Higher Risk Of Hypertension Research Articles

Life-course trajectories of body mass index and cardiovascular disease risks and health outcomes in adulthood: Systematic review and meta-analysis.

This systematic review aimed to assess the effect of life course body mass index (BMI) trajectories (childhood to adulthood) on cardiovascular disease (CVD) risk factors and outcomes. Prospective or retrospective cohort studies were identified that assessed the association of BMI trajectories with CVD risks and outcomes from databases published in English. The pooled effect sizes were estimated using a random-effects model. Seventeen eligible studies were included in this systematic review. The results revealed that a persistently overweight trajectory from childhood to adulthood was associated with a higher risk of hypertension (RR: 2.49; 95% CI: 1.9, 3.28) and type 2 diabetes (RR: 4.62; 95% CI: 2.36, 9.04) compared with a trajectory characterized by a normal BMI throughout both childhood and adulthood. Similarly, the risk of hypertension (RR: 2.38; 95% CI: 1.70, 3.33) and type 2 diabetes (RR: 3.66; 95% CI: 2.57, 5.19) was higher in those with normal-to-overweight trajectory compared with participants with a stable normal weight trajectory. The findings suggest that lifetime BMI trajectories may be influential on health outcomes, and preventive strategies should be designed accordingly. Implementing appropriate preventive strategies at all life stages may reduce CVD risks and adverse outcomes later in life.

Association of parity with the prevalence of hypertension in Japan: The Tohoku Medical Megabank Community-based cohort study.

This study investigated the association of parity with hypertension prevalence in Japanese women while considering a clinical history of hypertensive disorders of pregnancy (HDP) and menopausal status. This cross-sectional study included 30,530 Japanese women (6700 premenopausal; 23830 postmenopausal). The association between parity and the prevalence of hypertension was evaluated using a multiple logistic regression model with possible confounders. In premenopausal women, no statistically significant association between parity and hypertension prevalence was found. When not adjusted for current body mass index (BMI), a linear graded association was observed between parity and the prevalence of hypertension in postmenopausal women. However, the association between parity and hypertension prevalence in postmenopausal women was attenuated after adjustment for current BMI. Both current BMI and a clinical history of HDP were significantly associated with a high risk of hypertension in both premenopausal and postmenopausal women. Our results also suggest that continuous surveillance and preventive measures for hypertension should be provided for women with HDP and high parity.

Relationship between trimethylamine N-oxide and the risk of hypertension in patients with cardiovascular disease: A meta-analysis and dose-response relationship analysis.

The gut microbiota-dependent metabolite trimethylamine N-oxide (TMAO) has recently been recognized to be one of the risk factors for cardiovascular disease (CVD). However, there is a scarcity of data on the relationship between circulating TMAO levels and hypertension in patients with CVD. Meta analysis and a dose-response relationship were used in this study to assess the relationship between circulating trimethylamine N-oxide levels and the risk of hypertension in patients with CVD. CNKI, Wanfang Database, Pubmed, Embase, Cochrane Library, and Web of Science were searched up to June 01, 2023. Meta-analysis and dose-response analysis of relative risk data from prospective cohort studies reporting on the relationship between circulating TMAO levels and hypertension risk in patients with CVD were conducted. Fifteen studies with a total of 15,498 patients were included in the present meta-analysis. Compared with a lower circulating TMAO level, a higher TMAO level was associated with a higher risk of hypertension in patients with CVD (RR = 1.14,95%CI (1.08, 1.20)). And the higher the TMAO level, the greater the risk of hypertension. The dose-response analysis revealed a linear dose-response relationship between circulating TMAO levels and the risk of hypertension in patients with CVD. The risk of hypertension increased by 1.014% when the circulating TMAO level increased by 1 μ mol/L. In patients with CVD, the level of circulating TMAO is significantly related to the risk of hypertension. The risk of hypertension increased by 1.014% for every 1 μ mol/L increase in circulating TMAO levels.

