Family History Of Hypertension Research Articles

Hypertension and its risk factors among pregnant garment workers attending a health centre in Bangladesh

Background: The burden of hypertension among the pregnant garment workers in Bangladesh is not well known. The aim of this study was to determine the prevalence of hypertension and its associated factors among pregnant garment workers attending a health centre in Narayanganj, Bangladesh. Methods: A cross-sectional study was done among conveniently selected adult pregnant garment workers at ≥20 weeks of gestation who visited a health centre of a garment company in Narayanganj, Bangladesh, between July and October 2023. Data on age, education, job nature, family history, clinical, height, weight, and blood pressure were collected. Binary logistic regression was performed to identify factors associated with hypertension. Results: Of 150 participants the average age was 27.3 years (standard deviation, 3.2) and mean gestational age was 21.7 weeks. The prevalence of hypertension among the participants was 7.3% (95% confidence interval, 4.0% - 12.3%). A family history of pregnancy-related hypertension was found to be associated with hypertension (adjusted odds ratio, 34.7; 95% confidence interval, 2.0 - 619.0). Conclusion: Approximately one in 14 pregnant garment workers had hypertension, and family history of pregnancy-related hypertension was an associated factor. Healthcare professionals may consider this factor while providing care and counseling to this population.

The correlation of shift work and CLOCK, BMAL1, and PER1 gene polymorphisms with hypertension in healthcare workers: A cross-sectional study

This study aimed to investigate the polymorphisms of circadian clock genes and the association of shift work and gene polymorphisms with hypertension in healthcare workers. This study recruited 222 healthcare workers, of whom 76 had primary hypertension (Hyp group) and 146 served as controls (Control group). General information and working hours were collected through questionnaires. Next, the identification of specific single nucleotide polymorphism (SNP) loci related to the Circadian locomotor output cycles kaput (CLOCK), brain and muscle arnt-like 1 (BMAL1), and PER1 genes was conducted by literature and PDGene database search. Venous blood samples were then collected for DNA extraction, and polymerase chain reaction-restriction fragment length polymorphism techniques were used to analyze the genotyping and allele frequency of the SNP sites. Finally, multivariate logistic regression was employed to analyze the association between various risk factors and hypertension in healthcare workers. Compared to the control group, the Hyp group had significantly higher proportions of alcohol consumption and family history of hypertension, while the average sleep duration and average exercise time were significantly lower. Shift work analysis showed that the Hyp group had a significantly lower average number of evening shifts per month while a much higher average number of night shifts per month compared to the control group. The GG genotype at the CLOCK rs1801260 locus was associated with a lower risk of hypertension (OR = 0.446), and the TT genotype of the BMAL1 rs11022775 locus also showed a similar protective effect (OR = 0.426). However, the genotype distribution of the PER1 rs2735611 locus was not significantly associated with the risk of hypertension. Multivariate regression analysis revealed that a family history of hypertension and insufficient sleep were significantly associated with the risk of hypertension, and the average number of night shifts per month was positively correlated with the risk of hypertension. Specific polymorphisms in the CLOCK and BMAL1 genes may have a protective effect against hypertension in healthcare workers, while polymorphisms in the PER1 gene are not significantly associated with the risk of hypertension. Additionally, a family history of hypertension, insufficient sleep, and shift work patterns may be significant risk factors for hypertension.

A parent and child with Liddle syndrome diagnosed correctly with the child as the proband: a case report with review of literature.

