Elevated Blood Pressure Levels Research Articles

Prognostic Impact of Metabolic Syndrome and Steatotic Liver Disease in Hepatocellular Carcinoma Using Machine Learning Techniques

Metabolic dysfunction-associated steatotic liver disease (MASLD) currently represents the predominant cause of chronic liver disease and is closely linked to a significant increase in the risk of hepatocellular carcinoma (HCC), even in the absence of liver cirrhosis. In this retrospective multicenter study, machine learning (ML) methods were employed to investigate the relationship between metabolic profile and prognosis at diagnosis in a total of 219 HCC patients. The eXtreme Gradient Boosting (XGB) method demonstrated superiority in identifying mortality predictors in our patients. Etiology was the most determining prognostic factor followed by Barcelona Clinic Liver Cancer (BCLC) and Eastern Cooperative Oncology Group (ECOG) classifications. Variables related to the development of hepatic steatosis and metabolic syndrome, such as elevated levels of alkaline phosphatase (ALP), uric acid, obesity, alcohol consumption, and high blood pressure (HBP), had a significant impact on mortality prediction. This study underscores the importance of metabolic syndrome as a determining factor in the progression of HCC secondary to MASLD. The use of ML techniques provides an effective tool to improve risk stratification and individualized therapeutic management in these patients.

#1713 Blood pressure goals in kidney transplant recipients: an analysis of the collaborative transplant study

Abstract Background and Aims Hypertension is an independent risk factor for cardiovascular disease, the leading cause of death in kidney transplant recipients. Because there is no “one size fits all” approach to blood pressure targets, particularly in the heterogenous group of kidney transplant recipients, identification of subgroup-specific targets, considering factors like age and sex, may be appropriate. However, currently available studies are limited because of sample sizes, and no subgroup analyses have been performed examining the effects of different blood pressure targets on allograft and patient survival. The aim of our study was to investigate the impact of different ACC/AHA blood pressure categories on graft survival and patient mortality and to identify subgroup-specific targets. Method This large-scale retrospective study included 1-year blood pressure data from 62, 556 kidney transplant recipients reported to the Collaborative Transplant Study from 209 centers in 39 countries. Hypertension was categorized according to 2017 ACC/AHA guidelines. The primary outcomes were death-censored graft failure and patient mortality during post-transplant year 1 to 6. Multivariable Cox regression analysis was performed to control for immunologic and nonimmunologic confounders. Results One year after transplantation, 77% of kidney transplant recipients had hypertension. Hypertension stages 1 (130–139/80–89 mmHg), 2a (140–159/90–99 mmHg), and 2b (≥160/≥100 mmHg) were associated with an 8%, 34%, and 102% increased risk of death-censored graft failure, respectively, whereas elevated blood pressure levels (120–129/<80 mmHg) did not significantly increase the risk. Patient mortality was only significantly higher in those with hypertension stage 2b with a Hazard Ratio of 1.21 (95% CI, 1.08–1.36; P < .001). In addition, the impact of hypertension stages on death-censored graft failure varied in different subpopulations (Fig. 1). Female recipients, younger recipients, recipients who received kidneys from donors younger than 60 years, re-transplanted recipients, and recipients with pre-transplant HLA antibodies had a significantly increased risk of death-censored graft failure associated with higher blood pressure levels (Fig. 1). Kidney transplant recipients with hypertension stage 2 continued to have an increased risk of graft failure one year after transplantation, even when they achieved normal blood pressure in the second year. Conclusion This study highlights the importance of treating hypertension early after kidney transplantation to improve long-term graft and patient survival. Attention should be paid to female, younger, and sensitized recipients, who may particularly benefit from optimal blood pressure control.

