Family History Of High Blood Pressure Research Articles

Risk factors for kidney disease among civil servants: Report of annual screening and medical evaluation.

The outlook of chronic kidney disease (CKD) is worse among the poor sub-Saharan Africa populace due to limited and unaffordable renal replacement therapy. Regular screening of at-risk population can contribute to delaying or even preventing the progression of the disease. This study was designed to evaluate prevalent risk factors for CKD among the urban dwelling civil servants in Ado Ekiti. This is a cross-sectional observational study involving healthy adults above 18 years old. Data on sociodemographic and relevant lifestyle pattern such as smoking, alcohol intake, personal and family history of hypertension, diabetes, and kidney disease were obtained. Clinical variables such as anthropometric measurements, blood pressure (BP), and blood samples for laboratory investigations were taken. There were 122 participants with a mean age of 47.26 ± 5.62 years. About half of them earn <$140/month. Fifty-two (42.6%) individuals admitted taking local herbs and/or Chinese medicines and about a third (36.1%) use unprescribed medi-cations including nonsteroidal anti-inflammatory drugs. Family history of high BP and diabetes mellitus was present in 15.6% and 11.5% of individuals, respectively. We found 45 (32.6%) individuals with body mass index ≥30 kg/m2, while 13.3% and 3.3% have at least 1+ of dipstick and microalbuminuria, respectively. About one-third (25.4%) were either found to be hypertensive or were on antihypertensives, while 12 (9.8%) were either diabetic or had hyperglycemia during the screening. There is a high prevalence of risk factors for CKD among these apparently well individuals. Regular screening, and treatment of the identified risk factors is recommended.

Arterial Hypertension in Patients Aged 15 Years and Over in the Cardiology Department of Sikasso Hospital in Mali: About 250 Cases

Introduction: High blood pressure is a global public health problem due to its high prevalence and multiple complications that often lead to major disability. It is a major cardiovascular risk factor for often late diagnosis. It is emerging in Africa, particularly in Mali. Objective: To determine the epidemiological, diagnostic and progressive aspects of high blood pressure in patients 15 years of age or older. Patients and methods: This is a descriptive cross-sectional study over a two-year period (June 1, 2008 to May 31, 2010) in the Cardiology Department of Sikasso Hospital in any patient aged 15 years and over admitted for high blood pressure. Results: Two hundred and fifty patients were selected, representing a hospital prevalence of 18.2%. High blood pressure was most common in patients 50 years of age and older (65.6%), followed by those 19 to 49 years of age (30%) and those 15 to 18 years of age. The average age of the population was 50 years (15-92 years) with a male predominance of 61.6% and a sex ratio of 1.6. The predominance of traditional housewives and farmers was 30% and 26.4%. The notion of a family history of high blood pressure was found in 56.4% of cases. High blood pressure grade 3 according to the classification of the World Health Organization was mostly found in our patients (64%). Biological abnormalities were dominated by hyperglycemia (14%), hypercreatininemia (8%). The main clinical manifestations were headache (40%), dyspnea (20%) and vertigo (16%). On physical examination, there were mainly signs of heart failure (50%), arrhythmia (12%), heart murmur (28%), hemiplegia (10%). The electrocardiogram showed left ventricular hypertrophy in 79.2% of cases, left atrial hypertrophy (16.4%), repolarization disorder (3.2%), atrial fibrillation (1.2%). Chest x-rays showed cardiomegaly in 67.2%. Echocardiographic abnormalities were left ventricular hypertrophy (64.8%), left atrial dilation (16.4%), left ventricular systolic dysfunction (14.4%). Therapeutically, diuretic combination with conversion enzyme inhibitors was the most prescribed treatment (58%), followed by combination of calcium channel blockers and conversion enzyme inhibitors (15.6%), calcium channel blockers (18%), conversion enzyme inhibitors (4.4%), beta-blockers (4%). The low-salt diet and physical activity were constantly recommended. Complications were hypertensive retinopathy (33.2%), heart failure (25.2%), stroke (24.8%), renal failure 4.8%. Conclusion: High blood pressure is a major public health problem. This work identified a high hospital prevalence of high blood pressure in patients aged 15 years and older with a clear male predominance. Late diagnosis is responsible for serious complications that often lead to major disabilities.

