Higher Incidence Of Hypertension Research Articles

Mediterranean Alcohol-Drinking Pattern and Arterial Hypertension in the "Seguimiento Universidad de Navarra" (SUN) Prospective Cohort Study.

Alcohol drinking patterns may determine the risk of hypertension and may also modify the detrimental effect of high alcohol intake. We prospectively evaluated the effect of the Mediterranean alcohol-drinking pattern and its interaction with the amount of alcohol consumed on the incidence of arterial hypertension. In the "Seguimiento Universidad de Navarra" (SUN) cohort, we followed-up 13,805 participants, all of them initially free of hypertension, during a maximum period of 16 years. Information about diet, chronic diseases, lifestyle and newly diagnosed hypertension was collected using validated questionnaires. We used a 7-item score (0 to 9 points) that jointly considered moderate alcohol consumption, distributed over the week, with meals, and a preference for red wine and avoidance of binge-drinking. During 142,404 person-years of follow-up, 1443 incident cases of hypertension were identified. Low adherence (score < 2) to the Mediterranean alcohol-drinking pattern was significantly associated with a higher incidence of hypertension (multivariable-adjusted hazard ratio 1.81, 95% confidence interval 1.09-2.99) as compared to the high-adherence (score > 7) category. Among alcohol consumers, a high adherence to the MADP is associated with a lower incidence of hypertension. Compared with abstinence, a high adherence did not seem to differ regarding its effect on hypertension risk.

Analiza nivoa insulinske rezistencije u pacijenata sa tipom 1 dijabetesa

Introduction: Numerous studies have identified the presence of insulin resistance (IR) so far in type 1 diabetes (T1D), for which the estimated glucose disposal rate (eGDR) is determined. Aim: Analysis of IR levels in patients with T1D and comparison according to the presence of chronic complications of diabetes. Material and methods: The research was done in the form of a retrospective analysis of the database of medical records of 180 patients of both sexes with T1D, disease duration greater than one year in the period 2016 - 2021, who were divided into two groups based on eGDR levels - IRG (N = 86 , eGDR < 8) and ISG (N = 94, eGDR ≥ 8). Results: Patients with IRG were statistically significantly older (39.35 ± 1.39 vs. 32.13 ± 0.90, p < 0.01), higher BMI (25.93 ± 0.59 vs. 21.78 ± 0.36 kg/m2, p < 0.01), HbA1c levels (9.63 ± 0.24 vs. 8.30 ± 0.15%, p <0.01) and daily insulin dose (46.51 ± 1.89 vs. 35.89 ± 1.34 j/day, p < 0.01) compared with ISG patients. At the same time, IRG patients had significantly higher cholesterol levels (4.97 ± 0.14 vs. 4.51 ± 0.10 mmol/l, p <0.01), LDL (2.97 ± 0.13 vs 2.51 ± 0.09 mmol/l, p < 0.01) and tgc (1.65 ± 0.16 vs. 1.01 ± 0.06 mmol/l, p < 0.01) compared to ISG. The IRG has a statistically significantly higher percentage of hypertension (97.27 vs. 2.73%, p < 0.01), retinopathy (25.83 vs. 14.57%, p < 0.01), neuropathy (31.79 vs. 25.16%, p = 0.021) and nephropathy (27.03 vs. 12.16%, p < 0.01) compared with ISG. Conclusion: Patients with T1D and IR were older, with higher BMI, HbA1c, and daily insulin doses, with a more atherogenic lipid profile, higher incidence of hypertension, and more frequent microvascular and macrovascular complications.

Efficacy and safety of anti-PD-1 monotherapy versus anti-PD-1 antibodies plus lenvatinib in patients with advanced hepatocellular carcinoma: a real-world experience.

