Higher Incidence Of Hypertension Research Articles

Supermarket Proximity and Risk of Hypertension, Diabetes, and CKD: A Retrospective Cohort Study

Living in environments with low access to food may increase the risk of chronic diseases. We investigated the association of household distance to the nearest supermarket (as a measure of food access) with the incidence of hypertension, diabetes, and chronic kidney disease (CKD) in a metropolitan area of the United States. Retrospective cohort study. 777,994 individuals without hypertension, diabetes, or CKD at baseline within the HealthLNK Data Repository, which contains electronic health records from 7 health care institutions in Chicago, Illinois. Zip code-level average distance between households and nearest supermarket. Incidence of hypertension, diabetes, and CKD based on presence of ICD-9 code and/or blood pressure≥140/90mm Hg, hemoglobin A1c≥6.5%, and eGFR<60mL/min/1.73m2, respectively. Average distance to nearest supermarket was aggregated from street-level metrics for 56 Chicagoland zip codes. The cumulativeincidence of hypertension, diabetes, and CKD from 2007-2012 was calculated for each zip code in patients free of these diseases in 2006. Spatial analysis of food access and disease incidence was performed using bivariate local indicator of spatial association (BiLISA) maps and bivariate local Moran I statistics. The relationship between supermarket access and outcomes was analyzed using logistic regression. Of 777,994 participants, 408,608 developed hypertension, 51,380 developed diabetes, and 56,365 developed CKD. There was significant spatial overlap between average distance to supermarket and incidence of hypertension and diabetes but not CKD. Zip codes with large average supermarket distances and high incidence of hypertension and diabetes were clustered in southern and western neighborhoods. Models adjusted only for neighborhood factors (zip code-level racial composition, access to vehicles, median income) revealed significant associations between zip code-level average distance to supermarket and chronic disease incidence. Relative to tertile 1 (shortest distance), ORs in tertiles 2 and 3, respectively, were 1.27 (95% CI, 1.23-1.30) and 1.38 (95% CI, 1.33-1.43) for diabetes, 1.03 (95% CI, 1.02-1.05) and 1.04 (95% CI, 1.02-1.06) for hypertension, and 1.18 (95% CI, 1.15-1.21) and 1.33 (95% CI, 1.29-1.37) for CKD. Models adjusted for demographic factors and health insurance showed significant and positive association with greater odds of incident diabetes (tertile 2: 1.29 [95% CI, 1.26-1.33]; tertile 3: 1.35 [95% CI, 1.31-1.39]) but lesser odds of hypertension (tertile 2: 0.95 [95% CI, 0.94-0.97]; tertile 3: 0.91 [95% CI, 0.89-0.92]) and CKD (tertile 2: 0.80 [95% CI, 0.78-0.82]; tertile 3: 0.73 [95% CI, 0.72-0.76]). After adjusting for both neighborhood and individual covariates, supermarket distance remained significantly associated with greater odds of diabetes and lesser odds of hypertension, but there was no significant association with CKD. Unmeasured neighborhood and social confounding variables, zip code-level analysis, and limited individual-level information. There are significant disparities in supermarket proximity and incidence of hypertension, diabetes, and CKD in Chicago, Illinois. The relationship between supermarket access and chronic disease is largely explained by individual- and neighborhood-level factors.

Patients With Diabetes at High Bleeding Risk With 1-Month Dual Antiplatelet Therapy: Onyx ONE Clear Results.

Patients with diabetes mellitus (DM) are at a higher risk of ischemic events compared with patients without DM. Percutaneous coronary intervention (PCI) with the Resolute Onyx zotarolimus-eluting stent (ZES) followed by 1-month dual antiplatelet therapy (DAPT) is safe and effective in patients with high bleeding risk. However, outcomes in patients with DM are not fully understood. Onyx ONE Clear was a prospective, multicenter study that included patients receiving the Resolute Onyx ZES during PCI and 1-month DAPT. The primary end point was a composite of cardiac death (CD) or myocardial infarction from 1 month to 12 months. Among the Onyx ONE Clear population (N = 1506), 39% had DM. Patients with DM had a higher incidence of hypertension, hyperlipidemia, and previous PCI and a higher body mass index than patients without DM. Patients with diabetes were also younger, more likely to be anemic, and experience renal failure. After adjusting for baseline differences between the groups, the Kaplan-Meier rates of CD or myocardial infarction (9.3% vs 6.1%; P = .122, unadjusted P = .010) and target lesion failure (10.2% vs 7.7%; P = .294, unadjusted P = .056) between 1 month and 12 months were not significantly different in patients with and without DM. The rates of target lesion revascularization were also similar in both groups, and stent thrombosis was very low and comparable in both arms after adjusting for baseline differences. Non-CD and bleeding were more frequent in patients with DM. Patients with diabetes treated with the Resolute Onyx ZES followed by 1-month DAPT had favorable 12-month ischemic outcomes after accounting for baseline differences between patients with and without DM, supporting the safety and efficacy of the treatment in selected patients with DM at high bleeding risk.