Assessing the impact of annual health screenings in identifying noncommunicable disease risk factors within Qatar’s primary health care corporation Qatari registered population

BackgroundNoncommunicable diseases (NCDs) are a significant global health burden, including in Qatar, where cardiovascular diseases cause mortality. This study examines the outcomes of the annual health checkup implemented by the Primary Health Care Corporation (PHCC) in Qatar in detecting NCDs risk factors among Qataris aged 18+ years.MethodsA cross-sectional study design was implemented to calculate the prevalence of behavioural and metabolic NCDs risk factors among Qataris who underwent annual health checkups between 2017 and 2019. Data on age, gender, tobacco consumption, height, weight, blood pressure, glycated haemoglobin (HbA1c), and cholesterol levels were extracted from electronic medical records.ResultsIn 2019, Qatar experienced an 80% rise in Annual Health checkups attendance compared to 2017. Tobacco use fluctuated between 11.79 and 12.91%, peaking at 35.67% among males in 2018. Qataris with elevated blood pressure dropped from 29.44% in 2017 to 18.52% in 2019. Obesity decreased from 48.32 to 42.29%, more prevalent in females. High HbA1c levels reduced from 13.33 to 8.52%, while pre-diabetic levels rose from 21.1 to 25.52%. High cholesterol ranged from 7.31 to 9.47%. In a regression analysis, males had 2.28 times higher odds of elevated blood pressure and 1.54 times higher odds of high HbA1c, with a 0.68 lower odds of obesity compared to females. Ages 36 and above had 2.61 times higher odds of high cholesterol compared to younger age groups.ConclusionThe annual health screening has shown promising results in detecting and addressing NCDs risk factors among Qataris. The attendance rate has increased over the three-year period, and there has been a decrease in the prevalence of elevated blood pressure, obesity, and high HbA1c levels. However, tobacco consumption and pre-diabetic levels remain significant concerns. These findings can guide the implementation of tailored preventative and curative services to improve the health and well-being of the Qatari population.

A LONG QT SYNDROME WITHOUT MANIFESTATION

Abstract A 66–year–old Caucasian woman presented for outpatient evaluation due to elevated blood pressure levels at home (approximately 220/120 mmHg) and a significant family history of long QT syndrome. The index case in the family appeared to be her sister, investigated following an ECG showing markedly prolonged QT interval and a family history of sudden cardiac death. The patient underwent genetic analysis, revealing a positive mutation in KCNQ1. She was currently on treatment with Levotiroxina for recently discovered hypothyroidism.The ECG showed sinus rhythm with a heart rate of 85 bpm, signs of left ventricular hypertrophy, particularly Sokolow (SV1 + RV6 70 mm) and Peguero Lo Presti (SD + SV4 50 mm). The QTc interval was 515 ms (Bazett). Echocardiography revealed severe left ventricular hypertrophy (SIVd 14 mm; PWd 12 mm; LVMi 128 g/m2; RWT 0.5) with normal overall systolic function (EF 60%). No significant valvular pathologies were observed, and the right ventricle appeared normal in size and function.The hypertrophy was attributed to uncontrolled severe arterial hypertension. However, the identification of a prolonged QT interval in a patient with a strong family component (Schwartz score 4, high probability) led to genetic testing, confirming a mutation in KCNQ1. As the patient was asymptomatic with a low risk of major arrhythmias over the next 5 years (1–2–3–LQTS–risk score 2.77%), she entered follow–up and received beta–blocker therapy, specifically nadolol, combined with other antihypertensive medications.This clinical case describes an entire family with LQTS1 (type 1) positive for KCNQ1 mutation, exhibiting phenotypic manifestations distinct from those reported in the literature. Notably, there was a prevalence in females, and the condition was incidentally discovered during a routine checkup conducted for unrelated reasons, without any history of major arrhythmias.Long QT syndrome (LQTS) is characterized by a prolonged QT interval, predisposing individuals to life–threatening arrhythmias leading to syncope and sudden death. Mutations in genes encoding ion channels account for 75% of LQTS cases. LQTS1, associated with a "loss–of–function" mutation in the KCNQ1 gene, represents one of the three genetic subtypes. LQTS1 typically manifests with arrhythmias in childhood, with a male predominance. Adrenergic triggers are crucial precipitants for arrhythmic events

Effect of DASH vs. mediterranean diet accompanied by a salt restriction on metabolic syndrome and cardiometabolic risk factors in adults with high normal blood pressure or grade 1 hypertension: secondary analyses of a randomized controlled trial