School screening programs to identify hypertension in Hispanic youth

Elevated blood pressure during childhood can lead to hypertension in adulthood and is associated with an increased risk of future cardiovascular disease with early identification as the best option for prevention. This study examines the prevalence of hypertension in Hispanic and White youths and reports the ability of a school-based program to identify hypertension in school-aged children. Approximately 3.5 % of students had hypertension while 7.5 % of students had elevated blood pressure. Elevated body mass index (BMI) was the most common predictor of hypertension in all three grade levels (elementary: 5th grade, middle: 7th grade, and high school: 10th grade). In the elementary school age group, the significant predictors of hypertension were an elevated BMI, sex, and height. In the middle school age group, the factors that were significant predictors of hypertension included ethnicity, an elevated BMI, and height. In high school age students, the only significant predictor of hypertension was elevated BMI; ethnicity alone was not a significant predictor. The only group that ethnicity was a significant predictor of hypertension was the middle school age. Given that at all three grade levels, the Hispanic students had a higher percentage with elevated BMIs compared to White students, they should be considered at higher risk of hypertension.

Association of living alone and living alone time with hypertension among Chinese men aged 80 years and older: a cohort study.

There is little evidence of the influence of living alone on hypertension risk among men 80 years or older. Additionally, the influence of living alone duration on hypertension risk lacks thorough investigation. Hence, this cohort study examines living alone and its duration's link to hypertension risk in this specific group. We included 2009 older men aged ≥80 years without hypertension from the Chinese Longitudinal Healthy Longevity Survey in the 2008 wave. Follow-up was conducted in the 2011 wave. Multivariable Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) to assess hypertension risk related to living alone and living alone time. We included 2,009 older men, with a mean age of 90.7 years (standard deviation: 6.8). Over a median follow-up of 2.9 (1.3-3.0) years, 573 participants (28.5%) developed hypertension. Living alone was significantly associated with a higher hypertension risk than living with family (HR: 1.42; 95% CI 1.11-1.80). When compared to living with family, the hypertension risk was increased in the first quartile of living alone time (0-6.1 years) (HR: 1.76; 95% CI 1.16-2.66), the second quartile (6.1-10.6 years) (HR: 1.56; 95% CI 1.07-2.29), and the third quartile (10.6-19.3 years) (HR: 1.66; 95% CI 1.08-2.55). Surprisingly, no significant association was found in the fourth quartile (≥19.3 years) with hypertension risk. Stratified and Interaction analyses indicated no significant interaction effects between subgroups. Sensitivity analyses yielded consistent results. Living alone was independently associated with an increased risk of hypertension in older men. The highest risk was found in those with the least time alone. These findings imply that social isolation and lack of companionship could be pivotal in hypertension development. Furthermore, the study highlights the need to consider living alone duration when assessing its impact on health outcomes.

Central and peripheral blood pressures in relation to the triglyceride-glucose index in a Chinese population

BackgroundThe triglyceride-glucose (TyG) index has been proposed as a surrogate marker of insulin resistance. However, the relationship between the TyG index and central blood pressure (BP), has not been well studied in adults.MethodsA total of 715 Chinese adult participants were enrolled in this study. Anthropometric and BP were assessed. The TyG index was calculated as ln[fasting triglycerides(mg/dL) × fasting glucose(mg/dL)/2]. Central BP was measured using SphygmoCor system.ResultsThe participants were stratified into three groups based on the TyG index, and significant differences were observed in metabolic and cardiovascular parameters and the prevalence of hypertension among the groups. Both brachial (β = 1.38, P = 0.0310; group highest vs. lowest, β = 2.66, P = 0.0084) and aortic (β = 2.38, P = 0.0002; group highest vs. lowest, β = 3.96, P = 0.0001) diastolic BP were significantly and independently associated with the TyG index and increasing TyG index tertile. However, there was no independent association between the TyG index and systolic BP. A one-unit increase in the TyG index was associated with a 46% higher risk of hypertension (P = 0.0121), and compared with the lowest group, participants in the highest group had a 95% higher risk of hypertension (P = 0.0057).ConclusionsOur study demonstrates a significant and independent association between the TyG index and both brachial and aortic diastolic BP in Chinese adults. Furthermore, the TyG index was found to be an independent predictor of hypertension.

