Higher Risk Of Hypertension Research Articles

INCREASING THE CAPACITY OF CADRE FOR CONTROLLING HIGH BLOOD PRESSURE (HYPERTENSION) IN THE COMMUNITY IN THE WORKING AREA OF CIBADAK HEALTH CENTER RANGKASBITUNG LEBAK DISTRICT

57 million (63%) mortality occurs in the world, and 36 million (43%) morbidity is caused by non-communicable diseases. WHO in 2010 reported that 60% of the causes of death for all ages in the world were PTM and 4% died before the age of 70 years. Community service in the regional partnership program contributed to the Cibadak Rangkasbitung Community Health Center program with the Lebak District Health Office, PTM patient care with hypertension control. Efforts by the Health Office, Cibadak Health Center to educate the community on prevention, control through POSBINDU, training of cadres in the village on hypertension control. not yet optimal and evenly reach the community. The solution is to increase the understanding of cadres in the village of the Cibadak Community Health Center who have not had training in controlling high blood pressure (hypertension). The method of carrying out the Pre test, providing information inviting health service resource persons to increase the cadre's understanding of the concept of hypertension, prevention efforts, early detection. Lecturers train the skills of cadres to measure blood pressure with digital blood pressure. The next meeting was Post test, Monev cadres conducted education, examined 5 patients with high risk of hypertension. There was an increase in the average score of community knowledge about hypertension from 64.3% to 88.3% from 64.3%, there was an increase in the skills of cadres to measure blood pressure with digital blood pressure from 5 people to 12 people. As a continuation of activities, there needs to be community participation, good cooperation between health cadres and village supervisors, program holders

Upaya Pemberdayaan Masyarakat dalam Pencegahan dan Pengendalian Hipertensi di Desa Sungai Cuka

The prevalence of hypertension in South Kalimantan is 44.1%. In Tanah Bumbu Regency, hypertension is among the top 10 diseases. Coastal areas, like Desa Sungai Cuka, have a high risk of hypertension due to residents' habit of processing seafood with salting as a preservation method. To address this, the community service team implemented the CERDIK program, which involved providing education through posters, counseling, and various tools such as leaflets, digital tensimeters, blood test cards, powerpoints, and pre-post test questionnaires. The program, conducted in August 2022, resulted in a significant change in people's behavior, including regular exercise and reduced salt consumption, to prevent hypertension. These positive outcomes indicate the success of the program delivered by the community service team in Desa Sungai Cuka.

Associations between multiple urinary metals and the risk of hypertension in community-dwelling older adults.

Although metal exposure has been associated with hypertension, the conclusions remain controversial, and studies investigating the predictive effect of multiple metals on hypertension are limited. In this study, we aimed to evaluate the nonlinear dose-response relationship between a single urinary metal and the risk of hypertension, and to assess the predictive effect of multiple urinary metals on hypertension. Of the Yinchuan community-dwelling elderly cohort launched in 2020, 3,733 participants (803 with hypertension and 2,930 without hypertension) were analysed in this study, and the concentrations of 13 metal elements in urine were measured. We found that urinary vanadium (odds ratio (OR): 1.16, 95% confidence interval [CI]: 1.08-1.25), molybdenum (OR: 1.08, 95% CI: 1.01-1.16), and tellurium (OR: 1.14, 95% CI: 1.06-1.22) were associated with higher risk of hypertension, whereas iron (OR: 0.92, 95% CI: 0.85-0.98) and strontium (0.92, 95% CI: 0.85-0.99) were significantly associated with lower risk of hypertension. Restricted cubic splines analysis was conducted in patients with iron concentrations of ≥ 15.48μg/g and ≤ 399.41μg/g and a strontium concentration of ≤ 69.41μg/g, results showed that the risk of hypertension decreased gradually as the urinary concentrations of these metals increased. With an increase in the vanadium concentration in urine, the risk of hypertension gradually increased. In patients with a molybdenum concentration of ≥ 56.82μg/g and a tellurium concentration of ≥ 21.98μg/g, the risk of hypertension gradually decreased as the urinary concentrations of these metals increased. Predictive scores based on the 13 metallic elements were significantly associated with a higher risk of hypertension (OR: 1.34 (95% CI: 1.25-1.45). After additionally including urinary metal concentrations as a parameter variable in the traditional hypertension risk assessment model, integrated discrimination and net reclassification increased by 8.00% (P < 0.001) and 2.41% (P < 0.001), respectively. Urinary vanadium, Mo, and Te concentrations were associated with a higher risk of hypertension, while iron and strontium concentrations were associated with a lower risk of hypertension. Multiple urinary metal concentrations can significantly improve the predictive ability of traditional hypertension risk-assessment models.

