Higher Blood Pressure Levels Research Articles

A Novel Reciprocal Domain Adaptation Neural Network for Enhanced Diagnosis of Chronic Kidney Disease

ABSTRACTChronic kidney disease (CKD) is a major global health concern caused mostly by high blood pressure and glucose levels. Detecting CKD early is critical for reducing its negative consequences since it can lead to increased mortality rates. With CKD's rising incidence expected to make it the fifth biggest cause of death by 2040, rapid advances in diagnostic approaches are required. This study presents the Reciprocal Domain Adaptation Network (RDAN) as a potential approach to the various issues of CKD diagnosis. RDAN is a neural network model that will help to traverse the complexity of CKD diagnosis by smoothly combining diverse data sets. RDAN consists of two critical units at its foundation: Mutual Model Adaptation (MMA) and Domain Model Learning. The MMA unit uses a powerful Global and Local Pyramid Pooling technique to extract rich features from a variety of data domains. Meanwhile, the DML unit uses semi‐supervised domain‐independent features combined with MMA features to improve representation learning. RDAN includes a reciprocal regularizer to promote cross‐domain knowledge transfer, maximising feature representation for accurate CKD identification. An analysis of RDAN's performance on a variety of real‐world datasets showed remarkable results in terms of accuracy (96.94%), precision (98.81%), recall (98.73%), F1‐Score (98.88%), and area under the curve (AUC—99.35%). These results highlight the unmatched expertise of RDAN in managing data bias, domain changes, and privacy issues related to CKD diagnosis. Beyond statistical measures, RDAN's implications promise revolutionary breakthroughs in early CKD identification and subsequent therapeutic therapies. RDAN stands out as a groundbreaking method for diagnosing CKD. It delivers exceptional accuracy and can be seamlessly applied in various clinical environments.

High blood pressure and blood pressure level among preschool children in Brazzaville (Republic of the Congo)

High blood pressure and blood pressure level among preschool children in Brazzaville (Republic of the Congo)

Molecular Links and Clinical Effects of Inflammation and Metabolic Background on Ischemic Stroke: An Update Review.

Stroke is a major global health concern, with 12.2 million new cases and 6.6 million deaths reported in 2019, making it the second leading cause of death and third leading cause of disability worldwide. Ischemic stroke, caused by blood vessel occlusion, accounts for 87% of stroke cases and results in neuronal death due to oxygen and nutrient deprivation. The rising global stroke burden is linked to aging populations and increased metabolic risk factors like high blood pressure, obesity, and elevated glucose levels, which promote chronic inflammation. This article explores the intricate molecular and clinical interplay between inflammation and metabolic disorders, emphasizing their role in ischemic stroke development, progression, and outcomes.

Social Determinants of Health, Blood Pressure Classification, and Incident Stroke Among Chinese Adults

Although cumulative evidence suggests that higher blood pressure (BP) and a greater burden of social determinants of health (SDOH) are associated with an increased risk of stroke, few studies have examined whether SDOH burden modifies the association between BP and stroke risk. To evaluate whether the association between BP classification and stroke risk differs by SDOH burden among Chinese adults. In this cohort study, analyses were conducted among 90 850 participants in the prospective subcohort of the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, with recruitment from January 1, 2016, to December 31, 2020. Participants without cardiovascular diseases and with complete data were included and followed up for stroke events until June 30, 2023. Social determinants of health burden was defined using 5 components: educational attainment, economic stability, health care access, social support, and urban vs rural residence. Blood pressure was categorized according to the 2017 American College of Cardiology/American Heart Association BP guideline. Multivariable Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs for associations of BP classification with incident stroke stratified by SDOH burden groups. The study included 90 850 participants (median age, 54.0 years [IQR, 46.0-62.0 years]; 55 390 women [61.0%]). During a median follow-up of 5.0 years (IQR, 4.1-5.8 years), 4408 incident stroke events were recorded. Compared with normal BP, elevated BP (HR, 1.33 [95% CI, 1.17-1.52]), stage 1 hypertension (HR, 1.60 [95% CI, 1.43-1.78]), and stage 2 hypertension (HR, 1.79 [95% CI, 1.61-2.00]) were associated with stroke among participants with high SDOH burden, while only stage 2 hypertension (HR, 1.52 [95% CI, 1.20-1.93]) was associated with stroke among those with low SDOH burden, with a significant multiplicative interaction of SDOH burden and BP classification (P = .03). Participants with high SDOH burden and stage 2 hypertension had the highest risk of stroke compared with participants with low SDOH burden and normal BP (HR, 2.13 [95% CI, 1.75-2.60]). This study suggests that higher BP levels, even at lower stages of hypertension, pose a greater stroke risk for individuals with high SDOH burden. Early surveillance and intervention for high BP should be emphasized in socioeconomically disadvantaged populations.

