Hypertension In People Research Articles

Effect of Green Tea Supplementation on Blood Pressure Among Hypertensive People: A Community-based Randomized Control Trial

Background: A significant risk factor for cardiovascular disease, hypertension, affects more than a billion people globally. Numerous non-pharmacological methods work well to lower blood pressure. The objective of this study was to assess the short-term effect of green tea supplementation on blood pressure among people with hypertension. Methods: This community-based randomized controlled trial was conducted among people with hypertension recruited using a purposive sampling technique from the village of Lakhnaur, Mohali, Punjab, India. Sixty patients were randomly assigned to receive either supplementation with green tea beverage (one cup/day) or no intervention. The primary outcome measure was systolic and diastolic blood pressure. Blood pressure was measured at the baseline and 15 days after the intervention using a standard calibrated digital sphygmomanometer. Results: Post-intervention, the decrease in the mean systolic blood pressure was significantly greater (p <) in the experimental group (129.83±6.497) than in the control group (135.0±6.433). Conclusion: Green tea supplementation significantly lowered the systolic blood pressure among study participants. Green tea may be included as part of a lifestyle intervention to manage and control systolic blood pressure in hypertensive patients.

Профілактика артеріальної гіпертензії як складової метаболічного синдрому

Purpose. To evaluate the features of the development of arterial hypertension in people with metabolic syndrome and to justify preventive measures. Object and research methods. 92 adult patients aged 40 to 49 years were examined, among them 73 women and 19 men. The survey was conducted among respondents using a questionnaire. General clinical indicators were recorded: determination of height, weight with subsequent calculation of body mass index (kg\m2), waist circumference, systolic and diastolic blood pressure. Among the laboratory indicators, the following results attracted attention: glucose, insulin, Homa index, leptin, creatinine, cystatin-c, glomerular filtration rate (GFR). Statistical processing of the results was carried out with the help of correlation analysis, definition of criteria of differences, graphic methods. Statistical processing of the results was carried out with the help of correlation analysis, definition of criteria of differences, graphic methods. During the research, the author adhered to the principles of bioethics and the Order of the Ministry of Health of Ukraine "On the approval of the Procedure for conducting clinical trials and the Standard Regulations on the Commission on Ethics No. 66 dated February 13, 2006, with amendments of 2006-2008. All patients signed an informed consent to participate in the study. Research results and their discussion. A register of respondents was created - adult men and women who were under the influence of a modified factor - overweight or obesity, which is a trigger for the prevalence of such conditions as insulin resistance, leptin resistance, arterial hypertension. The research found that 73% of the examined were overweight or obese. A reliable relationship between quantitative indicators was also confirmed using Pearson's correlation analysis (r) between waist circumference and age (r=0.55, p<0.002), height (r=0.547, p<0.002), weight (r=0.547, p<0.002), BMI (r=0.753, p<0.001), creatinine (r=0.548, p<0.002). This once again confirms that waist circumference increases with age, height, weight, body mass index, and the increase in creatinine depends on waist circumference and height (r=0.364, p<0.048). Thanks to the analysis of variance, reliable relationships were found between quantitative and rank indicators: Homa's index and sport (F=1.809, P=0.049), as well as leptin and sport (F=1.809, P=0.049), leptin and weight (F=0.644, P=0.035). Conclusions. An in- depth comprehensive examination with the simultaneous determination of anthropometric, hemodynamic, and hormonal indicators of the state of health made it possible to justify preventive measures against metabolic syndrome. It was shown that 73.0% of respondents were overweight and obese, which can be considered a risk factor for the development of arterial hypertension. A reliable relationship between quantitative indicators was established using Pearson's correlation analysis (r) between waist circumference and age, height, weight, BMI, creatinine. It was determined that cystatin – c is negatively correlated with the rate of glomerular filtration in the absence of an increase in creatinine. People with metabolic syndrome (both men and women) are recommended to take preventive measures to prevent the development of complications of arterial hypertension. Keywords. Body mass index, arterial hypertension, metabolic syndrome.

Association between complete blood-count-based inflammatory scores and hypertension in persons living with and without HIV in Zambia.