Association between solid fuel use and the risk of hypertension in China.

To assess the association between solid fuel use for cooking or heating and the risk of hypertension among individuals over 45 years of age. Baseline questionnaires were used to collect self-reported primary cooking and heating fuel usage. Outcomes were defined as the time of first diagnosis of hypertension. Data were analyzed using Cox proportional hazards models. Solid fuel use for cooking was associated with a higher risk of hypertension. The association between solid fuel for cooking and hypertension remained significant among residents in north China, individuals aged 45-65 years, urban residents, and non-smokers. Solid fuel for heating was associated with a higher risk of hypertension only in South China. Solid fuel use may result in an increased risk of hypertension. Our findings further emphasize the health hazards of solid fuel for cooking and heating.

Pregnancy Complications and Impact on Kidney Allograft After Kidney Transplantation in IgA Nephropathy.

Pregnancy in kidney transplantation (KT) recipients has been challenging because of the high risk of maternal, fetal, and renal complications. Although patients with immunoglobulin A nephropathy (IgAN)-chronic kidney disease (CKD) are at a high risk for hypertension in pregnancy (HIP), the maternal risk in KT recipients with IgAN as the etiology remains unclear. We retrospectively reviewed the medical records of pregnant KT recipients who delivered at our hospital. The incidence of maternal and fetal complications and the impact on kidney allografts between the group with IgAN as the primary kidney disease and the group with other primary diseases were compared. The analysis included 73 pregnancies in 64KT recipients. The IgAN group had a higher incidence of HIP than the non-IgAN group (69% vs. 40%, p = 0.02). IgAN as primary kidney disease and interval from transplantation to conception were associated with HIP (OR 3.33 [1.11-9.92], p = 0.03, OR 0.83 [0.72-0.96], p < 0.01, respectively). The 20-year graft survival or prevention of CKD stage 5 in group with IgAN was lower than that in the group with other primary disease (p < 0.01). KT recipients should be informed of the risk of HIP and possibility of long-term worsening of postpartum renal function.