Clinical impact of beta-blockers at discharge on long-term clinical outcomes in patients with non-reduced ejection fraction after acute myocardial infarction

BackgroundBeta-blockers are associated with several clinical benefits in patients with reduced left ventricular ejection fraction (REF) after acute myocardial infarction (AMI), such as lower rates of mortality, recurrence of myocardial infarction, and heart failure. However, the long-term prognosis of beta-blockers has rarely been investigated in patients with non-REF after AMI. This study aimed to investigate the clinical benefits of beta-blockers in these patients. MethodsA total of 3281 consecutive patients who were hospitalized within 48 h after AMI were registered in the J-MINUET study. Patients who underwent primary percutaneous coronary intervention (PCI) and had a left ventricular ejection fraction ≥40 % were enrolled, and patients who died during admission were excluded. Included patients were divided into two groups according to the prescription of beta-blockers at discharge. Their characteristics and clinical outcomes were compared. ResultsThe number of AMI patients treated with beta-blockers was 1353 (70.4 %). Patients who received beta-blockers were younger and had a higher incidence of hypertension, dyslipidemia, and ST-segment elevation myocardial infarction than those who did not receive beta-blockers. The peak creatine kinase level after primary PCI was significantly higher in patients who received beta-blockers. These patients also had a lower incidence of a composite of all-cause death, myocardial infarction, and stroke compared to those that did not receive beta-blockers (7.3 % vs. 11.9 %, p = 0.001). Multivariate analysis showed that beta-blocker use was an independent factor for better clinical outcomes. ConclusionsThe J-MINUET study revealed the clinical benefit of beta-blockers in AMI patients with non-REF after primary PCI.

Change in Body Mass Index and Attributable Risk of New-Onset Hypertension Among Obese Living Kidney Donors.

To examine whether body mass index (BMI) changes modify the association between kidney donation and incident hypertension. Obesity increases hypertension risk in both general and living kidney donor (LKD) populations. Donation-attributable risk in the context of obesity, and whether weight change modifies that risk, is unknown. Nested case-control study among 1558 adult LKDs (1976-2020) with obesity (median follow-up: 3.6 years; interquartile range: 2.0-9.4) and 3783 adults with obesity in the Coronary Artery Risk Development in Young Adults (CARDIA) and Atherosclerosis Risk in Communities (ARIC) studies (9.2y; interquartile range: 5.3-15.8). Hypertension incidence was compared by donor status using conditional logistic regression, with BMI change investigated for effect modification. Overall, LKDs and nondonors had similar hypertension incidence [incidence rate ratio (IRR): 1.16, 95% confidence interval (95% CI): 0.94-1.43, P =0.16], even after adjusting for BMI change (IRR: 1.25, 95% CI: 0.99-1.58, P =0.05). Although LKDs and nondonors who lost >5% BMI had comparable hypertension incidence (IRR: 0.78, 95% CI: 0.46-1.34, P =0.36), there was a significant interaction between donor and >5% BMI gain (multiplicative interaction IRR: 1.62, 95% CI: 1.15-2.29, P =0.006; relative excess risk due to interaction: 0.90, 95% CI: 0.24-1.56, P =0.007), such that LKDs who gained weight had higher hypertension incidence than similar nondonors (IRR: 1.83, 95% CI: 1.32-2.53, P <0.001). Overall, LKDs and nondonors with obesity had similar hypertension incidence. Weight stability and loss were associated with similar hypertension incidence by donor status. However, LKDs who gained >5% saw increased hypertension incidence versus similar nondonors, providing support for counseling potential LKDs with obesity on weight management postdonation.

Association of cooking fuel with incident hypertension among adults in China: A population-based cohort study.