Hypertension is a risk factor for cardiovascular events. Inflammation plays an important role in the development of essential hypertension. Studies assessing the association between complete blood count-based inflammatory scores (CBCIS) and hypertension are scarce. Therefore, this study aimed to determine the relationship between CBCIS and hypertension among individuals with and without human immunodeficiency virus (HIV). This was a cross-sectional study among 344 participants at Serenje District Hospital and Serenje Urban Clinic. We used structured questionnaires to collect sociodemographic, clinical and laboratory characteristics. CBCIS included lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), derived neutrophil-lymphocyte ratio (d-NLR), and differential white blood cells. The primary outcome variable was hypertension defined as systolic and diastolic blood pressure higher than or equal to 140/90 mmHg. Logistic regression was used to estimate the association between hypertension and CBCIS in statistical package for social science (SPSS) version 22.0. The participants had a median age of 32 years (interquartile range (IQR) 24-42) and 65.1% (n = 224) were female. The prevalence of hypertension was 10.5% (n = 36). Among those with hypertension, 55.6% (n = 20) were female and 44.4% (n = 16) were male. The CBCIS significantly associated with hypertension in people living with HIV (PLWH) was PLR (adjusted odds ratio (AOR) 0.98; 95% confidence interval (CI) 0.97-0.99, p = 0.01) while in people without HIV, AMC (AOR 15.40 95%CI 3.75-63.26), ANC (AOR 1.88 95%CI 1.05-3.36), WBC (AOR 0.52 95%CI 0.31-0.87) and PLR (AOR 0.98 95%CI 0.97-0.99) were the factors associated with hypertension. Compared to people without HIV, only WBC, ANC, NLR, and d-NLR were good predictors of hypertension among PLWH. Our study indicates a notable HIV-status driven association between CBCIS and hypertension, suggesting the use of CBICS as potential biomarkers for hypertension risk with substantial implications for early detection and preventive measures.

Prescribing Pattern and Effectiveness of Antihypertensives in Patients Suffering from Hypertension to Diabetes Mellitus with and without Compelling Indications in Tertiary Care Hospital.

Aim: The prevalence of hypertension (HTN) and diabetes mellitus (DM) is increasing worldwide, and their coexistence is well-documented. Managing both conditions is challenging due to shared pathophysiological mechanisms and the need to balance blood pressure (BP) control with glycemic management. The objective of this protocol was to consider the prescribing pattern and effectiveness of antihypertensive agents in hypertensive and diabetic patients, with and without compelling indications, at tertiary care hospital. Materials and methods: A prospective, observational study was conducted over 6 months in total 226 diabetic hypertensive patients from a tertiary care hospital. Demographic and medication history data were collected using a self-designed patient profile form. Descriptive statistics were used to analyze the data, and the results were expressed as percentages or means with standard deviations. Results: A total of 226 patients were included in the study, with 62% males and 38% females. 73% of patients were classified as stage 1 and 27% as stage 2 HTN. Among the prescribed antihypertensive agents, β-blockers (BBs) were the most prescribed, followed by angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs), diuretics, and other classes. Combination therapy was predominantly used, with dual-drug therapy being the most common. Compelling indications for antihypertensive treatment included ischemic heart disease (IHD) (38.49%), chronic kidney disease (CKD) (12.38%), and stroke (6.63%). The choice of antihypertensive agents varied based on the presence of compelling indications, with BBs and ARBs being frequently prescribed. BP control was achieved in 93% of the patients, with 85.96% of patients with HTN + DM, and 82.84% of patients with additional compelling indications having controlled BP. Conclusion: Therefore, it can be concluded that the antihypertensive medications prescribed to the study adhered to guidelines and that long-term use of these combinations proved to be more effective, safe, and well-tolerated for patients with HTN and DM with or without convincing indications. Adopting the best approach to managing HTN in people with diabetes is crucial for ameliorating patient outcomes and enhancing overall quality of life.

Risk factors for cardiometabolic multimorbidity: an analysis of 4 million participants from May Measurement Month 2017-2019

Abstract Background Cardiometabolic multimorbidity (CMM), defined as the presence of two or more cardiometabolic conditions, presents a significant global challenge due to aging populations and a growing prevalence of cardiometabolic diseases. However, evidence regarding the risk factors for CMM is scarce, particularly in low- and middle-income countries. May Measurement Month (MMM) is the largest annual global campaign collecting data on blood pressure (BP) and cardiometabolic diseases. Purpose To determine the proportion of hypertension in people with CMM and risk factors associated with CMM, from the three MMM campaigns in 2017-2019. Methods A total of 3 397 746 participants (≥18 years) were included, arising from 103 countries. CMM was defined as having two or more of three cardiometabolic diseases: myocardial infarction, stroke, and diabetes. Hypertension was defined as a systolic BP≥140mmHg and/or diastolic BP≥90mmHg, using the average of the second and third of three readings and/or taking antihypertensive medication. A multivariable logistic mixed effects regression model was used to examine associations between CMM and potential risk factors, including age, sex, BMI category, smoking status, and alcohol consumption in the model, with random effects for country. Results Amongst all participants, 316 940 (9.3%), 62 731 (1.8%), and 28 491 (0.8%) had one, two or three cardiometabolic conditions, respectively, and 91 222 (2.7%) had CMM. The proportion with hypertension increased with an increasing number of cardiometabolic conditions: 29.6% in those with none, and 63.0%, 68.6% and 71.2% in those with one, two, or three conditions, respectively. In a fully adjusted model, females had 16% (OR = 1.16, 95% CI: 1.12-1.20, p-value <0.001) higher odds of having CMM than males (Figure). Increasing age was associated with higher odds of having CMM, the highest risk being found in participants ≥70 years. Participants who were underweight, overweight, or obese, were more likely to have CMM than those with a healthy weight. Of the risk factors studied, current smoking was associated with the highest odds for CMM, (OR = 12.8, 95% CI: 12.62-13.04, p-value<0.001) compared with not smoking. Participants consuming alcohol at least once per week had 74% lower odds (OR = 0.26, 95% CI: 0.25-0.27, p-value <0.001) of having CMM compared with those who never or rarely consumed alcohol (Figure 1). Conclusions The risk of CMM increases with female sex, older age, abnormal weight, and smoking. Additionally, CMM is associated with a higher likelihood of having hypertension. Efforts targeting high-risk populations with modifiable CMM related-risk factors are crucial for prevention of CMM.Figure 1.Risk factors for CMM

