Female Hypertensive Patients Research Articles

Gender differences in the relationship between the systemic immune-inflammation index and all-cause and cardiovascular mortality among adults with hypertension: evidence from NHANES 1999-2018.

There are gender differences in hypertension and the effect of gender on the relationship between systemic immune-inflammation index (SII) and mortality in hypertensive patients is unclear. Hypertensive patients (n=7444) from ten cycles of the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018 were enrolled in this study. The maximally selected rank statistics method was employed to identify the optimal cut-off value for the SII. Survey-weighted Cox regression analysis was utilized to explore the links between SII and all-cause and cardiovascular mortality. Kaplan-Meier method and time-dependent receiver operating characteristic curve analysis was conducted to assess the predictive accuracy of SII for mortality. Whether SII was considered as a numerical variable or as a binary variable (higher- and lower-SII groups), higher SII levels were associated with a higher risk of all-cause and cardiovascular mortality in female hypertensive patients (all P < 0.001), but no such association was observed in the males. The area under the curve of the SII was 0.602, 0.595, and 0.569 for 3-, 5-, and 10-year all-cause mortality, respectively, in females, but was 0.572, 0.548, and 0.554 in males. High SII levels interacted with the poverty income ratio and physical activity to affect mortality in the male population (P for interaction < 0.05), and there was an interaction between race and SII in the female cardiovascular mortality rate (P for interaction < 0.05). Higher levels of SII may be closely related to the high risk of all-cause and cardiovascular mortality in hypertensive patients, and the results showed that this relationship is more significant and stable in the female group. High SII interacts with PIR, physical activity, and race to affect the mortality rate in different gender populations.

Renin and CYP P450 gene variations significantly associated with essential hypertension: A prospective pharmacogenomics study

ObjectiveThis study aims to investigate the association between Renin-angiotensin aldosterone system (RAAS) and Cytochrome P450 gene polymorphisms in hypertension patients of the South Indian population using pharmacogenomics profile. MethodsHypertension cases (N = 147) and control subjects (n = 150) were collected from Tamil Nadu, India. A case-control association study was conducted to assess the involvement of RAAS gene polymorphisms (REN rs397514691, REN rs544315427, REN rs567667202) and CYP gene polymorphisms (CYP2D6 rs754164689, CYP2D6 rs1058172, CYP3A4 rs765598920) in essential hypertensive patients. Genotyping was performed using the PCR-RFLP method, and significant results were validated through RT-PCR analysis. ResultsThe genotype and allele distribution of REN rs397514691 and rs544315427 variants significantly associated with hypertensive patients (Variant Allele Frequency (VAF) = 0.11; VAF = 0.27, respectively). CYP2D6 polymorphisms rs754164689 and rs1058172 variant alleles were significantly associated with female hypertensive patients, suggesting a potential risk allele for essential hypertension in the South Indian population. REN and CYP3A4 variants, highly connected in pharmacology action, were validated through RT-PCR amplification studies, providing new insights into their role in the development of hypertension. Association confirmation was achieved through multifactor dimensionality reduction analysis. ConclusionThe genes associated with specific variants, particularly REN and CYP2D6, may serve as potential markers for the early diagnosis of hypertension and as new drug targets, particularly in the female population.

The association between dietary selenium intake and telomere length in hypertension.

Telomere length is closely linked to biological aging, oxidative stress, and the development of cardiovascular diseases. This study aimed to assess the association between dietary selenium intake and telomere length in individuals with hypertension. Data on dietary selenium intake were captured through the National Health and Nutrition Examination Survey (NHANES) computer-assisted dietary interview system (CADI). Telomere length determination entailed selecting blood samples from all participants in the NHANES database. The analysis was performed using Analysis System software, with Empower stats utilized for data analysis. Results showed that there was a significant association between dietary selenium intake and telomere length in hypertension, particularly within the female group. In female hypertension cases, a 1 mcg increase in dietary selenium intake corresponded to a telomere length increase of 1.19bp, even after adjusting for age, race, BMI, marital status, physical activity, energy intake, and stroke history. The relationship between dietary selenium intake and telomere length exhibited a linear pattern in female hypertension patients. This study identified a positive association between dietary selenium intake and telomere length in hypertension, particularly within the female group.