Прогнозування рівня артеріального тиску за допомогою нейромережних моделей

Psychophysiological changes are common factors contributing to the development of arterial hypertension. The aim of this study was to examine the psychophysiological characteristics of individuals with different levels of blood pressure (BP), to build and compare the predictive accuracy of a classical neural network and a Kolmogorov-Arnold network in forecasting BP levels, as well as to determine the prognostic value of the studied psychophysiological parameters. The study involved 240 practically healthy individuals aged 18 to 22. All participants underwent initial BP measurements, based on which they were divided into three groups according to the recommendations of the European Society of Cardiology. The research included 24-h BP monitoring, an assessment of anxiety levels, and evaluations of well-being, activity, mood, and sleep quality. Predictive models were created from the obtained data to forecast systolic BP levels >130 mmHg. Situational and trait anxiety levels were found to be significantly higher in individuals with normal-high BP compared to those with normal-low and normal BP levels. Sleep quality, measured by the PSQI (Pittsburgh sleep quality index) questionnaire, was significantly lower in individuals with normal-high BP compared to the other groups. The neural network constructed in this study demonstrated that psychophysiological indicators can be effectively used for predicting elevated BP levels and for the early diagnosis of arterial hypertension. This research is the first to apply the Kolmogorov-Arnold network for predicting high BP levels. The study found that this network was highly effective, outperforming the multilayer perceptron with a larger number of neurons in terms of predictive accuracy.

Pre-Stroke Frailty Negatively Affects Leptomeningeal Collateral Flow in Proximal Middle Cerebral Artery Occlusion

Introduction: The adequacy of blood flow from the leptomeningeal collaterals is considered one of the most important factors determining the rate of infarct progression and response to acute stroke treatments in the setting of large vessel occlusions. Several patient-related variables, including age, vascular risk factors, and laboratory parameters, have been proposed to explain the interindividual variability of collateral flow among stroke patients. This study aimed to assess how pre-stroke frailty, an aging-related syndrome characterized by a loss in the physiologic reserve of numerous body functions, affected the degree of leptomeningeal collateral flow in the setting of acute ischemic stroke. Methods: A consecutive series of patients presenting with proximal middle cerebral artery occlusion were enrolled in this prospective, multicenter observational study. Collateral flow was determined by the regional leptomeningeal collateral (rLMC) score on admission computed tomography angiography images. Pre-stroke frailty was assessed by the Edmonton Frailty Scale (EFS), based on the information obtained from patients or their next of kin. The relationship between collateral flow and frailty was evaluated by bivariate and multivariate analyses taking into consideration the demographic, clinical, and imaging characteristics of the patients. Results: The study population was comprised of 116 patients (median [interquartile range] age 78 [71–84] years; 60% female). The EFS scores were negatively correlated with the rLMC score (r = −0.264; p = 0.004). A vulnerable or frail (EFS ≥6) status before stroke, higher blood pressure levels at admission, having imaging studies performed at an earlier phase after contrast injection, and presenting with thrombi extending to the proximal half of the M1 portion of the middle cerebral artery were significantly related to poor collateral circulation (rLMC score ≤10). After adjustment for potential confounders in multivariable analyses, a vulnerable/frail status was independently associated with poor leptomeningeal collateral flow (OR: 2.97 [95% CI: 1.15–7.69]; p = 0.025). Conclusion: Our findings highlight that the leptomeningeal collateral flow is also compromised as part of the diminished physiologic reserve characterizing the frailty status in patients with acute ischemic stroke. Future studies are needed to understand how this interplay contributes to the unfavorable clinical outcomes observed in frail patients after stroke.

