Family History Of Hypertension Research Articles

Maternal Cardiac Functional and Structural Changes in Preeclampsia: an Echocardiographic Study

Background & objective: Preeclampsia is a pregnancy-induced multi-organ syndrome of acute cardiovascular manifestations with significant short and long-term sequelae. However, there is a relative lack of knowledge with respect to cardiac functional and structural changes in women with preeclampsia Therapeutic interventions used in the management of preeclampsia may cause iatrogenic adverse consequences due to this lack of knowledge. The present study was therefore designed to evaluate the echocardiographic changes in cardiac structural and functional indices in pregnant women with PE. Methods: This cross-sectional study was carried out in the Department of Obstetrics and Gynaecology Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College Hospital (DMCH), and Shaheed Suhrawardy Medical College Hospital (SSMCH) in collaboration with National Institute of Cardiovascular Diseases (NICVD), Dhaka over a period of one year from July 2013 to June 2014. A total of 30 single-tone pregnant women of 20-40 weeks gestation with preeclampsia were taken as cases. An equal number of gestationally-matched healthy pregnant (HP) women of similar age cohorts having no history of preexisting hypertension were included as controls. Preeclampsia was defined as SBP ≥140and/or DBP ≥ 90 mmHg after 20 weeks gestation in a woman with previously normal blood pressure and with proteinuria≥1 + in the dipstick test. Pregnant women with systolic and diastolic blood pressures within the normal range (< 140mmHg and > 90 mmHg respectively), trace or absence of proteinuria by dipstick test were defined as controls. All thesubjects were investigated with ECG, standard two-dimensional, M-mode, and Doppler transthoracic echocardiography. The cardiac functional and structural changes were measured in terms of interventricular septal thickness (IVSTd),posterior wall thickness (PWTd), left ventricular internal diameter at the end of diastole (LVIDd), ejection fraction (EF), transmitral velocity (MV E/A ratio), MV deceleration time (MV DecT). Result: Half of the women with preeclampsia were primigravidae and there was no association between gravidity and the occurrence of preeclampsia. Prepregnancy overweight or obesity (in terms of BMI) was found to be strongly associated with preeclampsia. One in 10 PE women had a previous history of preeclampsia as opposed to none in the HP women. A substantial proportion (56.7%) of PE women had a family history of hypertension in comparison to healthy pregnant women (16.3%). The women with PE had significantly higher SBP, DBP, & MAP than the HP women. Parameters of diastolic dysfunction, like mitral E/A ratio was reduced and deceleration time was prolonged in PE with diastolic dysfunction (mean E/A ratio < 0.73 and mean DceT >178 ms respectively) than those in PE with normal diastolic function (mean E/A ratio 1.2 and mean DceT 192.4 ms respectively) healthy pregnant women (mean E/A ratio 1.3 and mean DecT 186.5 ms respectively). Over one-third (36.7%) of women with PE met the criteria of diastolic dysfunction compared to none in healthy pregnant women. The LVH appears to be a frequent occurrence in pregnancies complicated by preeclampsia (43.3%) as compared to none in healthy pregnant women. In the present study, the systolic function was assessed with the help of EF, which was well-preserved both in PE and HP with no significant intergroup difference. Conclusion: Preeclampsia is associated with left ventricular diastolic dysfunction and hypertrophy preserving the systolic function. These structural and functional changes are primarily adaptive in nature for maintaining cardiac systolic function. Ibrahim Card Med J 2022; 12 (2): 32-39

Hypertension doctors' awareness and practice of medication adherence in hypertensive patients: a questionnaire-based survey.

Poor adherence to antihypertensive drugs is a major cause of unsatisfactory blood pressure control. Hypertension doctors play an integral role in improving medication adherence in hypertensive patients. Although most existing studies have recognized the status quo and influencing factors of medication adherence, little attention has been paid to hypertension doctors' awareness and practice in hypertension management. Therefore, in this study, we aimed to investigate hypertension doctors' awareness and practice of medication adherence in hypertensive patients. This is a cross-sectional survey. A self-reported questionnaire was developed and sent to hypertension doctors in Hunan province, China, between May 1, 2022 and July 1, 2022. Univariate and generalized linear models were used to identify the factors influencing hypertension doctors' awareness and practice. The correlation between awareness and practice was determined using Spearman's correlation coefficient. In total, 236 valid questionnaires were collected (valid response rate, 73.5%). Of the respondents, 44.1% were chief physicians and 64.4% were females. Approximately half of the respondents were ≥40 years old and had over 14 years of working experience. Most respondents (87.7%) did not have hypertension, but 54.2% had a family history of hypertension. The average awareness and practice scores were 29.8 ± 8.8 and 39.4 ± 7.1, respectively, out of 50, with higher scores indicating higher levels of awareness or practice. More hypertension consultations and more antihypertensive prescriptions issued were associated with better awareness and practice among respondents (ps < 0.05). Respondents with higher education and professional titles had higher awareness (ps < 0.05). Moreover, respondents with 6-13 years of work experience had better practice than those with <5 years of work experience (p = 0.017). There was a significant correlation between hypertension doctors' awareness and practice of medication adherence in hypertensive patients (R = 0.682, p < 0.001). These findings indicate that misconceptions persist in hypertension doctors' awareness and practice of patient medication adherence. Hypertension doctors lack sufficient and correct awareness and practice of medication adherence in hypertensive patients.