ObjectiveLifestyle interventions are recommended as the first-line treatment to control metabolic syndrome components and improve cardiometabolic risk factors. However, studies directly comparing the cardiometabolic effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) accompanied by salt restriction are currently lacking. Thus, with the present secondary analyses of a randomized trial, we aimed to assess the cardiometabolic effects of a 3-month intensive dietary intervention implementing salt restriction alone or on top of the DASH and MedDiet compared to no/minimal intervention in never drug-treated adults with high normal blood pressure (BP) or grade 1 hypertension. MethodsWe randomly assigned individuals to the control group (CG, n = 60), salt restriction group (SRG, n = 60), DASH diet with salt restriction group (DDG, n = 60), or MedDiet with salt restriction group (MDG, n = 60). ResultsAccording to the intention-to-treat analysis, the DDG and the MDG had lower odds ratio (OR) (95% CI) of metabolic syndrome [0.29 (0.12, 0.72), and 0.15 (0.06, 0.41), respectively] compared to the CG. Moreover, the MDG had lower odds of metabolic syndrome compared to the SRG and lower odds of elevated BP levels than the DDG and the SRG. Moreover, total and LDL-cholesterol, fasting glucose, HbA1c, and systolic/diastolic BP were reduced in all three intervention groups compared to the CG. ConclusionOn a background of salt restriction, the MedDiet was superior in BP reduction, but the DASH and MedDiet reduced the prevalence of metabolic syndrome to the same extent.

Vitamin D deficiency and the vitamin D receptor (VDR) gene polymorphism rs2228570 (FokI) are associated with an increased susceptibility to hypertension among the Bangladeshi population.

Vitamin D receptor (VDR) gene is implicated in hypertension vulnerability due to its role in regulating the renin-angiotensin system (RAS) and blood pressure. In this case-control study, a carefully selected cohort of 111 hypertensive individuals and 100 healthy controls underwent serum analysis using HPLC to measure 25-hydroxy vitamin D levels. Polymorphic variations in the VDR gene were detected and characterized using the PCR-RFLP method. At first, lower 25-hydroxy vitamin D levels were observed in hypertensive individuals compared to controls (p<0.001). The genotype frequency of the VDR gene TaqI showed no significant difference between cases and controls (p>0.05). Similarly, no significant difference was found in the VDR gene BsmI genotype frequency between hypertensive patients and controls (p>0.05). However, a statistically significant distinction was observed in the VDR gene FokI genotype frequency between cases and controls (p<0.01). The odds ratios for FokI genotypes (CC, CT, TT, and CT+TT) were 1.0, 0.590, 1.566, and 0.963, respectively. Furthermore, serum 25-hydroxy vitamin D levels were significantly higher in control subjects compared to hypertensive patients across all genotypes of VDR (p<0.001). Hypertensive patients, excluding those with the FokI VDR gene CC genotype, exhibited significantly higher systolic blood pressure levels compared to the control group (p<0.05). Similarly, hypertensive subjects displayed elevated diastolic blood pressure levels compared to the control group (p<0.001). Overall, the results suggest the presence of a potential inverse correlation between serum 25-hydroxy vitamin D levels and hypertension. The association analysis conducted indicated that there is no significant association between TaqI and bsmI genotypic variants and the risk of developing hypertension. However, it was observed that VDR gene polymorphisms do have a clear association with hypertension susceptibility, as evidenced by the significantly higher occurrence of FokI genotypic variants in hypertensive patients. Our study therefore introduces the possibility of utilizing 25-hydroxy vitamin D deficiency and VDR gene polymorphisms as a biomarker for hypertension.

Incidence of hypertension and its risk factors: a systematic review

Hypertension is a persistent, metabolic condition indicated by elevated blood pressure levels. Since hypertension comes with no warning signs, mostly people are not aware of it. The aim of the study was to assess the change in the prevalence of hypertension among adults of Punjab and Haryana and to investigate its risk factors. Medline, Web of Science and Scopus databases from 2009 to 2023 were searched for ‘prevalence, burden, awareness, and control of blood pressure (BP) or hypertension (≥140 SBP and or ≥90 DBP) among Indian adults’ (≥18 years). The incidence of hypertension varied from 32.4 to 88.2 percent in male subjects and 30 to 84.7 percent in female subjects. Hypertension was more prevalent among males of Punjab and Haryana. Whereas females were more hypertensive in different districts of Haryana. The considerable upward trend has been observed over the time, among males and females in both Punjab and Haryana, yet awareness and control rates are comparatively low. Various researchers have discovered that younger the age of beginning of hypertension, the higher the decline in life expectancy if raised blood pressure is not managed.