Abstract 4145840: Hypertensive Cardiorenal Disease with Cardiorenal Failure vs. Hypertensive Renal Disease with Renal Failure: Racial Mortality Trends from 1999 to 2020 in the United States

Introduction: High levels of blood pressure (BP) are responsible for 7.6 million deaths each year worldwide, more than any other risk factor. The diagnosis of hypertension is associated with a significant increase in the risk of kidney or cardiovascular events, with no prior history of these events. Our study aims to analyze trends in hypertensive heart disease and hypertensive heart and kidney disease-related mortality in the United States, focusing on different races. Method: We retrieved death certificate data from the CDC-WONDER database for adults aged ≥25 years. Crude mortality rates (CMRs) and age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated. Temporal trends were examined using the average annual percent change (AAPC) determined by joinpoint regression. Result: From 1999 to 2020, a total of 100,705 people died from hypertensive heart and renal disease in the USA. The overall AAMR of 1.4 per 100,000 displayed a trend during this period (AAPC: 4.8, 95% CI [3.3–6.2]). Total deaths from hypertensive heart disease and renal disease associated with heart failure were 5,274, showing an increasing trend from 1999 to 2020. The AAMR for hypertensive heart and renal disease with heart failure was 0.1 (AAPC: 5.2, 95% CI [3.8–6.7]). Black or African Americans have the highest AAMR (0.1, 95% CI [0.1–0.1]). Total deaths from hypertensive heart disease and renal disease associated with renal failure were 34,519, showing an increasing trend from 1999 to 2020. The AAMR for hypertensive heart and renal disease with renal failure was 0.4 (AAPC: 3.9, 95% CI [2.6–5.1]). Black or African American has the highest AAMR (1.6, 95% CI [1.5–1.6]), followed by American Indian or Alaska Native (0.5, 95% CI [0.4–0.5]), Asians and Pacific Islanders (0.4, 95% CI [0.4–0.4]), and White (0.4, 95% CI [0.3–0.4]). Conclusion: African Americans and other identified high-risk races should get targeted therapies to reduce the burden of hypertensive-related morbidity and mortality; those with renal impairment should receive special attention. The goals of these interventions ought to be to increase access to healthcare, raise public knowledge of hypertension, and support lifestyle changes.

Gender differences in clinical characteristics and influencing factors of suicide attempts in first-episode and drug-naïve major depressive disorder patients with comorbid metabolic syndrome

BackgroundsPatients with major depressive disorder (MDD) have a high rate of metabolic syndrome (MetS), which could worsen disease progression. One of the most serious progressions in MDD is suicide attempts (SAs). Previous studies have found gender differences in MetS and SAs among MDD patients respectively. Therefore, we aimed to explore gender differences of SAs in first-episode and drug-naïve (FEDN) MDD patients with comorbid MetS.Methods1718 outpatients with FEDN MDD were recruited. Depression, anxiety and psychotic symptoms were evaluated using the Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Positive and Negative Syndrome Scale (PANSS) positive subscale, respectively. Blood sugar, blood fat, blood pressure and body mass index (BMI) were measured to evaluate MetS.Results34.4% patients with FEDN MDD were diagnosed as MetS and those subjects with or without MetS differed in the distribution of SAs and gender. In MetS subgroup, 29.5% and 29.7% of male and female subjects had SAs respectively, without significant differences. However, compared with non-suicide attempters, suicide attempters had higher level of blood pressure in female subjects, while there are no differences in any clinical variables in male subjects. Additionally, the influencing factors for SAs differed by gender. The HAMA scores and BMI were variables associated with SAs in male patients while HAMA scores, marital status and systolic blood pressure (SBP) were associated with SAs in female patients. Furthermore, the receiver operating characteristics (ROC) curves, demonstrating the combination all influencing factors by gender, showed good performance and model accuracy.ConclusionsIn FEDN MDD patients with comorbid MetS, there were no gender differences in SAs. However, clinical characteristics and influencing factors of SAs differed in different gender groups.