Association of parathyroid hormone with risk of hypertension and type 2 diabetes: a dose-response meta-analysis

BackgroundDespite an increase in parathyroid hormone (PTH) has been reported to be associated with a higher risk of hypertension and type 2 diabetes (T2D), the comprehensive evaluation of the dose-response relationship between PTH and hypertension and T2D remains ambiguous. Therefore, a dose-response meta-analysis was performed to quantitatively investigate this association.MethodsPubMed, Web of Science, and Embase were systematically searched up to May 2023. Random-effect models were used to estimate the summary odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines were used to model the dose-response association.ResultsTen articles (including 13 studies) were identified, with a total of 11,878 cases and 51,234 participants in the meta-analysis. Of these studies, eight (five cohort and three cross-sectional) studies investigated the association of PTH with hypertension; five (two cohort and three cross-sectional) studies assessed the association of PTH with T2D. The results showed a positive relationship between PTH and the risk of hypertension (OR,1.24, 95% CI: 1.16–1.33). We found a linear association between PTH and hypertension (Pnon−linearity= 0.222). In the dose-response analysis, the risk of hypertension increased 5% for every 10 pg/ml increase in PTH (OR,1.05, 95% CI: 1.02–1.08). The pooled OR of T2D risk for a 10 pg/ml increase in PTH was 1.00 (95% CI: 0.98–1.02).ConclusionsElevated PTH is associated with an increased risk of hypertension. However, the evidence of the association between PTH and T2D is limited, and more well-designed studies need to be explored.

Comparative safety of novel targeted therapies in relapsed/refractory chronic lymphocytic leukemia: a network meta-analysis.

The emergence of new antileukemic drugs, including Bruton tyrosine kinase inhibitors (BTKis), phosphoinositide 3-kinase inhibitors (PI3Kis), and B-cell lymphoma 2 antagonists (BCL-2a), has significantly improved the outcomes for patients with relapsed/refractory chronic lymphocytic leukemia (CLL). Despite advances in treatment efficacy, the comprehensive safety profile of these novel agents versus traditional chemotherapy and immunotherapy has not been adequately explored, and there have been few direct comparisons. This study aimed to compare the safety profiles of novel therapeutic agents, chemotherapy, and immunotherapy in patients with relapsed/refractory CLL using a Bayesian network meta-analysis (NMA). A systematic literature review was conducted to identify randomized clinical trials on relapsed/refractory CLL. The search encompassed major medical databases (MEDLINE, Embase, and CENTRAL) and gray literature, with the aim to integrate the findings into a Bayesian NMA framework for safety outcome assessment. Systematic literature review with Bayesian NMA. The systematic search identified 14 randomized trials that formed networks for the comparison of safety outcomes. No differences were shown between therapies in terms of overall adverse events (AEs). However, bendamustine + rituximab had a more favorable safety profile for grade ⩾3 AEs when compared with ibrutinib (risk ratio 0.62 (95% credible interval 0.40-0.86)), acalabrutinib (0.69 (0.45-0.94)), zanubrutinib (0.64 (0.42-0.91)), and venetoclax + rituximab (0.87 (0.79-0.96)). The frequency of grade ⩾3 AEs, serious AEs, and treatment discontinuations and deaths due to AEs was comparable between acalabrutinib, zanubrutinib, and venetoclax + rituximab. There were no significant differences in the safety profiles regarding hematological events, events affecting the quality of life, and infections for most comparisons of venetoclax + rituximab with BTKis. Among BTKi-specific events, zanubrutinib was associated with a higher risk of hypertension (2.96 (1.74-5.16)) and bleeding (1.38 (1.06-1.81)) than acalabrutinib. No differences in the risk of atrial fibrillation were found between acalabrutinib and zanubrutinib (1.56 (0.74-3.34)). Our findings showed that venetoclax + rituximab, acalabrutinib, and zanubrutinib have acceptable safety profiles, which indicates that they may be the preferred therapeutic options in the setting of relapsed/refractory CLL. PROSPERO CRD42022304330.