Uterine fibroid volume is not associated with blood pressure

Background: Females with uterine fibroids (UF), benign tumors of the myometrium, have a higher risk of hypertension than females without UF. The relationship between UF and hypertension is not fully understood. Case studies have reported hypertension in patients with large UF that compress the ureters, resulting in hydronephrosis. However, this pathophysiology is not present in all females with UF and hypertension. It is unknown if UF volume is correlated with blood pressure in the absence of renal compromise. Therefore, the goal of this study was to determine the potential associations between blood pressure and 1) volume of the largest UF and 2) volume of the uterus (a surrogate for total UF volume) in females with UF. Methods: We utilized the Mayo Clinic Data Explorer to identify patients, who had pelvic ultrasound or magnetic resonance imaging (MRI) studies performed at Mayo Clinic-Rochester in 2021 that reported the presence of UF, and who were ages 18-65 years old. From this system, we collected brachial blood pressure data (systolic, diastolic, and mean), assessed in the outpatient setting within 14 days of imaging. For each patient, dimensions of the largest UF and the uterus were abstracted from radiology reports. The largest UF was assessed, as it reliably had all three dimensions reported. Volume of the uterus was used as a surrogate for total UF volume to consider the possibility of multiple UF that were not detailed in the radiology report. Volumes of the largest UF and uterus were each calculated as for ellipsoid structures, (length✕depth✕width)✕0.523 in cm 3 . The Pearson correlation coefficient (r) was calculated to assess the linear relationship between blood pressure and largest UF volume, and blood pressure and uterine volume. A p-value &lt;0.05 denoted statistical significance. Results: One hundred thirteen females (48±9 years old) were included in the analysis, 88 with ultrasound and 25 with MRI reports. Average blood pressures were as follows, systolic: 121±16 mmHg (range: 92-185 mmHg), diastolic: 76±9 mmHg (52-101 mmHg), and mean: 91±11 mmHg (67-129 mmHg). Twenty-nine females (25.7%) had a diagnosis of hypertension. Hydronephrosis was not reported in any of the imaging reports. A mean of 2±2 UF were present per uterus (range: 1-15). Average volume of the largest UF was 75.0±115.9 cm 3 . Largest UF volume was not associated with systolic (r=0.023, p=0.812), diastolic (r=-0.040, p=0.677), or mean (r=-0.014, p=0.881) blood pressures. Average volume of the uterus was 219.6±215.6 cm 3 . Volume of the uterus was not associated with systolic (r=0.040, p=0.688), diastolic (r=0.102, p=0.305), or mean (r=0.071, p=0.475) blood pressures. Conclusion: In females with UF, blood pressure is not associated with the largest UF or uterine volumes. These data suggest that in the absence of hydronephrosis, the association between UF and blood pressure is not related to UF size. It is unknown if these findings differ based on factors, such as race. AHA 898649, NIH K01 HL1148144 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Long-Term Experience and Safety of Transitioning from Subcutaneous Treprostinil to Oral Selexipag in the High-Risk Pulmonary Hypertension Patient: A Case Report.

Long-Term Experience and Safety of Transitioning from Subcutaneous Treprostinil to Oral Selexipag in the High-Risk Pulmonary Hypertension Patient: A Case Report.

How Does the Method Used to Measure the VE/VCO2 Slope Affect Its Value? A Cross-Sectional and Retrospective Cohort Study.

Cardiopulmonary exercise testing (CPET) was limited to peak oxygen consumption analysis (VO2peak), and now the ventilation/carbon dioxide production (VE/VCO2) slope is recognized as having independent prognostic value. Unlike VO2peak, the VE/VCO2 slope does not require maximal effort, making it more feasible. There is no consensus on how to measure the VE/VCO2 slope; therefore, we assessed whether different methods affect its value. This is a retrospective study assessing sociodemographic data, left ventricular ejection fraction, CPET parameters, and indications of patients referred for CPET. The VE/VCO2 slope was measured to the first ventilatory threshold (VT1-slope), secondary threshold (VT2-slope), and included all test data (full-slope). Of the 697 CPETs analyzed, 308 reached VT2. All VE/VCO2 slopes increased with age, regardless of test indications. In patients not reaching VT2, the VT1-slope was 32 vs. 36 (p < 0.001) for the full-slope; in those surpassing VT2, the VT1-slope was 29 vs. 33 (p < 0.001) for the VT2-slope and 37 (all p < 0.001) for the full-slope. The mean difference between the submaximal and full-slopes was ±4 units, sufficient to reclassify patients from low to high risk for heart failure or pulmonary hypertension. We conclude that the method used for determining the VE/VCO2 slope greatly influences the result, the significant variations limiting its prognostic value. The calculation method must be standardized to improve its prognostic value.