Prevalence of and Factors Associated With High Blood Pressure at 15 Years of Age: A Birth Cohort Study.

Arterial hypertension is the greatest cause of morbidity and mortality worldwide. Our aim was to investigate the prevalence of and factors associated with high blood pressure (HBP) among adolescents. The Pelotas 2004 Birth Cohort included 4231 newborns from hospital births in Pelotas, Brazil. A digital automatic OMRON sphygmomanometer (model HEM 742) was used to measure blood pressure on 3 occasions (at 6, 11, and 15 years of age). Those with blood pressure ≥95th percentile for age, height, and sex on each of the 3 occasions were considered as presenting HBP. Independent variables included family (income and history of arterial hypertension), maternal (schooling, age, pregestational body mass index, and smoking during pregnancy), and adolescent characteristics at birth (sex, skin color, gestational age, intrauterine growth, and systolic and diastolic genetic factors), and at 15 years (sleep, physical activity, sodium intake, screen time, work, body mass index, fat mass index, fat-free mass index, growth pattern, and puberty status). The prevalence of HBP (95% CI) was calculated. Crude and adjusted odds ratios (ORs) stratified by sex were obtained by logistic regression. A total of 1417 adolescents with complete information on blood pressure on the 3 occasions were analyzed. The prevalence of HBP was 3.2% (95% CI, 1.9%-4.5%) in female adolescents and 4.3% (95% CI, 2.8%-5.8%) in male adolescents. Female adolescents with a family history of arterial hypertension had a 3 times higher chance of HBP than their counterparts (OR, 3.1 [95% CI, 1.26-7.54]). In male adolescents, excessive maternal pregestational weight was associated with a 2.3-fold increase in the chance of HBP. In both sexes, excessive adolescent weight was associated with HBP (ORs, 3.5 and 5.0, for female and male adolescents, respectively). A higher fat mass index and fat-free mass index in female (ORs, 1.4 and 1.2, respectively) and male adolescents (ORs, 2.5 and 3.0, respectively) increased the chance of HBP. Among male adolescents, the chance of HBP was higher among those with rapid weight gain between 48 months and 6 years and between 6 and 11 years and rapid height gain between 6 and 11 years. Higher fat mass in both sexes and rapid weight gain in male adolescents are risk factors for HBP in adolescents aged 15 years, potentially amenable to prevention.

Prevalence of undiagnosed hypertension and associated factors among adults in Durame town, Southern Ethiopia: a cross-sectional study.

Undiagnosed hypertension is a major public health problem causing severe cardiovascular disorders that are responsible for a high proportion of morbidities and mortalities, especially among adults living in low-income countries. However, there is a paucity of information that describes its epidemiology in Ethiopia. This study aimed to assess the prevalence of undiagnosed hypertension and associated factors among adults in Durame town, southern Ethiopia. A community-based cross-sectional study was conducted from July to September 2022. Data were collected from 526 randomly selected adults aged ≥18 years using a pre-tested questionnaire. The binary logistic regression models were used to identify factors associated with undiagnosed hypertension. The prevalence of undiagnosed hypertension among adults in Durame town, southern Ethiopia, was found to be 14.0% (95% CI: 11.2-17.1). Family history of hypertension [AOR = 6.9, 95% CI: (3.62, 13.27)], drinking too much alcohol [AOR = 5.7, 95% CI: (2.97, 10.75)], physical inactivity [AOR = 2.5, 95% CI: (1.34, 4.73)], consuming street foods regularly [AOR = 2.8, 95% CI: (1.28, 6.01)], and seeking healthcare for hypertensive symptoms without serious illness [AOR = 2.4, 95% CI: (1.28, 4.56)] were significantly associated with developing undiagnosed hypertension. The study has revealed that one in seven adults had undiagnosed hypertension in the study area. Thus, interventions to prevent hypertension should target increasing awareness among people with a family history of hypertension, controlling excessive alcohol consumption, promoting physical exercise, regulating street food markets, and improving the health-seeking behavior of adults in urban settings.