Adverse pregnancy outcomes associated with endometriosis in Ukraine: results a multicenter study.

Aim: To estimate pregnancy outcomes associated with endometriosis in Ukraine. Materials and Methods: We performed the multicentre prospective cohort study during the period from January 1st, 2019 to December 31st, 2021. The study included pregnant women aged ≥18 years hospitalized in 17 hospitals from 15 regions of Ukraine. Logistic regression analysis provided odds ratios (OR) with 95% confidence intervals (CI). Results: Of the 27,558 women, 990 (3,6%) reported a diagnosis of endometriosis before pregnancy. In 990 deliveries, women with endometriosis had a higher risk of hypertension in pregnancy (OR 1.2, 95% CI 1.0-1.3), preeclampsia (OR 1.4, 95% CI 1.3-1.5), severe preeclampsia (OR 1.7, 95% CI 1.5-2.3), hemorrhage in pregnancy (OR 2.3, 95% CI 2.0-2.5), placental abruption (OR 2.0, 95% CI 1.7-2.3), placenta previa (OR 3.9, 95% CI 3.5-4.3), premature rupture of membranes (OR 1.7, 95% CI 1.5-1.8), and retained placenta (OR 3.1, 95% CI 1.4-6.6). The neonates had increased risks of preterm birth before 28 weeks (OR 3.1, 95% CI 2.7-3.6), birth before 34 weeks (OR 3.2, 95% CI 2.8-3.6), being small for gestational age (OR 1.5, 95% CI 1.4-1.6), being diagnosed with congenital malformations (OR 1.3, 95% CI 1.3-1.4), and neonatal death (OR 1.8, 95% CI 1.4-2.1). Conclusions: Pregnant women with endometriosis are at elevated risk for serious and important adverse maternal, fetal and neonatal outcomes. The magnitude of these complications calls for more intensive antenatal care of pregnant women with endometriosis.

Arterial hypertension and smoking in pregnant women in the Valencian Community: maternal and neonatal outcomes

ObjectiveHypertension and smoking during pregnancy have been linked to various adverse maternal and fetal outcomes. The objective of this work is to study how the smoking influences the development of hypertension, its effects on the pregnant woman, and on the newborn. Materials and methodsAn observational study in two phases was carried out: the descriptive first phase allows characterization of the sample and the analytical second phase is a case–control nested in a retrospective cohort corresponding to pregnancy. ResultsA total of 712 women were included in the study. Of the 672 (94.4%) non-hypertensive women, 533 (79.3%) were non-smoking and 139 (20.7%) smoking. For the 40 (5.6%) hypertensive women, 30 (75.0%) were non-smoking and 10 (25.0%) smoking. The prevalence of hypertension was of 5.6%. Women who quit smoking before pregnancy saw a reduced risk of hypertension. For women who smoke during pregnancy, those of younger ages, with a normal body mass index, who are primiparous, employed and with a low-medium level of education have higher risk of hypertension. The risk of hypertension according to the level of physical activity during leisure time follows a “U” shape, with those who perform light physical activity at the lowest risk of hypertension. Hypertensive women have a higher risk of small for gestational age newborns. Smoking does not pose an additional risk for adverse outcomes once hypertension is diagnosed. ConclusionsFuture studies should aim to determine the role of smoking habit in the appearance of hypertension in pregnancy in order to establish adequate intervention guidelines that may aid in reducing the prevalence of hypertension.

The Association between Magnesium Depletion Score and Hypertension in US Adults: Evidence from the National Health and Nutrition Examination Survey (2007-2018).