Associations between cooking fuels and hypertension prevalence in Chinese adults: A prospective cohort analysis focusing on fuel transitioning

BackgroundUsing polluting cooking fuels is a suggested risk factor for hypertension. Transitioning to clean cooking fuels has occurred widely in China in the past 30 years. This provides an opportunity to examine whether the transition could reduce hypertension risk and to ascertain the inconsistent literature on the relationship between cooking fuels and hypertension prevalence. MethodsInitiated in 1989, the China Health and Nutrition Survey (CHNS) enrolled participants from 12 provinces in China. By 2015, nine waves of follow-up have been conducted. Based on self-reported cooking fuels, participants were classified into persistent clean fuel users, persistent polluting fuel users and those who transitioned from polluting fuels to clean fuels. Hypertension was defined as having systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg, or self-reported current use of antihypertension medication. FindingsAmong 12,668 participants, 3963 (31.28%) were persistent polluting fuel users; 4299 (33.94%) transitioned to clean fuels; and 4406 (34.78%) were persistent clean fuel users. During the period of follow-up (7.8 ± 6.1 years), hypertension was diagnosed in 4428 participants. Compared to persistent clean fuel users, persistent polluting fuel users had a higher risk for hypertension (hazard ratio [HR] 1.69, 95%CI 1.55–1.85), while those transitioned to clean fuels did not. The effects were consistent by gender and urbanicity, respectively. The HRs for hypertension were 1.99 (95%CI 1.75–2.25), 1.55 (95%CI 1.32–1.81) and 1.36 (95%CI 1.13–1.65) among those persistent polluting fuel users aged 18–44, 45–59 and ≥60 years old, respectively. InterpretationTransitioning from using polluting fuels to clean fuels prevented an increase in hypertension risk. The finding highlights the importance of promoting the fuel transition as a risk-reduction strategy for reducing the disease burden from hypertension.

Select Patients with High-Risk IIH May Be Managed with Medical Therapy Alone (P2-9.009)

<h3>Objective:</h3> Measure visual outcomes in high-risk idiopathic intracranial hypertension (IIH), with particular attention to medical or surgical treatment course and disease recurrence. <h3>Background:</h3> In IIH, presentations with BMI &gt;40, high-grade papilledema, worse visual field mean deviation (VFMD), and worse visual acuity are associated with worse visual outcomes. In the absence of randomized data on high-risk patients, surgery is often recommended, but risks complications, infections, or surgical revision. <h3>Design/Methods:</h3> We retrospectively reviewed the charts of all IIH patients who presented to 3 providers between April 2019 and April 2022 with grade IV or V papilledema. Patients were treated at the discretion of their neuro-ophthalmologist. Outcomes were stratified by presenting VFMD. <h3>Results:</h3> 11 patients were evaluated. Average age was 25.8 years, 10/11 were female, and average BMI was 38.3 kg/m2. On presentation, VA was 20/30 or worse in 9/11 patients, but improved to 20/20 or better in 9/11 patients. Average presenting VFMD was −13.8 dB, but improved by an average of 7.1 dB in those with initial VFMD worse than −7.0 dB and 2.1 dB in those with initial VFMD better than −7.0 dB. 2 patients met published criteria for “fulminant” IIH, but both improved to 20/20 acuity OU with significant VFMD improvements on medical therapy alone. All patients received acetazolamide with rapid dose escalation. Average maximum dose was 2.75 g per day. 2 also received topiramate. 1 patient received a ventriculoperitoneal shunt 3 days after presentation. 1 patient received an optic nerve sheath fenestration 15 days after presentation. 1 patient on medical therapy had recurrent disease over an average of 352 days of follow up. <h3>Conclusions:</h3> Select patients with high-risk or “fulminant” IIH may be successfully managed without surgery. These patients required close monitoring and aggressive medical therapy. Reduced visual acuity on presentation recovered well in most patients. Larger cohorts with longer follow-up are needed. <b>Disclosure:</b> Dr. Gluckstein has nothing to disclose. An immediate family member of Dr. Rizzo has received personal compensation for serving as an employee of LIfeBiosciences. Dr. Rizzo has received intellectual property interests from a discovery or technology relating to health care. Dr. Rizzo has received intellectual property interests from a discovery or technology relating to health care. Dr. Chen has nothing to disclose.

Children who appeared or remained overweight or obese predict a higher follow-up blood pressure and higher risk of hypertension: a 6-year longitudinal study in Yantai, China.