Bioanalytical methods and extraction techniques for the quantification of hydrochlorothiazide and its pharmaceutical combinations: A comprehensive review

AbstractHydrochlorothiazide has been utilized clinically for the past half-century, which is popularly known as a “water pill” as it produces increased urine output. The advancement of bioanalytical methods brought a dynamic field with exciting opportunities for future research. The current review emphasis the bioanalytical methods employed for the quantitative estimation of Hydrochlorothiazide as monotherapy and its popularly used combinational medications available from 1956 to till date. A fixed dose of 25 mg of hydrochlorothiazide with 43 combinational medications is currently available in the market and these combinations are widely employed in the treatment of hypertensive people; those whose blood pressure does not respond effectively to monotherapy of hydrochlorothiazide and also for the treatment of edema (excess fluid in the body) caused by illness such as heart failure, liver problems, and renal disease. It has been convincingly demonstrated that the combination of any two antihypertensive medications belonging to different groups of the same category, significantly lowers blood pressure, in comparison with the effect produced by increasing the dose of a single medicament. Among the various analytical techniques employed for the estimation of Hydrochlorothiazide, the review portrays that hyphenated technique, in specific liquid chromatography coupled with mass spectroscopy was widely employed. The validation parameters namely linearity, LOD, LOQ for individual drug and their combinations, were successfully calibrated. The effectiveness of analytical approaches was evaluated and enhanced for chemical factors. The involvement of green chemistry in the optimized methods for the evaluation of Hydrochlorothiazide for the future development, are suggested.

The role of gut microbiome in mediating the effect of inflammatory bowel disease on hypertension: a two-step, two-sample Mendelian randomization study.

Investigating the causal connection that exists between inflammatory bowel disease (IBD) and hypertension (HT). To gain a deeper insight into the correlation among IBD, gut microbiota, and HT, we conducted a two-step, two-sample Mendelian randomization study. An investigation of genome-wide association study (GWAS) summary-level data was utilized to conduct a two-sample Mendelian randomization (MR) analysis of genetically predicted inflammatory bowel disease: (12,882cases, 21,770controls) on Systolic/Diastolic blood pressure (N = 2,564). Subsequently, two-step MR analyses revealed that the relationship between IBD and SBP was partly mediated by Faecalicatena glycyrrhizinilyticum. The robustness of the findings was confirmed through several sensitivity assessments. This MR study showed that increase in genetically predicted IBD was associated with higher risk of genetically predicted SBP (OR: 1.08, 95% CI: 1.01-1.16, P < 0.05) and DBP (OR: 1.09, 95% CI: 1.02-1.17, P < 0.05), respectively. Inverse variance weighted (IVW) MR analysis also showed that increase in genetically predicted IBD was associated with higher abundance Faecalicatena glycyrrhizinilyticum (OR: 1.03, 95% CI: 1.01-1.04, P < 0.05), which subsequently associated with increased SBP risk (OR: 1.42, 95% CI: 1.06-1.9, P < 0.05). Faecalicatena glycyrrhizinilyticum abundance in stool was responsible for mediating 11% of the genetically predicted IBD on SBP. The research proposed a causal link between Inflammatory Bowel Disease (IBD) and Hypertension (HT), with a little percentage of the impact being influenced by Faecalicatena glycyrrhizinilyticum in stool. Mitigating gut microbiome may decrease the heightened risk of hypertension in people with inflammatory bowel disease.

Blood pressure targets for hypertension in people with chronic renal disease.

Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease, development of end-stage renal disease, and all-cause mortality. It affects around 10% of the population worldwide. The prevalence of hypertension in people with CKD ranges from 22% in stage 1 to 80% in stage 4. Elevated arterial blood pressure is one of the major independent risk factors for adverse cardiovascular events. Thereby, reducing blood pressure to below standard targets may be beneficial but could also increase the risk of adverse events. The optimal blood pressure target in people with hypertension and CKD remains unknown. Primary: to compare the effects of standard and lower-than-standard blood pressure targets for hypertension in people with chronic kidney disease on mortality and morbidity outcomes. Secondary: to assess the magnitude of reductions in systolic and diastolic blood pressure, the proportion of participants reaching blood pressure targets, and the number of drugs necessary to achieve the assigned target. We used standard, extensive Cochrane search methods. We searched the Cochrane Hypertension Specialized Register, CENTRAL, MEDLINE, Embase, one other database, and two trial registers up to 8 February 2023. We also contacted authors of relevant papers regarding further published and unpublished work. We applied no language restrictions. We included randomized controlled trials (RCTs) in people with hypertension and CKD that provided at least twelve months' follow-up. Eligible interventions compared lower targets for systolic/diastolic blood pressure (130/80 mmHg or lower) to standard targets for blood pressure (140 to 160/90 to 100 mmHg or lower). Participants were adults with CKD and elevated blood pressure documented in a standard way on at least two occasions, or already receiving treatment for elevated blood pressure. We used standard Cochrane methods. Our critical outcomes were: total mortality, total serious adverse events, total cardiovascular events, cardiovascular mortality, and progression to end-stage renal disease. Important outcomes were: participant withdrawals due to adverse effects, and number of participants with a doubling of serum creatinine level or at least a 50% reduction in the glomerular filtration rate (GFR) at the end of the study. We used GRADE to assess the certainty of the evidence for the critical outcomes. This review received no funding. We included six RCTs that contributed data for meta-analysis, involving 7348 participants overall (range 840 to 4733 people per study). The mean follow-up was 3.6 years (range 1.0 to 8.0 years). Three studies were publicly funded, two were privately funded, and one had both public and private funding. All RCTs provided individual participant data. None of the included studies blinded participants or clinicians because of the need to titrate antihypertensive drugs to reach a specific blood pressure target. However, an independent committee blinded to group allocation assessed clinical events in all studies. Critical outcomes. Compared with standard blood pressure targets, lower targets likely result in little to no difference in total mortality (risk ratio (RR) 0.90, 95% confidence interval (CI) 0.76 to 1.06; 6 studies, 7348 participants), total serious adverse events (RR 1.01, 95% CI 0.94 to 1.08; 6 studies, 7348 participants), and total cardiovascular events (RR 1.00, 95% CI 0.87 to 1.15; 5 studies, 6508 participants), all with moderate-certainty evidence. Compared with standard blood pressure targets, lower targets may result in little to no difference in cardiovascular mortality (RR 0.90, 95% CI 0.70 to 1.16; 6 studies, 7348 participants) and progression to end-stage renal disease (RR 0.94, 95% CI 0.80 to 1.11; 4 studies, 4788 participants), both with low-certainty evidence. Important outcomes. We found little to no differences in: participant withdrawals due to adverse effects; and the number of participants with a doubling of serum creatinine level, or at least a 50% reduction in GFR at the end of the study. Exploratory outcomes. Compared to the standard blood pressure target groups, participants in the lower target groups achieved lower systolic and diastolic blood pressure values after one year, and required a higher number of antihypertensive drugs at the end of the studies. A higher proportion of participants in the standard blood pressure target groups achieved the targets they were assigned than did participants in the intensive target groups. Compared to a standard blood pressure target, lower blood pressure targets probably result in little to no difference in total mortality, total serious adverse events, and total cardiovascular events, and may result in little to no difference in total cardiovascular mortality or in the progression to end-stage renal disease in people with hypertension and CKD. However, the evidence underpinning these conclusions has several limitations. All studies were open design, blood pressure measurement was performed at a medical office, and there was scant information about adverse events. Future research should include high-quality adverse event data, report results for people with different levels of proteinuria, and consider out-of-office blood pressure monitoring. Several studies are ongoing, and may provide new evidence for this topic in the near future.

Edukasi Hipertensi Dan Manajemen Nyeri Dengan Teknik Distraksi Menggunakan Media Audiovisual Untuk Meningkatkan Pengetahuan Pada Penderita Hipertensi

Introduction: Hypertension in the elderly is very important to know because the pathogenesis, course of the disease and its management are not entirely the same as hypertension in adults of easy age. Pain is subjective, while the discomfort experienced by a person can be known from autoanamnesis. Distraction technique is a way to relieve pain by diverting the patient's attention to other things so that the patient will forget about the pain he feels. Objective: This service aims to help increase the knowledge of hypertensive elderly people in managing pain against hypertension at the RW/5 Ledug elderly Posyandu. Method: The method of community service activities is to conduct Hypertension Counseling and Pain Management with Distraction Techniques Using Audiovisual Media to Increase Knowledge of Hypertension Patients. This community service activity begins with giving a post-test in the form of a questionnaire to measure the level of knowledge before being given education, then participants are given education, and after participants are given education, a questionnaire is given again to measure the level of knowledge after being given education. Result: The results of community education activities showed that the knowledge value of participants before education was in the good category as many as 23 respondents (76.7%), the moderate category was 7 respondents (23.3%). participants after education in the good category were 30 respondents (100%), the moderate category was 0 respondents (0%). Conclusion: From the results of the service it can be concluded that there is an increase in knowledge in people with hypertension.