The Level of Leptin in the Blood of Patients with Chronic Obstructive Pulmonary Disease and its Correlations with the Levels of Clinical, Functional and Anamnestic Indicators

Leptin, a hormone produced by white adipose tissue and recognised as an inflammatory biomarker, has an undefined role in the progression of chronic obstructive pulmonary disease (COPD). Objective — to evaluate the leptin level and its correlations with the levels of clinical, functional and anamnestic indicators in COPD patients. Materials and methods. This study employed a case-control design involving 42 patients experiencing acute exacerbation of COPD and 20 control subjects. The patients were examined according to the standard protocol. Additionally, the examination included ultrasonic scanning of the abdominal cavity, evaluation of the serum leptin level, scoring of the anxiety and depression and quality of life. Results and discussion. It was revealed that hyperleptinemia in the patients with acute exacerbation of COPD occurred significantly more frequently than in the healthy persons ((73.8 ± 6.8) vs (40.0 ± 11.0) %; р &lt; 0.05). Besides, the COPD patients manifested increased leptin levels much more frequently than normal levels ((73.8 ± 6.8) vs (26.2 ± 6.8) %; р &lt; 0.01). Hyperleptinemia was found to co-occur with severe COPD cases belonging to E clinical group ((51.6 ± 9.0) vs (18.2 ± 11.6) % in group with normal leptin level; р &lt; 0.05). Kendall correlation analysis established that elevated circulating leptin levels were associated with an increased body mass index (τ = 0.3; р = 0.02), female gender (τ = 0.3; р = 0.01), non-smoking history (τ = – 0.2; р = 0.03), stronger manifestation of such symptoms as shortness of breath (τ = 0.3; р=0.01), disturbed home (τ = 0.3; р = 0.002) and out-of-home activities (τ = 0.3; р = 0.02) and lack of energy (τ = 0.3; р = 0.01). It also correlated with increased severity of pulmonary insufficiency (τ = 0.3; р = 0.003) and decreased forced vital capacity (τ = – 0.2; р = 0.04), elevated systolic blood pressure (τ = 0.2; р = 0.02), elevated cholesterol (τ = 0.3; р = 0.01) and β-lipoproteins levels (τ = 0.2; р = 0.04), pronounced depression (τ = 0.3; р = 0.002) and lowered quality of life (τ = 0.3; р = 0.01). Сonclusions. COPD patients with elevated leptin levels manifest not only with an increased body weight, but also with arterial hypertension, disturbed lipid metabolism, more pronounced pulmonary insufficiency, depressive disorders and lowered life quality with more severe subjective respiratory symptoms.

Serum Phenylacetylglutamine among Potential Risk Factors for Arterial Stiffness Measuring by Carotid-Femoral Pulse Wave Velocity in Patients with Kidney Transplantation.

Phenylacetylglutamine (PAG), a gut microbiota metabolite, is associated with cardiovascular diseases. Arterial stiffness (AS), which is a marker of aging-associated vascular diseases, is an independent risk factor for cardiovascular morbidity and mortality. This study aimed to assess the correlation between serum PAG levels and AS in kidney transplantation (KT) patients, potentially uncovering new insights into the cardiovascular risks in this population. In this study, 100 KT patients were included. Carotid-femoral pulse wave velocity (cfPWV) was measured, and patients with cfPWV > 10 m/s were categorized as the AS group. Serum PAG levels were assessed using liquid chromatography-tandem mass spectrometry. Thirty KT patients (30.0%) exhibited AS, with higher percentages of diabetes mellitus, older age, and elevated levels of systolic blood pressure, serum fasting glucose, and PAG than the control group. After adjusting for factors significantly associated with AS by multivariate logistic regression analysis, serum PAG, age, fasting glucose levels, and systolic blood pressure were independent factors associated with AS. Furthermore, PAG levels had a negative correlation with the estimated glomerular filtration rate and a positive correlation with cfPWV values. Serum PAG levels are positively associated with cfPWV values and are a biomarker of AS in KT patients.

