Blood Pressure Status Research Articles

Hypertension Status Moderated the Relationship between the Hippocampal Subregion of the Left GC-ML-DG and Cognitive Performance in Subjective Cognitive Decline

Background To investigate the relationship between hypertension status, hippocampus/hippocampal subregion structural alteration, and cognitive performance in subjective cognitive decline (SCD). Methods All participants were divided into two groups according to blood pressure status: SCD without hypertension and SCD with hypertension. The cognitive assessments and T1-MPRAGE brain MRI were performed to measure the cognitive function and the volume of the hippocampus and hippocampal subregions. Association and mediating/moderating effects were analyzed between the volume of hippocampus/hippocampal subregions and cognitive scores. Results Compared to the SCD without hypertension, we found (1) increased reaction time (RT) of the Go/No go test, compatible test, and divided attention visual task and (2) decreased volume of the left whole hippocampal/left subiculum/left CA1/left presubiculum/left parasubiculum/left molecular layer HP/left GC-ML-DG/left HATA in SCD with hypertension. There was a significant negative association between the volume of the left GC-ML-DG and Go/No go test RT in SCD without hypertension. A significant moderating effect of hypertension status on the relationship between the volume of the left GC-ML-DG and Go/No go test RT was found. Conclusion The results suggested that hypertension status affects inhibitory control function and visual divided attention which may be related to the reduction of hippocampus/hippocampal subregion volume in SCD. Limitations. The study has several limitations. First, this study does not include a healthy control group. In further studies, healthy controls may need to assess the interaction between hypertension status and disease status on cognitive function. Second, we defined the hypertension status using with or without hypertension disease. More detailed parameters of hypertension status need to be further studied. Third, our study was a small number of participants/single-center and cross-sectional study, which may hinder its generalization. A large-sample/multicenter, longitudinal study is helpful to comprehensively understand the relationship between hypertension status and cognitive function in SCD patients.

Exploring the association between cognitive decline and all-cause mortality with blood pressure as a potential modifier in oldest old individuals

Few studies have systematically explored the association between cognitive decline and all-cause mortality among oldest old individuals (above 80 years old), and there is limited evidence of blood pressure (BP) as a potential effect modifier. Therefore, this study included 14,891 oldest old individuals (mean age: 90.3 ± 7.5 years); 10,904 deaths and 34,486 person-years were observed. Cognitive scores were calculated using the Chinese version of the Mini-Mental State Examination (MMSE). Cognitive decline was stratified into ten categories (C0–C9). Continuous cognitive scores were used to assess the interactions of modifiers of the cognitive decline and all-cause mortality association and potentially modifiable factors. Potential effect modifiers were explored by age, sex, BP status and hypertension. Cox proportional hazards models were used to evaluate the relationship between cognitive decline and all-cause mortality after adjustments for demographic characteristics, socioeconomic status, lifestyle factors, leisure activities and health conditions. Participants who progressed to severe cognitive impairment from high normal cognitive function (C3), low normal cognitive function (C6), or mild cognitive impairment (C8) had 55%, 56%, and 63% higher mortality risks, respectively, than those who maintained high normal cognitive function (C0). The multivariate-adjusted model indicated that oldest old individuals with a decrease of more than one point in the MMSE score per year had an approximately 4% all-cause mortality risk. The relationship between cognitive decline and mortality was statistically influenced by sex (P = 0.013), high BP in nonagenarians (P = 0.003), and hypertension (P = 0.004) but not by age (P = 0.277). Our findings suggest that periodic screening for cognitive decline and strengthening BP management may be necessary for public health.

Pulse pressure and all-cause mortality in ischaemic heart failure patients: a prospective cohort study