Few longitudinal studies have examined the effect of weight status change on blood pressure change over time and incidence of hypertension among Chinese children. The longitudinal study enrolled 17,702 Chinese children aged 7 years in Yantai in 2014 as baseline, with a continuous 5 years of follow-up to 2019. Generalized estimating equation model was fitted to examine the main and interaction effects of weight status change and time with blood pressure and the incidence of hypertension. Compared with the participants who remained normal weight, the participants who remained overweight or obese had higher systolic blood pressure (SBP) (β = 2.89, p < 0.001) and diastolic blood pressure (DBP) (β = 1.79, p < 0.001). Significant interactions were identified between weight status change and time with SBP (χ2interaction = 697.77, p < 0.001) and DBP (χ2interaction = 270.49, p < 0.001). The odds ratio (OR) and 95% confidence interval (CI) of hypertension were 1.70 (1.59-1.82) for participants who appeared overweight or obese, 2.26 (2.14-2.40) for participants who remained overweight or obese, compared with the participants who remained normal weight. Those who switched from overweight or obesity to normal weight had almost the same risk of developing hypertension (OR = 1.13, 95% CI: 1.02 to 1.26) as children who remained normal weight. Children who appeared or remained overweight or obese predict a higher follow-up blood pressure and higher risk of hypertension, whereas losing weight could reduce blood pressure and the risk of hypertension. Children who appeared or remained overweight or obese predict a higher follow-up blood pressure and higher risk of hypertension, whereas losing weight could reduce blood pressure and the risk of hypertension.

Is H19 RNA a Useful Marker of Acromegaly and Its Complications? A Preliminary Study

Acromegaly is a rare endocrine disorder caused by somatotroph pituitary adenoma. Besides its typical symptoms, it contributes to the development of cardiovascular, metabolic, and bone comorbidities. H19 RNA is a long non-coding RNA and it is suspected to be involved in tumorigenesis, cancer progression, and metastasis. H19 RNA is a novel biomarker for the diagnosis and monitoring of neoplasms. Moreover, there might be an association between H19 and cardiovascular and metabolic diseases. We enrolled 32 acromegaly patients and 25 controls. We investigated whether whole blood H19 RNA expression is associated with the diagnosis of acromegaly. Correlations between H19 and tumour dimension, invasiveness, and biochemical and hormonal parameters were evaluated. We analysed the coincidence of acromegaly comorbidities with H19 RNA expression. In the results, we did not observe a statistically significant difference in H19 RNA expression between acromegaly patients and the controls. There were no correlations between H19 and the adenoma size and infiltration and patients' biochemical and hormonal statuses. In the acromegaly group, hypertension, goitre, and cholelithiasis were observed more frequently. The diagnosis of acromegaly was a factor contributing to the occurrence of dyslipidaemia, goitre, and cholelithiasis. We found an association between H19 and cholelithiasis in acromegaly patients. To conclude, H19 RNA expression is not a relevant marker for diagnosis and monitoring of acromegaly patients. There is a higher risk of hypertension, goitre, and cholelithiasis related to acromegaly. Cholelithiasis is associated with a higher H19 RNA expression.

Management of Hypertension Using a Plant-Based Diet Among Farmers: Protocol for a Mixed Methods Study