Association of early life factors with metabolic syndrome in school going adolescents of an urban south Indian population: a case control study

Background: Multiple factors are attributed for the increase in the prevalence of metabolic syndrome (MS) in adolescents. Association of early life factors like birth weight with adolescent MS is not clearly understood. Objectives were to study the association of early life factors with adolescent MS between aged 10- 15 years of Belagavi city. Methods: Study design: Case control Study. Study period: January 2018 to December 2018. Study population: Adolescents of age group, 10 to 15 years from the schools of Belagavi, 400 adolescents (186-cases and controls-214) were enrolled and who were having waist circumference ≥90th percentile for that age and gender were subjected to the laboratory investigations to diagnose MS. Data regarding early life factors like birth weight, gestational age and breast feeding was obtained by parental interview. Results: Overall prevalence as per the international diabetes federation criteria was 11% and a significant difference in the prevalence between cases and controls (15.05% vs 7.48%) (p=0.0160) was observed. Positive association was observed between initiation, exclusivity, and total duration of breast feeding with MS (OD: 3.66, 2.01, 1), indicating no protection of these factors for development of MS. Birth weight had a positive association with MS (OD=7.26). Conclusions: The study showed no protective association between the initiation, exclusivity and the total duration of breastfeeding with MS. However, lower middle SES, family history of hypertension (HTN), central obesity, high BMI, high TG, and low HDL were significantly associated with increased risk of MS.

Exploring the Iceberg: Detection and Management of Isolated Interrupted Aortic Arch and Associated Hypertension- A Rare Entity

Objectives: Prompt diagnosis and management of hypertension, particularly in younger patients, are crucial to reducing complications, mortality, and expenses. A thorough history and careful physical examination are key steps. This article illustrates one such unusual case that had a subtle presentation and went undiagnosed until it was brought to our attention.&#x0D; Methodology: A 30-year-old male patient with a history of fatigue, poor exercise tolerance, and mild headaches was diagnosed with hypertension. He was commenced on amlodipine and had no family history of cardiac diseases or secondary hypertension. The patient appeared weak and thin, with a BMI of 16.6 kg/m2. His radial pulse was regular and 98 bpm, and his brachial blood pressure was recorded at 190/90 mmHg. Further examination revealed weak lower limb pulses, a radio-femoral delay, and an ankle blood pressure of 100/60 mmHg. A 3/6 systolic murmur was noted at the aortic area. Routine laboratory investigations revealed a chest x-ray showing notching of the ribs and an absent aortic knob. A transthoracic echocardiogram was performed, but it did not provide conclusive results. A CT angiography of the chest revealed a complete interruption of the aorta just below the left subclavian artery in a "rat tail fashion." The aortic valve was normal, and no other aortic or cardiac pathology was found. The patient was diagnosed with IAA type A and surgical correction was suggested. Antihypertensive medication was given to achieve blood pressure control, and surgical correction was done involving end-to-end anastomosis. The patient's postoperative period was uneventful, and at four weeks, his symptoms subsided, and his blood pressure was 130/80 mmHg without antihypertensive medications.&#x0D; Results: The patient had an interrupted Aortic Arch type A and underwent treatment with antihypertensive medications and surgical correction. After a month, symptoms subsided, blood pressure was 130/80 mmHg, and pulses were bilaterally normal. Post-op CT Aortogram showed good anatomic continuity and no complications.&#x0D; Conclusion: Mild symptoms might only be the tip of an iceberg, calling for further exploration. IAA, despite its rarity, should be considered a potential cause of hypertension.

The Association between Betel Quid Chewing and Metabolic Syndrome Among Urban Adults in Mandalay District of Myanmar.

As the prevalence of metabolic syndrome, obesity and diabetes increase worldwide, the need to identify modifiable lifestyle risk factors also increases, especially those that may be relatively unique to a specific population. To explore a possible association between betel quid chewing and metabolic syndrome, a community-based cross-sectional study was conducted. Three hundred ninety-one (391) adults were interviewed and the following parameters were measured: triglycerides, HDL-cholesterol, glucose, waist circumference, body mass index and blood pressure. Multiple logistic regression was used to determine the association between betel quid chewing and metabolic syndrome while controlling for confounders. The prevalence of metabolic syndrome was similar in chewers and non-chewers, 50% and 49%, respectively. After controlling for other factors, development of metabolic syndrome was positively associated with number of betel quids chewed per day, age greater than 40 years, and a positive family history of hypertension and diabetes. Regarding the duration of betel chewing, when analyzed by sex, the risk was doubled in men compared to non-chewers (OR 2.15; 95% CI = 1.21, 3.84). As a result, a man chewing more than 10 pieces (OR 2.49; 95% CI = 1.36, 4.57) of betel quids per day for more than 10 years had a two-fold increased chance of developing the metabolic syndrome. Frequency and duration of betel quid chewing may represent a behavioral lifestyle target for approaches to reduce the incidence of metabolic syndrome.