ASSESSING PATIENT KNOWLEDGE AND COMPLIANCE WITH ANTIHYPERTENSIVE TREATMENT IN TECHIMAN MUNICIPALITY

The study focused on hypertension (HPT), commonly known as high blood pressure, which is defined as persistently elevated blood pressure levels in adults. It aimed to assess the knowledge and compliance of hypertensive patients with their antihypertensive treatment in the Techiman Municipality. The study employed a hospital-based cross-sectional quantitative descriptive approachusing convenience sampling with a sample size of 234 adult hypertensive patients as respondents. The data was collected using structured questionnaires. The findings indicated that most patients believed that hypertension was caused by an increase in blood pressure. Furthermore, most of them were aware of practices that could elevate blood pressure, such as excessive salt intake and consuming fatty foods. Interestingly, some patients attributed hypertension to factors like witchcraft or financial constraints. The findings called for several key recommendations: Firstly, conduct larger-scale research to delve deeper into factors driving antihypertensive non-compliance. Strengthen health promotion initiatives, including advocating healthy lifestyles, patient education, family counseling, and robust social support networks, to boost treatment adherence and well-being. Implement compliance monitoring studies to pinpoint noncompliant patients more accurately and potentially reduce healthcare costs. Ensure convenient access and sufficient availability of antihypertensive medications. Lastly, prioritize patient education to dispel misconceptions about hypertension, especially beliefs related to witchcraft. In sum, these recommendations offer promise for improving hypertension management in Techiman Municipality.

Associations between Components of Metabolic Syndrome and Demographic, Nutritional, and Lifestyle Factors.

To evaluate the associations between individuals with and without changes in components of metabolic syndrome (MetS) and demographic, nutritional, and lifestyle factors. A cross-sectional study was conducted with 224 individuals followed-up at a public hospital in Northeast Brazil. We used National Cholesterol Education Program-Adult Treatment Panel III (NCEP) criteria to diagnose MetS. We assessed components of MetS as dependent variables, while sex, age, food consumption, smoking, alcohol intake, physical activity, anthropometric parameters, and sleep hours were independent variables. Comparing individuals with and without changes in components of MetS, the logistic regression models revealed that female sex was predictive of increased waist circumference and low HDL-c levels while advanced age was predictive of increased blood pressure and blood glucose levels. BMI emerged as a predictor for waist circumference and a protective factor for triglyceride levels. In addition, potassium intake, physical activity, and sleep duration were protective against decreased HDL-c, elevated triglyceride, and elevated blood pressure levels, respectively. This study demonstrated that sex, age, BMI, dietary potassium intake, physical activity, and hours of sleep are factors to be targeted in public health actions for prevention and treatment of MetS.

Sex Differences in the Primary Prevention of Cardiovascular Diseases in a Dutch Primary Care Setting.

Sex differences in the primary prevention of cardiovascular diseases (CVD) have been shown, but the evidence is mixed and fragmented. In this study, we assessed sex differences in cardiovascular risk factors assessment, risk factor levels, treatment, and meeting of treatment targets, within a Dutch primary care setting. Data were obtained from individuals aged 40 to 70 years old, without prior CVD, registered during the entire year in 2018 at one of the 51 general practices participating in the Julius General Practitioner's Network (JGPN). History of CVD was defined based on the International Classification of Primary Care (ICPC). Linear and Poisson regressions were used to investigate sex differences in risk factor assessment, risk factor levels, treatment, and meeting of treatment targets. We included 83,903 individuals (50% women). With the exception of glycated hemoglobin (HbA1c), all risk factors for CVD were more often measured in women than in men. Lipid measurements and body mass index values were higher in women, while blood pressure (BP) and HbA1c levels were higher in men, along with estimated glomerular filtration rate (eGFR) levels. Among individuals with elevated BP or cholesterol levels, no sex difference was observed in the prescription of antihypertensive medications (RR 1.00, 95% CI: 0.94-1.06) but women were less likely than men to receive lipid-lowering medications (RR 0.87, 95% CI: 0.79-0.95). Among treated individuals, women were more likely than men to meet adequate levels of blood pressure (RR 1.17, 95% CI: 1.09-1.25) and less likely to meet target levels of cholesterol (RR 0.90, 95% CI: 0.83-0.98). While women were more likely to have their CVD risk factors measured, they were less likely to be prescribed lipid-lowering medications and to meet target levels. When treated, men were less likely to achieve adequate blood pressure control.