Evaluation of the inter-arm blood pressure difference in subjects with hypertension in Nnewi North Local Government Area, Anambra state

Hypertension is defined as a sustained elevated blood pressure with a systolic blood pressure (SBP) of 140mmHg or more and a diastolic blood pressure of 90mmHg or more. The evaluation of the inter-arm blood pressure difference in subjects with hypertension in Nnewi North Local Government Area, Anambra state was done via sampling techniques. The study population was obtained using convenience sampling method and comprised of male and female hypertensive patients aged 25 to 90 years, from the cardiology unit NAUTH Nnewi. Normotensive subjects of the same age range and gender were used as control. The sample size was determined to be 70 subjects using this formula: n= (z2pq)/d2). The result of the finding showed that there was a significant increase in the mean age when the control was compared to the hypertensive group, and no significant difference in their weight, height and BMI. Furthermore, the findings of this research also supported a significant increase in the left arterial systolic and diastolic blood pressure in the control compared to the hypertensive groups. Also, the mean right systolic and diastolic blood pressure showed a significant increase when the control was compared to the hypertensive group. The inter-arm systolic and diastolic blood pressure had no significant difference when control was compared to the hypertensive group.

Differences of Gonial Index value in male and female hypertension patients using panoramic radiography

Objectives: This study is aimed to measure the Gonial index (GI) value in male and female hypertensive patients using panoramic radiography. Materials and Methods: This is a comparative analytical research. The sampling technique used was the purposive sampling technique. The sample of this study was primary data from panoramic radiographs of hypertensive patients who had been X-rayed at the Radiology Installation of Ulin General Hospital, Banjarmasin. Results: There was no significant difference in the gonial index (GI) values between men (17.83 mm) and women (19.17 mm), with the size of the right region of the female 20.33 mm and the left of the female 16.67 mm and the size of the right region of the male is 17.03 mm and the left male is 19.97 mm. Conclusion: There was no significant difference between the gonial index (GI) values ​​between women and men, although the decrease of bone density in women is higher than in men.

Differences in Panoramic Mandibular Index value between male and female hypertension patients using panoramic radiography

Objectives: This study is aimed to analyze the panoramic mandibular index value in male and female hypertensive patients using panoramic radiography.&#x0D; Materials and Methods: This research is a comparative analytic research with a purposive sampling technique. The study sample was hypertensive patients at Ulin Hospital, Banjarmasin from March to May 2023.&#x0D; Results: The results showed that there was no statistically significant difference through statistical data on the panoramic mandibular index value between men (0.27 ± 0.07) and women (0.26 ± 0.09), The age group that experienced a decrease in mandibular cortical thickness was most in the age group ≥ 65 years (0.22 ± 0.06).&#x0D; Conclusion: It is known that there is no significant difference in the panoramic mandibular index value between women and men.

A Randomized Controlled Trial of Blood Pressure Reduction Based on Disease Control Priorities 3 in Pakistan to Manage and Control Hypertension.

According to American Heart Association standards, hypertension is classified into three stages based on blood pressure measurements: essential hypertension, stage 1 hypertension, and stage 2 hypertension. The global target is to reduce the prevalence of high blood pressure by 25% by the year 2025. Worldwide, the prevalence of high blood pressure among men and women aged 18 and above reported to be 24% and 20%, respectively. The aim of this study was to overall reduce high blood pressure of hypertensive patients to the recommended level of 140/90 mm of Hg through implementing a non-pharmacological and multi-component intervention based on Disease Control Priorities (3rd edition). A randomized controlled trial in which a multi-component intervention for lowering high blood pressure was tested. This was pilot-tested for its acceptance, appropriateness, and relevance, explored through an earlier formative research and desk review conducted from the available evidence. A total of 240 study participants were enrolled after obtaining informed consent. Ethical approval was obtained from the Institutional Review Board of Health Services Academy and the trial was registered in clinicaltrials.gov number NCT04336631. SPSS software version 21 was used to enter and analyze the data. High blood pressure of hypertensive patients in a hospital setting during 03 months yielded -23.9 mm Hg of systolic blood pressure reduction (95% confidence interval, p ≤ 0.005). A significant reduction was observed in intervention group after delivering the intervention. Compared to patients in the usual care group, improved health outcomes were achieved for diet control, reducing salt intake and increased physical exercise. In the intervention group, the mean blood pressure among male hypertensive patients was 145/90 mm Hg and in female hypertensive patients, the mean blood pressure was recorded as 140/100 mm Hg. High blood pressure was significantly reduced in hypertensive patients who adhered to a low salt diet, weight loss measures, and increased physical activity.