Association Between Body Mass Index, Physical Activity, Stress Level, and Hypertension in Kalirejo Residents

Background: Hypertension is amongst the top 10 non-communicable diseases and is the leading cause of premature death worldwide. Multiple factors contribute to the occurrence of hypertension. Risk factors include modifiable ones, such as lifestyle, smoking habits, sleeping patterns, caffeine consumption, physical activity, high-sodium diet, and stress levels. On the other hand, factors such as gender and age are non-modifiable. A primary survey in Kalirejo, Lawang, showed that hypertension is the leading health issue. This research aims to analyze the association between body mass index, physical activity level, and stress level with hypertension in Kalirejo, Lawang.Method: This research is a correlative analytical descriptive study using the cross-sectional method that involves 99 residents aged ≥ 45 years old in Kalirejo. Results: This study revealed that the largest age group in Kalirejo is elderly people, with most respondents being female, non-smokers, and with no family history of hypertension. A majority of the respondents consume caffeine and use minimal salt. The largest BMI distribution is within the normal category (41.4%). High physical activity is found to be more frequent (45.5%), and stress level is primarily low (62.6%). Bivariate analysis shows a significant association between BMI and hypertension (p&lt;0.05). Meanwhile, physical activity and stress levels are irrelevant to the occurrence of hypertension. This study discovered that there is a significant association between BMI and hypertension, and a non-significant association between physical activity and stress level with hypertension, respectively, among pre-elderly and elderly residents in Kalirejo.

Preeclampsia and its determinants in Ethiopia: A systematic review and meta-analysis.

Preeclampsia is a serious condition that is linked to poor perinatal outcomes. In Ethiopia, the overall prevalence of preeclampsia and its associated factors is uncertain. Therefore, the purpose of this review was to find the prevalence of pre-eclampsia and its determinants in Ethiopia. To find primary studies, PubMed, Google Scholar, HINAR, Scopus, the Web of Sciences, and grey literature searches were used between January 1, 2013, and January 1, 2023, in Ethiopia. A Microsoft Excel sheet was used to extract data. The pooled prevalence of pre-eclampsia was predicted using a random-effect model. Twenty-nine studies were included. The pooled prevalence of pre-eclampsia was 11.51% (95% CI: 8.41, 14.61). Age > 35 years old (AOR = 2.34, 95%CI, 1.74-2.94; p-value = 0.64), housewife (AOR = 2.76, 95%CI, 1.2-4.32; p-value = 0.37), previous history of pre-eclampsia (AOR = 4.02, 95%CI, 2.91-5.55; p-value = 0.09), family history of hypertension (OR = 1.84, 95%CI, 1.39-2.3; p-value = 0.4), history of chronic hypertension (AOR = 2.44, 95%CI, 1.8-3.08; p-value = 0.67), history of multiple pregnancies (AOR = 1.45, 95%CI, 1.09-1.8; p-value = 0.38), and alcohol intake during pregnancy (AOR = 1.53, 95%CI, 1.03-2.04; p-value = 0.03) were the determinants of pre-eclampsia. When compared to previous studies, the overall pooled prevalence of pre-eclampsia was high. Pre-eclampsia is associated with maternal age >35 years, being a housewife, having a history of preeclampsia, having a history of chronic hypertension, having a family history of hypertension, having diabetes mellitus, drinking alcohol during pregnancy, and having multiple pregnancies.

The Clinical Profile and Hospital-based Outcome of Acute Myocardial Infarction in Elderly Patients More than 60 Years and Patients Younger than 60 Years: A Comparative Study