Hypertension control and risk of age-associated dementia in people with HIV infection.

Hypertension is a major risk factor for dementia, but sustained blood pressure control is difficult to achieve. We evaluated whether inadequately controlled hypertension may contribute to excess dementia risk among people with HIV. A retrospective cohort study. We studied demographically matched people with and without HIV between July 1, 2013, and December 31, 2021, who were at least 50 years old and had a hypertension diagnosis but no dementia diagnosis. Hypertension control was calculated using a disease management index (DMI), which captured degree and duration above the hypertension treatment goals of SBP less than 140 mmHg and DBP less than 90 mmHg. DMI values ranged from 0 to 100% (perfect control); hypertension was considered 'inadequately controlled' if DMI was less than 80% (i.e., in control for <80% of the time). Annual, time-updated DMI was calculated for SBP and DBP. Associations of SPB and DPB control with incident dementia were evaluated using extended Cox regression models. The study included 3099 hypertensive people with HIV (mean age: 58.3 years, 90.2% men) and 66 016 people without HIV. Each year of inadequate SBP control was associated with greater dementia risk in both people with HIV (adjusted hazard ratio [aHR] = 1.26, 0.92-1.64) and people without HIV (aHR = 1.27 (1.21-1.33); P- interaction = 0.85). Similarly, inadequate DBP control was associated with greater dementia risk in both people with HIV (aHR = 1.43, 0.90-1.95) and people without HIV (aHR = 1.71, 1.50-1.93; P -interaction = 0.57). Findings suggest the association of inadequate hypertension control with greater dementia risk is similar by HIV status. Stronger associations of DBP control with dementia merit further investigation.

Association between coffee and tea consumption and the risk of dementia in individuals with hypertension: a prospective cohort study

Many studies have shown that drinking coffee and tea may be associated with the risk of hypertension and dementia. Limited research exists on their impact on dementia risk in hypertensive patients. This study aimed to determine the association between coffee and tea consumption and the risk of dementia development in hypertensive population by utilizing Cox proportional risk modeling with 453,913 participants from a UK biobank. Our findings reveal a J-shaped and U-shaped association between the risk of all-cause dementia and the consumption of coffee and tea respectively in hypertensive people. The hypertensive patients who drink 0.5–1 cup of coffee or 4–5 cups of tea per day have the lowest risk of dementia. A U-shaped relationship was observed between daily caffeine consumption and the risk of developing all-cause dementia and vascular dementia in the hypertensive population. Furthermore, the significant association between the amount of coffee and tea consumed and the risk of all-cause and vascular dementia were more likely to be found in hypertensive patients than in the non-hypertensive population.

Abstract P375: Cardiovascular Correlates of Hypertension in People With and Without HIV

Introduction: Hypertension is associated with cardiometabolic and cardiovascular disease (CVD) risk especially in people with HIV (PWH) and the elderly. Lack of adherence to antihypertensive drugs heightens the CVD risk. Salt-sensitivity of blood pressure (SSBP), characterized by increases in blood pressure in response to increases in dietary salt intake is a risk factor for hypertension and HIV may likely increase this risk. Aim: The goal of this study was to determine the differences in cardiometabolic and cardiovascular risk correlates of hypertension between PWH and HIV-negative. Methods: We conducted a cross-sectional study at a large referral hospital in Zambia. We randomly sampled 132 adult PWH and HIV-negative individuals with known SSBP from an ongoing large cohort study. We conducted cardiovascular and metabolic phenotyping. Data was collected using research electronic data capture and analyzed using StatCrunch. We adjusted the multivariable analysis for age, sex, and BMI. All participants signed written consents. The study was approved by the Zambia National Health Research Authority. Results: The median age (interquartile range) for PWH and HIV negative group were 52 (46-63) vs 46 (29-59) years, respectively (p&lt;0.001). Females were preponderant in each group (32/50 PWH vs 50/82 HIV-negative). Hypertension was present in 28% (n=14/50) of PWH and 22% (18/82) among the HIV-negative. The factors associated with hypertension in the HIV-negative group after adjusting for age, sex, and BMI included development of heart palpitations following a salty meal ( AOR 4.53, 95% CI 1.10-2.18, p=0.047), preference for low salt (AOR 0.55, 95% CI 0.31-0.98, p=0.044), peripheral artery disease (AOR 5.90, 95% CI 0.39-8.95, p=0.003), left ventricular internal dimension at end -diastole (AOR 4.35, 95%CI 1.02-18.48, p=0.046), Framingham risk score (2008) ( AOR 1.20, 95% CI 1.04-1.39, p=0.012), and atherosclerotic cardiovascular disease risk score (AOR 2.13, 95% CI 1.25-3.63, p=0.005). However, in PWH only waist circumference (AOR 1.16, 95%CI 1.03-1.32, p=0.015), SSBP (AOR 9.69 95%CI 1.84-51.00, p= 0.007), and Interventricular septum thickness at end -diastole (AOR 12, 95%CI 0.14-11.07, p=0.034) remained significantly associated with hypertension. Conclusions: Hypertension is associated with CVD in both PWH and HIV negative. However, the CVD phenotype and risk are different and require further investigation.