Farmers in Indonesia have a high risk for hypertension owing to their lifestyle and working environment. Diet management is a solution to reduce hypertension, and Indonesia has natural resources in the agricultural sector that could help manage hypertension. Optimizing vegetable and fruit intake in a plant-based diet (PBD) could help maintain blood pressure among farmers in Indonesia. This study aims to explore the health problem of hypertension and the characteristics of local food sources to formulate a PBD menu for treating hypertension, as well as assess the prevalence of hypertension, level of acceptability of a PBD, and associated sociodemographic factors. Further, we want to examine the effectiveness of a community-based nursing program for managing hypertension using a PBD. We will use the exploratory sequential mixed methods approach. There will be a qualitative study (phase I) in 2022 and a quantitative study (phase II) in 2023. We will analyze data using a thematic framework in phase I. In phase II, the study will involve (1) questionnaire development and validation; (2) examination of the prevalence of hypertension, the level of acceptability of a PBD, and the associated factors; and (3) a randomized controlled trial. We will recruit farmers with hypertension who meet the study criteria. Moreover, in phase II, we will invite expert nurses and nutritionists to assess the face and content validity of the questionnaire. We will use multiple logistic regression models to estimate the associated sociodemographic factors and the level of acceptability of a PBD. Furthermore, a linear generalized estimating equation will be used to estimate the parameters of a generalized linear model with a possible unmeasured correlation between observations from different time points for systolic and diastolic blood pressure. A model PBD for hypertension management is expected to be developed. In 2022, we will collect information on hypertension and the characteristics of local food sources for managing hypertension, and will formulate a PBD menu to treat hypertension among farmers. In 2023, we will develop a questionnaire to assess the acceptability of a PBD to manage hypertension among farmers, the prevalence of hypertension, and the sociodemographic factors associated with hypertension among farmers. We will implement a community-based nursing program for managing hypertension using a PBD among farmers. The PBD model will not be readily available for other agricultural areas since validation of local food variation is required to design the menu. We expect contributions from the local government to implement the intervention as one of the policies in the management of hypertension for farmers in the agricultural plantation areas of Jember. This program may also be implemented in other agricultural countries with similar problems, so that hypertension can be optimally treated among farmers. PRR1-10.2196/41146.

63. Effect of Physical Activity on Hypertension in the Geriatric Population at Cawang, East Jakarta

Background: Geriatric population has a high risk for hypertension, mainly as the result of arterial stiffening caused by aging. Indonesia's RISKESDAS in 2018 shows that the prevalence of hypertension is rising with age. Lifestyle factors such as physical inactivity are one of the modifiable risk factors for hypertension. Regular exercise can reduce the stiffness of blood vessels and increase the endurance of the heart and lungs so that it can lower blood pressure. Objectives: This study aims of this study is to investigate the effect of physical activity on hypertension in the geriatric population in Cawang, East Jakarta. Methods: The research design used a quantitative cross-sectional research method with a random sampling technique and using the Chi-Square method to analyze the correlation between physical activity and blood pressure in the geriatric population. Blood pressure data were obtained using sphygmomanometer and hypertension criteria based on JNC VIII. Physical activity based on International Physical Activity Questionnaire. Results: In this study, 65 research samples were obtained that met the inclusion criteria in Cawang, East Jakarta. The amount of hypertension cases account for 78.5 percent of the people. Low physical activity was identified through 37 people (55.4%), moderate physical activity was identified through 9 people (17,6%), and high physical activity was identified through 5 people (10.8%). The result of the study found that there is a correlation between physical activity and the incidence of hypertension (p = 0.001). Conclusion: There is a correlation between physical activity and the incidence of hypertension.

Son preference and Chinese women's biological health risk in middle and older age: A life course study

Son preference is a severe form of gender discrimination and can impair women's health. Drawing on retrospective data from a nationally representative sample, this life course study examines how experience of guardians’ son preference in childhood is associated with Chinese women's health in middle and older age. Using imbalanced sex ratio at birth at the prefecture level as a proxy, this study also examines the health implications of adulthood exposure to regional son preference. Our regression estimates show that childhood experience of the male guardian's son preference is associated with higher biological risks of developing systemic inflammation at the 2015 follow-up among middle-aged and older women who were disease-free at the 2011 baseline. In contrast, childhood experience of the female guardian's son preference is associated with lower risk of developing systemic inflammation or hypertension at the follow-up, conditional on being disease-free at the baseline. Adulthood exposure to stronger regional son preference is associated with higher risk of hypertension at the follow-up, independent of childhood experience of guardians’ son preference.