Abstract P372: Association of Cardiovascular Disease Family History With Major Cardiovascular Risk Factors in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Introduction: Family history (FH) is a well-known risk factor for cardiovascular disease (CVD); however, the association of FH with CVD in Hispanic/Latino populations has not been well investigated. We examined the cross-sectional association of FH of CVD or CVD risk factors with individual CVD risk factors (hypertension, hypercholesterolemia, obesity, diabetes mellitus, and smoking), CVD risk profile, and prevalence of CHD or stroke in the HCHS/SOL. Methods: Baseline data on FH and CVD risk factors from 15,104 HCHS/SOL participants were analyzed. Self-reported first-degree FH of high blood pressure (BP), high cholesterol, diabetes, angina, heart attack, heart failure, rheumatic heart disease, angioplasty/bypass, stroke, aortic aneurysm, and peripheral artery disease was ascertained and categorized as any first-degree FH vs. no FH of each condition. Hypertension, high cholesterol, obesity and diabetes mellitus were ascertained by objective measures and/or medication use; smoking was self-reported. The CVD risk profile was calculated by assigning a score of 0 to 5 based on the number of adverse CVD risk factors. Analysis of CVD risk factors was dichotomized as low (0 and 1 risk factor) vs. high (2+ risk factors). Odds ratios and 95% confidence intervals were derived from logistic regression models, accounting for the complex study design and controlling for multiple covariates. Results: Prevalence of CVD risk factors and risk profile were associated with self-reported FH (see Table). Furthermore, prevalence of CHD was associated with FH of high BP, high cholesterol, diabetes, angina, heart attack, heart failure, and rheumatic heart disease. Personal history of stroke was associated with FH of high BP, angina, and aortic aneurysm. Conclusions: First-degree FH of CVD factors and diseases was associated with hypertension, high cholesterol, obesity, diabetes, CHD and stroke among Hispanics/Latinos in HCHS/SOL. Ascertainment of FH should be an integral part of CVD risk assessment in Hispanics/Latinos in the US.

Abstract P350: Early Signs of Stress Induced Arterial Hypertension During Cardiopulmonary Testing and Advantages in Cardiac Risk Lowering

Goal: to study early signs and hypertension reaction features during cardiopulmonary exercise testing (CPET) in intellectually working men with rare episodes of stress induced blood pressure (BP) increase. Methods: 47 patients (pats) with periodic episodes of high BP due to high level of stress were included (all men, 42 ± 4.6 years old). Risk factors: smoking had 83% of pats, high cholesterol level 87%, glucose intolerance 39%, family history of high BP 14%. All pats had normal BMI and no signs of visceral fat and target organ damage, 54% used hypotensive therapy non-systemically, 98% complained for sleep disorders. CPET was done for optimal training regime appointment. Baseline BP was 134± 2,8 mm Hg. Most of the pats demonstrated low physical tolerance level (6,7±0.4 MET). All patients demonstrated hypertensive reaction during test, and that was the reason for test stop. 68% of pats demonstrated systolic BP 220 mm Hg at respiratory compensation point (RCP) and RER 1,17 ± 0.01, 32% of pats demonstrated it earlier than RCP and at RER 0.85± 0.06. All pats got recommendations with optimal physical and pulse regime for training. All the patients had 3 ± 1 moderate intensive aerobic training per week for 34 ± 10.7 min. Results: in 6 months all the patients demonstrated increase in physical tolerance (ΔVO2 5,3 ±1,3 ml/kg/min). Patients with hypertension reaction at RCP showed significantly lower baseline BP (124.6± 3.5mm Hg vs 131.2 ± 4.1 mm Hg in other patients, p &lt;0.05), only 14% demonstrated hypertensive reaction during CPET vs 89% in other patients, p &lt;0.05 and mentioned less hypertension episodes during 6 months (7 ± 3 episodes vs 24 ± 2, p &lt;0.05). 96% pats of this group demonstrated higher level of physical tolerance (load 9,8 ± 0.3 MET vs 7.6± 1.1 MET, p &lt;0,05). Also, they didn't show abnormalities in glucose intolerance test. Conclusion: hypertension reaction at RCP during CPET in intellectually working man with episodic stress induced increase of blood pressure can be a predictor of great benefit in life style modification, cardiac risk lowering and arterial hypertension control

Health-related quality of life among adults with and without hypertension: A population-based survey using EQ-5D in Shandong, China

Previous studies have focused on health-related quality of life (HRQoL) in hypertensive individuals, but few studies have attempted to compare HRQoL between hypertensive and normotensive individuals using the EQ-5D in China. Based on a survey of 3509 adults aged 18 + years, we compared HRQoL between hypertensive and normotensive individuals using a chi-square test, t-test and multi-linear regression model. The results indicated that HRQoL in hypertensive individuals was poorer than that of normotensive individuals in all domains of the EQ-5D and its utility index. In addition, education, complications, household income, and family history of HBP were associated with HRQoL among the hypertensive patients. Factors including age, education, household income, health expenditure, place of residence, and family history of high blood pressure (HBP) were found to be associated with HRQoL in normotensive individuals. Interventions targeting at-risk subgroups, such as modifying existing health insurance schemes to improve them for poor individuals, might be helpful to improve HRQoL.