The efficacy of anti-programmed cell death (PD)-1 monotherapy in advanced hepatocellular carcinoma (aHCC) is limited, and combination therapy with lenvatinib and pembrolizumab has shown promising results. However, comparative studies between immune monotherapies and combination therapies are lacking. To investigate the efficacy and safety of anti-PD-1 monotherapy (PD-1) and anti-PD-1 plus lenvatinib (PD-1 + L) in patients with aHCC to guide clinical treatment decisions. A retrospective study was conducted on a cohort of patients with aHCC who received either PD-1 monotherapy or PD-1 + L combination therapy between January 2018 and January 2020. The study retrospectively reviewed the medical records of 94 eligible patients with aHCC, with 39 in the PD-1 group and 55 in the PD-1 + L group. The efficacy outcomes, including objective response rate (ORR), disease control rate (DCR), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety, were assessed. With a median follow-up of 30.1 months, the PD-1 + L group demonstrated a significantly higher ORR (32.7% versus 10.3%, p = 0.013), better DCR (80.0% versus 53.8%, p = 0.012), longer median PFS (10.6 versus 4.4 months, p < 0.001) and longer median OS (18.4 versus 8.5 months, p = 0.013) than PD-1 group. For the responders, the efficacy of the two groups was durable (DOR was 11.6 versus 3.5 months, p = 0.009). Subgroup analyses based on prior tyrosine kinase inhibitor (TKI) treatment and the presence or absence of macrovascular tumor thrombosis or extrahepatic metastases favored the PD-1 + L group. The combination therapy was a good predictor of PFS and OS in multivariate analysis. Grade 3/4 treatment-related adverse events were more common in PD-1 + L group, with higher incidences of hypertension and hand-foot skin reactions. PD-1 monotherapy and PD-1 plus lenvatinib combination therapy were well-tolerated in patients with aHCC. PD-1 + L showed significantly better survival benefits than PD-1 monotherapy.

THE RELATIONSHIP BETWEEN COVID-19 SEVERITY AND THE USAGE OF ANGIOTENSIN-II RECEPTOR BLOCKERS IN HYPERTENSIVE PATIENTS

Purpose of the study: As demonstrated by numerous epidemiological studies, the high incidence of hypertension among patients with coronavirus disease 2019 (COVID-2019) appears to be associated with an elevated risk of mortality. The angiotensin-converting enzyme (ACE) system is not expressed uniformly throughout the human population, and contemporary variations may account for part of the global disparities in infection prevalence. In addition, animal investigations have demonstrated that the ACE2 receptor is a potential infection route for the COVID-19-causing SARS-CoV-2 virus. As two-thirds of hypertension patients take ACE inhibitors/angiotensin receptor blockers, a number of concerns have been raised regarding the harmful or beneficial effects of contemporary antihypertensive medications in COVID-19. This study presents the most recent evidence for and against the impact of ACE blockade administration in the age of COVID-19 on the cohort of hypertension patients in Bangladesh (N = 300). Methods: We included in this study 300 patients who had a record of a COVID-19 test performed between July 2021 and September 2021 using RT-PCR. All the patients had a history of hypertension two years before the index date, based on the International Classification of Diseases codes (Tenth Revision, Clinical Modification, ICD-10-CM). All of them have been taking anti-hypertensive drugs for 1–2 years. We used logistic regression to estimate the odds ratio (OR) and the 95% confidence interval (CI) of COVID-19 severity in patients prescribed Angiotensin Receptor Blockers (ARB) versus those not prescribed ARB. We selected a cohort of 300 Bangladeshi patients who were covid posi tive and had been taking hypertensive medications for 1-5 years. Results: Among COVID-19-positive patients with hypertension, the use of ARB is associated with increased odds of hospitalization, including all patients admitted to ICU or CCU (OR = 1.008, (0.440, 2.309) and OR= 2.31, (0.024, 2.452) respectively). Participants receiving ARB have a lower odds ratio of using BiPAP, CPAP, and Ventilation (0.592, 0.010, and 0.031, respectively; p-value &lt; 0.5) compared to the non-ARB users. Research Implications: We noticed a statistically significant association between ARB administration and mechanical ventilation in our study. Since ARB use was also related to a decreased likelihood of needing additional oxygen support, such as nasal cannula, BiPAP, and CPAP, there is sufficient evidence from other clinical factors to indicate a consistent connection between ARB use and oxygen assistance among covid-positive patients. Further research is required to determine the molecular relationship between ARB use and oxygen level in Covid-positive individuals. Bioresearch Commu. 9(1): 1180-1195, 2023 (January)