A ATUAÇÃO DO FISIOTERAPEUTA NA SAUDE DO IDOSO HIPERTENSO

According to the WHO, in 2050 the number of elderly people aged 60 and over will exceed the number of total children aged zero to 14 years old. Arterial hypertension (technical term) or high blood pressure (term used by the lay public) is a chronic disease that often affects elderly people, characterized by high levels of blood pressure in the arteries. It occurs when the maximum and minimum pressure values are equal to or exceed 140/90 mmHg (or 14 by 9) The objective of the Physiotherapy professional is to assist in the prevention of diseases or mainly in the care of patients with SAH, promoting quality of life, independence and improving the daily life of the elderly. Care needs to be provided or better applied so that this high population population follows a path where morbidity and mortality do not increase as a result of the health of the elderly.

Impact of smoking status on incident hypertension in a Japanese occupational population.

Hypertension and tobacco smoking pose independent risks for cardiovascular diseases, but their association is unclear especially in Japanese. We investigated the impact of smoking status on the risk of new-onset hypertension in male and female Japanese workers. We evaluated 5439 subjects without hypertension who participated in medical check-ups in 2007-2018. The outcome was the development of hypertension (blood pressure ≥140/90 mmHg or initiation of antihypertensive drugs). Cox's proportional hazards models were used to assess the association between smoking status and the hypertension incidence. During the average 6.0-year follow-up, 1395 individuals (25.6%) developed hypertension. The crude incidence rates of hypertension (per 100 person-years) were: current non-smokers (n = 3033), 3.4; quitters (n = 445), 4.2; and sustained smokers (n = 1961), 5.7. The multivariable-adjusted hazard ratio was 1.34 (1.20-1.50) for sustained smokers and 1.03 (0.86-1.24) for quitters compared to current non-smokers (P for trend <0.01). In stratified analyses, the risk of incident hypertension was significantly higher in the sustained smokers with lower blood pressure or without diabetes at baseline versus the current non-smokers. A significant risk reduction of hypertension development due to smoking cessation was revealed in the subjects with higher blood pressure levels at baseline or without body weight gain after smoking cessation. Smoking was an independent risk factor for incident hypertension. Smoking cessation reduced the risk of hypertension development compared to sustained smoking, especially among the subjects with higher blood pressure levels. Maintaining one's body weight after smoking cessation would also help prevent hypertension development.

Consumption of Milk a Probable Risk Factor of Hypertension in India: A Study Based on National Family Health Survey-5

Introduction: Chronic high blood pressure, often known as hypertension, can cause a number of cardiovascular issues due to its higher blood pressure levels. A growing body of research points to a possible link between the use of dairy products and a higher risk of hypertension. Objectives: The present study aims to provide information regarding a probable association between dairy consumption and hypertension among the population of India. Methodology: The current study uses data from the fifth series of the National Family Health Survey (NFHS-5) 2019–21 in order to examine this association. The sample size is 724115 in total. This study included eight factors in total: systolic and diastolic blood pressure, age, religion, ethnicity, education, wealth index, and frequency of milk/curd consumption. IMB-SPSS version 26.0 was used for all data analysis. Results: It was found that those consuming milk products daily and weekly have very strong chances of having stage 1(95.3% and 93.2%, respectively in 95% CI) and stage 2 hypertension (92.4% and 90.4%, respectively in 95% CI). daily consumption of milk products also significantly increases 80.3% the chance of having stage 3 hypertension as well (95% CI). Conclusion: It is abundantly obvious from the current study that consuming milk and curd on a daily and weekly basis considerably raises your risk of developing stage 1, stage 2, and stage 3 hypertension. Given that India consumes the most milk globally and that the bulk of it is unpasteurized, it is crucial to consider the connection between milk consumption and hypertension discovered in the current study.