First-line diuretics versus other classes of antihypertensive drugs for hypertension.

First-line diuretics versus other classes of antihypertensive drugs for hypertension.

Functional symmetry of the aortic baroreflex in female spontaneously hypertensive rats.

Altered baroreflex function is well documented in hypertension; however, the female sex remains far less studied compared with males. We have previously demonstrated a left-sided dominance in the expression of aortic baroreflex function in male spontaneously hypertensive rats (SHRs) and normotensive rats of either sex. If lateralization in aortic baroreflex function extends to hypertensive female rats remains undetermined. This study, therefore, assessed the contribution of left and right aortic baroreceptor afferents to baroreflex modulation in female SHRs. Anesthetized female SHRs (total n = 9) were prepared for left, right and bilateral aortic depressor nerve (ADN) stimulation (1-40 Hz, 0.2 ms, 0.4 mA for 20 s) and measurement of reflex mean arterial pressure (MAP), heart rate (HR), mesenteric vascular resistance (MVR) and femoral vascular resistance (FVR). All rats were also matched for the diestrus phase of the estrus cycle. Reflex (%) reductions in MAP, HR, MVR and FVR were comparable for both left-sided and right-sided stimulation. Bilateral stimulation evoked slightly larger ( P = 0.03) reductions in MVR compared with right-sided stimulation; however, all other reflex hemodynamic measures were similar to both left-sided and right-sided stimulation. These data show that female SHRs, unlike male SHRs, express similar central integration of left versus right aortic baroreceptor afferent input and thus show no laterization in the aortic baroreflex during hypertension. Marginal increases in mesenteric vasodilation following bilateral activation of the aortic baroreceptor afferents drive no superior depressor responses beyond that of the unilateral stimulation. Clinically, unilateral targeting of the left or right aortic baroreceptor afferents may provide adequate reductions in blood pressure in female hypertensive patients.

PS-P06-6: GENDER DIFFERENCES ON DETERMINANTS OF GOOD KNOWLEDGE ON RECOGNITION OF STROKE SYMPTOMS AND ACTIONS DURING A STROKE AMONG HYPERTENSIVE PATIENT

Early recognition and action during a stroke are extremely important to improve stroke prognosis. This study aimed to examine the gender difference in the KAP of stroke in hypertensive patients. This was a cross-sectional study conducted on adults 18 years and older who participated in a community blood pressure (BP) screening program in Malaysia during MMM2017. The questionnaire was derived based on the acronym F.A.S.T recommended by the American Stroke Association and two common symptoms of middle cerebral artery occlusion (paralysis of one side of the body and numbness or tingling sensation of one side of the body). Using multivariate logistic regression, the determinants of recognizing stroke symptoms and knowing what to do during a stroke in female and male hypertensive patients were identified. Among 1019 hypertensive patients, 85.% of women versus 84% of men were able to recognise symptoms of stroke (p = 0.564) but the prevalence of good knowledge of actions to be taken by being hospitalised within 4.5 hours during a stroke was 74% among women vs. 80% in men (p = 0.05). Using multivariate logistic regression, the determinants for recognising stroke symptoms among male hypertensive patients were age more than 45 year old(OR: 2.670,p = 0.016) compared with those aged below 45, symptom of body paralysis (OR: 9.37,p = 0.001) and symptom of numbness of the body(OR:6.177,p &lt; 0.001);whereas in female hypertensive patient were symptoms of body paralysis (OR:26.582,p &lt; 0.001), being Malay (OR:2.306, p = 0.034) vs. non-Malay and age more than 45 year old(OR:2.706,p = 0.024) compared to those under 45 years old. The determinants of good knowledge on actions to be taken during a stroke among male hypertensive patient were symptoms of body paralysis (OR:8.25,p = 0.031) compared to female respondents were symptom of body paralysis (OR:5.603,p &lt; 0.001),symptom of slurred speech (OR:5.597,p = 0.003) and diastolic BP (OR:0.962, p = 0.005). Men know better what to do during a stroke. Symptoms of body paralysis was the most common stroke symptoms recognized by all hypertensive patients regardless in order to take further action. Clinicians need to be aware of these findings, and more action needs to be taken to educate female hypertensive patients about other stroke symptoms so that further action can be taken.