Background: Acute myocardial infarction refers to a pathological state characterized by the obstruction of blood supply to the myocardium, resulting in the subsequent necrosis of cardiac tissue. It constitutes a significant etiological factor contributing to the development of heart failure and global mortality rates. Objective: The purpose of this study was to conduct a comparative analysis of the clinical characteristics of acute myocardial infarction in old and young individuals who sought medical attention at a tertiary care hospital. Methods: This cross-sectional observational study was done from January 2023 to June 2023 at the Mymensingh Medical College Hospital, Mymensingh, Bangladesh. A total of 100 people were observed in this study. Result: We have two age groups: under 60 (60%) and over 60 (40%). We name them A and B. Group A patients are 86.7% male and 13.3% female. Group A patients are 88.3% Muslim and 7% Hindu. This patient group includes 30% service workers and 20% businesses. The remaining 28.3% were patients from diverse jobs and 1.7% were farmers. With 55% male and 45% female Muslim patients, Group B includes domestic workers (45%) and businessmen (22.5%). Service workers 17%, farmers 2.5%, and other patients 12.5%. Group A had 85% chest pain, 46.7% dyspnea, 90% palpitations, and 86.7% nausea and vomiting. Ischemic chest pain, dyspnea, palpitations, nausea, and vomiting affected 87.5% of Group B.Top MI risk factors. Group A had dyslipidemia (95%), family history of MI (93.3%), sedentary lifestyle (91.7%), smoking (88.3%), hypertension (86.7%), and diabetes (78.3%). The sedentary lifestyle, 100% family history of ischemic heart disease, 97.5% dyslipidemia, and 77.5% diabetes and hypertension characterized Group B. Lastly, our study reports patients' average pulse and blood pressure. In Group A, the average pulse was 81.73 ± 14.60, systolic blood pressure was 129.50 ± 20.28 mmHg, and diastolic blood pressure was 89.41 ± 12.35. Group B had an .......

Genetic predisposition to high blood pressure and out-of-office hypertension: insights from a population sample in Liechtenstein

Abstract Genetic predisposition is a risk factor for office hypertension. We tested whether genetic background could identify individuals with ambulatory daytime hypertension in a sample of white Europeans from Liechtenstein. We evaluated two measures of predisposition to hypertension: family history and polygenic risk scores (PRS). Our analytic sample contained 1444 participants aged 25 to 41. 12% of participants had office hypertension, while 37% had out-of-office hypertension. The correlation between blood pressure PRS and family history of hypertension was low (R2 = 4.96x10-3), but both were strongly associated with ambulatory blood pressure (2.2 mmHg per 1 SD increase [95% CI: 1.6, 2.7] &amp; 2.4 mmHg increase with positive family history [95% CI: 1.3, 3.4], respectively). PRS provides incremental improvement in predicting ambulatory systolic blood pressure beyond a validated blood pressure prediction algorithm (ΔAIC = -33), whereas family history does not (ΔAIC = 1). The difference in performance between a baseline algorithm for identifying ambulatory systolic daytime hypertension (positive likelihood ratio of 6.87 [95% CI: 5.56, 8.49]; negative likelihood ratio of 0.45 [95% CI: 0.39, 0.51]) and the same model with PRS integrated (positive likelihood ratio of 7.69 [95% CI: 6.18, 9.57]; negative likelihood ratio of 0.43 [95% CI: 0.37, 0.49]) was modest. In conclusion, in a European sample from Liechtenstein, PRS and family history represent distinct constructs associated with ambulatory blood pressure. Unlike family history, polygenic risk scores provide incremental information identifying individuals with ambulatory hypertension. However, these gains are modest and warrant further development to improve performance at the point-of-care.

Retrospective analysis of confirmed cases of pulmonary veno-occlusive disease: a single tertiary referral center study

Abstract Background Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary hypertension that primarily results in intimal fibrosis of the pulmonary venules and veins, the venous lesions are often associated with changes in interlobular septa, lung parenchyma, and pulmonary arterioles and arteries. Purpose We sought to study the clinical characteristics of patients with confirmed PVOD at a single large referral center. Methods We retrospectively reviewed data from a total of 675 patients with pulmonary hypertension (identified by ICD codes or search of text) from 2017 and 2022 from a database obtained from electronic medical records at our institution. Patients with group 2 pulmonary hypertension were excluded. Only 29 cases were confirmed by histology or genetic testing. Results Out of the 29 patients confirmed with PVOD, 28 (96.5%) had a characteristic histology (lung biopsy (55.1%), explanted lung for transplant (27.5%) and autopsy (13.7%)) and 1 (3.4%) had a positive genetic test for EIF2AK4 biallelic mutation. The age at diagnosis was 53±16 years, 14 (48.2%) were men, 2 (6.8%) had systemic scleroderma, 2 (6.8%) had psoriasis, 2 (6.8%) were exposed to cytotoxic agents, 16 (55.1%) were smokers and 2 (6.8%) had a family history of pulmonary hypertension. All patients had computed tomography of the chest but only 12 (41.3%) had all 3 typical features found in PVOD (ground glass opacities, interlobular septal thickening, and lymphadenopathy). The most common feature was interlobular septal thickening in 26 (89.6%), followed by ground glass opacities present in 25 (86.2%) and lymphadenopathy in 12 (41.3%) of the patients. At diagnosis, mean pulmonary artery pressure was 45±15 mmHg and pulmonary vascular resistance was 9±6 WU. The median DLCO was 41 (34-58) %. On echocardiogram, 14 (48.2%) had severely enlarged right ventricle (RV), RV function was ≥moderately reduced in 17 (58.6%), RV systolic pressure was 63±20 mmHg and 6 (20.6%) had pericardial effusion. Out of 21 (72.4%) patients who received pulmonary vasodilators, 4 (13.7%) received single agent. 10 (34.4%) received 2 agents, 6 (20.6%) 3 agents, and 1 (3.4%) received 4 agents. 35.7% of these treated patients reported an improvement or initial worsening of symptoms with subsequent improvement afterwards. 18 (62%) patients with PVOD died, 12 (41.3%) had a lung transplant and 6 (20.6%) were still alive without the transplant until the day data was collected. Mean duration from diagnosis to death and lung transplantation was 446 ± 405 days and 274±479 days respectively. Conclusion PVOD is a rare and lethal cause of pulmonary hypertension. When suspected, a trial of medical therapy should be initiated carefully. The evaluation for lung transplant should be considered early given its high mortality.

