Higher Prevalence Of Hypertension Research Articles

Pre-diagnostic risk factors for brain cancer incidence and survival: insights from the Golestan Cohort Study

BackgroundBrain cancer is an important public health concern in terms of its burden and the cost of its treatment. Evidence on determinants of brain cancer incidence and survival are sparse and inconsistent. We aimed to explore the pre-diagnostic factors for brain cancer incidence and survival in northeastern Iran.MethodsData for the current study were derived from the Golestan Cohort Study, the largest cohort study in the Middle East on over 50,000 participants aged 40 to 75 years with a median follow-up of 15 years. Minimally adjusted and multiple Cox proportional hazards models were used to investigate the association of demographic and behavioral risk factors with brain cancer incidence and survival.ResultsOut of the 49,783 cancer free participants recruited at baseline, 77 patients were diagnosed with brain cancer and 62 patients were deceased till the end of the follow-up. Annual cancer mortality rate was 0.31 (95% Confidence Interval: 0.24 – 0.39), one-year survival was 38%, and the median survival was 0.72 years. In the multiple model, Turkmen ethnicity (Hazard Ratio = 0.42 (0.23–0.76)), urban residence (HR = 0.46 (0.25–0.84)), overweight or obesity (HR = 0.48 (0.25–0.93)), and history of animal contact (HR = 0.43 (0.19–0.96)) were associated with a better survival. Patients diagnosed with brain cancer had higher prevalence of hypertension, opium use, and smoking compared to cancer free participants.ConclusionsOur results indicate a complex interplay of demographic and life style risk factors influencing both the incidence and prognosis of brain cancer. Further research is mandated to inform policy makers of potentially effective preventive initiatives to reduce the burden of this cancer.

Cohort profile: Noncommunicable diseases and ideal cardiovascular health among people living with and without HIV in Zambia and Zimbabwe (NCDzz cohort)

PurposeThe NCDzz study is a prospective cohort of people living with and without HIV attending primary care clinics in Zambia and Zimbabwe and was established in 2019 to understand the...

Community prevalence of positional obstructive sleep apnea.

The prevalence of positional obstructive sleep apnea (POSA) in community populations warrants further investigation. Further, more research is needed into the clinical characteristics of its subtypes such as supine predominant OSA (spOSA) and supine isolated OSA (siOSA). A cross-sectional analysis was performed on 1870 Sleep Heart Health Study participants. OSA was defined by an apnea-hypopnea index (AHI) of five events or more per hour of sleep. Participants with OSA were classified as POSA if the supine AHI was ≥2 times the non-supine AHI. Participants with OSA who did not meet this threshold were classified as non-positional OSA participants (non-POSA). Demographics, polysomnographic data, comorbidities, and medications were all considered. The POSA subtypes spOSA and siOSA were also investigated. POSA participants were slightly older, less obese, and had higher systolic blood pressure than non-POSA subjects, in addition to being more prevalent (62% and 38%, respectively). POSA exhibited higher supine and total AHI. The prevalence of comorbidities or prescription drugs did not differ. In the POSA cohort, spOSA was more prevalent than siOSA (56% vs. 44%). When compared to siOSA, spOSA was associated with more fragmented sleep and higher AHI. Furthermore, when compared to the siOSA group, the spOSA group had a higher prevalence of hypertension and diabetes, as well as more frequently prescribed medications for these comorbidities. In the SHHS population the prevalence of POSA is greater than non-POSA. The spOSA subtype is more prevalent and appears to have worse health consequences than siOSA.

A Study Of the effect of Sex on drug dosing, concentrations, and pharmacogenomics in the Montreal Heart Institute Hospital Cohort (SOS-PGx): methodology and research progress.

Women are underrepresented in drug development trials and there is no sex-tailored drug regimen for most medications. It has been repeatedly shown that women have more adverse drug reactions than men for several medications. These differences could be explained by higher dose-adjusted drug concentrations in women. Thus, we aim to identify sex-related differences and to characterize the clinical and genetic predictors of these differences in drug concentrations, dosing, and adherence for 47 commonly used drugs in a large cohort. The objective of this article is to present an overview of the methods and characteristics of the study population. We performed a cross-sectional study that included 10,082 men and women of European ancestry aged ≥ 18years from the Montreal Heart Institute Hospital Cohort taking at least one of the 47 medications regularly. Of the 10,082 participants included, 36% were women. Women had lower weight, height, waist girth, and body mass index than men, but they had higher hip girth (all p < 0.001). Men had a higher level of education and annual income and were more likely to be employed full-time compared to women. Furthermore, men had a higher prevalence of hypertension, type2 diabetes, dyslipidemia, andmyocardial infarction (all p < 0.001) and were more likely receiving lipid-lowering agents, beta-blockers, antidiabetic drugs, and angiotensin-converting enzyme inhibitors. Conversely, proton pump inhibitors were more prevalent in women. Interestingly, nearly half of the women had a history of drug allergy or intolerance, compared with less than one-third of the men (p < 0.001). This study has a high potential in understanding eventual sex differences in drug dosing requirements and will most likely provide useful information to personalize drug regimens in women.