Effectiveness of an intervention to improve screening and treatment management of hypertension at the Commune Health Stations, Cao Bang province in 2021 – 2022

The study aimed to evaluate the effectiveness of interventions in screening and treatment management of hypertension at commune health stations (CHSs) in Cao Bang province in 2021- 2022. All 161 CHSs in Cao Bang province were selected for the study. The intervention package was developed based on the needs of CHSs in Cao Bang, including i) conducting advocacy workshops to support and remove barriers that affect activities on screening and treatment management of hypertension at CHSs; ii) providing capacity building for commune health workers, village health worker through hand-on training and supportive supervision; iii) providing CHSs with essential equipment; and iv) using software to support the management of data on hypertension screening and treatment management. Data were collected through self administered questionnaires filled by CHSs, and extracted from the management software. The effectiveness of the intervention was analyzed based on a comparison of pre and post-intervention outcomes. Results showed that the rate of CHSs implementing screening for hypertension increased from 27.3% to 95.0%. The rate of CHSs conducting treatment management also increased from 69.6% to 96.9%. The proportion of people screened for hypertension increased from 31.8% to 86.0%. The average number of hypertensive people who received treatment management at CHSs increased from 3.0 to 54.2 people. Additionally, the rate of patients achieving target blood pressure increased by 10.4% (64.4% compared to 54.0%). The results showed that the intervention package was effective and suitable for CHSs, and it should be replicated in other provinces.

Penerapan Metode Pijat Refleksi Kaki pada Lansia Penderita Hipertensi di Desa Palur Kabupaten Sukoharjo

Background: Elderly is an aging process with increasing age which is characterized by a decrease in the ability of organ functions and an increase in the loss of active tissue, which makes the body more susceptible to various types of diseases. One of the diseases that elderly people often suffer from is hypertension or high blood pressure. One non-pharmacological treatment that can be done is the foot reflexology massage method..Purpose: To describe the results of comparing blood pressure before and after applying the foot reflexology massage method to elderly hypertensive people. Method: his study used a descriptive design on 2 elderly respondents with hypertension, which was carried out 3x a week with a frequency of 1x a day for 15-20 minutes. Results: There was a decrease in blood pressure after applying the foot reflexology massage method to Mrs. Y went from stage I hypertension to still being in the stage I hypertension category but has experienced a decline and Mrs. S from stage II hypertension to stage I hypertension.. Conclusion: Application of the foot reflexology massage method can reduce blood pressure in elderly people with hypertension.

Hypertension among persons with type 2 diabetes and its related demographic, socioeconomic and lifestyle factors in the Fasa cohort study

Hypertension is a very common comorbidity in type 2 diabetes patients, which leads to important health and treatment challenges. The present study was conducted with the aim of determining the prevalence of hypertension and its risk factors in type 2 diabetes patients. This study was conducted using cross-sectional data from 1245 participants aged between 35 and 70 years and diagnosed with type 2 diabetes at baseline in the Fasa cohort study. The prevalence hypertension was determined and multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between various risk factors and hypertension prevalence. The average age of the participants was 53.5 ± 8.7 years and 71.7% (n = 893) were female and 28.3% (n = 352) were male. The prevalence of hypertension in people with type 2 diabetes was 45.5% (n = 566). Higher age (AOR, 95% CI: 8.1, 4.6–14.3), female gender (OR, 95% CI: 1.8, 1.2–2.5), Fars (AOR, 95% CI: 1.6, 1.1–2.4) and Turk (AOR, 95% CI: 1.6, 1.1–2.5) vs. other ethnicity, and overweight (AOR, 95% CI: 1.8, 1.38–2.38) and obesity (AOR, 95% CI: 2.7, 2.0–3.8) vs. BMI < 25 was associated with a higher prevalence of hypertension, while higher physical activity (AOR, 95% CI: 0.57, 0.42–0.78) was associated with lower prevalence of hypertension in the multivariable model. The prevalence of hypertension in persons with type 2 diabetes was high and increased with greater age, in some ethnic groups, and with higher BMI and low physical activity. Further prospective studies are needed to investigate these associations in this population.