The magnesium depletion score (MDS) emerges as a new valuable predictor of the body's magnesium status index. This study aims to explore the link between MDS and hypertension (HTN) using the National Health and Nutrition Examination Survey (NHANES) data. A total of 9708 participants from NHANES (2007-2018) were enrolled to investigate MDS's connection with HTN. HTN was defined based on clinical guidelines. MDS classification (low, 0-1; middle, 2; high, 3-5) relied on alcohol consumption, diuretic use, proton-pump inhibitor (PPI) usage, and kidney disease. Multivariable logistic regression assessed MDS-HTN association. Subsequent analyses included interaction tests, subgroups, and sensitivity analysis. Each unit increase in MDS correlated with an 87% higher HTN risk (OR, 1.87; 95% CI, 1.64-2.13) after adjusting for confounders. High MDS participants exhibited significantly elevated HTN risk compared to low MDS counterparts (OR, 8.31; 95% CI, 4.81-14.36), with a significant trend across MDS groups (p < 0.001). Subgroup analyses supported a consistent positive correlation. Sensitivity analysis confirmed a robust association. The results indicated a positive correlation between MDS and the risk of developing HTN in US adults.

The Correlation Between Smoking Behavior and The Use of “Used Cooking Oil” with Hypertension Incidences at Malimbu Coastal Area

Hypertension is the main risk factor that leads to cardiovascular disease such as heart attack, heart failure and stroke, which is the highest cause of death in the world. One area with high risk of hypertension is the coastal area. The famous coastal area in the Lombok is Malimbu, located in North Lombok, West Nusa Tenggara Province. This research is an analytical observational study with a cross sectional design. This study aims to determine the correlation between smoking behavior and use of “used cooking oil” and the incidence of hypertension. Samples in this study were 70 people (n=70), and was taken using accidental sampling technique. Data were analyzed using chi-square. The results showed that the incidence of hypertension was 48% of the 70 respondents. Most of the respondents (70%), had no history of hypertension in their family. This research shows that there is no correlation between smoking behavior and the incidence of hypertension (p=0.807) with PR=1.156 (0.354 - 3.797). The use of “used cooking oil” was also found to be not correlated with the incidence of hypertension (p=0.632) with PR=1.275 (0.486 - 3.345). Although several previous studies showed that the smoking behavior and the use of used cooking oil correlate to hypertension, but this study result shows different data. This can be caused by other factors. Future research needs to examine the characteristics of smokers that may be related to the incidence of hypertension

Applying the transtheoretical model of health behavior change: using calendars for hypertension management in elderly individuals during the COVID-19 pandemic in Phrae Province, Thailand

Hypertension is a persistent global public health concern, particularly affecting elderly individuals and is further compounded by the challenges posed by the COVID-19 pandemic. Innovative interventions are essential to effectively manage blood pressure in this vulnerable demographic group. This quasi-experimental study implemented a calendar-based intervention among 84 elderly individuals in Phrae Province, Thailand. The intervention integrated dietary recommendations, physical activity guidelines, and hypertension education. Over eight weeks, the intervention group exhibited a significant reduction in systolic blood pressure (6.59 mmHg) and diastolic blood pressure (2.52 mmHg) levels (p-value&lt;0.05), contrasting with the comparison group's increase. The calendar-based program effectively enhanced hypertension knowledge, empowering participants to make informed health decisions. The study's holistic approach, grounded in health behavior change models, effectively promoted hypertension awareness and facilitated healthier lifestyles. Results suggest the calendar-based program's suitability for elderly individuals at high risk of hypertension, especially during the COVID-19 pandemic, due to its cost-effectiveness and accessibility. This research underscores the potential of calendar-based interventions in supporting blood pressure management among elderly populations, with broader implications for public health strategies, especially during challenging circumstances such as pandemics.

Sex and Race Differences in Obesity-Related Genetic Susceptibility and Risk of Cardiometabolic Disease in Older US Adults