Background Whether the association between pulse pressure (PP) and mortality varies with systolic blood pressure (SBP) in ischaemic heart failure (HF) with left ventricular systolic dysfunction (LVSD) is unknown. Objective To evaluate the association between PP and all-cause mortality in ischaemic HF patients with SBP status at admission. Patients and methods This prospective cohort study included 1581 ischaemic HF patients with LVSD. A total of 23.3% (n = 368) and 22.2% (n = 351) of the participants had SBP <110 mmHg and SBP >140 mmHg, respectively, with more than 80% of participants being male. Restricted cubic spline was performed to determine whether a nonlinear relationship existed between PP and all-cause mortality risk. A multivariable Cox proportional hazards model was used to assess the association between PP and all-cause mortality. Results After a median of follow-up of 3.0 years, 257 events (16.4%) were observed in the cohort. There was a J-shaped relationship between PP and all-cause mortality (P value for nonlinearity = 0.020), with a risk nadir of approximately 46–49 mmHg. All-cause mortality risk varied with SBP status. Higher PP was associated with worse prognosis when the SBP was ≥110 mmHg, whereas the relationship did not reach statistical significance when the SBP was <110 mmHg. Conclusion A J-shaped relationship between PP and all-cause mortality was observed in ischaemic HF patients with LVSD, and higher PP was associated with worse prognosis only in those with SBP ≥110 mmHg. Further studies are needed to corroborate these findings. KEY MESSAGES A J-shaped relationship between pulse pressure and all-cause mortality was observed in ischaemic heart failure patients with left ventricular systolic dysfunction, with a risk nadir of approximately 46–49 mmHg. All-cause mortality risk varied with systolic blood pressure status, and higher pulse pressure was associated with worse prognosis when systolic blood pressure was above 110 mmHg.

Non-dipping heart rate &amp; major adverse cardiovascular events in type 2 diabetes mellitus

Abstract Background Type 2 diabetes mellitus (T2DM) is a known major risk factor for cardiovascular disease. Whilst the influence of traditional risk factors such as hypertension, hyperlipidaemia and smoking are well-established determinants of major adverse cardiovascular events (MACE) in subjects with T2DM, the impact of insulin resistance, non-dipping blood pressure and heart rate status have not been adequately investigated. Purpose To determine predictors of MACE in a population of T2DM with underlying target-organ damage at baseline. Methods This study included 196 subjects with T2DM with advanced proliferative diabetic retinopathy. These subjects were recruited in 2008–2009 and were consequently followed up till February 2022 to determine independent predictors of MACE. At baseline, the median age of the participants was 64 years (IQR: 59–71 years) and the median diabetes duration was 18 years (IQR: 10–25 years). At baseline, all underwent 24-hour blood pressure and heart rate (HR) monitoring, and were assessed for markers of inflammation, insulin resistance, albuminuria, presence of peripheral neuropathy and peripheral vascular disease. Subjects whose night-time HR did not decrease by more than 10% as compared to daytime readings were classified as non-dippers. Similarly, a non-dipping BP profile was defined as a nocturnal decline of mean arterial pressure of less than 10%. At follow-up, the all-cause death rate was noted as well as MACE. The latter was defined as all-cause death, non-fatal MI, non-fatal stroke, coronary revascularisation or hospitalisation for unstable angina pectoris or heart failure. Univariate followed by multivariate Cox-regression analysis was performed to determine independent predictors of both all-cause mortality and MACE. Results At follow-up, 46% of the study participants had died whilst 63.1% had exhibited MACE. Multivariate analysis revealed age (OR: 1.05, 95% CI 1.02–1.07, p&amp;lt;0.001), ESR (OR: 1.012, 95% CI: 1.001–1.02, p=0.035), GGT (OR: 1.005, 95% CI 1.001–1.009, p=0.025) and eGFR (OR: 0.99, 95% CI 0.98–0.99, p=0.016) at baseline to be independent determinants of all-cause death. With regards MACE, likewise, age (OR: 1.028, 95% CI 1.007–1.05, p=0.009), GGT (OR: 1.004, 95% CI 1.001–1.008, p=0.017) and eGFR (OR: 0.99, 95% CI 0.98–0.99, p=0.022) were shown to be independent determinants together with diabetes duration (OR: 1.034, 95% CI 1.014–1.055, p=0.001) and presence of non-dipping heart rate at baseline. The latter was shown to be the strongest predictor of MACE (OR: 1.55, 95% CI 1.06–2.26, p=0.024). Conclusion Whereas increasing age and impaired renal function are known risk factors for cardiovascular disease, this long-term follow-up study has highlighted the relevance of non-dipping heart rate in type 2 diabetes mellitus. Previous studies had shown an association between non-dipping heart rate and target-organ damage in diabetic subjects. The impact on MACE merits further investigation. Funding Acknowledgement Type of funding sources: None.