Potential mechanism associated with post-heart transplantation diabetes mellitus in Chinese patients.

Post-transplantation diabetes mellitus (PTDM) is a common metabolic complication following heart transplantation, which not only leads to elevated microvascular morbidity, but also seriously affects graft function and recipient survival. However, the specific metabolites and underlying mechanisms are not yet fully understood. A total of 106 adult heart transplant recipients (56 PTDM and 50 non-PTDM) who followed for more than one year were enrolled in the study. The untargeted metabolomics was performed by ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). The demographic, clinical data and drug information were collected at the time of sample collection. PTDM patients were older (p=0.003), with higher BMI (p=0.010), higher triglyceride levels (TG, p=0.007), and a higher prevalence of hypertension (p=0.001) than non-PTDM. A total of 1174 metabolites were detected, of which 99 metabolites showed significantly differentially abundant (VIP>1, p<0.05, FC>1.5 or <0.67). KEGG functional enrichment analysis showed these differently expressed metabolites could be further enriched in ABC transporter, carbon metabolism, retrograde endocannabinoid signaling, phospholipase D signaling pathway. Compared with non-PTDM group, glutamate, diacylglycerol (DAG) and D-sorbitol were significantly changed in PTDM through metabolomics. These findings may provide a novel understanding of the pathological mechanism of PTDM and could be utilized to predict the development and progression of PTDM.

Abstract TP334: Racial Disparities in Functional Outcomes and Stroke Recurrence in Young Patients with Ischemic Stroke

Introduction: Studies have reported racial disparities in acute stroke treatment and follow-up care in young patients which lead to less desirable outcomes for minorities. This study aimed to identify potentially modifiable factors for better stroke treatment and prevention in minority populations. Methods: Young patients aged 18-50 years who were admitted with ischemic stroke during 09/2016-12/2022 were retrospectively identified and stratified as non-Hispanic White (WH), non-Hispanic Black (BL), and Hispanic (HS). Racial differences in risk factors, stroke etiology, acute intervention, and follow-ups were examined using Chi-square and Kruskal-Wallis tests as appropriate. Cumulative probabilities of stroke recurrence were estimated using the Kaplan-Meier (KM) method and tested with the Log-rank (Mantel-Cox) test. A logistic regression was used to evaluate the odds ratio of favorable functional outcomes (mRS ≤2) by 90 days. A backward stepwise Cox regression was conducted to identify predictors of stroke recurrence reported as hazard ratio (HR) and a 95% confidence interval (CI). Results: A total of 318 patients were identified with a median age of 43 and 57.5% male, covering 57.2% WH, 22.3% BL, and 20.4% HS. Compared to WH, more BL and HS were comorbid with diabetes, hypertension, and prior stroke (p&lt;0.05). The rates of other risk factors did not vary by race. The distribution of stroke etiologies and rate of acute interventions (IV tPA, thrombectomy) were similar among the three. After discharge, 77.3% of young patients had ≥1 follow-ups at stroke clinic. The total number of stroke clinic follow-ups were similar among racial groups. At 90 days, 89.6% of patients achieved mRS≤2; the odds of having this favorable functional outcome were similar among racial groups ( p =0.207). The KM curve indicates that the first-year risks of stroke recurrence were similar among racial groups and that a trend showed BL had the highest risk of recurrent strokes, followed by HS, and WH had the lowest risk in 1-3 year follow up. Yet, these differences were not statistically significant ( p =0.056. BL was found to have 2.7 times higher risk to have a recurrent stroke than whites (HR: 3.7; 95% CI: 1.4-10.1; p=0.01). Conclusions: Findings highlighted high prevalence of hypertension and diabetes in young BL and HS and a higher risk of recurrent stroke in young BL, suggesting tailored interventions for comorbidities are urged for better stroke prevention in minorities.