Abstract P169: Long-term Yogurt Intake is Associated with a Lower Risk of High Blood Pressure in Middle-aged Nurses and Health Professionals

While dairy products have been shown to reduce the risk for high blood pressure (HBP) in at-risk adults, few long-term studies have examined independent effects of yogurt consumption, a dietary component that may have particularly beneficial effects on blood pressure. We used repeated measures of diet and lifestyle collected over 2-3 decades among participants without prevalent HBP in the two Nurses’ Health Study cohorts (NHS and NHS II) and the Health Professionals Follow-up Study (HPFS) to examine this question. After 18 to 30 years of follow-up, we documented 74,609 new cases of HBP in the three cohorts. After adjusting for age, race, family history of HBP, physical activity, energy, and intakes of total protein, fruits and vegetables, milk, and cheese, women who consumed 5 or more servings of yogurt per week (compared with those consuming 0-&lt;1.0 serving per month) had statistically significant 23% (95% CI: 0.70-0.84) and 17% (95% CI: 0.77-0.90) reductions in risk of HBP in the NHS and NHS II respectively, while men in the HPFS cohort had essentially no reduced risk. To determine whether the effect of yogurt consumption might be explained or modified by other healthy dietary factors, the independent and combined effects of yogurt and a DASH diet score (excluding yogurt from the calculation of that score) were examined. Those in the highest tertile of the DASH score who did not consume yogurt had 15%, 29%, and 15% reductions in HBP risk, respectively, in the two NHS and the HPFS cohorts. The beneficial effects of yogurt intake were modified by a higher DASH score. In these analyses, the beneficial effects of 5 or more servings of yogurt per day on HBP risk were strongest among those in the highest tertile of DASH scores (NHS: HR=0.66; 95% CI: 0.59-0.75; NHS II: HR=0.68; 95%CI: 0.62-0.75; HPFS: HR=0.75; 95% CI: 0.64-0.88). Results were partially attenuated when controlling for BMI. These analyses from three large, longitudinal cohorts suggest that regular yogurt consumption, especially as a part of an otherwise healthy diet, is associated with a reduced risk of developing HBP during the middle adult years. These beneficial effects may be partially explained by intermediate effects on BMI.

Risk factors associated with high blood pressure in two-to five-year-old children.

BackgroundOver recent decades, the prevalence of high blood pressure (BP) has increased among children. Several risk factors are involved in the genesis of high BP during childhood, and their early identification can prevent the development of that disease. ObjectivesTo assess the prevalence of high BP and associated factors in children. MethodsCross-sectional, population-based study, carried out at the household. This study included 276 two- to five-year-old children in the city of Goiânia, state of Goiás, and assessed their BP, sociodemographic characteristics, birth weight, high BP family history, passive smoking, maternal breastfeeding, dietary habits, sedentary lifestyle and nutritional status. Poisson regression was used to assess the association between risk factors and high BP. ResultsTheir mean age was 3.1 ± 0.79 years, and high BP and overweight were observed in 19.9% and 11.2% of the children, respectively. Direct association of high BP was identified with age [prevalence ratio (PR) = 2.3; 95%CI: 1.2 - 4.8; p = 0.017] and overweight (PR = 2.0; 95%CI: 1.2 - 3.6; p = 0.014). No other variable associated with high BP. ConclusionsThe prevalence of high BP in children was high. Overweight and younger children had greater prevalence of high BP.

Oscillometrically measured blood pressure in Hong Kong Chinese children and associations with anthropometric parameters

Oscillometric devices are increasingly used to measure blood pressure (BP). Reference data are limited and have not used devices validated against sphygmomanometric measurements on which current standards are based. BP standards for Chinese children have been based on sphygmomanometry and have not provided height-related or weight-related BP percentiles. BP was measured in 14842 Hong Kong Chinese schoolchildren aged 6-18 years randomly selected from 36 schools in the 18 Hong Kong districts, using a validated oscillometric device (Datascope Accutorr Plus). Height, weight, heart rate and waist circumference were measured. Percentiles for systolic BP and diastolic BP by sex, age, height and weight were generated. Features associated with systolic BP and diastolic BP in 12680 children were analysed by univariate and multivariate analysis. Reference BP standards by sex, age, weight and height are presented. BP was associated (in descending order of strength) with weight > height > age > waist circumference > body mass index, and weakly with heart rate (which added considerable influence on multivariate analysis). BP increases similarly with age, height (which can normalize for variations in growth) and weight (which is associated most strongly with BP). BP was associated also with family history of high BP and (inversely) with sleep duration. The study provides oscillometrically measured BP standards for Chinese children, with age-related and sex-related height-specific and weight-specific percentiles. Implications of the findings are discussed. Screening by sex-specific BP-height percentile charts, and then if high, reference to the BP-sex-age-weight table, is suggested.