Liddle syndrome (LS) is an autosomal dominant genetic disorder characterized by early onset hypertension, hypokalemia, and low plasma aldosterone or renin concentration. It is caused by mutations in subunits of the epithelial sodium channel (ENaC). The clinical phenotypes of LS are variable and nonspecific, making it prone to both misdiagnosis and missed diagnosis. Genetic analysis is necessary to confirm the diagnosis of LS. Herein, we report the case of a 42-year-old male with LS and a 30-year history of hypertension. He was being treated for possible primary aldosteronism (PA) over the preceding 7 years; however, his hypertension was poorly controlled despite intensive combination therapy. His 13-year-old son served as a proband for a diagnosis of LS, as he had hypertension, hypokalemia, and a significant family history of hypertension. Genetic testing revealed a heterozygous pathological variant in the SCNN1B gene. This led to a diagnosis of LS, as the father was found to harbor the same mutation. Both were treated with ENaC inhibitors and a salt-restricted diet, which improved their symptoms markedly. The son's genetic diagnosis facilitated the subsequent proper diagnosis and treatment of his father. LS causes early onset hypertension; hence, its early diagnosis and treatment can prevent complications. Hereditary hypertension should be considered in cases of early onset hypertension with a significant family history. Patients diagnosed with PA using outdated criteria may have concomitant LS and require careful evaluation of biochemical and endocrine tests according to the current criteria.

Attitudes of Individuals with a Family History of Hypertension Towards the Prevention of Hypertension and Health Locus of Control

Attitudes of Individuals with a Family History of Hypertension Towards the Prevention of Hypertension and Health Locus of Control

Risk factors for chronic kidney disease in the community: A decade of outreach in Kenya

Problem ConsideredBurden of chronic kidney disease (CKD) is increasing globally. We present chart analysis of data obtained during community screening for kidney disease between 2011-2021 in various parts of Kenya with objectives to document and stratify risks for kidney disease in the community. MethodsThis was a descriptive analysis charts. Age, sex, individuals’ data on smoking, diabetes, hypertension, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), random blood sugar (RBS), dipstick urinalysis, as well as family history of CKD, hypertension and diabetes were analysed. Continuous variables had mean, standard deviation (SD), median and interquartile range (IQR) while frequencies for categorical variables were calculated. ResultsAbout 10,675 individuals were analysed. Median age was 41 years (25 – 53). Females were 6,092(57.1%). Known hypertensive, diabetic and smokers were 2,028(19.0%), 881(8.3%) and 523(4.9%) respectively. Family history of hypertension, diabetes and CKD was reported by 3,810(35.7%), 2,751(25.8%) and 978(9.2%) respectively. In 10,121(94.8%) RBS was tested. About 470(4.6%) had RBS < 4.0 mmol/L, 9,298(91.9%) 4.0-11.0 mmol/L while 368(3.6%) was > 11.0 mmol/L. Incidental hyperglycemia was in129 (1.2%). Median SBP and DBP was 128 mmHg (116-143) and 78 mmHg (70 – 87) respectively. Mean BMI was 25.96±5.27 kg/m2. Subgroups with diabetes and hypertension had higher mean age, SBP, DBP and RBS, family history of hypertension, diabetes and CKD. ConclusionBurden of risks for CKD in the community high. Blood sugar and blood pressure controls were suboptimal. There was concordance in the findings of hypotensive, diabetic and family history of similar conditions.

Construction of OSA-related hypertension prediction model based on nomogram

Objective:This study aimed to construct a risk prediction model for obstructive sleep apnea（OSA） related hypertension based on the nomogram, and to explore the independent risk factors for OSA-related hypertension, so as to provide reference for clinical treatment decision-making. Methods:The clinical data of OSA patients diagnosed by polysomnography from October 2019 to December 2021 were collected retrospectively and randomly divided into training sets and validation sets. A total of 1 493 OSA patients with 27 variables were included. The least absolute shrinkage and selection operator（Lasso） logistic regression model was used to select potentially relevant features and establish a nomogram for OSA-related hypertension.The performance and clinical benefits of this nomogram were verified in terms of discrimination, calibration ability and clinical net benefit. Results:Multivariate logistic regression showed that body mass index（BMI）, family history of hypertension, lowest oxygen saturation（LSaO2）, age and cumulative percentage of total sleep time with oxygen saturation below 90% were independent risk factors for OSA-related hypertension. Lasso logistic regression identified BMI, family history of hypertension, LSaO2 and age as predictive factors for inclusion in the nomogram. The nomogram provided a favorable discrimination, with a C-indexes of 0.835（95% confidence interval[CI ]0.806-0.863） 0.865（95%CI 0.829-0.900） for the training and validation cohort, respectively, and well calibrated. The clinical decision curve analysis displayed that the nomogram was clinically useful. Conclusion:Compared with cumulative percentage of total sleep time with blood oxygen saturation below 90%, LSaO2 may have a greater impact on the incidence of OSA-related hypertension, and the effects of different times and degrees of hypoxia on OSA-related hypertension should be further explored in the future. Apnea hypopnea index involvement is weak in predicting OSA-related hypertension, and the blood oxygen index may be a better predictor variable. Furthermore, we established a risk prediction model for OSA-related hypertension patients using nomogram, and demonstrated that this prediction model was helpful to identify high-risk OSA-related hypertension patients. This model can provide early and individualized diagnosis and treatment plans, protect patients from the serious.