Salivary Calcium Level and Its Correlation with Salivary pH, Salivary Volume, and Calcium Intake in Hypertensive Female Patients with Different Blood Sugar Levels.

This study aimed to evaluate the salivary calcium level and its correlation with salivary pH, salivary volume, and calcium intake in hypertensive female patients with different blood sugar levels. This cross-sectional study included 49 female subjects with hypertension. Subjects were divided into three groups based on the HbA1c test: normal, prediabetes, and diabetes. Unstimulated whole saliva was collected using the spitting method. Salivary calcium levels were evaluated using an Atomic Absorption Spectrophotometer. Salivary pH was obtained using a universal indicator pH paper test. Calcium intake was assessed by a semi-quantitative food frequency questionnaire. The Kruskal-Wallis test was used to compare salivary parameters and total calcium intake within study groups. Spearman rank correlation and multiple regression analysis were used to evaluate the correlation between salivary calcium levels and all variables in the study. No significant difference in salivary calcium, volume, pH, and total calcium intake was observed within the study groups. However, a significant correlation was found between salivary calcium levels and salivary pH in hypertensive females with normal blood glucose levels. Moreover, salivary calcium levels have a significant correlation with systolic blood pressure in prediabetes and diabetes groups. This study found a decrease in all salivary parameters (calcium, pH, and volume) as well as a low calcium intake in hypertensive females, despite no significant difference found in groups with different blood glucose levels. Blood glucose levels appeared to be a confounder in the relationship between salivary calcium with salivary pH and systolic blood pressure.

Prevalence of depressive symptoms in hypertensive patients in Taif city

Background: The co-existence of depression and hypertension increases the risk of cardiovascular disease mortality than hypertension alone. It is postulated that both these conditions share a common pathway, and understanding the natural history of their co-existence would be helpful for effective management. Objectives: to assess the prevalence of depression symptoms among hypertensive patients in Taif city, Saudi Arabia, and also to analyze various determinants related to their co-existence. Methods: Hypertensive patients attending a single tertiary care hospital in Taif city were recruited for our study after taking informed consent and ethical approval from the institution. A pretested proforma was used to collect data from the participants. Data were collected using three methods; the investigator recorded participants’ medical history and other clinical findings from hospital records in the first part. The participants themselves filled the second and third parts during their consultation in FM clinics. All data obtained were subjected to statistical analysis by an independent biostatistician. Results: The prevalence of depression among these hypertensive patients was 27.5%, and 2.5% had a severe form of depression. Middle-age was found to be an independent risk factor for the co-existence of hypertension and depression. Female hypertensive patients had a comparatively higher prevalence of depression (p=0.05). Even though depression was more seen among patients who smoked and didn’t do any physical activity, these were statistically not significant. Conclusion: Considering the high prevalence of depression among hypertensive patients, it is critical to developing screening programs and community education campaigns. Keywords: Prevalence, depressive, symptoms, hypertensive, patients, Taif

Retrospective Study of Aging and Sex-Specific Risk Factors of COVID-19 with Hypertension in China.