Consumption frequencies of beverages and the hypertension risk in adults: a cohort study in China

ObjectiveTo explore the associations between the consumption frequencies of alcohol, tea and sugar-sweetened beverages (SSBs) and the hypertension risk among Chinese adults.DesignA longitudinal study of the effect of beverage consumption...

Model Development for Reducing Sodium Consumption at the District Level Using a District Health Board Mechanism

High levels of dietary sodium are associated with hypertension and non-communicable diseases. We aimed to develop a model for reducing sodium consumption at the district level using a mechanism developed by the District Health Board (DHB). Hankha District in Chai Nat Province was selected as the study area. The study was conducted between June and December 2022. Research methods included the development of a model to reduce sodium consumption, questionnaires and focus group discussions, and measuring the amount of salt in food and blood pressure levels among study participants. The developed model comprised three measures; monitoring people’s sodium consumption; creating a mechanism for driving and managing the environment contributing to behavioral changes; and providing knowledge and promoting behaviors among groups at high risk for hypertension. After model development, the mean knowledge scores among DHB members and their skills in managing plans and projects were significantly higher than those before the process. Mean knowledge scores, health literacy and proper sodium consumption behaviors among at-risk groups were also higher. In addition, the increased knowledge scores significantly correlated with proper sodium consumption behaviors. Our results should encourage authorities at the policy level to apply a DHB mechanism to reduce sodium consumption in communities.

The impact of gestational weight gain on pregnancy outcomes among Saudi women delivered at maternal and child hospital, Al Ahsa, Saudi Arabia, 2022

Background: The pregnant women who gain the excessive weight outside the recommendation of Institute of Medicine (IOM) during pregnancy lead to adverse pregnancy outcome. Women with excessive gestational weight gain have high risk of gestational diabetes, gestational hypertension, preeclampsia, cesarean section, macrosomia, preterm delivery and birth weight. The aim of this study was to assess the prevalence of excessive gestational weight gain and to identify its association with adverse pregnancy outcomes among Saudi women delivered at Maternity and Child hospital (MCH) , Al Ahsa Materials and Methods: It was a cross-sectional chart review study. All pregnant women who were admitted in the postnatal ward in MCH after delivery were the study population. A sample size of 250 was calculated using online software (OpenEpi).Convenience sampling was used, as we want to reach all the women who are admitted to the ward after delivery. A special data sheet was prepared based on similar previous study and modified to meet our study objectives. The data were computerized, processed and analyzed using SPSS version 24.Descriptive statistics were presented using counts, proportions (%), mean ±, standard deviation whatever appropriate. The association of the weight gain and pregnancy outcome was tested by chi square test. A P -value cut off point of 0.05 or less was used to determine statistical significance. Results: The data of 250 women could be collected during the study period. The mean age of the participants was 28.34 years ± Std. Dev. 9.24 years. As far as the BMI is concerned more than thirty seven percent (37.6%) of the participants were of normal weight while 22% and 33.3% were overweight and obese respectively. Only 7.2% of the participants were underweight. The mean Wight gain by the underweight pregnant women was 11.29Kg while those with normal weight were 10.5Kg. The pregnant women who were overweight gained a mean weight of 12.85kg and those who were obese gained 13.47kg.. Recurrent UTI was significantly higher among the normal weight pregnant women with weight gain of 10.53Kg than those of under weight with weight gain of11.59 kg , overweight with weight gain of 12.85 kg and obese with weight gain of13.47kg(40.54% vs.2.7% vs.26.13% vs,30.62%, P=0.023).Vaginal infection(P=0.023), vaginal infection plus UTI (0.0.023) were significantly more associated with excess weight gain during pregnancy. Gestational diabetes(P=0.013), preeclamsia (P=0.013)was significantly more prevalent among the obese pregnant women However the pregnancy induced hypertension was more prevalent among normal weight with weight gain of10.53Kg (P-0.013).Normal delivery was significantly more common among the normal weight with weight gain of10.53Kg than (P-0.013) , delivery by induction (P=0.013) and the delivery by caeserian section was significantly more among the obese pregnant women with weight gain of 13.47kg The obese pregnant women with weight gain of 13.47kg were significantly associated with the preterm delivery (P=0.034).