Assessment of adherence to antihypertensive medication and its associated factors: a cross-sectional study

Background: Hypertension is a silent killer. India is home to approximately 220 million hypertensive individuals. Poor adherence to medication may lead to complications and add to the burden of disease. So, this study aims to assess medication adherence and its associated factors. Methods: This hospital based cross sectional study was conducted at Urban Health Training center. Patients who attended Out Patient Department over the period of three months were enrolled in the study. Morisky Medication Adherence four-point scale (MMAS-4) was used to study compliance, while JAMOVI software was used for data analysis. Results: Around half (45%) of the patients had high adherence to anti-hypertensive medication. Various sociodemographic factors like age, gender, education, occupation, family history, personal history and duration of hypertension were considered. A significant association was observed between age and duration with adherence. Conclusions: There was significant association between age and poor adherence. Timely interventions are necessary to reinforce good compliance to antihypertensive drugs.

Relationship between fibrosis-4 index and new onset hypertension in the general population

Abstract Background/Introduction Non-alcoholic fatty liver disease (NAFLD) is a risk for cardiovascular events and malignant tumors as well as liver cirrhosis, and the risk increases with increasing fibrosis of the liver. Thus, the fibrosis-4 (FIB-4) index, developed as a noninvasive test to stage liver fibrosis, may predict the development of hypertension. Purpose The present study investigated the relationship of FIB-4 index with the prevalence and future development of hypertension in the general population. Methods A total of 16125 participants who visited our hospital for a physical check-up at least twice from 2008 to 2018 (male=9700, 52.0±12.3 year-old) were subjected for cross-sectional analysis. Among them, 3995 participants were hypertensive. The remaining 12111 normotensive participants (male=6984, 49.5±11.9 year-old) were followed up for the median of 1643 days with the endpoint being the development of hypertension, defined as systolic blood pressure ≥140mmHg, diastolic blood pressure ≥90mmHg or the use of antihypertensive medication. FIB-4 index was calculated as follows; (age×AST)/(platelet number×√ALT). Results Cross-sectional analysis revealed that FIB-4 index was higher in hypertensive than normotensive participants (1.40±0.74 vs. 1.09±0.54, p&amp;lt;0.001). During the follow-up, 2819 participants (45.7 per 1000 person-year) developed hypertension. The incidence was more frequent in male (55.6 per 1000 person-year) than female participants (32.7 per 1000 person-year, p&amp;lt;0.001). High level of FIB-4 index (≥2.67, n=194) showed a significant impact on the incident hypertension (80.5 per 1000 person-year) as compare with middle (≥1.30, &amp;lt;2.67, n=3082) or low level (&amp;lt;1.30, n=8835) of FIB-4 index (65.4 and 38.8 per 1000 person-year, respectively). Non-adjusted hazard ratio (HR) (95% confidence interval [CI]) of FIB-4 index for the new onset of hypertension was 1.483 (1.416-1.553). In multivariate Cox hazard analysis adjusted for sex, body mass index, systolic blood pressure, pulse rate, serum creatinine, uric acid, HbA1c, LDL-cholesterol, triglyceride, hemoglobin, current smoking, frequent alcohol consumption and family history of hypertension, FIB-4 index was an independent predictor of the development of hypertension (HR 1.321, 95%CI [1.213-1.438]). Similar results were obtained in analyses of male (HR 1.382, 95%CI [1.300-1.470]) and female subgroups (HR 1.369, 95%CI [1.230-1.524]). History of viral hepatitis or frequent alcohol consumption did not affect the results (data not shown). Conclusions FIB-4 index is a useful predictor of the development of hypertension in the general population. Increased risk of cardiovascular events in patients with NAFLD may partially be attributable to the development of or coexistence with hypertension.