With an increasing prevalence of hypertension, indoor air‐pollution factors began to attract extensive attention. However, the association of cooking fuel with the incidence of hypertension was inconsistent. The aim of this study was to investigate the association of household air‐pollution caused by cooking fuel with the incidence of hypertension. Data were derived from the China Health and Nutrition Survey. Participants aged 18 years or older were eligible. A validated questionnaire was used to collect the information on the type of cooking fuel, including electricity, natural gas, coal, and wood/charcoal. Participants with a systemic blood pressure (SBP) ≥ 140 mmHg or /and a diastolic blood pressure (DBP) ≥ 90 mmHg without use of anti‐hypertensive medications, or participants with an SBP/DBP < 140/90 mmHg but having hypertensive history or currently being taking anti‐hypertensive medication were identified as hypertension. Multilevel Cox regressions were employed to examine the association of cooking fuel with incident hypertension. Compared to participants using electricity, participants using wood/charcoal had a higher incidence of hypertension (HR: 1.581; 95% CI: 1.373‐1.821; and P < .001), which was independent of sex and living areas. Furthermore, this significant association was observed only in the participants aged 18–39 years (HR: 1.443; 95% CI: 1.131‐1.840; and P = .003). Compared to participants using non‐polluting energy, participants using solid fuel were more likely to develop hypertension (HR: 1.309; 95% CI: 1.191‐1.439; and P < .001). In conclusion, household air‐pollution was associated with the incidence of hypertension among Chinese adults. Using wood/charcoal or solid fuel in youth was associated with a higher incidence of hypertension later in life.

Hubungan Karakteristik Penderita Hipertensi dengan Tingkat Kepatuhan Minum Obat di RSUD Embung Fatimah Kota Batam

Hypertension is one of the non-communicable diseases which is a problem in the health sector and is often found in primary health services. A person is said to suffer from hypertension when systolic blood pressure ≥ 140 mmHg and diastolic pressure ≥ 90 mmHg. The use of antihypertensive drugs alone is proven to be insufficient to produce long-term blood pressure control effects if it is not supported by adherence to the use of antihypertension. The high incidence of hypertension in the world, is influenced by two types of factors, namely factors that cannot be changed such as age, sex, and race. Furthermore, factors that can be changed include obesity, alcohol consumption, lack of exercise, excessive salt consumption, and smoking habits. The purpose of this study was to determine the relationship between the characteristics of hypertension sufferers with the level of adherence to take medication at Embung Fatimah District Hospital in Batam. This study used a cross-sectional descriptive study method using the MMAS-8 (Morisky Medication Adherence Scale) questionnaire. Respondents who were the subject of this study were suffering from hypertension at Embung Fatimah Regional Hospital in Batam. The sampling technique used is a simple random sampling technique with a total sample of 96 people. The results of this study generally showed that 36.5% of patients had high adherence to take hypertension medication while the remaining 13.5% of patients had moderate adherence and as many as 50% had high adherence. To support the success rate of hypertension treatment can be done with the presence of hypertension counseling so that adherence to taking medication for hypertension sufferers can increase.

Racial Disparities in Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: Does Aggressive Surgical Treatment Overcome Cancer Health Inequities?

BackgroundAdvanced cancer states perpetuate health-related disparities. Peritoneal-based cancers are clinically advanced cancers that present a significant clinical dilemma. Peritoneal cancers are managed aggressively with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). While racial and ethnic disparities are prevalent in cancer, there are no studies investigating if racial disparities exist in patients with peritoneal carcinomatosis managed with CRS and HIPEC. We hypothesized that this advanced disease state further delineates racial disparities.MethodsA retrospective chart review was conducted on patients with peritoneal carcinomatosis receiving CRS and HIPEC at a single institution from January 1, 2017-October 4, 2021. Descriptive statistics were used to compare racial groups. The Cox Proportional Hazards Model and Log Rank Test were used for multivariate and overall survival analysis.ResultsIn total, 67 patients underwent CRS and HIPEC, of which 41 (61.2%) were White, 20 (29.8%) were Black, 3 (4.5%) were Asian, and 3 (4.5%) were Other race. When compared to White patients, Black patients had lower income (p=0.0011), higher incidence of hypertension (p=0.0231), and lower performance status (p=0.0441). Cancer type, including colorectal, appendiceal, ovarian, etc., was similar between groups (p=0.8703). Despite these differences in sociodemographic and morbidity factors, when comparing Black patients to White patients, there were no differences in peritoneal cancer index score (13.2 vs. 12.3, p=0.6932), estimated blood loss (748 vs. 655 mL, p=0.6332), minor/major complication rates (1.1 vs. 1.2, p=0.7281; 0.4 vs. 0.7, p=0.3470, respectively), 30-day readmission rates (25.0% vs. 17.1%, p=0.6210), disease recurrence (40.0% vs. 51.2%, p=0.3667), or 30-day mortality (0.0% vs. 2.4%, p=1.0000). Overall survival was similar for Black and White patients (p=0.2693). The occurrence of a major complication was the only factor associated with overall survival (HR 2.188 [1.502, 3.188], p< 0.0001).ConclusionsDespite differences in patient socioeconomic factors and comorbid conditions, outcomes were similar between Black and White patients receiving CRS and HIPEC at our institution. While larger studies with more diverse patient populations are needed to confirm these findings, our data provide evidence that aggressive surgical management across diverse patient populations allows for equitable outcomes.