Management challenges in primary hyperoxaluria type 1 with end-stage kidney disease: A case report

Introduction and importancePrimary hyperoxaluria (PH) is a metabolic condition that leads to oxalate production, resulting in kidney failure and oxalate nephropathy. Posttransplant mobilization of oxalate poses a risk of recurrence. This case emphasizes the importance of measures in cases of end-stage kidney disease (ESKD) with unknown origins. Case presentationA 53-year-old man with a history of hypothyroidism, recurring kidney stones, and a family background of renal disease and stomach cancer presented with high blood pressure and elevated creatinine levels (2 mg/dL). A subsequent renal biopsy confirmed PH1. Despite initiating hemodialysis, his kidney function deteriorated, necessitating a liver and kidney transplant. Following the transplant, the patient developed lymph node enlargement. Experienced humoral rejection, leading to the resumption of hemodialysis. Clinical discussionThe case discussion highlights the treatment complexities associated with PH1, emphasizing the importance of detection and vigilant monitoring post transplantation and multidisciplinary care for managing complications effectively. ConclusionEarly detection, thorough diagnostics, and customized posttransplant care play roles in managing hyperoxaluria. Future research should focus on enhancing methods, refining transplantation techniques, and developing strategies to prevent and manage complications effectively.

Initial blood pressure and adverse cardiac events following acute ischaemic stroke: An individual patient data pooled analysis from the VISTA database.

Adverse cardiac events following ischaemic stroke (stroke-heart syndrome, SHS) pose a clinical challenge. We investigated the association between initial blood pressure at stroke presentation and the risk of SHS. We utilised data from the Virtual International Stroke Trials Archive (VISTA). We defined SHS as the incidence of cardiac complications within 30 days post-ischaemic stroke. These presentations included acute coronary syndrome encompassing myocardial injury, heart failure/left ventricular dysfunction, atrial fibrillation/flutter, other arrhythmia/electrocardiogram abnormalities, and cardiorespiratory arrest. Using Cox proportional hazards models, we assessed the risk trajectories for developing SHS and its presentations associated with initial blood pressure. We also explored the risk trajectories for 90-day mortality related to initial blood pressure. From 16,095 patients with acute ischaemic stroke, 14,965 (mean age 69 ± 12 years; 55% male) were analysed. Of these, 1774 (11.8%) developed SHS. The risk of SHS and initial blood pressure showed a U-shaped relationship. The lowest blood pressures (⩽130 mmHg systolic and ⩽55 mmHg diastolic) were associated with the highest risks (adjusted hazard ratio [95%confidence interval]: 1.40 [1.21-1.63]; p < 0.001, 1.71 [1.39-2.10]; p < 0.001, respectively, compared to referential blood pressure range).Cardiorespiratory arrest posed the greatest risk at higher blood pressure levels (2.34 [1.16-4.73]; p = 0.017 for systolic blood pressure >190 mmHg), whereas other presentations exhibited the highest risk at lower pressures. The 90-day mortality risk also followed a U-shaped distribution, with greater risks observed at high blood pressure thresholds. There is a U-shaped relationship between initial blood pressure at ischaemic stroke presentation and the risk of subsequent SHS.