The impact of maternal serum biomarkers on maternal and neonatal outcomes in twin pregnancies: a retrospective cohort study conducted at a tertiary hospital.

Prior prediction models used for screening preeclampsia (PE) in twin pregnancies were found to be inadequate. In singleton pregnancies, various maternal biomarkers have been shown to be correlated with negative pregnancy outcomes. However, the impact of these biomarkers in twin pregnancies remained uncertain. A retrospective cohort study was carried out on 736 twin pregnancies at a tertiary hospital in Hangzhou, China. Multivariable logistic models were employed to examine the association between levels of serological markers and the likelihood of adverse pregnancy outcomes. The final logistic model was formulated as a user-friendly nomogram. The primary outcome assessed was the occurrence of PE. Results were presented as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). The prevalence of PE in the study was 10.3%. When comparing women diagnosed with PE to those without, it was evident that the former group experienced a significantly higher risk of unfavorable maternal and neonatal outcomes. A multivariable logistic regression analysis revealed notable associations between various factors including maternal age, parity, gestational weight gain, a family history of hypertension, as well as levels of cholesterol, albumin, and creatinine and the risk of developing PE, with a significance level of P < 0.05. The concordance index for the constructed nomogram was determined to be 0.792 (95% CI: [0.739-0.844]). Furthermore, an increment of 1 * 1012/L in red blood cell (RBC) count was associated with more than a two-fold increase in the odds of experiencing adverse maternal outcomes (OR 2.247, 95% CI: [1.229-4.107]). However, no significant correlations were identified between any of the examined variables and neonatal outcomes. In this study, we developed a user-friendly predictive model that achieves notable detection rates by incorporating maternal serum biomarker levels alongside maternal characteristics and medical history. Our findings indicate that the probability of adverse maternal outcomes increases with elevated levels of RBCs. Obstetricians should consider intensifying surveillance for these women in clinical practice.

Prediabetes and Associated Risk Factors among Undergraduate Medical Students in Bangladesh

Background: Early detection and timely intervention of prediabetes is an important first step in preventing the disease. Objectives: To assess the prediabetes and associated risk factors in medical students of Bangladesh. Materials and Methods: A cross-sectional study was done among 252 medical students of Shaheed Ziaur Rahman Medical College, Bogura. Data related to demography with some behavioral factors, anthropometry, blood pressure, fasting plasma glucose, family history of hypertension (HTN) and diabetes mellitus (DM) were collected. Prediabetes was assessed by the American Diabetes Association (ADA) and World Health Organization (WHO) criteria. Results: The proportion of prediabetes was 13% according to ADA and 1.6% according to WHO respectively. Students with a positive family history of hypertension (HTN) had more prediabetes compared to those who didn’t have. None of the demographic factors, family history of DM or HTN, exercise and obesity were related between prediabetic and normal students, though prediabetic students had more proportion of family history of HTN. Conclusion: Prediabetes is proportionately high among students with positive family history of HTN. We recommend a regular checking of fasting plasma glucose of medical students with special attention to those who have a strong positive family history of DM and HTN. KYAMC Journal Volume: 15, No: 01, April 2024: 20-24.