Association between human blood metabolome and the risk of hypertension

Hypertension, commonly referred to as high blood pressure, is a chronic medical condition characterized by persistently elevated blood pressure levels. It is a prevalent global health issue, affecting a significant portion of the population worldwide. Hypertension is often asymptomatic, making it a silent but potentially dangerous condition if left untreated. Genetic instruments for 1,091 were from a recent comprehensive metabolome genome-wide association study (GWAS). Summary statistics of diastolic blood pressure (DBP) and systolic blood pressure (SBP) involving 757,601 sample size were analyzed. Two-sample Mendelian Randomization (MR) was conducted to assess causal effect of metabolites on DBP and SBP risk, and reverse MR analysis was performed to identify the DBP/SBP causal effect on blood metabolites. Twelve and twenty-two metabolites were identified to be associated with DBP and SBP, respectively. Sensitive analysis showed four metabolites had robustness association on BP. Reverse MR demonstrated DBP and SBP could decrease the tricosanoyl sphingomyelin (d18:1/23:0)* level and increase the 2-hydroxyhippurate (salicylurate) level in blood, respectively. Our findings reveal an association between blood metabolites and blood pressure (DBP and SBP), suggesting potential therapeutic targets for hypertension intervention.

Combination of Remimazolam, Remifentanil Anesthesia, and Enteral Nutrition Support Restores Vital Signs and Nutritional Status of Patients Undergoing Intravascular Interventional Therapy for Intracranial Aneurysms

Ninety-eight patients from our hospital were included in the study from March 2022 to March 2023. The patients were divided into two groups: 49 patients received propofol + remifentanil in the control group and 49 patients received remimazolam + remifentanil in the observation group. Postoperatively, the control group accepted parenteral nutrition support, while the observation group accepted enteral nutrition support. The observation group experienced a longer duration of consciousness loss but shorter times for consciousness recovery and trachea extubation than the control group. Although both groups experienced elevated mean blood pressure, heart rate, norepinephrine, angiotensin II, and plasma cortisol levels during tracheal intubation and extraction, the observation group showed differences compared to the control group. No statistical significance was discovered in the incidence of postoperative adverse reactions between the two groups (P = 0.29). Furthermore, tumor necrosis factor-α and interleukin-6 levels were lower in the observation group than in the control group, while total protein, albumin, and hemoglobin levels were higher. Overall, remimazolam combined with remifentanil demonstrated superiority over propofol combined with remifentanil in the perioperative period for patients undergoing intravascular interventional therapy for intracranial aneurysms.

Epidemiology and Management of Hypertension and Diabetes Mellitus in Patients with Mild Autonomous Cortisol Secretion: A Review.

Mild autonomous cortisol secretion (MACS) is associated with a higher cardiometabolic risk than that observed in patients with nonfunctioning adrenal adenomas and in the general population. In patients with MACS, the excess of glucocorticoids affects various metabolic pathways, leading to different manifestations of metabolic syndrome and other comorbidities. Hypertension and diabetes mellitus are two of the most common cardiometabolic comorbidities associated with MACS, reaching a prevalence of up to 80% and up to 40%, respectively. In addition, they are the comorbidities that experienced a greater improvement after adrenalectomy in patients with MACS. Hypertension pathogenesis is multifactorial, including the coexistence of comorbidities such as obesity or diabetes and the role of the different polymorphisms of the glucocorticoid receptor gene, among others. Glucocorticoid-induced diabetes mellitus is mainly related to the detrimental effects of glucocorticoids on insulin-dependent glucose uptake in peripheral tissues, gluconeogenesis and insulin secretion. There are no specific recommendations for hypertension and diabetes treatment in patients with MACS. Thus, considering the similar underlying pathogenesis of hypertension and diabetes mellitus in overt and mild hypercortisolism, our recommendation is to follow this general stepwise approach: surgically remove the adrenal culprit lesion to induce remission from hypercortisolism; control hypercortisolism with steroidogenesis inhibitors; and treat elevated blood pressure or high glucose levels using carefully selected anti-hypertensives and glucose-lowering medications if blood pressure and glucose levels remain uncontrolled, respectively. In this review, we summarize the epidemiology, physiopathology and management of diabetes mellitus and hypertension in patients with MACS.

The impact of dietary and sleep rhythms on blood pressure in children and adolescents: a cross-sectional study.