Serum cholesterol levels, blood pressure response to stress and incidence of stable hypertension in young subjects with high normal blood pressure.

Elevated serum cholesterol levels are common in patients with high blood pressure (BP) and could contribute to the progression of the hypertensive disease. To determine whether serum cholesterol levels affect the BP response to mental stress (MA) and the development of stable hypertension in young subjects with high normal BP. Seventy young (age < 45 years) high normal BP subjects with elevated (> 200 mg/dl, n = 49; HC) or normal (< or = 199 mg/dl, n = 21; NC) serum cholesterol levels, and 20 normotensive normocholesterolaemic (serum cholesterol < 199 mg/dl; C) subjects undergoing standardized mental challenge (mental arithmetic) were followed up for 15 years according to a prospective, longitudinal, cohort study design conducted in an ambulatory setting. The main outcome measure was the evaluation of the 15-year incidence of stable hypertension (diastolic BP > 95 mmHg). After adjustment for age, resting BP, family history of high BP and body mass index at the study entry, high normal BP subjects with HC showed an enhanced BP reactivity to stress and a higher 15-year incidence of stable hypertension compared to high normal BP and NC subjects [relative risk (RR) = 2.1; 95% confidence interval (CI) = 1.7-5.5, P < 0.001] and controls (RR = 3.1; 95% CI = 1.4-5.3, P < 0.001). In a multivariate analysis of data the presence of high cholesterol levels was an independent predictor for the development of hypertension. These data suggest that subjects with high normal BP and elevated serum cholesterol might have an exaggerated cardiovascular response to stress and have an increased risk for stable hypertension that can be detected at young age.

Dyslexia and familial high blood pressure: an observational pilot study

Background: Developmental dyslexia is a neurodevelopmental learning disability characterised by unexpectedly poor reading and unknown aetiology. One hypothesis proposes excessive platelet activating factor, a potent vasodilator, as a contributor, implying...

Blood pressure and growth at 6 years of age among offsprings of mothers with hypertension of pregnancy

The association between hypertension of pregnancy and blood pressure (BP) and physical growth of the offspring at 6 years of age has been studied in a historical prospective study. Ninety-four consecutive women who developed hypertension during pregnancy and were hospitalized with a diagnosis of pre-eclampsia and their children were included. The comparison group consisted of individually-matched normal pregnant women. Each mother-child pair was examined when the child was 6 years of age. The mean systolic BP (SBP) of the offspring was 101.3 ± 10.2 (S.D.) mmHg and that of the controls 99.8 ± 9.5 mmHg. The mean diastolic BP (DBP) was significantly higher among the cases than among the controls (66.2 ± 8.3 mmHg and 63.9 ± 8.0 mmHg, P = 0.03). Among the cases, 11 children had a DBP above the 90th centile, whereas only four among the controls. A low, but significant, correlation was found between maternal and child BP for the cases. The DBP of the children with a positive family history of high BP was significantly higher than those with a negative history. There were no differences in height, weight or obesity index between cases and controls.

Parental history and cardiovascular disease risk factor variables in children

As part of a total community study of cardiovascular disease (CVD) risk factor variables in children (ages 5–17 years), parental histories of heart attacks, hypertension, diabetes, and stroke were obtained for each of 4,074 participating children. Subsequently, each child was examined for serum total cholesterol, triglycerides, lipoproteins (LP) and glucose, measurement of height, weight, triceps skinfold thickness, and blood pressure (BP), and had a physical examination. A family history of high BP was reported by 26.5% of all children, diabetes by 7.1%, heart attacks by 6.8%, and stroke by 2.1%. The children of parents with heart attacks or diabetes were heavier and had different lipid and LP profiles than children without this background. Children of reported hypertensive parents had higher systolic and diastolic BP, were heavier and had thicker skinfolds. The heaviest children were more likely to have a parental history of diabetes, hypertension, and heart attack. Children in the highest decile for systolic or diastolic BP were more likely to come from a family reporting hypertension. Children with the highest cholesterol, triglycerides, β + pre-β-LP and lowest α-LP values tended to have parents with heart attacks or diabetes. These data indicate that familial tendencies in multiple CVD risk factors are observable early in life. Children of parents with CVD or manifested risk factors clearly differ in their own risk factor profiles from children of parents without these conditions.