Background Coronavirus disease 2019 (COVID-19) has been a global threat that pushes healthcare to its limits. Hypertension is one of the most common risk factors for cardiovascular complications in COVID-19 and is strongly associated with disease severity and mortality. To date, clinical mechanisms by which hypertension leads to increased risk in COVID-19 are still unclear. Furthermore, additional factors might increase these risks, such as the consideration of age and sex, which are of interest when in search of personalized treatments for hypertensive COVID-19 patients. Methods We conducted a retrospective cohort study of 543 COVID-19 patients in seven provinces of China to examine the epidemiological and clinical characteristics of COVID-19 in this population and to determine risk factors of hypertensive COVID-19 patients. We also used univariable and multivariable logistic regression methods to explore the risk factors associated with hypertensive COVID-19 patients in different age and sex subgroups. Results Among the enrolled COVID-19 patients, the median age was 47 years (interquartile range (IQR) 34.0–57.0), and 99 patients (18.23%) were over 60 years old. With regard to comorbidities, 91 patients (16.75%) were diagnosed with hypertension, followed by diabetes, coronary disease, and cerebrovascular disease. Of the hypertensive COVID-19 patients, 51 (56.04%) were male. Multivariable analysis showed that old age, comorbid diabetes or coronary heart disease on admission, increased D-dimer, increased glucose, and decreased lymphocyte count were independent risk factors associated with hypertensive COVID-19 patients. Elevated total bilirubin (odds ratio [OR]: 1.014, 95% confidence interval [CI]: 0.23–1.05; p = 0.043) and triglycerides (OR: 1.173, 95% CI: 0.049–1.617; p = 0.007) were found to be associated with elderly hypertensive COVID-19 patients. In addition, we found that decreased lymphocytes, basophil, high-density lipoprotein, and increased fibrinogen and creatinine were related to a higher risk of disease severity in male patients. The most common abnormal clinical findings pertaining to female hypertensive COVID-19 patients were hemoglobin, total bile acid, total protein, and low-density lipoprotein. Conclusions Factors associated with increased risk of hypertensive COVID-19 patients were identified. Results to the different age and sex subgroups in our study will allow for better possible personalized care and also provide new insights into specific risk stratification, disease management, and treatment strategies for COVID-19 patients with hypertension in the future.

Effects of Obstructive Sleep Apnea and Gender on Glomerular Filtration Rate in Hypertensive Population

Objective To explore the associations of obstructive sleep apnea(OSA) and gender with estimated glomerular filtration rate(eGFR) in hypertensive populations.Methods From February 2005 to August 2010,2064 hypertensive patients who were treated in the Department of Hypertension Center underwent overnight polysomnographic monitoring.According to the apnea-hypopnea index(AHI),they were assigned into an hypertension combined with OSA group and a hypertension group.The clinical characteristics and sleep monitoring indicators were compared between different genders and between the two groups.Multivariate Logistic regression was employed to analyze the influencing factors of eGFR.Results Among the 2064 hypertensive patients,there were 1537 males(including 1221 patients with OSA) and 527 females(including 350 patients with OSA).The males had higher prevalence of OSA(χ2=36.631,P<0.001) and diastolic blood pressure(Z=-7.776,P<0.001) and lower eGFR(Z=-3.010,P=0.003) than the females.The males had higher AHI(Z=-8.727,P<0.001),apnea index(Z=-9.252,P<0.001),hypopnea index(HI)(Z=-4.868,P<0.001) than the females,and the lowest oxygen saturation(t=-3.325,P=0.001) was significantly lower in males than in females.The hypertension combined with OSA group showed lower eGFR than the hypertension group(Z=-27.434,P<0.001;Z=-18.762,P<0.001).HI was negatively correlated with eGFR in the male population(r=-0.006,P=0.017),and AHI and HI were negatively correlated eGFR in females(r=-0.108,P=0.013;r=-0.094,P=0.032).After adjustment,Logistic regression showed that OSA and oxygen desaturation index 4 were the risk factors for the reduction of eGFR in hypertensive patients in males and females,respectively(OR=1.383,95%CI=1.010-1.905,P=0.045;OR=1.013,95%CI=1.002-1.024,P=0.021).Conclusion OSA lowers the eGFR of hypertensive patients,and OSA and oxygen desaturation index are the risk factors for the decrease in eGFR in male and female hypertensive patients,respectively.