Evidence about the relationship between meal and sleep time and CVD in children is scarce. The aims of this study were to describe the association between life rhythm patterns and blood pressure in children. This research was conducted among 5,608 children aged 6 to 15 years old in Chongqing and Sichuan provinces in 2021 and 2022. Dietary and sleep rhythms information was collected. The time of the first meal and last meal, and sleep time, were obtained. The mean age was 10.48 ± 2.24 years old, with 2958 (52.75%) male participants. The mean feeding window on weekdays was 11.69 h, 12.42 h, and 13.23 h for participants aged 6-7 years old, 8-12 years old and 13-15 years old, respectively. Weekday feeding window and last mealtime were positively correlated with blood pressure levels. And the changes in the feeding window between weekdays and weekends were significantly correlated with BP. Sleep duration and change in wake time were significantly correlated with SBP. Based on these results, this study identified the optimal combination of dietary and sleep rhythm interventions for children younger than 12 years of age and aged 12 and older, respectively. Disorder dietary and sleep rhythms disorders may correlate with elevated blood pressure levels, suggesting developing optimal dietary and sleep rhythm patterns could prevent the incidence of CVDs in children. The optimal dietary rhythm was defined by the indexes of breakfast time, dinner time and daily feeding window. As good meal patterns are defined as satisfied the following three items: for children younger than 12 years should have breakfast after 7:30 am; aged 12 years and over should have breakfast after 7 am; having dinner before 6 pm; daily feeding window less than 12.5 h. And less optimal dietary rhythm should satisfy any condition or eat dinner between 6 pm and 8 pm; and poor dietary rhythm should not satisfy any of the three criteria and eat dinner after 8 pm. Children with optimal dietary rhythm (in group A) had lower SBP (P < 0.001), DBP (P = 0.002) and MAP (P < 0.001) than those in group C.

11.F. Workshop: Health examination surveys to support decision making and for monitoring risk factors

Abstract Non-communicable diseases (NCDs) contribute for 74% of all deaths globally. They are also major cause of morbidity and disability. Many of the NCDs could be prevented with timely lifestyle changes and treatment of biological risk factors. Several NCDs, such as diabetes, cardiovascular diseases, chronic respiratory diseases and several cancers share same risk factors namely smoking, harmful alcohol use, unhealthy diet and lack of physical activity which impact on biological risk factors such as obesity, elevated blood pressure, elevated blood cholesterol and raised blood sugar levels. Up-to-date, representative, and high-quality health information is needed to support evidence-informed policy making and innovative research. Monitoring of lifestyles and biological risk factors affecting the NCDs is needed, to identify current the situation among different population groups and to plan and target required actions for prevention and treatment. Information on lifestyles is usually collected through survey questions about smoking habits, alcohol use, diet and physical activity. For biological risk factors, self-reported information tends to be biased. For example, elevated blood pressure, blood cholesterol and blood sugar levels are asymptomatic for a long time and people often don’t know about their condition. For obesity, stigma and societal pressure may lead to misreporting. For health care registers, information on biological risk factor is not systematically recorded and whenever data is available, it represents only patients. Therefore, for biological risk factors, the only reliable source for information about population level situation are health examination surveys (HES). At the European level, European Health Examination Survey (EHES) has provided a standardized protocols for measurement of key biological risk factors. These recommendations are in line with the WHO Stepwise approach for NCD risk factor surveillance. In the past ten years, less than half of the EU Member States have conducted at least one national HES. This workshop will include four presentations providing a general overview of why we need to be monitoring NCD risk factors and how broadly this is done in Europe. Three case examples showcase how the monitoring is conducted in different countries. Finland has done NCD risk factor monitoring regularly since 1960's and has the longest time series in Europe, Germany has conducted several comprehensive multi-year cross-sectional surveys since early 2000's and is piloting more flexible methods, and Portugal had their first health examination survey in 2015-2016 and is now planning the next one. How these countries have organized their monitoring and how the data obtained have been used to support actions targeting to improve population health will be discussed. Key messages • Health examination surveys are needed to obtain reliable and representative information about NCD risk factors at the population level. • Standardized protocols for measurements of biological risk factors are needed to ensure cross-country and over time comparison of the outcomes.