Prevecardio: a single-visit population screening model for detection and prevention of 10-year cardiovascular risk

Abstract Introduction Cardiovascular diseases (CVDs) are a major contributor to global mortality. The early detection of cardiovascular risk factors, coupled with timely intervention strategies, is essential for CVD prevention. PreveCardio was developed as an innovative, single-visit population screening model designed to facilitate the early identification and management of cardiovascular risk factors within a population of 1 million in a European capital city region totaling 6 million inhabitants. Purpose This study aimed to ascertain the prevalence of cardiovascular risk factors within the general population and to evaluate the effectiveness of the PreveCardio model in estimating 10-year cardiovascular risks and promoting preventive interventions. Methods In this cross-sectional prevalence study, individuals aged 50 to 75 from a health network were randomly selected and invited to participate in a comprehensive health check. The 30-minute screening consisted of lifestyle evaluations, anthropometric measurements, and blood tests for lipid profiles and glycated haemoglobin. The methodology was designed to provide participants with immediate feedback on their results, cardiovascular health and practical guidance for risk management. Results From the 8,492 individuals solicited, 3,546 took part in the screening: 56,83% were female, mean age 61,17 ± 7,33 y.o. Picture 1 shows the population's percentages with various modifiable cardiovascular risk factors, including 20% with active smoking, 30% with sedentarism, 16% with risky alcohol consumption, 49% with non-adherence to the Mediterranean diet, 40% with overweight, and 30% with obesity. The screening revealed new diagnoses of LDL-hypercholesterolemia in 47% participants, high levels of blood pressure in hypertension range in 49%, prediabetes in 30% and diabetes in 2% (Picture 2). After use SCORE2 and SCORE-OP risk prediction algorithms, PreveCardio is estimated to potentially prevent between 39 to 202 fatal and non-fatal cardiovascular events over 10 years. Predictive modelling based on PreveCardio data projected that expanding the screening across the capital region could prevent at least 26,260 cardiovascular events over 10 years. Conclusion(s) PreveCardio has established itself as a viable and effective model for the early detection of cardiovascular risk factors in a general population. It holds significant promise for public health impact by potentially reducing the incidence of CVD through comprehensive screening and proactive intervention.

Obesity plays a key role in inducing myocardial and vascular dysfunction in a translational model of heart failure with preserved ejection fraction in rats

Abstract Background Exploring experimental models of heart failure with preserved ejection fraction (HFpEF) may help to understand the mechanisms leading to this challenging condition. Purpose In a translational model, we aimed to assess the relative contribution of hypertension and obesity in inducing structural, functional and hemodynamic changes associated to the HFpEF phenotype. Methods We investigated 3 groups of male 40 weeks old rats: control Wistar Kyoto (WKY, n=10), Spontaneous Hypertensive Rats (SHR, n=10) and SHR with obesity induced by consumption of cafeteria diet during 28 weeks (Ob-SHR, n=9). Animals were submitted to assessment of: body weight, systolic (SBP) and diastolic (DBP) blood pressure; in vivo structural and functional changes evaluated by high resolution Echocardiography including left atrial dimension (LA), left ventricle (LV) diastolic dimension (LVDD), LV posterior wall thickness (LVPW), LV wall relative thickness (LVWRT), LV ejection fraction (LVEF). Invasive hemodynamic evaluation assessed the intraventricular pressure curves obtaining LV end diastolic pressure (LVEDP) and calculation of LV diastolic time constant (Tau). After euthanasia, thoracic aorta was used for vascular function assessment by measuring the maximal cumulative concentration-effect curves of contraction to phenylephrine (PE), expressed as Emax (%). Protein expression of Intercellular Adhesion Molecule 1 (ICAM-1) was determined in myocardial tissue (% in relation to WKY). Results were expressed as mean ± SEM and effects of groups vs time were compared with mixed ANOVA. Results The results are shown in the table. We observed higher levels of SBP and DBP in SHR and Ob-SHR when compared to WKY, but with similar values between SHR and Ob-SHR groups. Regarding the structural LV changes, we observed LV remodeling and LA dilation in both SHR and Ob-SHR groups, but with no difference between both hypertensive groups. The Ob-SHR was the only group showing increased LVEDP in comparison to other groups. The Tau was also increased in the Ob-SHR animals. Concordantly, the Ob-SHR group showed increased expression of ICAM-1 (figure - A) that was concomitant to abnormal vascular response with increased contraction to PE (figure - B) as compared to SHR and WK groups. Conclusions In this translational model of HFpEF in rats, the structural changes related to LV remodeling were similar in SHR and Ob-SHR, probably reflecting comparable higher levels of blood pressure observed in both groups. In contrast, elevated EDP, a hallmark of HFpEF, was only seen in the Ob-SHR group and this was concomitant to diastolic dysfunction, endothelial inflammatory activation and altered vascular function. Our results indicate that obesity is a key factor inducing vascular and myocardial changes that triggers HFpEF phenotype in this model.