Association between dietary fiber intake and peripheral artery disease in hypertensive patients

BackgroundAt present, no studies explored whether dietary fiber intake was associated with the risk of peripheral artery disease (PAD) in hypertensive patients. This study assessed the association between dietary fiber intake and PAD in hypertensive patients.MethodsThis cross-sectional study collected the data of 4628 participants with the measurement of ankle-brachial pressure index in the National Health and Nutrition Examination Surveys database. Univariate logistic regression analysis was applied to identify variables associated with PAD as confounding factors. Univariate and multivariable logistic regression analyses were used to explore the association between dietary fiber intake and PAD in hypertensive patients. Subgroup analysis was stratified by age, cardiovascular disease, dyslipidemia, diabetes, smoking, and physical activity.ResultsAfter adjusting for confounding factors, decreased risk of PAD was observed in hypertensive patients with dietary fiber intake > 21 g [odds ratio (OR) = 0.67, 95% confidence interval (CI) 0.46–0.99]. Compared with people with dietary fiber intake ≤ 21 g, those with dietary fiber intake > 21 g were associated with decreased risk of PAD in hypertensive patients < 60 years (OR = 0.23, 95%CI 0.08–0.66). In hypertensive patients without dyslipidemia, dietary fiber intake > 21 g were associated with reduced risk of PAD (OR = 0.33, 95%CI 0.12–0.95). Decreased risk of PAD was also found in hypertensive patients without diabetes in dietary fiber intake > 21 g group (OR = 0.50, 95%CI 0.31–0.78). Dietary fiber intake > 21 g was linked with reduced risk of PAD in hypertensive patients in never smoke group (OR = 0.46, 95%CI 0.24–0.86).ConclusionHigher dietary fiber intake was associated with reduced risk of PAD in hypertensive patients, suggesting the importance of increase the daily dietary quality especially fiber intake in hypertensive people.

Educational inequalities in blood pressure across the adult life course: Evidence from a 20-year follow-up study.

High blood pressure (BP) is a key contributor to the burden of disease. This study aimed to assess: a) educational differences across the entire BP distribution, and b) educational differences in the trajectories of BP across the adult life course. Longitudinal data from the Stockholm Diabetes Prevention Program was analysed using quantile regression and linear mixed effects models. Models were adjusted for age, sex, lifestyle, and BP medication. Lower educational level was associated with higher systolic BP (SBP) at all follow-up periods. Age and sex adjusted mean SBP was 2.49 (95% confidence interval (CI) 1.10, 3.87), 3.95 (95% CI 2.45, 5.45) and 2.61 (95% CI 1.09, 4.13) mmHg higher for people with pre-secondary education compared with post-secondary at baseline, 10 years and 20 years follow-up, respectively. Quantile regressions revealed that the inequalities could be observed across the entire BP continuum. Longitudinally analysed, people with pre-secondary education had 3.01 (95% CI 1.91-4.11) mmHg higher SBP than those with post-secondary education, age and sex adjusted. No significant convergence or divergence of the educational gaps in SBP was observed. Educational differences remained even after adjusting for lifestyle and BP medication. These results imply that public health interventions should aim to bring about distributional shifts in blood pressure, rather than exclusively focusing on hypertensive people, if they are to effectively minimize the educational disparities in blood pressure and its consequences.

Uncontrolled blood pressure among the established hypertensive elderly people in Jashore, Bangladesh: A cross‐sectional type of observational study

AbstractObjectivesHypertension is one of the major modifiable risk factors for cardiovascular mortality and morbidity throughout the world. Increased life expectancy leads to increase prevalence of non‐communicable diseases among the elderly people including Bangladesh. However, different studies reported high prevalence of uncontrolled hypertension ranging from 52.6% to 67.9% among the elderly people in different countries. With this view, we aimed to assess the frequency of uncontrolled blood pressure (BP) among the elderly hypertensive people and its associated risk factors and treatment pattern in Bangladesh.MethodologyThis cross‐sectional type of observational study recruited 246 eligible hypertensive elderly patients attending in 250 Bedded General Hospital, Jashore, Bangladesh dated from 1st July to 31st December 2022. A structured questionnaire was developed and data on associated risk factors, treatment pattern and current blood pressure (BP) measurement were collected by face‐to‐face interview for the purposive sampling technique.ResultsThe mean age of our study patients was 72 ± 7 years with a male and female ratio nearly 1:1. Of the total hypertensive patients aged over 65 years or more, 56.5% remained with uncontrolled hypertension even on their prescribed antihypertensive medications. The mean systolic (SBP) and diastolic (DBP) blood pressure were significantly high (P &lt; 0.001) as 167 ± 22 mm Hg and 95 ± 11 mm Hg, respectively, among the uncontrolled hypertensive patients. However, we noticed the mean SBP and DBP among the total hypertensive patients were also significantly high (P &lt; 0.001) as 148 ± 27 mm Hg and 87 ± 13 mm Hg, respectively. In this study, we reported that the mean number of last prescribed antihypertensive medications used by the total patients was 2 ± 1 (P =0.224) which was similar among the controlled and uncontrolled hypertensive patient groups. Among the elderly hypertensive patients, the most commonly prescribed antihypertensive medications were Amlodipine 39.8% (P =0.006), Olmesartan 29.3% (P = 0.186), Losartan 24.4% (P = 0.127), Bisoprolol 15.0% (P = 0.266) and Atenolol 14.6% (P = 0.224).ConclusionWe noticed high frequency of uncontrolled blood pressure among the elderly hypertensive patients, despite of using multiple antihypertensive medications in Jashore, Bangladesh.