The fat mass and obesity-associated gene (FTO) is associated with obesity phenotypes, but the association is inconsistent across populations. Within-population differences may explain some of the variability observed. To investigate sex differences in the association between FTO single-nucleotide variants (SNVs) and obesity traits among self-identified non-Hispanic Black and non-Hispanic White US adults, to examine whether the SNVs were associated with cardiometabolic diseases, and to evaluate whether obesity mediated the association between FTO SNVs and cardiometabolic diseases. This cross-sectional study used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a US population-based cohort study with available genetic data (assayed in 2018) and phenotypic data at baseline (enrolled 2003-2007). Participants were aged 45 to 98 years at baseline. Data were analyzed from October 2021 to October 2022. Eleven SNVs in the FTO gene present among both Black and White participants. Objectively measured obesity indicators (body mass index and waist-to-height ratio), objectively measured and/or self-reported cardiometabolic diseases (hypertension, stroke history, heart disease, and diabetes), and self-reported social-economic and psychosocial status. A total of 10 447 participants (mean [SD] age, 64.4 [9.7] years; 5276 [55.8%] women; 8743 [83.7%] Black and 1704 [16.3%] White) were included. In the White group, 11 FTO SNVs were significantly associated with obesity, hypertension, and diabetes using linear models (eg, body mass index: β = 0.536; 95% CI, 0.197-0.875), but none of the FTO SNVs were associated with obesity traits in the Black group. White males had a higher risk of obesity while White females had a higher risk of hypertension and diabetes. However, 1 FTO SNV (rs1121980) was associated with a direct increase in the risk of heart disease in Black participants not mediated by obesity (c' = 0.145 [SE, 0.0517]; P = .01). In this cross-sectional study of obesity phenotypes and their association with cardiometabolic diseases, the tested FTO SNVs reflected sex differences in White participants. Different patterns of associations were observed among self-identified Black participants. Therefore, these results could inform future work discovering risk alleles or risk scores unique to Black individuals or further investigating genetic risk in all US residents.

Effectiveness of Aerobic, Resistance, and Combined Training for Hypertensive Patients: A Randomized Controlled Trial.

Physical exercise is a well-established method for managing blood pressure (BP). The purpose of this study was to compare the effectiveness of aerobic, resistance, and a combination of both aerobic plus resistance training on BP, body composition (BC), and cardiorespiratory fitness (CRF) among hypertensive patients. The total population was sixty hypertensive patients; of these, forty-eight male adults (45.28 ± 7.44, years); with a sedentary lifestyle were randomized to one of the three exercise interventions or a control group. Subjects in all three exercise groups had an equal total exercise time (60 minutes), which included 10-15 minutes of warming up and dynamic stretching, 10-15 minutes of cooling down and static stretching and 30- 40 minutes for the main workout. Data were presented as mean (standard deviation, SD) or mean change with 95% confidence intervals (CI). All three-intervention trainings showed improvement in BP, CRF, and BC. However, the most effective intervention training was combined training. Combined training resulted in significant reductions in body composition, resting heart rate (RHR) and, BP: body weight -7.92 kg, BML -5.96 kg/m2, SBP -17.75mmHg, DBP -12.5 mmHg, RHR -8.17 bpm, and percent body fat (%BF) -6.49%. The aerobic training group only increased VO2max 12.44 ml/kg/m. Compared to aerobic or resistance training alone, a 12-week of combination exercise may offer more comprehensive advantages for those at a higher risk for hypertension.

The correlation between ambulatory blood pressure parameters and cardiovascular risk factors in older adults with high-risk hypertension

Objective: To explore the correlation of 24-hour ambulatory blood pressure (BP) monitoring (ABPM) parameters and cardiovascular risk factors in older adults with high-risk hypertension. Material and method: A cross-sectional study was conducted on 96 older adults (≥ 60 years old) with treated high-risk hypertension. Socio-demographic and cardiovascular risk information were gathered. The patients were performed 24-hour ABPM. Results: The mean age was 70.88 ± 7.86 years, and 64.6% were women. The prevalence of cardiovascular risk factors was as follows: dyslipidemia: 80.2%, family history of hypertension: 54.2%, diabetes mellitus: 51%, smoking: 24%, prior stroke: 11.5%. Significant differences in 24-hour, awake, and sleep systolic BP were observed between men and women. There were significant correlations between 24-hour mean systolic BP with age (r = 0.229, p = 0.025), dyslipidemia (r = 0.223, p = 0.029), family history of hypertension (r = 0.214, p = 0.036), BMI (r = 0.212, p = 0.039), waist circumference (r = 0.226, p = 0.027) and creatinine level (r = 0.207, p = 0.043). There were significant correlations between 24-hour mean diastolic BP with BMI (r = 0.289, p = 0.004) and prior stroke (r = -0.224, p = 0.029). There were significant correlations between 24-hour mean BP with BMI (r = 0.268, p = 0.009), waist circumference (r = 0.220, p = 0.032) and prior stroke (r = -0.215, p = 0.036). Conclusion: There were significant correlations between ABPM parameters and cardiovascular risk factors in older adults with high-risk hypertension. Key words: 24-hour ambulatory blood pressure, cardiovascular risk factors, high-risk hypertension, older adults, correlation.