COVID-19 and the autonomic nervous system

Abstract Background COVID-19 infection has been shown to have an adverse impact on the cardiovascular system. Cardiac injury, as indicated by elevated cardiac troponin and NT-proBNP levels have been confirmed in COVID-19 cases. There is still ambivalent data on the effect of left ventricular function. Cases of left ventricular impairment, persistent hypotension, acute myopericarditis, myocarditis, arrhythmia and heart failure have been reported in the short term, but there is a significant lacuna when it comes to medium and long-term follow-up of subjects previously infected with COVID-19. Purpose To assess any residual myocardial and autonomic injury in subjects previously infected with COVID-19 at a median follow-up of 5 months. Methods A case-control study was performed. Cases were randomly selected subjects who were previously diagnosed with COVID-19 infection following nasopharyngeal swabbing. Controls were subjects who had not been found to be infected with COVID-19 following swabbing and were negative for COVID-19 IgG antibodies. All participants were submitted a standardised questionnaire regarding past medical history. Blood investigations were taken including NT-proBNP and troponin I levels. In addition, all participants underwent 24-hour ambulatory blood pressure monitoring (ABPM) and 24-hour ECG monitoring. The latter was used to assess both for underlying arrhythmias as well as heart rate variability (HRV), a measure of autonomic regulation of the heart. All data was analysed using SPSS version 23.0. Results The study comprised 259 subjects, whereby cases included 174 participants while 75 subjects were age- and gender-matched controls. The study cohort was relatively young with a mean age of 46.1±13.8 years. The median follow-up was of approximately 5 months (median 173.5 days, IQR 129–193.25 days). There was no statistically significant difference between cases and controls with regards cardiovascular risk factors and underlying medical conditions. Likewise, there was no difference in blood investigations, including troponin I and NT-proBNP levels at 5-months follow-up. No difference was noted between the two groups in both awake and asleep blood pressure (BP) readings, as well as dipping BP status. No significant arrhythmias were noted in both groups on 24-hour ECG monitoring. However, when assessing for heart rate variability, it was shown that subjects who had been previously infected with COVID-19 exhibited lower root-mean square differences of successive R-R intervals (RMSSD), p=0.028. This indicates poor vagus nerve-mediated autonomic control of the heart. Conclusion Subjects previously infected with COVID-19 exhibited lower HRV as exhibited by low RMSSD as compared to controls. Reduced HRV is a known biomarker for mortality and sudden death in cardiac disease. The possible long-term implications of reduced HRV in subjects previously infected with COVID-19 merits further investigation. Funding Acknowledgement Type of funding sources: None.

High Prevalence and Lack of Parental Awareness of Pediatric Hypertension Among a Low-income Sample in Worcester, MA.

To identify frequency and correlates of hypertension in a low income, ethnically diverse, sample of children as well as to assess parental awareness of hypertension. This cross-sectional study included parent-child dyads (n = 228), from which physical measurements of the child, and parent reported survey measures were collected. Child's blood pressure percentile was determined via 2017 American Academy of Pediatrics (AAP) clinical practice guidelines and categorized as normal (< 90th percentile), elevated (≥ 90th percentile to < 95th percentile), or hypertensive (≥ 95th percentile). Bivariate multinomial logistic regression models assessed the relative risk ratio for potential correlates of blood pressure categorization and frequency distribution of parental awareness of blood pressure status was examined. Median child age was 8.1 years (IQR 6.5-9.9). Half were female, 61.8% were Latino and 15.8% were Non-Latino Black. Median body mass index (BMI) percentile was 83.6 (IQR 58.4-97.1) and 31.6% exceeded the 95th percentile. AAP criteria for hypertension and elevated blood pressure were met by 30.7% and 14.3% of children respectively. After full adjustment, the relative risk of categorization as hypertensive versus normal increased by a factor of 1.16 (95% CI 1.02-1.3) per 10-unit increase in BMI percentile, and 0.86 (95% CI 0.74-1.0) per one-year increase in age. Less than five parents (redacted due to low sample size) reported their child having a history of high blood pressure. In this low income, racially/ethnically diverse sample, we observed levels of hypertension and elevated blood pressure considerably higher than national estimates. However, in contrast, extremely low parental awareness was observed.

Hypertension and clinical outcomes in patients with familial hypercholesterolemia.

Hypertension is a known risk factor for cardiovascular disease; however, its impact on clinical outcomes in patients with heterozygous familial hypercholesterolemia (HeFH) is unclear. Hence, we aimed to investigate the effects of hypertension on severity of coronary artery atherosclerosis and cardiovascular outcomes in patients with HeFH. A total of 480 patients with clinical or molecular diagnosis of definite or probable familial hypercholesterolemia according to Dutch Lipid Clinic Network criteria (DLCN score ≥6) were included in the study. They were divided into the two groups according to their blood pressure status: hypertension group and normotension group. The severity of coronary stenosis was assessed by a number of diseased vessels, Gensini, Syntax, and Jeopardy scores. All individuals were followed up for cardiovascular events (CVEs) and cox proportion hazard models were used to evaluate the association of hypertension with cardiovascular outcomes. Patients with hypertension had more severe coronary stenosis and a higher incidence of CVEs compared with the ones with normotension (log-rank P < 0.001). After multivariable adjustment, there was a 2.1-fold increased risk of CVEs among patients with hypertension compared with patients with normotension (adjusted hazard ratio 2.06, 95% confidential interval 1.17-3.65, P < 0.01). Hypertension control status was also associated with CVEs even after adjustment of multiple variables. However, no combined effect on increased cardiovascular risks was detected in this HeFH cohort. In patients with HeFH, hypertension is an independent risk factor for cardiovascular events. Moreover, blood pressure control status in patients with hypertension is associated with the worse outcomes.