Pregnancy-induced Hypertension: What Are the Associated Factors in Rural Areas? A Study from Rural Dehradun, Uttarakhand

Abstract Background: Pregnancy-induced hypertension (PIH) is a major significant cause of adverse pregnancy outcomes – mortality and morbidities in both mother and foetus. Aims: The present study aims to determine the prevalence of PIH and its associated factors among pregnant women attending antenatal care in rural field areas of a tertiary care hospital in Uttarakhand. Patients and Methods: A cross-sectional study was conducted on pregnant women-seeking antenatal services from January 2020 to October 2020 at three sub-centres (Raiwala, Pratit Nagar and Haripur Kala) of the Primary Health Centre (Raiwala) after giving informed consent. A sample size of 113 was calculated and included in our study. A pre-tested structured schedule was used to interview the study participants after a pilot test. Blood pressure was determined using an average of three measurements, and some clinical and laboratory findings were reviewed from medical records; these were mainly the mother-child protection card. Data were presented as frequency, percentage frequencies and the results are presented with the table. Fisher’s exact statistics were calculated for the association with pregnancy-induced hypertension, and logistic regression was performed to identify independent predictors. P &lt;0.05% was considered statistically significant. Results: The prevalence of PIH among total study participants in Dehradun District, Uttarakhand, was 6.2% (95% confidence interval [CI], 1.8%–10.6%). The majority of respondents were noted in ≤ 30 years of age group (91.15%), followed by &gt; 30 years of age group (8.84%). In univariate regression, factors such as age, pre-term birth, abortion, pedal oedema, blurred vision, proteinuria, present history of gestational diabetes mellitus, present history of diabetes, present history of other morbidities, past history of diabetes, past history of other morbidities, i.e. surgeries, otitis media, obesity and thyroid, family history of hypertension and family history of diabetes were associated with pregnancy-induced hypertension. In multivariate logistic regression, maternal age (adjusted odds ratio AOR = 18.29, 95 CI% =2.3–141.4, P = 0.005*), pre-term birth (AOR = 61.7, 95% CI = 3.5–1071.3, P = 0.005*), (proteinuria AOR = 8, CI = 0.80–79.6, P = 0.006*), gestational diabetes (AOR = 19.9, CI = 2.9–133.06, P = 0.002*), history of other morbidities (AOR = 13.4, 95% CI; 1.7–106.5, P = 0.014*) and family history of diabetes (AOR; 8.7, 95% CI = 1.7–43.3, P = 0.008*) were found as the predictor factors for developing PIH. Conclusions: Early detection and treatment of pregnancy-induced hypertension and risk factors in pregnant women by healthcare professionals and policy-makers at the community level should be strengthened.

Exaggerated Blood Pressure Response to Exercise Is a Risk of Future Hypertension Even in Healthy, Normotensive Young Individuals—Potential Preventive Strategies for This Phenomenon?

Physical activity and regular exercise are well known to reduce the risks of cerebrovascular and cardiovascular diseases, leading the American College of Sports Medicine to endorse the concept that “exercise is medicine”. However, a single bout of exercise temporarily raises arterial blood pressure (BP) to meet the metabolic demands of working muscle, and this BP response is particularly exaggerated in older adults and patients with cardiovascular conditions, such as hypertension, resulting in an exaggerated BP response during exercise. This presents a paradox: while regular exercise is crucial for preventing these diseases, excessively high BP responses during exercise could increase the risk of vascular damage. The mechanisms underlying this exaggerated BP response during exercise remain unclear, and effective exercise regimens for these populations have yet to be established. Currently, low-intensity exercise is recommended; however, its efficacy in disease prevention is uncertain. Notably, even among healthy individuals, there is significant variation in the BP response to exercise. Some healthy individuals, despite having normal resting BP, exhibit an exaggerated BP response during physical activity. Importantly, these individuals are often unaware that their BP becomes excessively elevated during physical activity. Repeated exposure to these heightened BP responses through regular physical activity may increase their long-term risk of cardiovascular disease. How can we prevent disease development in these individuals while still ensuring the effectiveness of exercise? Some studies have shown that individuals with a family history of hypertension may experience this phenomenon even in children and adolescents. Additionally, left ventricular hypertrophy contributes to an exaggerated BP response to exercise, suggesting a possible genetic influence. Conversely, other reports indicate that factors such as arterial stiffness, obesity, and low exercise capacity also contribute to this exaggerated response. Our recent preliminary data suggest that the cognitive benefits of exercise may be diminished in individuals who exhibit an exaggerated BP response during exercise. This implies that individuals with an exaggerated BP response, despite having normal resting BP, may not fully benefit from exercise. In this perspective paper, we review the physiological aspects of this phenomenon and explore strategies to address it. Additionally, we discuss BP responses in athletes within this content. Our goal is to prevent disease while maximizing the benefits of exercise for healthy individuals with an exaggerated BP response, as well as for elderly and cardiovascular patients.