HIGH LEVEL OF THE AMOUNT OF ECG PEAKS SV1+RV5–V6 PREDICT NEW CASES OF HYPERTENSION IN THE ORGANIZED POPULATION OF THE PETROCHEMICAL INDUSTRY WORKERS

Objective: Identify risk factors for new cases of hypertension according to a 10-year prospective study of the organized population of the petrochemical industry workers in Belarus. Design and method: New cases of hypertension were revealed according to a 10-year prospective study in 2004/2014 in the organized population of 1,431 workers of petrochemical industry. In 2004 871 subjects with normal blood pressure were divided into two groups. The first group included 260 workers without adverse working factors, the second group included 611 workers with adverse working factors. The survey included standard questionnaires for detection of cardiovascular risk factors, anthropometric measurements, data from instrumental and laboratory examination. Results: According to a 10-year prospective study, a high incidence of hypertension in the studied population was established (37.5%: 31.5% in persons without adverse working factors and 40.1% in persons with adverse working factors) (p &lt; 0.05). A significant positive relationship was found between the incidence of hypertension and work in harmful working conditions (p &lt; 0.05), the strongest connection of which had psycho-physiological factors of labor intensity (p &lt; 0.01). There was revealed significant positive association between the amount of ECG peaks SV1+RV5–V6 (&gt;24 mm) and the frequency of new cases of hypertension adjusted for age, sex and factor of working conditions (df = 1; x2Wald = 33,0; p &lt; 0,001). There were identified other significant factors affecting new cases of hypertension after adjusting for age, sex and factor of working conditions: systolic (p &lt; 0.001) and diastolic blood pressure (p &lt; 0.001), heredity (p &lt; 0.01), absence of higher education (p &lt; 0.001), smoking in the past and present (p &lt; 0.001), alcohol abuse (p &lt; 0.001), low physical activity (p &lt; 0.001), body mass index (p &lt; 0,001), level of salt taste threshold (p &lt; 0,001), level of triglycerides (p &lt; 0,01), glucose (p &lt; 0,001) and GFR (p &lt; 0,001) according to multifactorial regression analysis. Development of hypertension was also associated with a lack of recreational activities (p &lt; 0.001). Conclusions: In addition to classical risk factors level of the amount of ECG peaks SV1+RV5–V6 &gt; 24 mm is a new predictor of development of hypertension in the Belarusian organized population.

МЕТАБОЛИЧЕСКИЙ СИНДРОМ ПРИ РЕВМАТОИДНОМ АРТРИТЕ КАК КРИТЕРИЙ КАРДИОВАСКУЛЯРНОГО РИСКА

Abstract. Introduction. Rheumatoid arthritis and metabolic syndrome have common pathogenic mechanisms, thus mutually reinforcing each other, creating a higher risk of cardiovascular disease. Objectives: study the effect of metabolic syndrome on the course of rheumatoid arthritis and the formation of cardiovascular risk. Material and methods. The study included a clinical evaluation of 100 patients with rheumatoid arthritis (average age 55±12,4 years). The patients were divided into 2 groups depending on the presence of metabolic syndrome: 1st group – persons with metabolic syndrome (59 people, 59%) and 2nd group - persons without metabolic syndrome (41 patients, 41%). The received data were processed using the program STATISTICA 10. The differences in the indicators were considered statistically significant at p&lt;0,05. Results. In 1st group, the activity of rheumatoid arthritis was higher (DAS-28 was 5.58±0.9) than in 2nd group (DAS-28 was 5.23±0.85) (p=0.02). The daily dose of steroids was higher in the group with metabolic syndrome: in terms of prednisone 7.5 [5; 10] mg versus 5 [5; 10] mg in the group without metabolic syndrome (p=0.013). Verified arterial hypertension was 3.8 times more common in the presence of metabolic syndrome. Left ventricular myocardial hypertrophy was 1.5 times more common in patients in the group with metabolic syndrome (35.9%), and it was noted both in combination with arterial hypertension and without it. In 1st group, left ventricular myocardial hypertrophy, unrelated to hypertension, was found in 9 people (9.78%). In 2nd group, myocardial hypertrophy was associated with arterial hypertension in all patients. Conclusion. The presence of metabolic syndrome in rheumatoid arthritis is associated with a higher activity of rheumatic disease. In patients with rheumatoid arthritis, it contributes to an increase in cardiovascular risk, characterized by a higher incidence of hypertension (3.8 times), an increase n total cholesterol and an increase in left ventricular myocardial mass. In patients with a combination of rheumatoid arthritis and metabolic syndrome, myocardial hypertrophy was detected even in the absence of an increase in blood pressure, which dictates the need for echocardiography in this group of patients.