Expanding access to non-communicable disease screening in war-affected communities in Ukraine

Abstract Background Non-communicable diseases (NCDs) account for 91% of premature deaths in Ukraine. However, NCD screening lags among young people and across the entire population. The ongoing war has exacerbated barriers to NCD screening due to damaged infrastructure, understaffed medical facilities, and health system deterioration. Intervention/response To improve screening, diagnosis, and care, in March 2023 the PATH-led, USAID-funded Support TB Control Efforts in Ukraine (STBCEU) project established community level health access points (HAPs) in five conflict-affected communities. STBCEU procured screening tools (tannometers, glucometers, portable ECGs) for common NCDs, printed informational materials, trained 143 specialists, designed a reporting system, and facilitated monitoring visits to 77 HAPs. Results By the end of 2023, the project equipped 113 HAPs in the five communities, and 102 of them initiated NCD screening. From January-March 2024, 1,694 people under 40 years old were screened for NCDs. Among 1,488 blood pressure measurements, 143 cases had high readings (9.6 ±1.5%), 90 (62.9%) of which were first-time diagnoses, and 53 (37.1%) treatment monitoring. Glucose levels were measured 809 times, with elevated levels in 44 cases (5.4 ±1.5%), 30 (68.2%) of which were first-time diagnoses, and 14 (31.8%) treatment monitoring. Additionally, 1,144 mental health consultations were provided. Conclusions This initiative represented a first in Ukraine: per national requirements, young people have not historically been screened for NCDs. Expanding NCD screening in war-affected communities has demonstrated substantial early success, with significant detection of high blood pressure and elevated glucose levels among people under 40. This proactive, cost-effective intervention underscores the need for accessible, community-level health interventions in crisis settings and showcases a scalable model for integrating NCD screening into emergency health response frameworks. Key messages • The implementation of community-level NCD screening has shown early success in detecting high blood pressure and elevated glucose levels among people under 40. • Cost-effective NCD screening underscores the need for accessible, community health interventions, providing a scalable model for integrating NCD screening into emergency health response.

Blood pressure variability compromises vascular function in middle-aged mice.

Blood pressure variability (BPV) has emerged as a novel risk factor for cognitive decline and dementia, independent of alterations in average blood pressure (BP). However, the underlying consequences of large BP fluctuations on the neurovascular complex are unknown. We developed a novel mouse model of BPV in middle-aged mice based on intermittent Angiotensin II infusions. Using radio telemetry, we demonstrated that the 24-hr BP averages of these mice were similar to controls, indicating BPV without hypertension. Chronic (20-25 days) BPV led to a blunted bradycardic response and cognitive deficits. Two-photon imaging of parenchymal arterioles showed enhanced pressure-evoked constrictions (myogenic response) in BPV mice. Sensory stimulus-evoked dilations (neurovascular coupling) were greater at higher BP levels in control mice, but this pressure-dependence was lost in BPV mice. Our findings support the notion that large BP variations impair vascular function at the neurovascular complex and contribute to cognitive decline.