Prediction of pre-eclampsia with machine learning approaches: Leveraging important information from routinely collected data

BackgroundGlobally, pre-eclampsia (PE) is a leading cause of maternal and perinatal morbidity and mortality. PE prediction using routinely collected data has the advantage of being widely applicable, particularly in low-resource settings. Early intervention for high-risk women might reduce PE incidence and related complications. We aimed to replicate our machine learning (ML) published work predicting another maternal condition (gestational diabetes) to (1) predict PE using routine health data, (2) identify the optimal ML model, and (3) compare it with logistic regression approach. MethodsData were from a large health service network with 48,250 singleton pregnancies between January 2016 and June 2021. Supervised ML models were employed. Maternal clinical and medical characteristics were the feature variables (predictors), and a 70/30 data split was used for training and testing the model. Predictive performance was assessed using area under the curve (AUC) and calibration plots. Shapley value analysis assessed the contribution of feature variables. ResultsThe random forest approach provided excellent discrimination with an AUC of 0.84 (95% CI: 0.82–0.86) and highest prediction accuracy (0.79); however, the calibration curve (slope of 1.21, 95% CI 1.13–1.30) was acceptable only for a threshold of 0.3 or less. The next best approach was extreme gradient boosting, which provided an AUC of 0.77 (95% CI: 0.76–0.79) and well-calibrated (slope of 0.93, 95% CI 0.85–1.01). Logistic regression provided good discrimination performance with an AUC of 0.75 (95% CI: 0.74–0.76) and perfect calibration. Nulliparous, pre-pregnancy body mass index, previous pregnancy with prior PE, maternal age, family history of hypertension, and pre-existing hypertension and diabetes were the top-ranked features in Shapley value analysis. ConclusionTwo ML models created the highest-performing prediction using routinely collected data to identify women at high risk of PE, with acceptable discrimination. However, to confirm this result and also examine model generalisability, external validation studies are needed in other settings, utilising standardised prognostic factors.

A comparative study between current and past Helicobacter pylori infection in terms of microalbuminuria in patients with type 2 diabetes

BackgroundThe prevalence of Helicobacter pylori (H. pylori) infection and its potential relationship to various diseases is currently a focus of attention. The aim of this study is to investigate the association between current and past H. pylori infections and elevated levels of microalbuminuria in type 2 diabetic patients.MethodsTwo hundred patients with type 2 diabetes mellitus were tested for the presence of H. pylori infection. They were divided into three groups: 52 had a current H. pylori infection, 38 had a past H. pylori infection, and 110 had no H. pylori infection. All study participants underwent assessments of plasma glucose levels, glycated hemoglobin (HbA1c), albuminuria levels, inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), as well as other relevant investigations.ResultsThe prevalence of H. pylori infection (current and past) was detected in 90 out of 200 diabetic patients (45%). There was no statistically significant difference between the three groups in terms of age, diabetes duration, family history of DM, family history of hypertension, residence, or dyspeptic symptoms, indicating that current or past infection with H. pylori has no association with these variables. The current H. pylori infection group showed the highest levels of inflammatory markers, ESR and CRP, which were significantly different from those in the non-infected group (p = 0.013 and p < 0.001, respectively). The median (IQR) of albuminuria levels in the current H. pylori infection group, the past H. pylori infection group, and the non-infected group were 125 (4.8–290), 7.6 (2.4–271), and 5.1 (1.2–173), respectively. The current H. pylori infection group showed the highest albuminuria level, which was significantly different from that of the non-infected group (p = 0.001).ConclusionThere might be an association between microalbuminuria levels, general inflammatory markers (ESR and CRP), and current H. pylori infection in type 2 diabetic patients.