Modelling the impact of salt reduction policies on hypertension in Portugal

Abstract Salt reduction policies are identified as effective; however, the assessment of their impact in European countries has been underexplored. The aim of this study is to assess the impact of salt reduction policies on hypertension in Portugal, to ultimately guide future policies. Based on national data, the top five foods contributing to salt intake, their salt content, and daily consumption were determined. Food reformulation included current policies and proposed targets for future agreements. Food availability trend from the main contributors was estimated from national food balance sheets. For this study, we considered five counterfactual scenarios (CF) to estimate salt intake variation: (1) reduction of salt content of foods targeted by current policies, while assuming stable consumption of the primary contributors; (2) proposal to extend CF 1 to other food categories; (3) change in the principal contributor's consumption based on the trend, assuming stable salt content; (4) combination of CF 2 and 3; (5) CF 4 and assuming a reduction of “1 pinch of salt”. Relative risk was estimated from regression coefficients to then calculate the potential impact fraction (PIF) and ultimately provide the hypertension cases prevented per year for each CF. The change in salt intake expected by each CF is -11.16%, -13.57%, +0.12%, -13.40% and 23,99%, respectively. For each CF, PIF and hypertension cases avoided per year was, as follows (mean (95%CI)): 9.46% and 46401 (44201;48925) for the first; 14.05% and 68921 (66149;72025) for the second; -1.24% and -6099 (-7636;-4763) for the third; 13.2% and 65125 (62286;67892) for the fourth; and, 15.58% and 76397 (73208;80021) for the last. This study suggests that if the salt content of main contributors was not reduced, its increasing food trend consumption might result in higher incidence of hypertension in Portugal. However, by combining current policies with targets on additional foods, more than 60,000 cases could be avoided annually. Key messages • Salt content reduction policies are necessary if we want to reduce the incidence of hypertension among the Portuguese population. • Assessment of the impact of salt reduction policies is crucial if we want to choose those that have a stronger impact on the health of our population.

ALDH2 knockout protects against aortic dissection

BackgroundThe incidence and mortality of aortic dissection (AD) are increasing. In pathological studies, macrophages, T lymphocytes and dendritic cells were found in the tunica media of the aorta. Acetaldehyde dehydrogenase 2 (ALDH2) gene polymorphisms are associated with a high incidence of hypertension in Asian populations. However, there is no clear evidence of the relationship between ALDH2 and aortic dissection in Asians. The aim of this study was to investigate the incidence of aortic dissection in different ALDH2 genotypes and explore changes in the vasculature.Materials and methodsThree-week-old male mice were administered freshly prepared β-aminopropionitrile solution dissolved in drinking water (1 g/kg/d) for 28 days to induce TAD. An animal ultrasound imaging system was used to observe the formation of arterial dissection and changes in cardiac function. Subsequently, mice were euthanized by cervical dislocation. The aortas were fixed for HE staining and EVG staining to observe aortic elastic fiber tears and pseudoluma formation under a microscope.ResultsKnockout of ALDH2 mitigated β-aminopropionitrile-induced TAD formation in animal studies. Ultrasound results showed that ALDH2 knockout reduced the degree of ascending aortic widening and the incidence of aortic dissection rupture. Pathological sections of multiple aortic segments showed that the protective effect of ALDH2 knockout was observed in not only the ascending aorta but also the aortic arch and descending aorta. The expression levels of genes related to NK CD56bright cells, Th17 cells, T cells and T helper cells were decreased in ALDH2 knockout mice treated with β-aminopropionitrile for 28 days.ConclusionALDH2 knockout protects against aortic dissection by altering the inflammatory response and immune response and protecting elastic fibers.