A phase II study of anlotinib in the first-line treatment of locally advanced or metastatic soft-tissue sarcoma: Updated results.

e23559 Background: Standard treatment for patients with unresectable locally advanced or metastatic soft-tissue sarcoma is chemotherapy based on anthracyclines, while the tolerance of chemotherapy is limited. Anlotinib had demonstrated promising efficacy and favorable tolerance in the first-line treatment of these patients in the previously report ( 2021 ASCO). We updated the latest long-term efficacy and safety data. Methods: This multicenter, open-label, single-arm, phase II clinical trial (NCT03792542) was done at 7 hospitals in China. Patients diagnosed with locally advanced or metastatic soft-tissue sarcoma who had evaluable lesion per Response Evaluation Criteria in Solid Tumors version 1.1 were eligible for inclusion. Additional inclusion criteria were 1) 18-70 years old, 2) ECOG PS 0-2, 3) chemotherapy intolerance judged by investigators, 4) chemotherapy and anti-angiogenesis treatment naïve. All patients received 12mg anlotinib once daily for 14 days every 3 weeks until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS). Safety assessment was done in patients who received at least one dose of anlotinib. Results: 39 patients (24 males and 15 females) were enrolled between April 2019 to October 2021with a median follow-up 13.4 months (IQR 6.55-19.40), and the median age is 58 (range 23-69) years old. Pathological types included liposarcoma (n = 11), fibrosarcoma (n = 8), undifferentiated pleomorphic sarcoma (n = 5), leiomyosarcoma (n = 4), synovial sarcoma (n = 4), malignant peripheral nerve sheath tumor (n = 4), and others (n = 3). At the data cutoff date on December 27, 2021, the median PFS and median overall survival (OS) were 7.1 months [95%CI 5.42-8.77], 24.3 months [95%CI 14.9-33.7], respectively. The PFS at 6 months was 60.0%, and the OS at 12 months was 76.6%. 37 patients were eligible for the evaluation of tumor response.1 achieved confirmed partial response (PR) and the objective response rate (ORR) was 2.7% (1/37). 30 had stale disease (SD) and the disease control rate (DCR) was 83.8% (31/37). The incidence of adverse events of grade 3 was 33.3%, with a higher incidence of hypertension (12.8%), proteinuria (7.7%) and fatigue (5.1%). Conclusions: Anlotinib has shown encouraging anti-tumor activity and well tolerance in the first-line treatment of locally advanced or metastatic soft-tissue sarcoma who were not suitable for chemotherapy. Clinical trial information: NCT03792542.

The Effect of Decoction of Coriander Seeds on Blood Pressure in Menopausal Women with Hypertension in the Work Area of the Mrican Health Center Kediri in 2022

This study is based on the high incidence of hypertension in menopausal women and 40% of them solved it by consuming herbal drinking from their parents before. One of the herbs that can be used to lower blood pressure is coriander seeds. The purpose of this study is the influence of coriander seed stew to the blood pressure of menopausal women who experience hypertension in the work area of ​​Mrican Public Health Center Kediri in 2022.&#x0D; The design used in this research is pre experimental with pretest-post test one group design approach. The population in this study were all postmenopausal women who experienced hypertension in Gayam Posyandu village 3 working area of ​​Mrican Kediri Public Health Center in April 2022 of 27 people. Sampling technique of this research is purposive sampling. The sample size is 20 people. The independent variable (X) in this research is coriander seed stew while blood pressure as dependent variable (Y). The instrument used is spygmo manometer. Data analysis using T paired samples.&#x0D; The results showed that the mean blood pressure value of sistole after giving the coriander seed stew was lower than before, as was the diastolic blood pressure. Result of data analysis got pvalue = 0.000 or less from α = 0,05 meaning that H0 rejected and H1 accepted, meaning there is influence of coriander seed stew to blood pressure of menopausal women who have hypertension in Work Area of ​​Mrican Kediri Public Health Center in 2022.&#x0D; Coriander seeds can lower blood pressure elderly because it contains flavonoids. Elderly are expected to consume coriander seed stew regularly because hypertension is a chronic disease, control blood pressure to the health center on a regular basis.

Little evidence for long-term harm from antenatal corticosteroids in a population-based very low birthweight young adult cohort.