Association of abruptio placentae with hypertension in pregnancy: Analysis of risk factors in Nigerian women

AbstractObjectiveThe incidence of abruptio placentae complicating hypertensive diseases of pregnancy is high in Nigerian referral hospitals. We conducted a retrospective case‐control study to identify the socio‐demographic, behavioural, and clinical risk factors associated with abruptio placentae in women with hypertensive diseases of pregnancy.MethodsThe 41 cases of hypertensive diseases complicated by abruptio placentae identified in the records of the University of Benin Teaching Hospital over 2 years (January 2021–December 2022) were compared with 208 women (controls) who had hypertensive diseases without developing abruptio placentae. Multiple regression analysis was used to develop maximum likelihood estimates of the adjusted odds ratios and 95% confidence intervals to predict the likelihood of the association between the exposure factors and the risk of abruptio placentae.ResultsHigh blood pressure levels at presentation, when managed, can decrease the odds for abruptio placentae by 9% OR 0.91, CI:0.83–0.9, but smoking and alcohol intake were not significantly associated with abruptio placentae. A higher haemoglobin concentration decreased the likelihood of abruptio placentae by 60% OR 0.40, (CI 0.24– 0.68), while higher birth weight babies minimally decreased the odds for abruptio placentae, OR 1.01 (CI 0.08–12.49).ConclusionWe conclude that abruptio placentae is most likely to complicate hypertensive diseases of pregnancy in Nigerian women when there are concurrent pregnancy anaemia and low birth weight babies, while higher blood pressure levels at presentation, when promptly managed, can reduce the risk of abruptio placentae. Efforts to address the concurrent management of anaemia associated with hypertensive diseases in pregnancy will most likely reduce the incidence of abruptio placentae in this population.

From BpTRU to OMRON: The impact of changing automated blood pressure measurement devices on adult population estimates of blood pressure and hypertension.

In Cycle 7 (2022), the Canadian Health Measures Survey (CHMS) introduced the OMRON (OM) IntelliSense HEM-907XL blood pressure (BP) monitor after using the BpTRU (BT) BPM-300 BP monitor for six cycles. This study assessed differences between adult BP values measured by both devices and whether equations could be developed to compare BP measurements taken using the two devices. In Cycle 6 (2018 to 2019) of the CHMS, BP was measured using BT and OM devices. Between-device estimates of systolic BP (SBP), diastolic BP (DBP), and hypertension prevalence were compared for 1,072 adults aged 18 to 79 years. Sex, age, body mass index (BMI), and the use of antihypertensive medication were examined in linear regression models to predict SBP and DBP values measured with OM based on those measured with BT. Average SBP measured with OM was 6 millimetres of mercury (mmHg) higher than average SBP measured with BT, and average DBP measured with OM was 2 mmHg lower than DBP measured with BT. Hypertension prevalence based on OM readings was 35.4%, compared with 34.0% based on BT readings. Between-device BP differences varied in magnitude by sex, age group, and BMI category. Average model-predicted estimates of BP were comparable to measured estimates, but predicted values were lower at higher levels of BP. Switching BP monitors will substantively affect population estimates of adult SBP and DBP but may have less impact on estimates of adult hypertension prevalence. The prediction equations proposed in this study can be applied to adult BP data from cycles 1 to 6 of the CHMS for comparison with BP measurements taken in Cycle 7, with some caveats. The impact of changing to the OM monitor in Cycle 7 should be acknowledged when reporting estimates of adult BP based on the CHMS.

Fatores de risco e sua influência na Síndrome Metabólica: Uma revisão narrativa da literatura

Objective: To analyze risk factors and their influence on Metabolic Syndrome. Literature Review: METABOLIC SYNDROME (MS) represents a set of risk factors of metabolic origin that promote the development of cardiovascular diseases and type 2 diabetes mellitus (DM). Regardless of the group or entity that defines MS, the risk factors, that is, the components adopted for its definition, are practically the same. The following components are included: obesity (especially abdominal obesity), high blood pressure levels, glucose metabolism disorders, and hypertriglyceridemia and/or low levels of HDL cholesterol. Final considerations: It is noteworthy that dietary factors can play a fundamental role both in the individual components and in the prevention and control of MS. Recent data associate the presence of MS with lower consumption of whole grains, fruits, and vegetables. There is a close relationship between these foods and dietary fiber, and it is likely that soluble fibers are more directly related to these effects