Central hypertension is a non-negligible cardiovascular risk factor.

High blood pressure (BP) confers cardiovascular risk. However, the clinical value of central BP remains debatable. In this article, we aim to briefly review the prognosis, diagnosis, and treatment of central hypertension. Central and brachial BPs are closely correlated. In most prospective investigations, elevated central and peripheral BPs were similarly associated with adverse outcomes. Outcome‐driven thresholds of the central systolic BP estimated by the type I device were on average 10 mmHg lower than their brachial counterparts. Cross‐classification based on the central and brachial BPs identified that nearly 10% of patients had discrepancy in their status of central and brachial hypertension. Irrespective of the brachial BP status, central hypertension was associated with increased cardiovascular risk, highlighting the importance of central BP assessment in the management of hypertensive patients. Newer antihypertensive agents, such as renin–angiotensin–aldosterone system inhibitors and calcium channel blockers, were more efficacious than older agents in central BP reduction. Clinical trials are warranted to demonstrate whether controlling central hypertension with an optimized antihypertensive drug treatment will be beneficial beyond the control of brachial hypertension.

The Time-course Of Blood Pressure Change In Adults During Prolonged Sitting: A Three-level Meta-analysis

PURPOSE: Acute bouts of prolonged sitting have been found to detrimentally impact the cardiovascular system, including acute increases in blood pressure (BP). Repeated increases in BP can damage the heart and blood vessels. While the responses to prolonged sitting have been reported independently in many studies, a multi-level meta-analysis that can consider non-independence of measurements and effect sizes of blood pressure change during prolonged sitting has not been explored. Therefore, we conducted a meta-analysis to track BP change during prolonged sitting. METHODS: Four databases were searched through September 2021. Inclusion criteria were sitting trials > 1 hour, adults (>18 years old), and brachial measurements of either mean arterial pressure (MAP), systolic BP (SBP), diastolic BP (DBP) obtained at more than two time points. Trials with standing, aerobic-, or simple resistance interruption strategies were included and analyzed separately. A random-effects 3-level meta-analysis was conducted to account for the interdependence of multiple data points from the same participants and the same trials. RESULTS: Thirty-one articles (36 trials, n = 572) met inclusion criteria. Prolonged uninterrupted sitting resulted in significant increases of all BP indices; MAP (ꞵ = 0.60 mmHg/hr, 95% CI: 0.18, 1.02, p = 0.004), SBP (ꞵ = 0.60 mmHg/hr, 95% CI: 0.30, 0.90, p < 0.001), and DBP (ꞵ = 0.48 mmHg/hr, 95% CI: 0.18, 0.72, p < 0.001). In trials where sitting was interrupted, there were non-significant effects of time on MAP (ꞵ = 0.06 mmHg/hour, 95% CI: -0.24, 0.36, p = 0.750), and small significant decreases in SBP (ꞵ = -0.24 mmHg/hr, 95% CI: -0.42, -0.06, p = 0.018) and DBP (ꞵ = -0.24 mmHg/hr, 95% CI: -0.42, 0.06, p = 0.004). Significant heterogeneity between studies was observed for all outcomes (MAP, SBP, DBP: I2 > 85%, p < 0.001). CONCLUSIONS: All BP indices increased progressively with uninterrupted sitting. Over time, prolonged-sitting-induced increases in BP could lead to decreased elasticity in arteries, left-ventricular hypertrophy, or other cardiovascular diseases and symptoms. While considerable heterogeneity was observed (potentially due to variability in age, baseline BP status, and measurement type), results suggest that detrimental increases in BP can be avoided by regularly interrupting sitting.