The Association Between Some Endocrine Conditions and COVID-19: A Review

The review aimed to understand and explain the association between some major endocrine conditions and COVID-19. Since March 2019, COVID-19 has been identified as a pandemic by the World Health Organization (WHO) and has infected millions of individuals worldwide. According to the literature review, endocrine disorders include diabetes, obesity, hypertension, and thyroid. The development and progress of COVID-19 patients could be affected but not yet approved by all the studies. In diabetes mellitus, COVID-19 may affect cytokines and increase releases of IL-1, IL-6, and complications caused by diabetes. In obese patients, there was an increased risk of progressing to severe COVID-19. Because of the international spread of severe acute respiratory syndrome coronavirus, clinicians should pay special attention to obese patients who should be monitored closely with timely and aggressive care. COVID-19 pathophysiology and risk in a high incidence of hypertension has been found in patients with COVID-19 and can be studied in many kinds of studies, such as in China. However, hypertension is considered one of the most significant risk factors for COVID-19. In addition to the above data on associations between COVID-19 and endocrine disorders, data on thyroid function or thyroid disease in COVID-19 is not yet available and cannot be commonly reported.

A prospective study on the application of HINTS in distinguishing the localization of acute vestibular syndrome

BackgroundAcute vestibular syndrome (AVS) is a common clinical syndrome in neurology clinics and emergency department. Canonical standard for AVS diagnosis requires the presence of persistent vertigo for more than 24 h. HINTS (head impulse-nystagmus-test of skew) is an emerging scheme in the diagnosis of AVS. In this prospective study, we evaluated the specificity and sensitivity of HINTS in distinguishing between central and peripheral AVS.MethodsA cohort of 239 cases with complete clinical record was recruited in the study. All patients completed emergency brain CT examination to exclude hemorrhagic stroke. HINTS examination was conducted to distinguish between central AVS and peripheral AVS, and all patients completed head MRI, BAEP and vestibular function examinations within one week. Patients diagnosed as central AVS were subject to angiography (CTA/MRA/DSA), and patients with peripheral AVS were considered for a 3-month follow-up to correct the initial diagnosis.ResultsPatients with central AVS were associated with an elder age, higher incidences of hypertension, atrial fibrillation, family history of stroke and previous history of stroke. Posterior circulation cerebral infarction, vestibular migraine and cerebellitis were the dominant diseases associated with central AVS. The sensitivities of HIT, GE, and TS in the diagnosis of central AVS were 73.5%, 61.2%, and 26.5%, and the specificities were 97.9%, 92.6%, and 93.2% respectively.ConclusionsThe sensitivity of HINTS for central AVS diagnosis is 89.8% and the specificity is 84.2%. HINTS is an easy-to-operate, low-cost, high-sensitivity and specific examination technique, which is practical in neurology outpatient clinics and emergency departments.

Lower stress perfusion in patients with myocardial infarction with non-obstructive coronary arteries compared to controls in long-term follow-up with quantitative perfusion mapping