Psychosocial and Perceived Stress Associated with Pre-eclampsia in a Periurban Hospital

Pre-eclampsia complicates about 2% of pregnancy Exact aetiology of Pre-eclampsia is not known, however a number of psychosocial factors are often found to be associated with it. The purpose of the study was to ascertain the prevalence of psychosocial factors and perceived stress among patients with Pre-eclampsia. This was a cross sectional study done at institute of child and mother health during July to September, 2015. Total 71 women admitted for delivery with diagnosis of Preeclampsia were interviewed in the postnatal ward within three days of delivery using a structured questionnaire. Informed consent was taken. Data analyzed using SPSS version 22. Mean age was 23.9± 4.3 years with a range of 18-36 years, about a quarter were illiterate. Majority of them stay within extended family and mean household family member was 6.25± 1.93 about 77.5% of husbands were smokers, history of abortion was present in 21.1%. More than half of them have history of hypertension or diabetes in the family. Mean Systolic BP was 122.6±21.3 and mean diastolic BP was 83.5±14.6. About 42.2% reported that their family members were not aware of need of proper nutrition during pregnancy rather were indifferent. Ability to spend money by her was limited, sometimes by 33.8%, 28.2% if they ask for and 36.6% never have the opportunity. On recall of last one month period a significant proportion of women stated that they felt to be stressed sometimes during pregnancy. Risk factors for Preeclampsia like family history of Hypertension and Diabetes, passive smoking, low education level was found quite prevalent among women with pre-eclampsia. Majority of women reported to experience moderate stress and prevalence of stress was more among 19-24 years age group. Bangladesh J Obstet Gynaecol, 2022; Vol. 37(2): 119-126

Association between endometriosis and risk of type 2 diabetes: Results from the prospective E3N cohort.

Several studies suggest an association between endometriosis and the risk of cardio-metabolic diseases. This study aimed to prospectively evaluate the association between history of endometriosis and incident type 2 diabetes. E3N is a prospective cohort of 98,995 French women aged 40-65years at inclusion. Multivariable Cox regression models were used to estimate hazard ratios and 95% confidence intervals for the association between endometriosis and incident type 2 diabetes. We evaluated effect modification by age, body mass index, infertility treatment, adherence to the Mediterranean diet, and menopausal status. Age at inclusion was 51±6years and there were 2672 incident cases of type 2 diabetes. A total of 4606 women reported surgically-confirmed endometriosis among 83,582 women with no history of diabetes at inclusion. Endometriosis was not associated with type 2 diabetes risk in a model adjusted for age, BMI, physical activity, smoking, education, age at menarche and oral contraceptive use (hazard ratio [HR]=1.09; 95% confidence interval [CI]=0.92-1.29), neither after further adjustment for family history of diabetes, hypertension and menopausal status (HR=0.97;95%CI=0.80-1.16). The relationship did not differ by age at inclusion, BMI, infertility treatment, diet or menopausal status (p>0.05). Surgically-confirmed endometriosis was not associated with the risk of type 2 diabetes in this large cohort, confirming that endometriosis is not a risk marker for type 2 diabetes.

Prevention is better than cure: identifying and dealing with the key features involved in the prevention of gestational diabetes - A bird's eye view.

Gestational diabetes (GDM) is considered to be the most common metabolic problem of pregnancy, which, if not recognized and treated on time, can lead to devastating effects on both the mother's health and the health of the fetus and the newborns. Many studies have revealed that the children born of GDM mothers or grandmothers have higher chances of developing diabetes type I or type II later in their life. Early identification of risk factors can help prevent the appearance of severe GDM and its complications witnessed both in the child and the mother. Obesity is one of the major risk factors that should not be ignored, and obese females should first undergo weight reduction plans in case of planned pregnancies. Other risk factors include a family history of DM arterial hypertension, significant weight gain during pregnancy, short sleep duration, women's exposure to stressful environments, changes in alpha and beta microbiota, and air pollution. Proper care should be provided to females of reproductive age both before and during pregnancy to avoid complications. Awareness programs for healthy lifestyles and diets, oral hygiene maintenance guides, and regular health check-ups can all be considered as a key to a healthy society. Expanding the analysis of gut microbiota in individuals at a heightened risk of GDM can hold particular value, especially during the preconception phase. The alterations in gut microbiota can serve as crucial factors in enhancing lifestyle modifications prior to conception. Further studies are required in this direction to decrease the prevalence of GDM, and efficient measures should be implemented before the consequences appear.