BackgroundAntenatal corticosteroids (ACS) given to mothers with anticipated very preterm delivery are widely used and improve infant outcomes. Follow‐up studies of the first trials of ACS have shown no adverse effects, but recently there have been concerns about possible longer‐term harms.ObjectivesWe aimed to assess the relationship of ACS therapy to a range of physical health and welfare measures in a cohort of very low birthweight (VLBW; <1500 g) young adults.MethodsPopulation‐based cohort follow‐up study. All VLBW infants born in New Zealand in 1986 were included in a prospective audit of retinopathy of prematurity. Perinatal data collection included information on ACS. At 26–30 years, 250 of 323 (77%) survivors participated, 58% having received ACS, with 229 assessed in one centre, including cardiovascular, metabolic, respiratory and neurocognitive measures. Differences in outcome between those receiving/not receiving ACS were summarised by the mean difference for continuous outcomes supplemented by Cohen’s d as a standardised measure of effect size (ES), and risk ratios (RRI) for dichotomous outcomes, adjusted for relevant covariates using generalised linear regression methods.ResultsThere were no or minimal adverse effects of receipt of ACS versus no receipt across a range of health and welfare outcomes, both for the full cohort (adjusted ES range d = 0.01–0.23; adjusted RR range 0.78–2.03) and for individuals with gestation <28 weeks (extremely preterm; EP), except for a small increase in rates of major depression. In EP adults, receipt of ACS was associated with a higher incidence of hypertension, but might have a small benefit for IQ.ConclusionsIn this population‐based VLBW cohort, we detected minimal adverse outcomes associated with exposure to ACS by the third decade of life, a similar result to the 30‐year follow‐up of participants in the first ACS trial. However, further follow‐up is warranted.

ANALYSIS BETWEEN THE NUMBER OF ANTIHYPERTENSIVE WITH MEDICATION ADHERENCE IN END STAGE RENAL DISEASE

&#x0D; End-Stage Renal Disease (ESRD) is a condition of severe renal damage associated with a higher incidence of hypertension that requires antihypertensive therapy to prevent the worsening disease. Therefore, patients who received more than two types of antihypertensives have affected medication adherence. This study aimed to analyze relationship between the number of antihypertensives and medication adherence in ESRD patients. The study was a cross-sectional design involving 77 participants selected by a purposive sampling technique at Outpatient Private Hospital Buleleng Bali in July-September 2020. Data were collected based on patient’s medical records and the Probabilistic Medication Adherence Scale (ProMAS) questionnaire. The inclusion criteria were ESRD patients aged ≥18 years, with hypertension history, taking the same antihypertensive for three months before the study, sign informed consent, and completed medical record data. Those who were a weak general condition and cognitive impairment were excluded from the study. Data were analyzed using a Kruskal-Wallis test. The results showed that overall, of patients were &lt;65 years old (80.52%), male (70.13%), duration of ESRD &lt;5 years (89.61%), primarily high school (57.14%), and without complications (57.1%). Most patients used a combination of two antihypertensives (35.07%), and 61.04% has a high medication adherence. There was no significant relationship between the number of antihypertensives and medication adherence (p=0.847). Nevertheless, it was still shown that the higher number of antihypertensives in ESRD patients was directly proportional to the lower medication adherence.&#x0D; &#x0D;

Evaluation of circulating endothelial progenitor cells and the severity of transient ischemic attack

ObjectiveEndothelial progenitor cells (EPCs) are believed to have a positive effect on maintaining endothelial integrity and participate in angiogenesis after cerebral infarction. Numerous studies have demonstrated that EPCs promote ischemic tissue angiogenesis after stroke. However, there are few studies on the relationship between the level of EPCs and the severity of transient ischemic attacks (TIAs). The current study aimed to investigate the evaluation value of EPCs and serum stromal cell-derived factor-1α(SDF-1α) levels on the severity of TIA. MethodsA total of 144 patients with TIA who had an onset of symptoms within 24 h were enrolled and divided into a high-risk TIA (HR-TIA) group (79 cases) and a nonhigh-risk TIA (NHR-TIA) group (65 cases). Clinical data of these patients were collected. Flow cytometry (FCM) was used to measure the number of CD34+KDR+ EPCs, and enzyme-linked immunosorbent assay (ELISA) was used to determine the concentration of serum SDF-1α and vascular endothelial growth factor (VEGF). Fifteen healthy donors were selected as the normal control (NC) group. Circulating EPCs were isolated by density gradient centrifugation from the first 15 patients in the high-risk TIA group, the nonhigh-risk TIA group, and the NC group. A colony assay and MTT assay were used to determine the proliferation ability of each group, and a Boyden chamber was used to determine the migration potential of EPCs. ResultsCompared with the nonhigh-risk group, patients in the high-risk TIA group were older and had a higher incidence of hypertension and diabetes and stroke recurrence. Patients in the high-risk TIA group had higher levels of triglycerides, cholesterol, and low-density lipoprotein. However, there were no significant differences between the two groups in sex, time from onset to blood draw, smoking, body mass index, or homocysteine (P > 0.05). The number of circulating EPCs in the nonhigh-risk TIA group was higher than that in the high-risk TIA group (P < 0.01). SDF-1α and VEGF levels in the nonhigh-risk TIA group were lower than those in the high-risk TIA group (P < 0.01). The results of multivariate regression analysis showed that age, hypertension, diabetes, smoking, and SDF-1α were risk factors for high-risk TIA, and EPCs were protective factors for high-risk TIA. EPCs were separated and cultured for 72 h. Compared with the NC group, EPCs functions were weakened in the high-risk TIA group and nonhigh-risk TIA group (P < 0.05). Compared with the nonhigh-risk TIA group, EPC functions were decreased in the high-risk TIA group (P < 0.01). ConclusionCD34+KDR+ EPCs are protective factors for high-risk TIA. The number of circulating CD34+KDR+ EPCs and the concentration of SDF-1α have important clinical value in predicting the progression of TIA to high-risk TIA.