Impaired sensitivity to thyroid hormones is associated with different grades of hypertension: A multicenter cross-sectional study

Background and aimAccumulating evidence suggests a potential link between thyroid function with hypertension. However, the research results are limited, and there is no research to explore the relationship between central and peripheral thyroid hormones (THs) sensitivity and different grades of hypertension in patients with coronary heart disease (CHD). This study aims to prove the complex interaction between thyroid system and blood pressure, and provides new ideas for the assessment of hypertension in patients with CHD. Methods and resultsCalculate parameters representing central and peripheral sensitivity to THs. Logistic regression analysis was used to analyze the relationship between central and peripheral THs sensitivity of CHD patients and different grades of hypertension, especially in different ages, sexes, blood glucose levels, smoking, and drinking statuses. Among the 34,310 participants, 19,610 (57.16 %) were diagnosed with hypertension. The risk of hypertension and TSHI (OR: 0.88; 95 % CI: 0.87–0.90; P < 0.001), TT4RI (OR: 0.998; 95 % CI: 0.998–0.999; P < 0.001), TFQI (OR: 0.63; 95 % CI: 0.60–0.67; P < 0.001), PTFQI (OR: 0.63; 95 % CI: 0.59–0.67; P < 0.001) was negatively associated. The risk of hypertension was positively associated with FT3/FT4 (OR: 1.20; 95 % CI: 1.17–1.22; P < 0.001). After stratified analysis, these associations remained significant at different ages, sexes, blood glucose levels, grades of hypertension, smoking, and drinking statuses (P < 0.001). ConclusionsThis study shows that the decrease in central THs sensitivity index and the increase in peripheral THs sensitivity index are associated with a higher risk of hypertension in CHD patients.

Racial and Ethnic Discrimination and Hypertension by Educational Attainment Among a Cohort of US Women

Although understudied, there are likely within-group differences among minoritized racial and ethnic groups in associations between racial and ethnic discrimination (RED) and hypertension risk, as minoritized individuals with higher educational attainment may more frequently encounter stress-inducing environments (eg, professional workplace settings, higher-income stores and neighborhoods) characterized by, for instance, exclusion and antagonism. To investigate educational attainment as a potential effect modifier of associations between RED and hypertension risk among US women; the study hypothesis was that the magnitude of associations would be stronger among participants with higher vs lower educational attainment. This is a nested case-control study using Sister Study data collected at enrollment (2003-2009) and over follow-up visits until September 2019. Among eligible US Black or African American (hereafter Black), Latina, and non-Hispanic White women without prior hypertension diagnoses, incidence density sampling was performed to select self-reported hypertension cases that developed over a mean (SD) follow-up 11 (3) years. Data were analyzed August 2022 to February 2023. Participants reported lifetime everyday (eg, unfair treatment at a business) and major (eg, mistreatment by police) RED via a self-administered questionnaire. Adjusting for sociodemographic characteristics, conditional logistic regression was used to estimate odds ratios (ORs) and 95% CIs for associations between RED and hypertension by educational attainment category at baseline (college or higher, some college, and high school or less) within racial and ethnic groups. Among 5179 cases (338 [6.5%] Black; 200 [3.9%] Latina; and 4641 [89.6%] non-Hispanic White) and 10:1 race and ethnicity- and age-matched control participants with a mean (SD) age of 55 (9) years at enrollment, half (49.9%) of women reported attaining college or higher education, and Black women with college or greater education had the highest burden of RED (eg, 83% of case participants with college or higher education reported everyday RED compared with 64% of case participants with high school or less education). Everyday RED was associated with higher hypertension risk among Black women with college or higher education (OR, 1.56 [95% CI, 1.06-2.29]) but not among Black women with some college (OR, 0.72 [95% CI, 0.47-1.11]), with evidence of both multiplicative and additive interaction. Results for Black women with high school or less education suggested increased risk, but confidence intervals were wide, and the result was not statistically significant but may be clinically significant (OR, 1.89 [95% CI, 0.83-4.31]). Educational attainment was not a modifier among other racial and ethnic groups or for associations with major RED. In this nested case-control study of RED and hypertension risk, chronic or everyday RED-associated hypertension disproportionately affected Black women with the highest levels of educational attainment.