English

Metabolic syndrome (MetS) has been variously defined because of varying emphasis placed on its components - dyslipidaemia, hypertension (HBP), hyperglyecmia (HG) and abnormal weight. MetS may be associated with diabetes (DM), HBP, chronic kidney disease (CKD) and apparent health (AH). Unfortunately, the frequency of the diagnostic combination of the risk factors in these conditions has not been reported because it could have therapeutic implications. Data generated in earlier studies on 1107 subjects were analyzed. MetS was diagnosed according to the NCEP-ATP 111 criteria. The frequency of the ten possible diagnostic combinations of the risk factor of MetS was counted and analyzed in each condition associated with the syndrome. The triad, truncal obesity (TO), HBP and decreased high density lipoprotein cholesterol (LHDC) recorded the highest frequency in AH subjects, (males 58.8 and females 38.1%)&nbsp; Among the male patients, HBP, HG and decreased LHDC had the highest frequency (DM, 29.9%; HBP 31.8%; CKD 35.5%). The frequency of the diagnostic triads in the female patients differed from that of the males.&nbsp; The combination of TO, HBP and hypertriglyceridaemia (HTG) absent among the male patients gave the highest frequency in female hypertension and CKD patients. The risk factors combination of TO, HBP and LHDLC can be used for screening MetS in the study population especially among the AH subjects. Moreover, TO appears to be the single most significant risk factor for MetS in the population. Key words: Metabolic syndrome, truncal obesity, diabetes, hypertension, chronic kidney disease, risk factors.

Bacteriological profile of conjunctiva bacterial Flora in Northeast China: a hospital-based study

PurposeTo investigate the distribution and influencing factors of preoperative conjunctival flora from patients undergoing penetrating ocular surgeries in northeast China.MethodsAn observational and cross-sectional study design was used. In 305 eyes of 305 patients without infective eye diseases who underwent ocular surgeries at the First Affiliated Hospital of Harbin Medical University between May 2018 and May 2019, conjunctival sac scrapings were collected on the day before surgery.ResultsThe mean age of the participants was 60.73 ± 14.23 years, with the majority being female, married and unemployed with at least primary school education. The positive culture rate was 48.20% (147/305 eyes), and 191 bacterial strains were isolated; two or more strains were isolated from 22.45% (33/147) of positive samples. The most commonly isolated bacteria was Staphylococcus epidermidis (64.92%), surpassing Staphylococcus aureus (5.76%). The culture positive rate of the young (18–40 years) group was different between the females (26.67%) and males (69.23%) (P = 0.024), but in the middle-aged group and the elderly group, the rates between the sexes were similar, with an increasing trend. Patients who visited in summer or autumn presented a higher positive rate than other seasons. Hypertensive women had a higher rate than hypertensive men (58.14% vs. 40%, χ2 = 5.8662, P = 0.0154).ConclusionsIn northeastern China, coagulase-negative Staphylococcus were the most common preoperative conjunctival bacteria. Hypertensive female patients, elderly patients, or those operated on in the summer and autumn should pay more attention to perioperative treatment.Trial registrationChiCTR2100044659.

The ascending aorta of male hypertensive bicuspid aortic valve patients preferentially associated with a cellular aneurysmal phenotype

Male sex and hypertension represent risk factors in the progression of an aortic aneurysm. The present study examined the morphological/cellular phenotype of the ascending aorta (AA) of male and female patients diagnosed with a bicuspid aortic valve (BAV) to test the hypothesis that hypertension‐induced remodeling of male BAV patients preferentially recapitulated the expression of a panel of proteins favoring aneurysm formation. The diameter of the AA of hypertensive male (35 ± 6 mm) and female (39 ± 5 mm) BAV patients was comparable to normotensive patients reflecting an early phase of vessel expansion. Morphological/structural remodeling of the medial region of the AA of male normotensive and hypertensive BAV patients were comparable. Protein levels of non‐muscle myosin IIB, the cell cycle inhibitor p27kip1, tumor suppressor p53 and matrix metalloproteinase‐2 and −9 were significantly upregulated in the AA of male hypertensive BAV patients. In female hypertensive BAV patients, collagen content was significantly increased whereas elastin content and medial width of the AA were similar to normotensive BAV patients. In the AA of female hypertensive BAV patients, matrix metalloproteinase‐9 and p27kip1 protein levels were unchanged whereas p53 and matrix metalloproteinase‐2 protein expression was significantly reduced. Nestin protein levels were diminished in the AA of male and female hypertensive BAV patients. Thus, sexual dimorphic remodeling of the AA was prevalent in hypertensive BAV patients. Moreover, during the early phase of vessel expansion, the AA of male hypertensive BAV patients was preferentially associated with the upregulation of a panel of proteins linked to progressive dilatation and potential aneurysm formation.