Association of severity and prognosis with elevated blood pressure and heart rate levels in patients with intracerebral hemorrhage

BackgroundIntracerebral hemorrhage (ICH) has a high mortality and morbidity in the world. Elevated blood pressure (BP) and heart rate (HR) have been identified as independent risk factors, with potential to predict prognosis and recurrence of cardiovascular diseases. Our study aimed to elucidate the association between BP and HR levels and the severity, as well as prognosis, of patients diagnosed with ICH.MethodsThe basic characteristics of patients and laboratory examination results, inclusive of BP and HR levels upon admission, were recorded as baseline data. The modified Rankin Scale and living status were taken into account for all patients at a 1-year follow-up. The relationship between various BP and HR levels and clinical outcome was analyzed using logistic regression and the Kaplan-Meier survival method.ResultsA total of 1,416 patients with acute ICH from 13 hospitals in Beijing were enrolled in our study. Logistic regression analysis indicated that patients with higher HR and BP (group 4), along with those with higher HR but lower BP (group 2), exhibited a poorer prognosis compared to those with lower BP and HR (group 1). This result was particularly pronounced in younger, male subgroups (OR (95% CI) = 4.379(2.946–6.508), P < 0.0001 for group 4; OR (95% CI) = 1.819 (1.219–2.714), P = 0.0034 for group 2). At the 1-year follow-up, group 4 patients demonstrated a significantly higher rate of fatal incidence compared to other groups (P < 0.01).ConclusionsHigher HR and BP levels, suggestive of an autonomic dysfunction, were independently associated with a poorer 1-year prognosis and reduced survival rate in ICH patients. Our findings underscore the need for early intervention to modulate these physiological parameters in patients with ICH.

A Narrative Review of Parameters Influencing Preeclampsia in the COVID-19 Era.

The COVID-19 outbreak has emerged as one of the most profound medical events of the 21st century, leaving an indelible impact on a global scale. The widespread prevalence causing significant illness and death needs collaborative and inventive efforts to deal with this challenge. One of the particular subset of the general population that had endured a significant impact was the pregnant population. A key complication of pregnancy seen in patients with a COVID-19 infection was the increased risk of developing preeclampsia.The angiotensin-converting enzyme 2 (ACE2) receptor is an important part of the renin-angiotensin system, which has been implicated in the control of blood flow and also is a key receptor in the pathogenesis of the multitude of symptoms of COVID-19. This study aimed to evaluate the psychiatric, hematological, neurological, and social factors influenced by the COVID-19 virus and its subsequent effect on the development of preeclampsia. Increased rates of anxiety and depression were seen globally during the COVID-19 pandemic and due to the following physiological response of anxiety and depression, elevated blood pressure levels and development of preeclampsia were noted. Neurological factors such as the development of posterior reversible encephalopathy syndrome and its relationship between COVID-19 and preeclampsia were also strongly observed. The observation suggested biomarkers such as serum neurofilament light may be used as a screening tool to stratify the severity of preeclampsia. Hematological parameters observed were most notable for the presence of thrombocytopenia, which itself is a marker of the severity of preeclampsia. The numerous effects of COVID-19 on preeclampsia have proven to have a tremendous impact on the healthcare burden. Careful analysis and prevention strategies, if implemented, will contribute to reducing the morbidity and mortality of patients with preeclampsia and COVID-19 infections.

A self-powered biocompatible brain probe for remote blood pressure regulation

Hypertension, a common cardiovascular disorder characterized by elevated blood pressure levels, is conventionally managed using pharmacological interventions to achieve optimal blood pressure control. In this study, a novel self-powered, biocompatible brain probe is presented as a potential long-term and remote approach to blood pressure regulation. The device consists of a piezoelectric transducer, an electronic module, brain stimulating electrodes, and a drug microneedle array. As the resonator, the piezoelectric transducer is embedded in resonant structure within resin shell, enabling the harvesting of acoustic energy from smartphone audio tone without any external power sources. By programming specific audio signals, the resonator can be activated, and the electronic module can output corresponding electrostimulation signals on demand. Implanted brain stimulating electrodes in the ventrolateral periaqueductal grey matter (vlPAG) of rats can be wirelessly controlled by the smartphone, resulting in a significant reduction in blood pressure of approximately 20 mmHg. The device's drug microneedle array, located beneath the pedestal of device, can deliver antibiotics percutaneously to prevent post-surgical infections, indicating a biocompatible approach for long-term hypertension treatment. This novel, self-powered and wireless treatment has significant potential for clinical hypertension therapy and may broaden the scope of self-powered techniques for telemedicine and brain-machine interfaces.