLUSION AND RECOMMENDATION: Hypertension was substantially prevalent in Ethiopia, which calls for the implementation of timely and appropriate strategies for the prevention and control of the disease.
Approaches to the Management of Hypertension in Resource-Limited Settings: Strategies to Overcome the Hypertension Crisis in the Post-COVID Era.
Skeete J, Connell K, Ordunez P … +1 more , DiPette DJ
Integr Blood Press Control · 2020 · PMID 33061561 · Full text
The COVID-19 pandemic has changed most aspects of everyday life in both the non-medical and medical settings. In the medical world, the pandemic has altered how healthcare is delivered and has necessitated an aggressive...
The COVID-19 pandemic has changed most aspects of everyday life in both the non-medical and medical settings. In the medical world, the pandemic has altered how healthcare is delivered and has necessitated an aggressive and new coordinated public health approach to limit its spread and reduce its disease burden and socioeconomic impact. This pandemic has resulted in a staggering morbidity and mortality and massive economic and physical hardships. Meanwhile, non-communicable diseases such as hypertension, diabetes mellitus, and cardiovascular disease in general continue to cause significant disease burden globally in the background. Though presently receiving less attention in the public eye than the COVID-19 pandemic, the hypertension crisis cannot be separated from the minds of healthcare providers, policymakers and the general public, as it continues to wreak havoc, particularly in vulnerable populations in resource limited settings. On this background, many of the strategies being employed to combat the COVID-19 pandemic can be used to re-energize and galvanize the fight against hypertension and hopefully bring the public health crisis associated with uncontrolled hypertension to an end.
Aortic Stiffness and Diastolic Dysfunction in Sprague Dawley Rats Consuming Short-Term Fructose Plus High Salt Diet.
Komnenov D, Levanovich PE, Perecki N … +2 more , Chung CS, Rossi NF
Integr Blood Press Control · 2020 · PMID 33061560 · Full text
INTRODUCTION: High fructose and salt consumption continues to be prevalent in western society. Existing studies show that a rat model reflecting a diet of fructose and salt consumed by the upper 20th percentile of the hu...
INTRODUCTION: High fructose and salt consumption continues to be prevalent in western society. Existing studies show that a rat model reflecting a diet of fructose and salt consumed by the upper 20th percentile of the human population results in salt-sensitive hypertension mitigated by treatment with an antioxidant. We hypothesized that dietary fructose, rather than glucose, combined with high salt leads to aortic stiffening and decreased renal artery compliance. We also expect that daily supplementation with the antioxidant, 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl (+T; Tempol), will ameliorate the increase in mean arterial pressure (MAP) and vascular changes. METHODS: Male Sprague Dawley rats were studied with either 20% fructose or 20% glucose in the drinking water and normal salt (0.4%) or high salt (4%) in the chow resulting in four dietary groups: fructose normal Fru+NS or high salt (Fru+HS) or glucose with normal (Glu+NS) or high salt (Glu+HS). Tempol (+T) was added to the drinking water in half of the rats in each group for 3 weeks. RESULTS: MAP was significantly elevated and the glucose:insulin ratio was depressed in the Fru+HS. Both parameters were normalized in Fru+HS+T. Plasma renin activity (PRA) and kidney tissue angiotensin II (Ang II) were not suppressed in the high salt groups. Pulse wave velocity (PWV), radial ascending strain, and distensibility coefficient of the ascending aorta were significantly decreased in Fru+HS rats and improved in the Fru+HS+T rats. No differences occurred in left ventricular systolic function, but the ratio of early (E) to late (A) transmitral filling velocities was decreased and renal resistive index (RRI) was higher in Fru+HS rats; antioxidant treatment did not change these indices. DISCUSSION: Thus, short-term consumption of high fructose plus high salt diet by rats results in modest hypertension, insulin resistance, diminished aortic and renal artery compliance, and left ventricular diastolic dysfunction. Antioxidant treatment ameliorates the blood pressure, insulin resistance and aortic stiffness, but not renal artery stiffness and left ventricular diastolic dysfunction.
Admission and Inpatient Mortality of Hypertension Complications in Addis Ababa.
Zeru AB, Muluneh MA
Integr Blood Press Control · 2020 · PMID 32982396 · Full text
BACKGROUND: The number of people with undiagnosed, untreated, and uncontrolled hypertension is higher in Ethiopia. This in turn increases the risk of developing complications and hospitalization. This study aimed to asse...