Countries with Fewer Procedures for Cardiovascular Disease Management Face Greater Premature Mortality from Noncommunicable Diseases

Abstract Background: The rate at which low- and middle-income countries (LMICs) are transitioning into high-burden states for noncommunicable diseases (NCDs) is currently posing a global health security threat. Not only cardiovascular disease (CVD) occurs earlier in these countries but also it is likely that individuals do not have access to adequate management procedures. The present study was undertaken to find the effect of availability of procedures for CVD management on premature mortality in NCDs and to juxtapose this with the prevalence of two main risk factors, hypertension and diabetes. Methods: The World Health Organization’s Global Health Observatory data were used, which include health-related data on its 194 member states. The correlation matrix was constructed for risk factors, income classification, availability of CVD management procedures, and premature NCD mortality. Multiple linear regression was done to find the association between availability of management procedures, income classification, and premature NCD mortality. Results: A negative correlation was observed between premature NCD mortality and income group and between premature NCD mortality and availability of CVD management procedures. Countries possessing fewer procedures for CVD management suffered a greater burden of premature NCD mortality, and this was in the form of a strong linear association. Income class and availability of CVD management procedures both independently affected premature NCD mortality. Each unit increase in income class and number of CVD management procedures reduced the premature NCD mortality by 7.9 and 2.8 units, respectively. The impact of both these factors on premature NCD mortality was statistically significant. Countries with higher prevalence of hypertension were seen to be possessing fewer CVD management procedures. Income groups also demonstrated disparities, with high-income countries bearing less burden of hypertension and having more ubiquitous CVD management resources. Conclusion: The present study found that availability of CVD management procedures, such as thrombolysis, coronary bypass/stenting, and acute stroke care and rehabilitation, significantly reduce premature NCD mortality across the world. Countries that face higher burden of premature NCD mortality are not only the ones that are least prepared to manage them but also the ones that bear the greatest prevalence of risk factors like hypertension and diabetes. Making procedures for NCD management available in LMICs must be put on high priority on the global health agenda.

Assessment of serum levels of 8-hydroxy-2’ deoxyguanosine and f2-isoprostanes in newly diagnosed adult hypertensive with clinical depression in NAUTH, Nnewi, Nigeria

Despite the high prevalence of depression and hypertension, the relationship between the two diseases has received little attention. The potential roles of some biomarkes of oxidative stress in disease progression and management is very crucial. Aim: The present study therefore, evaluated the serum levels of 8-hydroxy-2’ deoxyguanosine (8-OHdG) and F-2 isoprostanes in newly diagnosed hypertensive individuals with and without depression at Nnamdi Azikiwe University Teaching Hospital, Nnewi. Method: This was a cross sectional study carried out on randomly selected 121 consented adult male and female participants within the ages of 18-65 years which comprises 30 newly diagnosed hypertensive individuals without depression (Hypertensive), 31 hypertensive individuals with depression selected from the department of internal medicine. 30 non hypertensive with depression (Depressive) and 30 apparently healthy non-hypertensive individuals without depression which served as control selected among the hospital staff. Their bio-data was obtained from their hospital records. 3 ml of venous blood were collected from each of the participants, dispensed into a plain container, centrifuged and serum separated into another container and stored at -20 0C for the assessment of serum 8-OHdG using Enzyme Linked Immunosorbent Assay (ELISA) Method. Result: The result showed that Hypertensive individuals with and without clinical depression (107.08±22.05, 129.16±82.49) had significantly higher serum level of 8-OHdG when compared with control group (53.95±28.25) (P&lt;0.05 respectively). Hypertensive individuals (129.16±82.49) also had significantly higher 8-OHdG level when compared with non-hypertensive with depression (63.31±37.30) (P&lt;0.05). Hypertensive individuals with depression (9.94±7.14) and depressive individuals (8.99±5.84) also had significantly higher F2-Isoprostanes level when compared with control (5.15±1.47) (P&lt;0.05 respectively). There was a moderately strong positive correlation between 8-OHdG level and body mass index in both hypertensive and depressive individuals (r=0.682, P&lt;0.05). Conclusion: The study observed higher 8-OHdG and F2-Isoprostanes in individuals with hypertension with and without clinical depression. In addition, there is evidence that oxidative stress is related to inflammation and endothelial activation in individuals with both conditions leading to disease severity.

Percutaneous edge-to-edge mitral valve repair in patients with complex mitral valve anatomy: mid- to long-term results in a tertiary referral university hospital.