Effect of Leaf Guava Extract on Blood Pressure in Rattus Norwegicus Wistar Strain

Guava leaf extract (Psidium guajava) is a component of traditional medicine containing flavonoids, tannins, triterpenoids, and carotenoids. The study aimed to determined effect of guava leaf extract on blood pressure status of white wistar rats were given an atherogenic diet. The study method was a study experimental with design completely randomized (CRD). The group intervention was given guava leaf extract to white rats which consisted of 3 treatment levels with 5 replications namely control (P0), atherogenic diet (P1), and atherogenic diet with guava leaf extract (P2). The research phase includes the acclimatization stage for 3 days, the atherogenic diet for 2 weeks, and the intervention stage for giving guava leaf extract for 4 weeks. Data analysis used the Shapiro Walk, Kruskall-Wallis test as an alternative of One Way Anova and the Wilcoxon test as an alternative of sample t-test with a value of = 0,01. The results showed that giving an atherogenic diet affected increasing blood pressure. There was a change in blood pressure after the intervention, P0 pre-test 80,40±3,65 mmHg and post-test 83,40±2,30 mmHg (p-value= 0,197), P1 pre-test 82,80±2,59 mmHg and post-test 188,60±2,19 mmHg, (p-value = 0,042), P2 pre-test 82,80±2,17 mmHg and post-test = 108,00±2,74 mmHg (p-value = 0,042). In conclusion, giving an atherogenic diet has an effect on increasing blood pressure and giving guava leaf extract can reduce blood pressure in white wistar rats.

Dietary total antioxidant capacity in relation to metabolic health status in overweight and obese adolescents

BackgroundAlthough several studies evaluated the relationship between individual dietary antioxidants and metabolic health conditions, data on the association between dietary total antioxidant capacity and metabolic health among children and adolescents is limited. This study investigated the relationship between dietary total antioxidant capacity and metabolic health status in Iranian overweight/obese adolescents.MethodsThis cross-sectional study was conducted on 203 overweight/obese adolescents. Dietary intakes were evaluated by a validated food frequency questionnaire. Ferric Reducing-Antioxidant Power (FRAP) was considered to indicate dietary total antioxidant capacity. Anthropometric parameters and blood pressure status were measured. Fasting blood samples were obtained to determine circulating insulin, glucose, and lipid profile. Two different methods (modified International Diabetes Federation (IDF) criteria and IDF criteria along with insulin resistance) were applied to classify participants as metabolically healthy obese (MHO) or metabolically unhealthy obese (MUO).ResultsAccording to IDF and IDF/HOMA definitions, a total of 79 (38.9%) and 67 (33.0%) adolescents were respectively defined as MUO. Considering IDF criteria, the highest tertile of FRAP was related to lower odds of being MUO in the maximally-adjusted model (OR: 0.40; 95%CI: 0.16–0.96), compared to the lowest tertile. However, based on the IDF/HOMA-IR criteria, no significant relation was found between FRAP and odds of MUO (OR: 0.49; 95%CI: 0.19–1.23) after considering all possible confounders.ConclusionsAdolescents with higher intakes of dietary antioxidants have a lower possibility of being MUO based on IDF criteria. However, no substantial relation was found considering HOMA-IR/IDF definition. Further prospective cohort studies need to be done to confirm these findings.

Patterns and predictors of elevated blood pressure and hypertension among primary school children in urban Kenya.

We examined the prevalence of elevated blood pressure (BP) and hypertension among 390 primary school children of different socioeconomic status (SES) in two urban settings in Kenya and explored the association between children's BP status and their sociodemographic characteristics, dietary behaviours and overweight/obesity status. Children's BP and anthropometric measurements were taken and parents, with the help of their children, completed questionnaires on the children's dietary behaviours. An average of three BP readings was used to calculate BP percentiles by age, sex and height. BMI-for-age z-scores, waist-circumference-to-height ratio and the sum of skinfold measures were calculated. We utilized prevalence ratio analysis to examine the association between BP and sociodemographic characteristics, dietary behaviours and overweight/obesity. About 9% of the school children had elevated BP and 33% had stage 1 hypertension. Among overweight children, the proportion of children with elevated BP was 1.85-fold greater and the proportion of children with hypertension was 1.83-fold greater compared with children with healthy body weight. Similar patterns of significant associations were seen among obese children, children with central obesity and children with high total skinfold values. The proportion of children with hypertension was 1.42-fold greater among children with high frequency of consumption of chips/crisps compared with children with lower frequency of consumption. These results increase our understanding BP patterns and determinants among school children in Kenya and can help inform noncommunicable disease prevention efforts.

Severity of Nonalcoholic Fatty Liver Disease is Associated With Cardiovascular Outcomes in Patients With Prehypertension or Hypertension: A Community-Based Cohort Study.