Abstract Introduction Myocardial infarction with non-obstructive coronary arteries (MINOCA) constitutes a heterogenous condition with different coronary, cardiac and non-cardiac etiologies. Cardiovascular magnetic resonance imaging (CMR) has emerged as an important diagnostic tool in recent years and is now recommended in patients with MINOCA as a working diagnosis. However, despite early CMR following admission for MINOCA, no cause can be found in around 25% of all patients. A pathophysiological mechanism may be diffuse global coronary microvascular dysfunction (CMD) which has emerged as an important cause of myocardial ischemia. Quantitative adenosine stress CMR perfusion mapping allows for absolute quantification of myocardial perfusion, reflecting CMD in the absence of obstructive coronary disease in MINOCA patients. Purpose To study the presence of CMD in MINOCA patients with an initial normal CMR scan compared to healthy controls. Methods Patients from the multicenter myocardial infarction in our city with normal Coronaries 2 (SMINC-2) study, with a normal CMR scan 2–4 days after hospitalization, and healthy age- and sex-matched controls underwent stress perfusion at 1.5T (MAGNETOM Aera). Native rest T1 and T2 short-axis maps were acquired. Quantitative perfusion maps were acquired during adenosine stress (140 micrograms/kg/min) and at rest following an intravenous contrast bolus (0.05 mmol/kg of gadoteric acid, Gd-DOTA). Post contrast T1 maps were acquired after intravenous contrast (total dose 0.2 mmol/kg) rendering extracellular volume (ECV) maps. Global native T1, T2, ECV and rest and stress perfusion values were acquired by averaging segmental values per patient. Myocardial perfusion reserve (MPR) was calculated as perfusion in stress divided by rest. Values were presented as mean±standard deviation and compared with the independent t-test in normally distributed data, and with the Mann-Whitney U test in non-normally distributed data. Clinical data regarding cardiovascular risk factors, smoking and medications were presented as numbers (percentages) and compared with Fisher's exact test. Rate pressure product (RPP) was calculated as systolic blood pressure multiplied by heart rate in rest and stress. Results In total, 15 patients (59±16 years old, 60% female), and 15 healthy age- and sex-matched controls, were included. There was a trend towards higher incidence of hypertension in patients compared to controls, however no difference in other risk factors (Table 1). Compared to controls, MINOCA patients had lower perfusion in stress (Figure 1). There was no difference in global native T1, T2, ECV, rest perfusion, MPR or hemodynamic parameters between the MINOCA patients and the controls (p&amp;gt;0.05 for all, Table 1). Conclusions Myocardial stress perfusion is lower in MINOCA patients with a normal initial CMR scan compared to age- and sex-matched controls suggesting CMD as a possible pathophysiological mechanism in MINOCA. Funding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Swedish Heart and Lung Foundation

Maternal Obesity: An Obstetric Risk.

Objective: To analyze the obstetric risks and to evaluate the effects of maternal obesity during pregnancy and postpartum period.Method: This is a retrospective study of pregnant women with a BMI of more the 30 conducted at Bahrain Defence Force Hospital, West Riffa, Bahrain, from September 2019 to August 2020. Data includes demographic characteristics, and course of pregnancy from gestational age 24 weeks, through intrapartum to the postpartum period. Adverse maternal effects and delivery complications were the primary study outcomes. The BMI was calculated at the time of the booking visit. Comparative analysis was done to calculate the odds of each outcome taking a non-obese group (BMI less than 30) as a reference. Results: The total number of pregnant women studied was 2972, out of which 1657 had BMI ≥30. In our study, women with high BMI were older (p<0.0001). High BMI was associated with high parity and higher miscarriage history. High BMI increased the risk of developing hypertension (OR 2.5; 95%CI 1.1-5.3). This analysis also found that high BMI was associated with increased risk of antepartum hemorrhage (OR 2.4; 95%CI 1-5.4), postpartum complications (OR1.6; 95%CI 1.1-2.2), and a hospital stay of more than five days (OR 1.6; 95%CI 1.3-2). High BMI patients were less likely to have Intrauterine growth restriction (OR 0.6; 95%CI 0.3-0.9). High BMI patients did not have an increased risk of gestational diabetes mellitus, induction of labor, or caesarean birth.Conclusion: Higher BMI pregnant women are associated with higher incidences of hypertension. The high BMI group also had a significant relationship with antepartum hemorrhage and postpartum length of stay.

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.

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.

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.