Abstract Introduction Transcatheter edge-to-edge repair (TEER) has proven to be an effective therapeutic alternative for certain cases of mitral regurgitation (MR) in patients who are not surgical candidates. Accumulated experience and technological advances allow TEER in selected patients with complex mitral valve anatomy who might initially be considered non-candidates for percutaneous treatment. Our main objective was to analyse the mid-to long-term characteristics and prognosis in patients with complex mitral valve anatomy treated with this technique compared to those with non-complex mitral anatomy. Methods An observational study was conducted on a prospective cohort of patients from a tertiary referral hospital, which included all cases of severe MR treated using TEER from November 2011 to January 2024. Two groups of patients were compared: those with complex valve anatomy (CVA) versus those who did not present it (NCVA). Mitral valve complexity was defined as the presence of mitral cleft, calcification in the grasping zone, mitral valve area (MVA) ≤3cm2 , mobile posterior leaflet length &amp;lt;7mm, rheumatic leaflet thickening or presence of Barlow syndrome. Clinical, analytical and echocardiographic variables were analysed at baseline and during follow-up. Baseline characteristics and event-free survival, defined as death or hospitalisation for heart failure (HF) during follow-up, were compared between the CVA and NCVA groups using Kaplan-Meier curves. Results A total of 191 patients were analysed (67% male, median age 74 (64-80) years), of whom 53 cases had complex valve anatomy. Among these, 7 cases presented with a mitral cleft, 2 cases had calcification in grasping zone, 3 cases had MVA≤3cm2, 35 cases with a mobile posterior leaflet length &amp;lt;7mm, 3 cases with rheumatic leaflet thickening and 8 cases had Barlow syndrome. Baseline clinical characteristics of both groups showed no significant differences, though there was a higher prevalence of hypertension in the CVA group, as shown in table 1. Most patients were in NYHA III-IV (62.3% CVA vs 72.4% NCVA, p=0.40) with a high percentage of prior hospitalization for HF in both groups without significant differences. The most common etiology of MR was functional with no differences between groups (CVA 77.4% vs NCVA 78.2%, p=0.43). With a median follow-up of 24 [9-50] months, event-free survival for readmission due to HF or all-cause mortality was 67% in CVA group, versus 64% in NCVA group, with no significant differences in median survival between them (p=0.41) (Figure 1). Conclusions In patients with MR and complex mitral valve anatomy who were initially not candidates for surgical or percutaneous treatment, a high event-free survival from death or readmission due to HF was achieved in the medium to long term. In centres with accumulated experience, TEER represents an effective therapeutic tool even in cases with complex anatomy, with no differences compared to those with more favourable anatomy. Baseline clinical characteristics. Kaplan-Meier curves

Dyspnoea and atypical angina: two sides of the same coin?

Abstract Introduction the latest guidelines from the European Society of Cardiology introduce dyspnoea into the risk stratification for patients with suspected coronary artery disease, equating it with atypical angina in terms of pre-test probability. Traditionally, dyspnoea has been considered an angina equivalent in certain patients, although its origin is often due to non-cardiological pathologies. Furthermore, the percentage of patients presenting with dyspnoea without chest pain and with ischaemia on stress tests varies widely across studies. Objectives the aims of our study were to determine the profile of patients referred to our Cardiac Imaging Unit for coronary artery disease screening whose symptom were dyspnoea or atypical angina, to assess the percentage of studies with induced ischaemia in this population, and to compare this percentage between the two groups of patients. Methods retrospective analysis including 626 consecutive patients who presented to our centre for stress echocardiography to screen for unknown coronary artery disease and whose referral symptons were atypical angina or dyspnoea without chest pain. To compare the probability of presenting ischaemia between the two groups, a 1:1 propensity score matching analysis was performed, incorporating traditional risk factors, as well as age, sex, body mass index (BMI), peripheral arterial vascular disease, pulmonary disease, obstructive sleep apnoea, anxiety-depressive syndrome, beta-blocker or contrast agents use, and baseline wall motion or electrocardiogram abnormalities. Results of the 626 patients, 149 (24%) were referred for dyspnoea without chest pain. Compared to patients presenting with atypical angina, those with dyspnoea were older (69.9 years vs 64.8 years, p&amp;lt;0.01), had a higher BMI (29.7kg/m² vs 28.8kg/m², p=0.05), and a higher prevalence of hypertension (71% vs 58%, p=0.006), diabetes mellitus (40% vs 28%, p=0.006), dyslipidaemia (68% vs 56%, p=0.009), and pulmonary disease (24% vs 12%, p&amp;lt;0.001). Patients referred for dyspnoea underwent pharmacological stress echocardiography more frequently (35% vs 20%, p&amp;lt;0.001) and contrast agents were used more often (30% vs 21%, p=0.020), with basal wall motion abnormalities observed more frequently (14% vs 5%, p&amp;lt;0.001). The percentage of studies with induced ischaemia in the dyspnoea group was slightly higher (6% vs 4%), but this difference was not statistically significant (p=0.349). Propensity matching score analysis did not reveal a higher odds of ischaemia in the dyspnoea group (OR 1.00, p=0.921, 95% CI 0.94-1.06). Conclusions the percentage of positive studies in patients referred for dyspnoea or atypical angina was low in both groups. Despite the higher prevalence of risk factors in the dyspnoea referral group, the likelihood of ischaemia on stress echocardiography is very similar between the two groups. Clinical and stress characteristics Balance plot between groups