BACKGROUND: The number of people with undiagnosed, untreated, and uncontrolled hypertension is higher in Ethiopia. This in turn increases the risk of developing complications and hospitalization. This study aimed to assess the prevalence of hypertension complication hospitalization among medical admissions and admission outcomes of hypertension complication patients in the medical ward of Saint Peter Specialized Hospital, Addis Ababa. METHODS: We used a hospital-based cross-sectional study. Data were collected by reviewing all medical ward admission logbook records from January 1st, 2018 to December 30th, 2019. An individual patient folder of 308 patients admitted due to hypertension complications was selected for further detailed investigation and then entered into Epi Data version 3.1 and exported to SPSS version 24 statistical software for analysis. RESULTS: Of the total 2728 medical admissions, 308 (11.3%) were patients with hypertension complications. Hypertension complications account for 308 (11.3%) of all medical admissions. Their mean age and length of hospital stay were 59.85 (± 16.36) years and 11.45 (± 11.48) days, respectively. Near to two-third of 196 (63.6%) of them were stroke patients followed by 76 (24.7%) heart disease. Fifty-two (16.9%) hypertension complication patients died at admission which accounts for 52 (14.6%) of all medical ward deaths. As age increases, the risk of death at admission increases by 6.5%. Similarly, the risk of death increased by three-fold for a month increase in the duration of anti-hypertensive drug discontinuation. Rural residents had a 3.5% lesser risk of death than urban patients. CONCLUSION: Hypertension complications had a significant share of the medical ward mortality rate. Cerebrovascular and cardiovascular complications were common causes of hospitalization and inpatient death. Old age, urban residence, and prolonged duration of anti-hypertensive drug discontinuation increased the risk of death at admission.
Prevalence of Hypertensive Emergency and Associated Factors Among Hospitalized Patients with Hypertensive Crisis: A Retrospective Cross-Sectional Study.
Desta DM, Wondafrash DZ, Tsadik AG … +4 more , Kasahun GG, Tassew S, Gebrehiwot T, Asgedom SW
Integr Blood Press Control · 2020 · PMID 32904390 · Full text
BACKGROUND: Hypertensive emergency (HE) is an acute stage of uncontrolled blood pressure which poses a substantial cardiovascular morbidity and mortality in developing countries. In our setting, the prevalence of HE and...
BACKGROUND: Hypertensive emergency (HE) is an acute stage of uncontrolled blood pressure which poses a substantial cardiovascular morbidity and mortality in developing countries. In our setting, the prevalence of HE and the characteristics of patients with a hypertensive crisis are not certainly known yet. OBJECTIVE: The study assessed the prevalence of hypertensive emergency and associated factors among hospitalized patients with hypertensive crisis. METHODS: A retrospective cross-sectional study was conducted by reviewing records of patients having a diagnosis of hypertensive crisis with systolic/diastolic blood pressure raised to more than 180/120 mmHg admitted to Ayder Comprehensive Specialized Hospital (ACSH) from September 2018 to August 2019. Patients' medical records with complete information were enrolled consecutively. Socio-demographic, clinical characteristics, and other related variables were collected using a structured data collection tool from patient medical records. Data were entered and analyzed using SPSS version 20. Logistic regression was employed to determine factors associated with HE. RESULTS: A total of 141 patients' records with a diagnosis of a hypertensive crisis were enrolled in the study; the majority were females 77 (54.6%) and residing in the urban setting 104 (73.8%). The mean age of the participants was 58.8 years. HE was found in 42 (29.8%) of patients. Intravenous Hydralazine 39 (27.7%) and oral calcium channel blocker 102 (72.3%) were the prescribed drugs for acute blood pressure reduction in the emergency setting. Surprisingly, patients who had no history of hypertension (adjusted odds ratio (AOR)=2.469; 95% confidence interval (CI): 0.176‒0.933) and female sex (AOR=2.494; 95% CI: 1.111‒5.596) were found to be independently associated factors with HE. CONCLUSION: The prevalence of HE was found to account a significant proportion of patients. Hence, hypertensive patients should be strictly managed accordingly, and promoting screening programs could reduce the risk of target organ damage.
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