Association of socioeconomic and lifestyle factors with prevalence of diabetes in rural southwest China: a structural equation modelling approach

ObjectivesThis study aimed to investigate the prevalence of diabetes using structural equation modelling (SEM) to examine the pathways and associations of socioeconomic and lifestyle factors on diabetes in rural southwest...

Positive genetic effect of hypertension family history on stroke: A cross Mendelian randomization study

BackgroundClinical observational study demonstrated that hypertension is an independent risk factor for stroke. Furthermore, both hypertension and stroke exhibit genetic predispositions. However, the genetic relationship between hypertension and stroke in first-degree relatives remains unclear. MethodThe Genetic effects were validated using an across-Mendelian randomization (MR) approach. The Genome-Wide Association Study summary data used in this study were obtained from a publicly available platform. The primary MR effect employed was inverse-variance weighted (IVW), and the other analysis methods included MR-Egger, weighted median, simple mode, and weighted mode. Prior to MR analysis, tests for MR_PRESSO, pleiotropy, and heterogeneity were conducted. ResultThe presence of family history of hypertension significantly contributed to the genetic predisposition to various types of stroke, including ischemic stroke, subarachnoid hemorrhage, lacunar stroke, cardioembolic ischemic stroke, small vessel ischemic stroke, and large artery atherosclerosis-related ischemic stroke. ConclusionBriefly, hypertension in first-degree relatives has a genetic impact on the risk of stroke development. Shared genetic factors may exist between hypertension and stroke.

IMPACT OF ANTIHYPERTENSIVE DRUGS ON C REACTIVE PROTEIN (HS-CRP) AND NEUTROPHIL LYMPHOCYTE RATIO (NLR)

Many studies showed the association between inflammation and Hypertension. Inflammatory markers may highlight the state of inflammation in hypertensive patients. This study aimed to investigate impact of antihypertensive drugs on high sensitive C-reactive protein (hsCRP) and neutrophil lymphocyte ratio (NLR). A comparative cross sectional study was conducted on 86 hypertensive patients attending cardiology outpatient clinic in Al-Gamhuoria Modern General Hospital, Aden, in the period from October to December 2023. Participants were divided into three groups: patients treated with mono-therapy from inhibitors of renin angiotensin aldosterone system (RAASI), patients treated with mono-therapy antihypertensive not acting on RAAS (NRAASI) and patients treed with combination of them (drug combination). Data on Age, Sex, BP level, BMI, duration of hypertension (HTN), family history of HTN, and medications used were collected. Blood samples for measuring HsCRP, neutrophils, lymphocytes were drawn. Descriptive statics and chi-square tests were used for data analysis. Almost equivalent distribution for males and females between groups, with a large proportion of the patients within each group laid in the age group 35-55 years. The median values of hypertension duration were 36, 48, and 54 months for RAASIs, NRAASIs and drug combination group, respectively. The target BP was obtained by 46.9% 45.5% and 50% of patients treated with RAASIs, NRAASIs and drug combination respectively. There was a statistically significant difference between SBP and DBP in patients with controlled BP and those with uncontrolled SBP levels and treated by different drug regimens (P=0.000 for each Bp level). There were significant differences between values of hs-CRP of patients with controlled (P=0.000) or uncontrolled (P=0.046) BP and treated with different modalities. The median differences in NLR between the groups were statistically significant; including groups of all patients P=.032, of patients having controlled BP P=0.014 as well as uncontrolled BP P=0.038. Comparing the uncontrolled of BP of the three groups we found the highest prevalence (9.3%)of patients with uncontrolled BP and had the lower level hsCRP (≤3mg /l) was in RAASIs group, while those with higher prevalence (11.6%) of uncontrolled BP and higher level of hs-CRP ( &gt;3mg/l) was in drug combination group. In conclusion, hypertensive patients treated with RAASI, NRAASI and drug combination and reached BP target showed significant reduction in hsCRP and NLR. Patients with uncontrolled BP treated with RAASIs revealed slightly lower hs-CRP than other groups. Careful selection of antihypertensive drugs may affect risks of CVD. This study recommends further prospective studies exploring the anti-inflammatory effect of antihypertensive drugs to ameliorate possible risks of cardiovascular disease.