Pulmonary vascular dysfunction in systemic sclerosis

PurposeThis study aimed to determine if any cases of pulmonary arterial hypertension (PAH) were missed using routine screening of systemic sclerosis (SSc). We assessed the potential benefits of adding the DETECT algorithm and invasive hemodynamic exercise testing into the local screening process in a Danish single-center cohort without known PAH. MethodsSeventy-three SSc patients (aged 60 ± 10 years; 56 (77%) females) underwent echocardiography. Among them, 24/73 had an elevated STEP 2 score of whom 3 had a high risk of pulmonary hypertension on echocardiographic assessment. Four patients declined right heart catheterization. Twenty patients (aged 62 ± 10 years, 13 (65%) females) underwent invasive haemodynamic assessment at rest. Nineteen patients participated in invasive haemodynamic exercise testing. ResultsAt rest, 3/20 patients met the 2022 ESC guidelines for PAH (mean pulmonary arterial pressure (mPAP) > 20 mmHg, pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg, and pulmonary vascular resistance (PVR) > 2 Wood units). According to the 2015 ESC guidelines, only 1/19 patients had PAH. During exercise, 18/19 experienced a mPAP of > 30 mmHg, with the majority (13/19) showing an abnormal pulmonary pressure-flow relationship > 3 mmHg/L/min. Interestingly, seven out of nine patients with no pulmonary hypertension (PH) at rest had exercise-induced pulmonary hypertension. One-quarter of the patients had pulmonary hypertension associated with left ventricular dysfunction (Group 2 PH, WHO classification). ConclusionIn a Danish cohort of 73 SSc patients already undergoing bi-annual PAH screening, applying the DETECT algorithm identified three patients meeting the 2022 ESC/ERS guideline criteria for PAH at rest, one of whom demonstrated increased PAWP with exercise. However, many patients exhibited an abnormal pulmonary vascular response to exercise and/or signs of Group 2 PH.

Analisis Kejadian Hipertensi Pada Wanita Menopause di Wilayah Kerja Puskesmas Lok Batu

Menopausal women have a higher risk of hypertension than those who have not been menopausal. Hypertension can damage organs and cause stroke, kidney failure and heart attack. The purpose of the study was to determine the incidence of hypertension in menopausal women in the Working Area of the Lok Batu Health Center. This research method uses quantitative analytical surveys with a cross sectional approach. The population is all menopausal women in the Working Area of Lok Batu Health Center as many as 156 people with purposive sampling techniques as many as 61 respondents. Chi square data analysis technique. The results showed that the majority of the incidence of level 2 hypertension was 33 respondents (54.1%), hormonal birth control history was 42 respondents (68.9%), normal BMI was 33 respondents (54.1%), basic education was 57 respondents (93.4%), working as many as 40 respondents (65.6%). The results of statistical tests using chi square had no relationship between family planning history p = 0.531 (p &gt; 0.05), body mass index p = 0.458 (p &gt; 0.05), education p = 0.403 (p &gt; 0.05) and work p = 0.399 (p &gt; 0.05) with the incidence of hypertension in menopausal women in the working area of the Lok Batu Health Center.