Hemorrhoidal Disease in the Diabetic Population: The Effects of Glucose Regulation and Lipid Profile

Background: Hemorrhoidal disease is a common anorectal condition characterized by the enlargement and distal displacement of the typical vascular structures in the anal canal. The relationship between DM, lipid metabolism, and hemorrhoidal disease remains underexplored. This study aims to investigate the prevalence of hemorrhoids and the association between glycemic control and lipid profile in diabetic patients. Methods: This retrospective cross-sectional study included 752 patients who underwent colonoscopy at Erzurum Regional Training and Research Hospital between June 2021 and August 2024. The study population comprised 452 patients with type 2 diabetes mellitus (mean age 63.4 ± 11.0) and 300 nondiabetic patients (mean age 62.8 ± 10.8). The presence of hemorrhoids was confirmed through colonoscopy. Glycemic control parameters, lipid profile, and other biochemical parameters were analyzed. Results: Hemorrhoids were found in 47.3% (n = 214) of diabetic patients and 17.3% (n = 52) of nondiabetic patients, indicating a significantly higher prevalence in the diabetic group (OR = 4.3, CI = 3.0–6.2, p &lt; 0.001). Diabetic patients with hemorrhoids had significantly higher mean HbA1C (8.1 ± 2.1 vs. 7.5 ± 1.8, p &lt; 0.001), low-density lipoprotein (p &lt; 0.001), and triglyceride levels (p = 0.005) compared to those without hemorrhoids. Additionally, a longer duration of diabetes and higher hypertension prevalence were observed in the hemorrhoid group. Conclusions: The findings suggest that poor glycemic control and dyslipidemia are significantly associated with an increased prevalence of hemorrhoids in diabetic patients. These results highlight the importance of comprehensive management of diabetes, including lipid control, to potentially reduce the risk of hemorrhoidal disease.

Medication adherence and blood pressure control in treated hypertensive patients: first follow-up findings from the PREDIcT-HTN study in Northern Bangladesh

IntroductionAdherence to antihypertensive medication is crucial to control blood pressure (BP) and hypertension management outcomes. In Bangladesh, as in many other countries, poor adherence to medication represents a challenge to effective hypertension management. This study aims to investigate the prevalence and relationship between medication adherence and BP management among hypertensive patients in Bangladesh.MethodsThe PREDIcT-HTN study in Northern Bangladesh aims to evaluate major adverse clinical events in treated hypertensive patients. The study involves 2643 hypertensive patients from a medical center, with data collected through baseline information and yearly follow-ups until 2025. The first follow-up visit was conducted between January and March 2021. Following the 2020 ISH-global hypertension guideline, patients were classified as having controlled BP, grade-I, or grade-II uncontrolled BP. Patients were divided into three groups (good, moderate, and poor) based on their 9-item Hill-Bone medication adherence scale. A multinomial regression analysis was conducted to identify the association between medication adherence and BP control after adjusting potential confounders.ResultsAnalysis of 2276 hypertensive patients (mean age 51.31 ± 11.58 years) revealed that 36.1% had grade-I and 24.2% had grade-II uncontrolled hypertension. Most patients (78%) displayed moderate adherence, and 15% showed poor medication adherence. Certain patient subgroups had higher rates of poor adherence: females (17.1%) compared to males (12.2%), rural residents (22.4%) compared to city-dwellers (12.2%), and newly diagnosed patients (17.2%) compared to those diagnosed 2–5 years earlier (12.6%). Multivariable analysis found a strong association between medication adherence and BP control. Compared to poor adherence, moderate adherence (relative risk ratio (RRR):0.50, 95%CI:0.36–0.68) and good adherence (RRR:0.56, 95%CI:0.35–0.91) were associated with better control. Increasing age, rural living, and uncontrolled hypertension were also linked. Comorbidities worsened BP control, and managing multiple medications contributed to poor adherence and grade-II hypertension in patients.ConclusionThe high prevalence of uncontrolled hypertension in Bangladesh underscores the need for improved treatment strategies. Addressing medication adherence is essential for better BP control, with particular attention needed for women, rural residents, and newly diagnosed individuals. A comprehensive approach is warranted, including strategies to enhance adherence, early diagnosis, personalized treatment, and simplified medication regimens. These efforts align with the UN's 2030 SDGs, emphasizing targeted interventions for equitable healthcare access and outcomes.