Abstract EP29: Sex Differences In Anxiety Associated With Left Ventricular Hypertrophy And Transmural Dispersion Of Repolarization In Hypertensive Patients

Background: Previous studies showed that hypertensive with anxiety have a higher mean left ventricular mass index (LVMI) and QTc dispersion. This study explores the associations between anxiety and left ventricular hypertrophy (LVH) as well as transmural dispersion of repolarization (TDR) (as detected by T peak-T end interval/QT interval, Tp-Te/QT ratio) in hypertensive patients. Methods: A total of 353 uncomplicated hypertensive patients were enrolled at Shaanxi Provincial People’s Hospital from 2017 to 2021. All enrolled subjects completed the Hamilton Anxiety Scale (HAMA). HAM-A score ≥14 was defined as the presence of anxiety. The association between HAM-A and hypertensive LVH was estimated with logistic regression models. The association between HAM-A score and Tp-Te/QT was estimated with linear regression model (adjusted for age, sex, body mass index, smoking, creatinine, uric acid, triglyceride, total cholesterol, low density lipoprotein cholesterol, and high-density lipoprotein cholesterol). This study was approved by the Ethics Committee of Shaanxi Provincial People’s Hospital and performed in keeping with the requirements of the Declaration of Helsinki. Results: Participants were divided into two groups according to anxiety or not. The LVMI was significantly higher in hypertensive patients with anxiety than hypertensive patients without anxiety (no anxiety: 84.36±23.82, anxiety: 105.75±25.45, g/m 2 , P &lt;0.001). The HAM-A score was positive correlated with LVMI (r=0.578, P &lt;0.001) and Tp-Te/QT (r=0.252, P &lt;0.001). In logistic regression models, hypertensive patients with anxiety had a higher risk of hypertensive LVH than hypertensive patients without anxiety (unadjusted OR, 2.86, 95% CI, 1.65-4.93, P &lt;0.001; adjusted OR, 2.62, 95% CI, 1.49-4.64, P &lt;0.001). Linear regression analysis also showed that HAM-A score was associated with Tp-Te/QT ratio (unadjusted β, 0.002, 95% CI, 0.001-0.002, P &lt;0.001; adjusted β, 0.002, 95% CI, 0.001-0.002, P &lt;0.001). There was an interaction between sex and anxiety in regard to LVH risk ( P for interaction = 0.035) and increased Tp-Te/QT ( P for interaction = 0.014). After stratification by sex, the anxiety group had a higher risk of hypertensive LVH than no anxiety group in male (unadjusted OR, 5.73, 95% CI, 2.43-13.50, P &lt;0.001; adjusted OR, 5.39, 95% CI, 2.13-13.66, P &lt;0.001) but not in female (unadjusted OR, 1.70, 95% CI, 0.82-3.53, P =0.152; adjusted: OR, 1.62, 95% CI, 0.76-3.45, P =0.209) hypertensive patients. HAM-A score was also associated with Tp-Te/QT ratio in male (unadjusted β, 0.003, 95% CI, 0.002-0.004, P &lt;0.001; adjusted β, 0.003, 95% CI, 0.001-0.004, P &lt;0.001) but not in female (unadjusted β, 0.001, 95% CI, -0.0001-0.002, P =0.061; adjusted β, 0.001, 95% CI, -0.0001-0.002, P =0.086). Conclusion: Our data indicated that anxiety is associated with LVH and increased TDR in male but not female hypertensive patients.