Association between human herpesvirus 8 and lipid profile in northwest China: A cross-sectional study.

Human herpesvirus 8 (HHV-8) infection shows obvious regional and ethnic differences. Although studies have shown that these differences may be associated with lipid metabolism, to date, no large-scale studies have explored this. This study explored the seropositivity rate of HHV-8 among 2516 residents from 10 regions of northwest China and then the correlates of HHV-8 infection with lipid profile. The HHV-8 serological positivity rate was 15.6% among all residents. The HHV-8 seroprevalence ranged 11.2-27.6% among different ethnicities. Across different BMI levels, the positive rates of HHV-8 were 27.6%, 16.9%, and 13.6% for a BMI < 18.5, 18.5-24.9, and ≥25, respectively. HHV-8 seropositivity rate was lower for hypertensive people (12.6%) than for non-hypertensive people (16.7%). Univariate logistic regression analyses revealed that age, hypertension, systolic blood pressure, BMI, total cholesterol, and high-density lipoprotein cholesterol (HDL-C) significantly correlated with HHV-8 seropositivity (p < 0.05). Multivariate logistic regression analysis after adjusting for confounding factors showed that HDL-C (odds ratio [OR]: 0.132, 95% confidence interval [CI], 0.082-0.212; p < 0.001) and BMI (OR: 0.959, 95% CI 0.933-0.986; p = 0.003) were associated with HHV-8 seropositivity. Subgroup analyses concerning ethnicity, sex, or age demonstrated a consistent relationship with HDL-C. The results of HHV-8 seropositivity and BMI were inconsistent in the subgroups. However, Spearman's correlation analysis between HHV-8 serum antibody titer and HDL-C levels showed no linear relationship among HHV-8 seropositive individuals (ρ = -0.080, p = 0.058). HHV-8 serum antibody titers were also not significantly correlated with BMI (ρ = -0.015, p = 0.381). Low HDL-C levels may be an independent risk factor for HHV-8 infection, but there is no significant correlation between HDL-C levels and HHV-8 antibody titers.

Mediation Effect of Obesity on the Association of Socioeconomic Status with Blood Pressure in the Elderly Hypertensive Population.

Socioeconomic status (SES) plays a crucial role in blood pressure (BP) control. SES may influence BP control through obesity indices, such as body mass index (BMI) and waist circumference (WC). This study aimed to understand the relationships between SES and BP control in the elderly hypertensive population, and to determine whether BMI and WC mediate the relationship between SES and BP control. The study was conducted in Jia County, Henan Province, China, from 1 July to 31 August 2023. The 18,963 hypertensive people over 65 years old who were included in the National Basic Public Health Service Program were investigated. The study utilized questionnaire surveys to collect data on participants' demographic characteristics, disease history, lifestyle behaviors, antihypertensive medication, and measured height, weight, and blood pressure. SES was indexed by participants' self-reported educational level, family income, and occupation, and categorized into low, medium, and high groups by using latent category analysis (LCA). Logistic regression models were used to analyze the associations between SES and BP control. Obesity indicators, represented by BMI and WC, were included in mediation models to examine the indirect effects of BMI/WC on the association between SES and BP control. The mean age of 17,234 participants was 73.4 years and 9888 (57.4%) of the participants were female. The LCA results indicated the number of participants in low SES, middle SES, and high SES groups were 7760, 8347, and 1127, respectively. Compared with the low SES group, the odds ratios (ORs) and 95% confidence intervals (CIs) for the association of BP control with middle SES and high SES were 1.101 (1.031, 1.175), and 1.492 (1.312, 1.696). This association was similarly found in the subsequent subgroup analyses (p < 0.05). Compared with low SES, our findings further suggested that BMI (indirect effects: 95% CIs: -0.004--0.001; p < 0.001) and WC (indirect effects: 95% CIs: -0.003--0.001; p = 0.020) play a suppressing role in the association between high SES and BP control. Our study indicated that the elderly hypertensive population with high SES may have a better result for BP control. However, we found that BMI/WC plays a suppressing role in this association. This indicated that despite the better BP control observed in elderly hypertensive populations with high SES, BMI and WC might undermine this beneficial relationship. Therefore, implementing strategies for obesity prevention is an efficient way to maintain this beneficial association between high SES and BP control.