Prevalence of hypertension and its risk factors among urban school children of Belagavi- a cross sectional study

Background: Primary hypertension is becoming common among apparently healthy children. Measures for early diagnosis of pre hypertension and hypertension along with its risk factors during childhood could benefit from earlier intervention and follow-up. Methods: This cross sectional study was conducted among 270 urban school students of Belagavi of class 10th in 2016 by using a structured questionnaire followed by anthropometry and blood pressure measurement. Results: About 39% of children had family history of hypertension and 27% had family history of chronic diseases. Majority had inadequate consumption of vegetables (84.07%) and fruits (83.70%). The overall physical activity among the students was inadequate (78.15%) and about 46.30% of them got easily angered, stressed or irritated. The waist circumference of 14.07% students was falling in obese category. About 11.48% of them were overweight and 7.04% were obese according to their body mass index. Among the students, 71.85% had normal blood pressure and 18.15% had pre-hypertension. Hypertension was detected among 10.00% of students of which 5.56% belonged to stage I and 4.44% belonged to stage II hypertension. Statistical association between the blood pressures of school children showed significance with family history of chronic diseases (p=0.025), body mass index and waist circumference (p&lt;0.001). Conclusions: One tenth of the children had hypertension and one fifth of the children had pre-hypertension. The children who were obese had increased blood pressure than those with normal weight. Health promotion at early phase of life can help in the prevention of hypertension.

Analysis of Risk Factors for Hypertension in Ship Crews of Seaports Work Coverage for Poso Port Health Office, Bungku Working Area

Objective: Ship crew as seafarers who work or are employed on board the ship by the owner or operator of the ship to carry out their duties following their position will have limitations in accessing health education, facilities, and infrastructure that support them to maintain their health. One of the non-communicable diseases that contributes to cardiovascular diseases is hypertension. This study aims to determine the risk factors related to the prevalence of hypertension in ship crew at Seaport work coverage for Poso Port Health Office, Bungku Working Area. Methods: This was a cross-sectional study with a sample size of 385 participant involve in data analysis. Chi-square analysis was employed to assess the relationship between respondent characteristic variables and independent variables concerning the occurrence of hypertension. Multivariate analysis was conducted on variables that showed an association with hypertension to obtain independent risk values using logistic regression analysis. This research used a 95% confidence level. Results: The prevalence of hypertension in ship crew is 12.73%. Logistic regression results showed that the crew members had an overweight (AOR=15.93, 95%CI: 5.080-49.981, p=0.000) and moderate and heavy smokers among crew members (AOR=2.51, 95%CI: 1.038-6.066), p=0.021) were factors associated with the prevalence of hypertension in ships crew members of hypertension in ships crew members after controlled by aged over 45 years (AOR=22.94; 95% CI: 2.587-203.477, p=0.005) and family history of hypertension (AOR=6.01; 95% CI: 2.741-13.168, p=0.000). Conclusions: Body mass index and smoking behavior among ship crew members are significant risk factors for hypertension in this study, while alcohol consumption and workplace-related environmental stress were not found to be significant risk factors in this research Implication of the research: This research can serve as a reference for determining health programs and more specific priority groups targeted for the prevention and control of hypertension among ship crew members on board. Originality: This study was conducted on ship crew members, legally active seafarers in the operational tasks on ship, whereas most similar research uses the health data of seafarers in healthcare clinics.

A Machine Learning Model Based on microRNAs for the Diagnosis of Essential Hypertension.