TO STUDY THE BIOCHEMICAL PARAMETER IN HYPERTENSION AND RENAL FAILURE

Background: In both economically developing and non-developing countries, hypertension is a major public health issue. India has been reported to have lower hypertension prevalence rates. The blood pressure of city dwellers is higher than that of rural dwellers. India is a populous and typical developing country with a vast population. Renal failure is defined as the retention of nitrogenous waste products due to impairment of renal function. Acute renal failure and chronic renal failure are the two types of renal failure. Acute renal failure is described as kidney failure that occurs in a matter of days or weeks. Acute renal failure is most common in older persons and is linked with considerable mortality and morbidity, with death rates ranging from 25 to more than 70% among hospitalized patients.&#x0D; Aim: To establish the above biochemical parameters for diagnosis and management of hypertension and renal failure.&#x0D; Material and Method: The clinical materials for present study entitled “To Study the Biochemical Parameter in Hypertension and Renal Failure” comprised 52 male hypertensive patients. 39 female hypertensive patients, 50 male chronic renal failure patients, 43 female chronic renal failure patients, 42 male chronic renal failure with hypertension, 40 female chronic renal failure with hypertension, 36 male acute renal failure, 48 female acute renal failure were admitted in Hospital.&#x0D; Results: Results revealed that highly significant decreased level of protein (Total), creatinine, and P-MDA were observed respectively. Serum sodium was found to be significant. Significant increased potassium was observed. Highly significant level of glucose, glutathione reductase, glutathione peroxidase, and catalase were observed respectively. Focus on acute renal failure patients were analyzed in both male and female. Highly significant decreased level of protein (Total), superoxide dismutase and P-MDA were observed respectively, glutathione reductase, glutathione peroxidase, and catalase were observed respectively. Significant increased serum glucose was observed, and highly significant increased level of glutathione reductase, glutathione peroxidase, and catalase were observed respectively.&#x0D; Conclusion: The study's key finding is that oxidative stress causes hypertension and can signal the onset of chronic renal failure. Oxidative stress in older people became more severe, especially if they had renal difficulties, especially in middle age.&#x0D; Keywords: P-MDA, Glutathione reductase, glutathione peroxidase, SOD, DBP

Association between comorbidity and health-related quality of life in a hypertensive population: a hospital-based study in Bangladesh

BackgroundHypertension is a known risk factor for several chronic conditions including diabetes and cardiovascular diseases. However, little is known about its impact on Health-related quality of life (HRQoL) in the context of Bangladesh. This study aimed to evaluate the association of hypertension on HRQoL among Bangladeshi patients corresponding to the socio-demographic condition, comorbid conditions, treatment, and health outcomes.MethodsA hospital based cross-sectional study was conducted using a pre-tested structured questionnaire among patients with hypertension in 22 tertiary medical college hospitals in Bangladesh. The study recruited male and female hypertensive patients of age ≥18 years between July 2020 to February 2021 using consecutive sampling methods. Health related quality of life was measured using the widely-used index of EQ-5D that considers 243 different health-related attributes and uses a scale in which 0 indicates a health state equivalent to death and 1 indicates perfect health status. The five dimensions of the quality index included mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. Ordered logit regression and linear regression models were used to estimate the predictors of comorbidity and HRQoL.ResultsOf the 1,912 hypertensive patients, 56.2% were female, 86.5% were married, 70.7% were either overweight or obese, 67.6% had a family history of hypertension, and 85.5% were on anti-hypertensive medication. Among the individuals with comorbidities, 47.6% had diabetes, 32.3% were obese, 16.2% had heart disease, 15% were visually impaired, and 13.8% were suffering from psychological diseases. HRQoL was found to be inversely proportional to the number of comorbidities. The most frequent comorbidities of diabetes and obesity showed the highest EQ- 5D mean utilities of 0.59 and 0.64, respectively.ConclusionsPrevalent comorbidities, diabetes and obesity were found to be the significant underlying causes of declining HRQoL. It is recommended that the comorbidities should be adequately addressed for better HRQoL. Special attention should be given to address mental health issues of patients with hypertension.