PREVALENCE OF HYPERTENSION IN MEDICAL PROFESSIONALS OF SMS, MEDICAL COLLEGE, JAIPUR AND ASSESSING THEIR AWARENESS ABOUT HYPERTENSION AND LIFESTYLE MEASURES TO CURB IT

Objective: Hypertension presents a significant public health challenge in India, particularly among medical professionals who are notably vulnerable to this condition. Assessing their awareness about hypertension and lifestyle measures is crucial for effective intervention. Methods: This cross-sectional study was conducted at SMS Medical College, Jaipur, involving 220 medical professionals aged 23 to 60 years, including 145 males and 75 females. The study aimed to estimate the prevalence of hypertension, assess knowledge regarding the condition, and gauge awareness of lifestyle interventions to curb it. Results: Among the participants, 45.4% were normotensive, 43.2% had Stage I hypertension, and 11.3% had Stage II hypertension. The prevalence of hypertension was notably higher among those with higher body mass indices (BMI): 70% in the obese category, 56% in the overweight category, and 41.8% in the normal BMI group. Regarding awareness, 85% of the participants had good knowledge about hypertension, and 78% were aware of lifestyle measures to manage it. However, only 60% reported implementing these measures in their daily lives. Conclusion: The study uncovered a high prevalence of hypertension among medical professionals. While awareness about hypertension and lifestyle measures is relatively high, actual implementation is suboptimal. Addressing BMI and promoting the adoption of lifestyle modifications could help mitigate the impact of hypertension within this group.

Prevalence of Hypertension and Associated Risk Factors among Post-Menopausal Women of Boalkhali Upazila of Chattogram District: Cross Sectional Observational Study

Background: Prevalence of hypertension increases with age and postmenopausal women remain at higher risk than other population group. Various risk factors attribute to the precipitation of the postmenopausal hypertension, however definitive mechanism have not been completely explicated till date. Aims of the study: The study attempted to evaluate the prevalence of hypertension and associated risk factors among postmenopausal women of Boalkhali Upazila, Chattogram, Bangladesh. Materials and method: This cross-sectional study was conducted at Boalkhali Upazila of Chattogram District with total 400 post-menopausal women who have been included in this study with convenient sampling method. Results: The study results showed that, mean age of postmenopausal women was 58.65±7.67 years, 11.75% of them had pre-hypertension and 35.75% of them had hypertension. A logistic regression analysis showed that, age, marital status, menopausal onset, BMI, hip circumference, family history of comorbidities (hypertension, diabetes mellitus and both hypertension and diabetes mellitus), comorbidities of the respondents such as diabetes mellitus, ischemic heart disease and sedentary life style were independent risk factors of hypertensive status of the post-menopausal women when adjusted for other risk factors (p&lt;0.05) Conclusion: This study conclude that, high prevalence of hypertension among post-menopausal women. So, its need to be more concern about post-menopausal women to reduce the prevalence of hypertension and risk factors to avoid hypertension related cardiovascular death and other dare complications. University Heart Journal 2024; 20(1): 22-30

Effects of Genetic Risk and Lifestyle Habits on Gout: A Korean Cohort Study.

Gout is a type of inflammatory arthritis caused by monosodium urate crystal deposits, and the prevalence of this condition has been increasing. This study aimed to determine the combined effects of genetic risk factors and lifestyle habits on gout, using data from a Korean cohort study. Identifying high-risk individuals in advance can help prevent gout and its associated disorders. We analyzed data from the Korean Genome and Epidemiology Study-Urban Health Examinees cohort (KoGES-HEXA). Genetic information of the participants was collected at baseline, and gout cases were identified based on patient statements. The polygenic risk score (PRS) was calculated using nine independent genome-wide association study datasets, and lifestyle factors and metabolic syndrome status were measured for each participant using the KoGES. Logistic regression models were used to estimate the odds ratios (ORs) for gout in relation to genetic risk, lifestyle habits, and metabolic health status, after adjusting for age and sex. Among 44,605 participants, 617 were diagnosed with gout. Gout was associated with older age, higher body mass index, and higher prevalence of hypertension, diabetes, and hypertriglyceridemia. High PRS, unfavorable lifestyle habits, and poor metabolic profiles were significantly associated with an increased risk of gout. Compared with that in the low-genetic-risk and healthy lifestyle group or ideal metabolic profile group, the risk of gout was increased in the high-genetic-risk plus unfavorable lifestyle (OR, 3.64; 95% confidence interval [CI], 2.32-6.03) or poor metabolic profile (OR, 7.78; 95% CI, 4.61-13.40) group. Conversely, adherence to favorable lifestyle habits significantly reduced gout risk, especially in high-genetic-risk groups. Genetic predisposition and unhealthy lifestyle habits significantly increase the risk of gout. Promoting healthy lifestyle habits is crucial to prevent the development of gout, particularly in individuals with high genetic susceptibility.

Use of the Ostial Flash balloon in aorto-ostial chronic total occlusion percutaneous coronary intervention.