BackgroundIt is unclear whether more severe non–alcoholic fatty liver disease (NAFLD) combined with prehypertension or hypertension is associated with a higher risk of cardiovascular events (CVEs). To evaluate the relationship between the severity of NAFLD and CVEs among patients with prehypertension or hypertension.MethodsIn this prospective community–based Kailuan cohort, participants without cardiovascular disease and alcohol abuse, or other liver diseases were enrolled. NAFLD was diagnosed by abdominal ultrasonography. Prehypertension was defined as systolic blood pressure (BP) of 120–139 mmHg or diastolic BP of 80–89 mmHg. Participants with NAFLD were divided into mild, moderate, and severe subgroups. Follow–up for CVEs including myocardial infarction, hemorrhagic stroke, and ischemic stroke. The Cox proportional hazards model was used to estimate hazard ratios and 95% CIs of CVEs according to the severity of NAFLD and hypertensive statutes. The C-statistic was used to evaluate the efficiency of models.ResultsA total of 71926 participants (mean [SD] age, 51.83 [12.72] years, 53794 [74.79%] men, and 18132 [25.21%] women) were enrolled in this study, 6,045 CVEs occurred during a median of 13.02 (0.65) years of follow–up. Compared with participants without NAFLD, the hazard ratios of CVEs for patients with mild, moderate, and severe NAFLD were 1.143 (95% CI 1.071–1.221, P < 0.001), 1.218 (95% CI 1.071–1.221, P < 0.001), and 1.367 (95% CI 1.172–1.595, P < 0.001), respectively. Moreover, participants with prehypertension plus moderate/severe NAFLD and those with hypertension plus moderate/severe NAFLD had 1.558–fold (95% CI 1.293–1.877, P < 0.001) and 2.357–fold (95% CI 2.063–2.691, P < 0.001) higher risks of CVEs, respectively, compared with those with normal BP and no NAFLD. Adding a combination of NAFLD and BP status to the crude Cox model increased the C–statistic by 0.0130 (0.0115–0.0158, P < 0.001).ConclusionsOur findings indicated that the increased cardiovascular risk with elevated BP is largely driven by the coexistence of moderate/severe NAFLD, suggesting that the severity of NAFLD may help further stratify patients with prehypertension and hypertension.

Effect of combined vitamin D and microwave ablation of parathyroid glands on blood pressure and cardiac function in maintenance-hemodialysis patients with uremic secondary hyperparathyroidism

Purpose: To investigate the effect of microwave ablation of parathyroid glands in combination with active vitamin D on blood pressure and cardiac function in maintenance-hemodialysis patients with uremic secondary hyperparathyroidism.&#x0D; Methods: One hundred and twenty maintenance-hemodialysis patients with uremic secondary hyperparathyroidism admitted to Meizhou People’s Hospital were assigned to 2 groups (A and B) in the order of their admission. Each group had 60 patients. Both groups were treated with active vitamin D, while patients in group A were, in addition, subjected to microwave ablation of parathyroid glands. Blood pressure, and indices for cardiac function, thyroid function s and anemia were determined.&#x0D; Results: After treatment, the blood pressure of group A was significantly lower than that of group B (p &lt; 0.05). Moreover, after treatment, there were significant improvements in indices of cardiac function, thyroid function and anemia in group A patients, relative to group B patients.&#x0D; Conclusion: Microwave ablation of parathyroid glands, when combined with active vitamin D, improves blood pressure, cardiac function and anemia status. Furthermore, the combined therapy enhances recovery of thyroid function in maintenance-hemodialysis patients with uremic secondary hyperparathyroidism. However, the combined therapy should be subjected to further clinical trials prior to application in clinical practice.&#x0D; Keywords: Microwave ablation; Parathyroid glands; Active vitamin D; Hyperparathyroidism