MANAGEMENT OF GESTATIONAL HYPERTENSION THROUGH FAMILY MEDICINE APPROACH: CASE REPORT

Several factors contribute to the incidence of hypertension during pregnancy, including a familial history of hypertension, obesity, and unhealthy dietary habits. Family habits can have a substantial impact on lifestyle, especially nutritional choices. This report presents a case of gestational hypertension in Mrs. DK, a 20-year-old pregnant woman with obesity, who was managed utilizing a family medicine approach. The identified root cause of her problem as an inherited genetic susceptibility to hypertension, exacerbated by poor dietary habit within the family. Mrs. DK and her family was given comprehensive intervention to ensure a healthy pregnancy. This strategy provided her with results in the form of controlled blood pressure and enhanced understanding of her condition and nutritional requirements, as well as strategies to fulfill them. Ongoing surveillance is necessary to guarantee that goals are being met.

Diastolic Blood Pressure Response During Non-isometric Exercise and Its Relationship with Family History of Hypertension

The purpose of this study was to find an association (if any) between isolated diastolic blood pressure response to non - isometric exercise and family history of hypertension. Diastolic blood pressure response (DBPR) of 32 apparently healthy young adults (aged 18 - 30 years) were noted during 10 minutes of cycling on a bicycle ergometer and during their recovery after exercise and their family history of hypertension were recorded by a separate observer.4 sets of data were rejected due to faulty technique and rest 28 sets of data were checked for association by a 2 by 2 contingency table and by performing Chi - Square test.17 subjects showed normal DBPR, 11 of them did not have any family history of hypertension, which should be a normal occurrence. And out of 11 subjects with abnormal/exaggerated DBPR, 6 had positive family history of hypertension, which was inconclusive. The test result gave us a more than 25% chance of randomness of association between abnormal/exaggerated DBPR and family history of hypertension, which refuted the association, meaning abnormal/exaggerated DBPR to non - isometric exercise and family history of hypertension can both be predictors of future hypertension but there is no association between them.

Prevalence and Risk Factors for Secondary Hypertension in Young Adults.

The prevalence of secondary causes of hypertension in young adults is unknown, and therefore, there is no consensus about the indication of screening of secondary hypertension (2HTN) in this population. The objective was to report the prevalence and the causes of 2HTN in young subjects. 2090 patients with confirmed hypertension aged 18 to 40 years with full workup for 2HTN screening were included in this cross-sectional study. We assessed the prevalence of 2HTN and analyzed the factors associated. 619/2090 patients (29.6%) had a 2HTN. The most frequent diagnoses of 2HTN in descending order were primary aldosteronism (n=339; 54.8%), renovascular hypertension (n=114; 18.4%), primary kidney disease (n=80; 12.9%), pheochromocytoma/functional paraganglioma (n=37; 5.9%), hypertension caused by drugs or substances (n=32; 6.0%), and other diagnoses (n=17; 2.7%). Patients with blood pressure <160/100 mm Hg did not have a lower prevalence of 2HTN regardless of the number of treatments. The prevalence of 2HTN was higher in the decade between 30 and 40 years of age than between 18 and 30 years of age (P=0.024). Female sex, hypokalemia, treatment with at least 2 medications, no familial history of hypertension, body mass index <25 kg/m², and diabetes were associated with a higher prevalence of 2HTN. The prevalence of 2HTN is high among young patients with hypertension (29.6% in our cohort), regardless of age and blood pressure level. All patients with hypertension under 40 years of age should be screened for secondary causes.