The use of the Ostial Flash balloon (Ostial Corporation) has received limited study in aorto-ostial chronic total occlusion (CTO) percutaneous coronary artery intervention (PCI). The authors evaluated the outcomes of Ostial Flash balloon use in a large CTO-PCI registry (PROGRESS-CTO, NCT02061436). The Ostial Flash balloon was used in 54 of 907 aorto-ostial CTO PCIs in 905 patients (6.0%). The mean patient age was 65.1 ± 10.7 and 80.6% were men, with a high prevalence of diabetes mellitus, hypertension, prior PCI, and prior myocardial infarction. The mean occlusion length was 40.5 ± 25.1 mm, 52.2% had moderate to severe calcification, and the mean Japanese-CTO score was 2.8 ± 1.1. Lesions treated with the Ostial Flash balloon were more frequently located in the right aorto-ostium (79.6% vs 66.0%, P = .002). In the Ostial Flash group, the most common successful CTO crossing technique was antegrade wiring (46.3%), followed by the retrograde approach (40.7%); intravascular imaging was used in 61.1% of cases. Technical success (92.6% vs 87.9%, P = .300) and the incidence of major adverse cardiac events (MACE) (5.6% vs 3.6%, P = .450) was similar in the Ostial Flash vs non-Ostial Flash patients, respectively. In multivariable analysis, PCI of proximal right coronary artery CTOs was independently associated with use of the Ostial Flash balloon (odds ratio 2.2; 95% CI, 1.1-4.8; P = .036). The Ostial Flash balloon is infrequently used in aorto-ostial CTO PCI. Although there were no differences in MACE with use of the balloon, randomized controlled trials are needed to determine its effectiveness.

Vitamin D Deficiency and Related Factors among Healthcare Professionals. A Cross-Sectional Study in a Tertiary Hospital

Vitamin D deficiency is a global health issue, affecting various populations including healthcare professionals. Despite their awareness and access to health resources, healthcare professionals are not immune to this deficiency. This study aims to investigate the prevalence and associated factors of vitamin D deficiency among licensed physicians and nurses in a tertiary hospital in Taiyuan, Shanxi Province. A cross-sectional study was conducted from January to March 2022, involving 1944 healthcare professionals (608 licensed physicians and 1336 nurses) at Shanxi Bethune Hospital. Serum 25-hydroxyvitamin D [25-(OH)D] levels were measured using the enzyme-linked immunosorbent assay (ELISA). Participants' demographic data, body mass index (BMI), and job-related factors were collected and analyzed. Significant differences were observed in age, gender distribution, and BMI between licensed physicians (LPs) and nurses. LPs were generally older, had a higher BMI, and a higher prevalence of hypertension. The median vitamin D level was slightly higher in LPs (9.4 ng/mL) compared to nurses (8.7 ng/mL). However, both groups exhibited a high prevalence of vitamin D deficiency, with 78.12% of LPs and 85.63% of nurses affected. Univariable and multivariable logistic regression analyses identified several factors associated with vitamin D deficiency. Age over 30 years was associated with a lower likelihood of deficiency (OR=0.68, 95% CI 0.50-0.92, P=0.013). Nurses were more likely to be deficient compared to LPs (OR=1.26, 95% CI 1.10-1.44, P=0.001). Lower-than-normal uric acid (UA) levels were associated with an increased risk of deficiency (OR=1.51, P=0.034). Vitamin D deficiency is prevalent among healthcare professionals, with nurses being more affected than licensed physicians. Factors such as age, job type, and UA levels significantly contribute to this deficiency. It is essential to implement multi-level interventions including increased sunlight exposure, work environment improvements, and regular health check-ups to enhance the vitamin D status of healthcare professionals. Keywords: Vitamin D deficiency, Healthcare professionals, Cross-sectional study, Tertiary hospital, Risk factors, Nurses, Licensed physicians

Using waist circumference as a predictor of hypertension in Manzese, Dar es Salaam: a community-based cross-sectional study, 2023