Cord Blood Insulin Concentration and Hypertension Among Children and Adolescents Enrolled in a US Racially Diverse Birth Cohort.

Although insulin resistance is closely related to hypertension, the debate continues as to whether insulin resistance is a cause or a consequence of hypertension. This study investigated the associations of cord blood insulin concentration with blood pressure (BP) and hypertension in childhood and adolescence. This study included 951 children enrolled from 1998 to 2012 and followed from birth onwards at the Boston Medical Center, Boston, MA. Cord blood insulin concentration was measured using a sandwich immunoassay. Hypertension in childhood and adolescence was defined based on the 2017 American Academy of Pediatrics Clinical Practice Guidelines. The median (interquartile range) for cord blood insulin concentration was 12.1 (7.2-19.0) µIU/mL. The age range of BP measurements was 3 to 18 years (median, 10.6 years). Cord blood insulin concentration was positively associated with systolic and diastolic BP as well as the risk of hypertension at age 3 to 18 years. Compared with the lowest tertile of cord blood insulin concentration, the top tertile insulin concentration was associated with a 5.18 (95% CI, 1.97-8.39) percentile increase in systolic BP, 4.29 (95% CI, 1.74-6.84) percentile increase in diastolic BP, and 1.62-fold (95% CI, 1.27-2.08) higher risk of hypertension. The association between insulin and hypertension was stronger among children born preterm (P for interaction=0.048). Furthermore, preterm birth and childhood overweight or obesity enhanced the associations. Our results suggest that elevated insulin concentration at birth plays a critical role in the early life origins of hypertension and support the hypothesis implicating insulin resistance in the etiology of hypertension.

Associations between short-term PM2.5 exposure and daily hospital admissions for circulatory system diseases in Ganzhou, China: A time series study.

Previous epidemiological studies have shown that both long-term and short-term exposure to fine particulate matters (PM2.5) were associated with the morbidity and mortality of circulatory system diseases (CSD). However, the impact of PM2.5 on CSD remains inconclusive. This study aimed to investigate the associations between PM2.5 and circulatory system diseases in Ganzhou. We conducted this time series study to explore the association between ambient PM2.5 exposure and daily hospital admissions for CSD from 2016 to 2020 in Ganzhou by using generalized additive models (GAMs). Stratified analyses were also performed by gender, age, and season. Based on 201,799 hospitalized cases, significant and positive associations were found between short-term PM2.5 exposure and hospital admissions for CSD, including total CSD, hypertension, coronary heart disease (CHD), cerebrovascular disease (CEVD), heart failure (HF), and arrhythmia. Each 10 μg/m3 increase in PM2.5 concentrations was associated with a 2.588% (95% confidence interval [CI], 1.161%-4.035%), 2.773% (95% CI, 1.246%-4.324%), 2.865% (95% CI, 0.786%-4.893%), 1.691% (95% CI, 0.239%-3.165%), 4.173% (95% CI, 1.988%-6.404%) and 1.496% (95% CI, 0.030%-2.983%) increment in hospitalizations for total CSD, hypertension, CHD, CEVD, HF, and arrhythmia, respectively. As PM2.5 concentrations rise, the hospitalizations for arrhythmia showed a slow upward trend, while other CSD increased sharply at high PM2.5 levels. In subgroup analyses, the impacts of PM2.5 on hospitalizations for CSD were not materially changed, although the females had higher risks of hypertension, HF, and arrhythmia. The relationships between PM2.5 exposure and hospitalizations for CSD were more significant among individuals aged ≤65 years, except for arrhythmia. PM2.5 had stronger effects on total CSD, hypertension, CEVD, HF, and arrhythmia during cold seasons. PM2.5 exposure was positively associated with daily hospital admissions for CSD, which might provide informative insight on adverse effects of PM2.5.