Hypothyroidism and Its Comorbidities - An Observational Study at A General Hospital

Background: Hypothyroidism is the most common metabolic disorder that slows metabolism and leads to many medical conditions like diabetes (DM) and its complications like hypertension (HTN) and ischemic heart disease (IHD). Objectives: This study was conducted to determine the prevalence of various comorbidities in the hypothyroid population, to compare them, and to demonstrate that we can prevent those comorbidities through early detection and treatment of primary diseases such as hypothyroidism. Materials and Methods: An observational study was conducted in a general hospital in Faridpur from October 2019 to December 2020 for a period of one year and three months. A total of 170 hypothyroid patients were selected randomly from all sexes and races to see their comorbidities. Clinically suspicious patients were selected for laboratory testing and, after confirmation of hypothyroidism, comorbid conditions were searched for by clinical examination and biochemical tests where needed. All new and old patients were included as cases in this study. Result: 170 cases were selected as hypothyroidism out of a total of 3233 patients (5.25%). Female patients were more than male cases (134 vs. 36 and a ratio 3.2:1). More patients were above 50 years (29.41%). Comorbidities present most of the patients (88.82%). Most common comorbidities were HTN, DM, BA, and IHD (40%, 19.41%, 14.11%, and 11.76%, respectively). Common concomitant comorbidities were HTN with DM (15.23%) and HTN with IHD (11.25%). Conclusion: There is a high incidence of HTN, DM, BA, and IHD in association with hypothyroidism. Overt hypothyroid patients are more likely to suffer from HTN and DM. As a result, these comorbid conditions should be investigated in all hypothyroid patients. KYAMC Journal. 2022;12(04): 222-225

Incidence of hypertension in people with HIV who are treated with integrase inhibitors versus other antiretroviral regimens in the RESPOND cohort consortium.

ObjectiveTo compare the incidence of hypertension in people living with HIV receiving integrase strand transfer inhibitor (INSTI)‐based antiretroviral therapy (ART) versus non‐nucleoside reverse transcriptase inhibitors (NNRTIs) or boosted protease inhibitors (PIs) in the RESPOND consortium of HIV cohorts.MethodsEligible people with HIV were aged ≥18 years who initiated a new three‐drug ART regimen for the first time (baseline), did not have hypertension, and had at least two follow‐up blood pressure (BP) measurements. Hypertension was defined as two consecutive systolic BP measurements ≥140 mmHg and/or diastolic BP ≥90 mmHg or initiation of antihypertensives. Multivariable Poisson regression was used to determine adjusted incidence rate ratios (aIRRs) of hypertension, overall and in those who were ART naïve or experienced at baseline.ResultsOverall, 4606 people living with HIV were eligible (INSTIs 3164, NNRTIs 807, PIs 635). The median baseline systolic BP, diastolic BP, and age were 120 (interquartile range [IQR] 113–130) mmHg, 78 (70–82) mmHg, and 43 (34–50) years, respectively. Over 8380.4 person‐years (median follow‐up 1.5 [IQR 1.0–2.7] years), 1058 (23.0%) participants developed hypertension (incidence rate 126.2/1000 person‐years, 95% confidence interval [CI] 118.9–134.1). Participants receiving INSTIs had a higher incidence of hypertension than those receiving NNRTIs (aIRR 1.76; 95% CI 1.47–2.11), whereas the incidence was no different in those receiving PIs (aIRR 1.07; 95% CI 0.89–1.29). The results were similar when the analysis was stratified by ART status at baseline.ConclusionAlthough unmeasured confounding and channelling bias cannot be excluded, INSTIs were associated with a higher incidence of hypertension than were NNRTIs, but rates were similar to those of PIs overall, in ART‐naïve and ART‐experienced participants within RESPOND.

Impact of chronic kidney disease on clinical outcomes in patients with Stage B progressive aortic regurgitation (mild to moderate and moderate grades).