IntroductionIt is estimated that 1.3 billion people in the world have hypertension and a large proportion of them are unaware. Waist circumference has emerged as Potential predictor of Cardiovascular Diseases (CVD) risk; however, fewer studies in Tanzania have evaluated its role in screening for CVD risk. This study aimed to determine the role of waist circumference in screening for hypertension, a major risk for CVD.MethodsAn analytical cross-sectional study was conducted in Manzese ward, Dar es Salaam, from August to September 2023. Adults who attended a screening campaign were systematically randomly sampled. Data were collected using WHO STEPwise Approach to Chronic Disease Risk Factor Surveillance questionnaire. The relationship between waist circumference and hypertension was analyzed using a Modified Poisson regression model with robust standard errors.ResultsAmong 561 participants screened, 70.4% were female, with a median age of 47 years (IQR: 34–58). The overall prevalence of hypertension was 45.8% (95% Confidence interval [CI]: 41.7–49.9). Those with elevated waist circumference had a 34% higher likelihood of hypertension (adjusted prevalence ratio [aPR] 1.34, 95% CI: 1.03–1.73, P = 0.027). Participants aged 35 and above were 160% more likely to be hypertensive (aPR 2.6, 95% CI: 1.79–3.78, P < 0.001). A family history of hypertension increased the likelihood by 31% (aPR 1.31, 95% CI: 1.08–1.59, P = 0.006). Conclusion This study reveals a high prevalence of hypertension among Manzese residents, with key risk factors including elevated waist circumference, age ≥ 35 years and a family history of hypertension. The strong association between waist circumference and hypertension suggests that incorporating waist measurement into cardiovascular risk assessment could enhance early detection and improve prevention efforts. This practical and cost-effective approach may improve the identification of at-risk individuals, enabling timely interventions and reducing the long-term burden of hypertension-related complications.

Clinical Characteristics and Outcomes of Elderly Patients Undergoing Primary Percutaneous Coronary Intervention: An Observational Cohort Study.

The global trend of population aging has resulted in more frequent cardiovascular disease among seniors. Primary percutaneous coronary intervention (pPCI) is the standard of care for ST-elevation myocardial infarction (STEMI) without an upper age limit. Nevertheless, the outcomes are variable among studies, and data on pPCI outcomes in the elderly in Africa is scarce. Thus, we attempted to gain better insight into the outcomes of primary PCI in this age group from a single center in upper Egypt. To study the patient characteristics and in-hospital outcomes of pPCI in elderly patients presenting with STEMI in a tertiary cardiac center in upper Egypt. This observational cohort study was based on data from the pPCI registry in a tertiary cardiac center in upper Egypt, which included 3,627 consecutive patients who underwent pPCI between January 2014 and June 2023. The elderly were defined as those aged 70 years or older and represented 15.9% (575 patients) of the entire cohort, of whom 103 (2.8%) were octogenarians. Clinical characteristics, procedural details, and in-hospital outcomes were compared between the age groups. The elderly had a significant trend of being female and hypertensive, and having chronic kidney disease (CKD), worse Killip class, more frequent severe non-culprit vessel lesions, and left main trunk involvement. The in-hospital mortality was significantly higher than that of younger patients (14.1 vs. 4%, p = <0.001), with higher mortality in octogenarians (23.3%). Killip class ≥II was independently associated with increased hospital mortality in all study age groups. Contrast-induced nephropathy and TIMI major bleeding were also significantly higher. Compared to younger patients, elderly patients undergoing pPCI had a higher prevalence of hypertension and CKD and were more likely to have a worse Killip class. The radial approach was utilized less often in the elderly group. In-hospital complications and mortality, particularly among the octogenarians, were significantly higher than in younger patients.

Evaluation of Myocardial Perfusion Imaging in Patients Undergoing Cardiac Surgery

Background: Precise preoperative risk assessment is essential in cardiac surgery to enhance patient outcomes. Myocardial perfusion imaging (MPI) plays a critical role in assessing myocardial ischemia and guiding surgical decisions, but its specific impact on surgical outcomes requires further investigation. Methods: This retrospective study included 780 patients who underwent cardiac surgery at the Interventional Centers in Xining, Qinghai, China, between March 2020 and September 2023. MPI findings were analyzed to assess their association with intraoperative and postoperative complications. Positron emission tomography (PET) imaging was evaluated for its sensitivity and specificity in detecting ischemia. Results: The cohort had a mean age of 65 years, with 66.5% being male, and a high prevalence of hypertension (69.6%) and diabetes mellitus (41.3%). The MPI results indicated that 33.2% of patients had normal perfusion, while 22.3, 16.8 and 14.9% of patients had mild, moderate and severe ischemia, respectively. Patients with severe ischemia experienced significantly higher rates of intraoperative complications (16.4%), postoperative myocardial infarction (10.3%), arrhythmias (14.7%) and mortality (5.2%) compared to patients with normal perfusion (1.9, 0.8, 3.1 and 0.4%, respectively). PET imaging demonstrated superior diagnostic performance, with the highest specificity (88.3%) and sensitivity (92.6%) for detecting ischemia and guiding surgical decisions. Conclusions: The severity of ischemia, as assessed by MPI, is a significant predictor of clinical outcomes in cardiac surgery. These findings underscored the importance of using MPI not only for preoperative risk stratification but also for guiding personalized treatment based on ischemia severity. PET imaging's diagnostic accuracy further highlights its role as a preferred modality in this context.