Hypertension is a major and modifiable risk factor for cardiovascular diseases. Essential, primary, or idiopathic hypertension accounts for 90-95% of all cases. Identifying novel biomarkers specific to essential hypertension may help in understanding pathophysiological pathways and developing personalized treatments. We tested whether the integration of circulating microRNAs (miRNAs) and clinical risk factors via machine learning modeling may provide useful information and novel tools for essential hypertension diagnosis and management. In total, 174 participants were enrolled in the present observational case-control study, among which, there were 89 patients with essential hypertension and 85 controls. A discovery phase was conducted using small RNA sequencing in whole blood samples obtained from age- and sex-matched hypertension patients (n = 30) and controls (n = 30). A validation phase using RT-qPCR involved the remaining 114 participants. For machine learning, 170 participants with complete data were used to generate and evaluate the classification model. Small RNA sequencing identified seven miRNAs downregulated in hypertensive patients as compared with controls in the discovery group, of which six were confirmed with RT-qPCR. In the validation group, miR-210-3p/361-3p/362-5p/378a-5p/501-5p were also downregulated in hypertensive patients. A machine learning support vector machine (SVM) model including clinical risk factors (sex, BMI, alcohol use, current smoker, and hypertension family history), miR-361-3p, and miR-501-5p was able to classify hypertension patients in a test dataset with an AUC of 0.90, a balanced accuracy of 0.87, a sensitivity of 0.83, and a specificity of 0.91. While five miRNAs exhibited substantial downregulation in hypertension patients, only miR-361-3p and miR-501-5p, alongside clinical risk factors, were consistently chosen in at least eight out of ten sub-training sets within the SVM model. This study highlights the potential significance of miRNA-based biomarkers in deepening our understanding of hypertension's pathophysiology and in personalizing treatment strategies. The strong performance of the SVM model highlights its potential as a valuable asset for diagnosing and managing essential hypertension. The model remains to be extensively validated in independent patient cohorts before evaluating its added value in a clinical setting.

The association between parity and hypertension: a cross-sectional, community-based study.

The available data on the association between parity and hypertension are inconclusive. This study was conducted to investigate the prevalence of hypertension and its association with parity among adult Sudanese women. A multi-stage sampling survey was conducted in four villages in the River Nile State in Sudan between July and September 2022. The World Health Organization's three-level stepwise questionnaire was used to gather the participants' sociodemographic characteristics (age, sex, marital status, parity, educational level, occupation, obstetric history, family history of hypertension, weight and height). Regression analyses were performed. A total of 408 women were recruited. The median [measured in terms of interquartile range (IQR)] age was 45.0 years (33.0-55.7 years). A linear regression analysis revealed a significant association between parity and diastolic blood pressure (coefficient, 0.60; P = 0.011). The prevalence of hypertension (55.9%) increased with parity and ranged from 43.7% to 74.9%. In the multivariate analyses, increasing age (adjusted odds ratio [AOR], 1.03; 95% confidence interval [CI], 1.02-1.05), increasing parity (AOR, 1.09; 95% CI, 1.01-1.19), family history of hypertension (AOR, 1.79; 95% CI, 1.15-2.77), and increasing body mass index (AOR, 1.09; 95% CI, 1.05-1.13) were associated with hypertension. In women of ages ≥ 50 years, increasing parity was significantly associated with hypertension (AOR, 1.15; 95% CI, 1.2-1.29). Para > 5 (AOR, 2.73; 95% CI, 1.11-6.73) was associated with hypertension. A high prevalence of hypertension was found among Sudanese women, and that parity at 5 or more is linked to hypertension.

Predictive model and classification for psoriatic arthritis risk assessment for Russian patients with psoriasis (on registry data)

Background. Psoriatic arthritis risk prediction and early detection in patients with psoriasis may help prevent irreversible musculoskeletal changes and improve patients outcomes.&#x0D; Aims. To develop and validate predictive model for psoriatic arthritis risk assessment and classification for patients with moderate-to-severe psoriasis based on demographic and clinical characteristics.&#x0D; Materials and methods. Data of psoriasis patient registry of Russian Society of Dermatovenereologists and Cosmetologists was analyzed. Significant differences between independent variables of interest among patients with and without psoriatic arthritis were determined by means of 2-test or MannWitney test. Predictive models were developed stepwise by means of logistic regression analysis. Independent variables of low significance were excluded from the model. Regression coefficients were considered significant if p 0.05. The optimal cut-off value was derived from ROC-analysis. The model performance was evaluated by calculation of AUC, sensitivity and specificity on training and test datasets. Finally, adjusted regression coefficients, AUC, sensitivity and specificity were derived for pooled data.&#x0D; Results. Training sample included 3245 patients with psoriasis, 920 of them had diagnosis of psoriatic arthritis. The final predictive model included five significant predictors: psoriasis duration, medical history of psoriatic erythroderma, family history of psoriatic arthritis, arterial hypertension, and fatty liver. All regression coefficients were highly significant (p 0.001). The AUC of prediction model adjusted on pooled data was 0,7473, sensitivity 70%, specificity 66% for cut-off value 0.212.&#x0D; Conclusions. Developed predictive model for risk assessment of psoriatic arthritis may contribute to its earlier detection in patients with psoriasis taking into account the degree of influence of significant predictors. The proposed classification may be used to discriminate patients at higher risk of psoriatic arthritis.