Prevalence and risk factors of prehypertension and hypertension in Algeria

BackgroundHypertension, also referred to as the silent killer, is known to be one of the most common chronic diseases in the world today. This study aimed to identify the prevalence and risk factors of prehypertension and hypertension among Algerian population.MethodsThis is a descriptive cross-sectional epidemiological study involving individuals aged 18 to 69 years old who were identified in the database of the national survey on non-communicable diseases (NCDs) risk factors conducted in Algeria between 2016 and 2017 using the World Health Organization’s (WHO) STEPwise approach.Differences in prevalence between normotensives, prehypertensives and hypertensives were assessed using the chi-square test. We also looked at the role of numerous socio-demographic, economic, geographical, and behavioural factors in blood pressure status using a logistic regression model.ResultsThe prevalence of prehypertension and hypertension was 36.2% (95% confidence interval: 35.2–37.5%) and 31.6% (95% CI: 30.5–32.7%) respectively. Prehypertension was shown to be substantially higher in males than in women, while hypertension was found to be higher in females compared to men. In addition, both sexes had a rise in the prevalence of blood pressure as they grew older.A according to multivariate logistic regression analysis, the main common risk factors for prehypertension and hypertension were ageing, obesity, and abdominal obesity. Moreover hypercholesterolemia, and marital status (separated/divorced) were correlated to hypertension.ConclusionPrehypertension and hypertension are high and epidemic in Algeria. Therefore, the urgent quantification and monitoring of their risk factors becomes a necessity to plan appropriate preventive measures, in order to fight against NCDs in general.

Shift work and cardiovascular strain on working and non-working days.

Shift work is often associated with adverse effects on cardiovascular health of employees. Only a few studies address the strain of shift and day workers on non-working days compared to working days. This study aims to determine how the cardiovascular strain of hotel and catering industry (HCI) employees who work alternating shifts differs from those working normal day shifts-on both a working day (WD) and a non-working day (ND). The sample consisted of 60 alternating shift (morning and afternoon, mean age: 31.5 ± 8.5 years) and 88 day workers (mean age: 35.3 ± 9.4 years). A 24-h ambulatory measurement of blood pressure (BP) and heart rate (HR) on WD and ND with the time phases DAY, SLEEP, and 24-h TOTAL was used to analyse cardiovascular strain. BP status was assessed by self-measurement (36% hypertensives). The total strain over 24 h was slightly higher on WD than ND (mean BP: 134/79 versus 127/75 mmHg, P = 0.002-0.020; mean HR: 78 versus 75 bpm, P = 0.055). In trend, shift workers had higher systolic BP than day workers during the individual time phases of DAY, SLEEP, and 24-h TOTAL on WD. Known cardiovascular risk factors emerged as critical determinants of cardiovascular strain: older age, male gender, and hypertensive blood pressure status. The results revealed no clear association between the alternating shift system in HCI and increased cardiovascular strain. The 24-h ambulatory measurement is considered ideal for determining cardiovascular strain in everyday life and under working conditions.

Educational Model: Anti-Stroke Gymnastics on Compliance and Health Status of Patients Hypertension

Background: The prevalence of hypertension continues to increase, various epidemiological studies show an increase in the incidence and prevalence of hypertension in various parts of the world. According to the American Heart Association (AHA), the American population aged over 20 years suffering from hypertension has reached up to 74.5 million people, but almost 90% of cases have no known cause. Hypertension is a silent killer where the symptoms can vary in each individual and are almost the same as the symptoms of other diseases. In Indonesia, the problem of hypertension is a big challenge, because hypertension is very often found in primary health services with a high prevalence. Hypertension if not handled properly can cause damage to blood vessels throughout the body and the most obvious is the risk of damage to the brain, eyes, heart, and kidney disease. These risks can be avoided and minimized by pharmacological and non-pharmacological management. Anti-stroke exercise is one of the gymnasticsthat is useful to prevent the risk of stroke in someone who suffers from hypertension. This research is a quasi experiment with pre-post test with control group design. This study aims to determine the effect of anti-stroke gymnastics education on adherence and health status of patients with hypertension. The sampling technique was simple random sampling and the determination of the sample size was using the hypothesis test of the average difference in two independent groups. Data processing and analysis in this study used paired t-test and independent t-test. The results showed that there were significant differences in knowledge, patient compliance, decreased blood pressure and health status of hypertension patients after anti-stroke gymnastics was performed. It is recommended that anti-stroke gymnastics can be used as a non-pharmacological therapy to treat hypertension patients to prevent stroke.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Assessment of Hydration Status and Blood Pressure in a Tertiary Care Hospital at Al-Khobar.