BackgroundChronic kidney disease (CKD) is a significant comorbidity in patients with heart failure and valvular heart disease. Renal impairment is not well evaluated in the patients with Stage B progressive aortic regurgitation (AR) (mild to moderate and moderate grades in this study), for estimating outcome.HypothesisWe sought to investigate the prognostic factor, especially CKD, in the patients with progressive AR.MethodsWe enrolled 262 patients with Stage B progressive AR and preserved left ventricular systolic function (ejection fraction ≥ 50%). Based on the presence of CKD, the patients were divided into CKD (n = 70) and non‐CKD (n = 192) groups, which CKD was defined as estimated glomerular filtration rate < 60 ml/min/1.73 m2. The primary outcome was major adverse cardiac events (MACEs), including cardiac death, myocardial infarction, hospitalization for heart failure, and aortic valve replacement.ResultsThe median follow‐up duration was 41.5 (interquartile range: 16.2–71.7) months. Between groups, the CKD patients were older; they had a higher pulse pressure and higher incidence of hypertension, diabetes mellitus, dyslipidemia, cerebrovascular accident, and atrial fibrillation. Compared to the non‐CKD group, the CKD group had lower eʹ velocity (4.36 ± 2.21 vs. 5.20 ± 2.30 cm/s, p = .009), higher right ventricular systolic pressure (38.02 ± 15.79 vs. 33.86 ± 11.77 mmHg, p = .047). The CKD group was associated with increased risk of MACEs (41.4% vs. 22.4%; unadjusted hazard ratio [HR]: 1.78, 95% confidence interval [CI]: 1.11–2.85, p = .017). In multivariate Cox regression analyses, the risk of MACEs was significantly different between groups (adjusted HR: 1.71, 95% CI: 1.11–2.62, p = .015); furthermore, the risk of hospitalization for heart failure (10.0% vs. 2.6%; adjusted HR: 2.30, 95% CI: 1.16–4.55, p = .017) was significantly higher in the CKD group than in the non‐CKD group.ConclusionsIn patients with Stage B progressive AR, CKD is an independent prognostic factor for clinical outcomes (composite clinical outcome, hospitalization for heart failure).

POS-358 SERUM NITRIC OXIDE AND NOT ASYMMETRIC DIMETHYL ARGININE OR MATRIX METALLOPROTEINASE 2 DETECTS ENDOTHELIAL DYSFUNCTION IN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE PATIENTS WITH EARLY DISEASE

Cardiovascular complications are the leading cause of death in patients with autosomal dominant polycystic kidney disease (ADPKD) and there is a high incidence of hypertension in ADPKD patients with early disease. Endothelial dysfunction (ED) is an early marker of cardiovascular complications and this has also been reported in ADPKD. However, published studies have included a significant number of patients with later stage disease and other known comorbidities that are also associated with ED including hypertension.

Incident hypertension in relation to aircraft noise exposure: results of the DEBATS longitudinal study in France

BackgroundAlthough several cross-sectional studies have shown that aircraft noise exposure was associated with an increased risk of hypertension, a limited number of longitudinal studies have addressed this issue. This study...

Defining kidney outcomes in children with acute lymphoblastic leukemia in the modern era.

To define the incidence of acute kidney injury (AKI), chronic kidney disease (CKD), and hypertension (HTN) in pediatric patients diagnosed with acute lymphoblastic leukemia (ALL) over a recent 9-year period. This study is a retrospective cohort study of all pediatric patients diagnosed with ALL at Nationwide Children's Hospital from January 1, 2008, to December 31, 2016. Patient demographic and clinical data including serum creatinine and blood pressure were collected at diagnosis up to 9years post diagnosis. A total of 222 patients were identified for this study. The overall incidence of AKI in our cohort was high, with 101 subjects (45.5%, CI 38.8-52.3%) developing AKI at least once. CKD status could only be determined in 214 patients due to limited later GFR data. The incidence of CKD was low with only 5 of 214 patients developing CKD (2.3%, CI: 0.8-5.4%). The overall incidence of HTN at diagnosis was 45.6% (95% CI: 59.1-72%), and at 1month post diagnosis was 65.8% (95% CI: 59.1-72.0%). Chronic HTN could only be determined in 216 patients due to limited blood pressure data. Chronic HTN was noted in 34.3% of patients (74/216, 95% CI: 28-41%). Among children with ALL, the incidence of AKI is relatively high at the time of diagnosis. However, development of CKD is relatively rare, suggesting good mid-term kidney prognosis. There is a high incidence of HTN at the time of diagnosis, 1month post diagnosis, and chronic HTN that often goes untreated. A higher resolution version of the Graphical abstract is available as Supplementary information.