BackgroundHigh blood pressure is a major cardiovascular risk factor. It is a leading cause of increasing morbidity and mortality worldwide. One-third of the adult population worldwide suffers from hypertension. Salt intake, obesity, decreased physical activity, and smoking are well known to increase blood pressure. Fluid retention is the main contributing factor to primary hypertension and adversely affects the cardiovascular system. The emerging evidence suggests a relationship between blood pressure and hydration status. Our study aims to assess the correlation between hydration status and blood pressure. We aim to assess the hydration status in subjects with normal and high blood pressure and to investigate the association of hydration status with hemodynamic measurement.MethodologyThis cross-sectional and observational study included adult (>18 years) male and female subjects who agreed to participate. In total, 235 subjects were recruited by convenience sampling from (1) patients and caregivers attending geriatric and internal medicine clinics, and (2) visitors coming to King Fahad University Hospital at Al-Khobar. There were five patients on oral diuretics who were excluded from the study. Data were collected from September 2021 to March 2022. Hydration status was measured by a bioelectrical impedance analyzer (Bioscan 920, Maltron International Ltd. Rayleigh, UK). Hemodynamic measurements included heart rate per minute, systolic blood pressure, diastolic blood pressure, pulse pressure (the difference between systolic and diastolic blood pressure), and mean arterial pressure calculated as blood diastolic pressure plus one-third of pulse pressure. Statistical analyses were performed using SPSS statistics for windows, version 28.0 (IBM Corp., Armonk, NY, USA). Descriptive data were reported using means with standard deviations for numerical data and relative frequencies (percentage) for categorical data. P-values of less than 0.05 were considered statistically significant. Comparison between groups was done using a one-way analysis of variance test.ResultsExtracellular water percentage was higher in hypertensive (45.0 ± 2) than prehypertensive (43.5 ± 3) or normotensive (43.0 ± 2) (p = 0.001) subjects. In contrast, intracellular water percentage and total body water percentage were significantly negatively related to hypertension status.ConclusionsOur results have shown a strong association between hypertension status and hydration parameters. In our study, hypertensive subjects tended to have lower total body water percentage and intracellular water percentage (bioimpedance value) than normotensive subjects. This might promote more research regarding the relationship between hypohydration and cardiovascular disease pathophysiology. This outcome should raise awareness about proper hydration as hypohydration can be a causative factor for hypertension.

The insulin sensitivity Mcauley index (MCAi) is associated with 40-year cancer mortality in a cohort of men and women free of diabetes at baseline

The association between insulin resistance and cancer-mortality is not fully explored. We investigated the association between several insulin sensitivity indices (ISIs) and cancer-mortality over 3.5 decades in a cohort of adult men and women. We hypothesized that higher insulin resistance will be associated with greater cancer-mortality risk. A cohort of 1,612 men and women free of diabetes during baseline were followed since 1979 through 2016 according to level of insulin resistance (IR) for cause specific mortality, as part of the Israel study on Glucose Intolerance, Obesity and Hypertension (GOH). IR was defined according to the Mcauley index (MCAi), calculated by fasting insulin and triglycerides, the Homeostatic Model Assessment (HOMA), the Matsuda Insulin Sensitivity Index (MISI), and the Quantitative Insulin Sensitivity Check Index (QUICKI), calculated by plasma glucose and insulin. Mean age at baseline was 51.5 ± 8.0 years, 804 (49.9%) were males and 871 (54.0%) had prediabetes. Mean follow-up was 36.7±0.2 years and 47,191 person years were accrued. Cox proportional hazard model and competing risks analysis adjusted for age, sex, country of origin, BMI, blood pressure, total cholesterol, smoking and glycemic status, revealed an increased risk for cancer-mortality, HR = 1.5 (95% CI: 1.1-2.0, p = 0.005) for the MCAi Q1 compared with Q2-4. No statistically significant associations were observed between the other ISIs and cancer-mortality. The MCAi was independently associated with an increased risk for cancer-mortality in adult men and women free of diabetes and should be further studied as an early biomarker for cancer risk.

Associations of Individual Characteristics and Nutritional Status with Hypertension in Adults

Background: Hypertension is a significant health problem and a modifiable risk factor for cardiovascular diseases. The prevalence of hypertension in adults continues to increase at a global and national level. Information regarding determinants of hypertension is critical for preventive measures, especially in adults. This study examined the associations of individual characteristics and nutritional status with hypertension in adults in East Ciputat, South Tangerang.Method: A cross-sectional study was conducted to 400 adults aged ≥35 years old. Data on their blood pressure and nutritional status (body mass index) were obtained by measurement, and data on individual characteristics, food consumption, and lifestyle were collected through an interview using a structured questionnaire. A multivariate analysis was performed using a logistic regression test. Results: The proportion of hypertension was 54%. The multivariate analysis results showed that older age, low education level, a family history of hypertension, overweight/obese status, and consumption of sweet foods for &gt;3 times/week increased the risk of hypertension (Odds Ratio 2.37-11.28). In conclusion, people aged ≥65 years were at the greatest risk of hypertension. This study highlights the importance of increasing health promotion on the modifiable risk factors of hypertension such as food consumption patterns, weight control, and knowledge about hypertension.