Hypertension In People Research Articles

Comparison of Hand Grip Strength in Hypertensive and Non-Hypertensive Middle-Aged People

Background: Hypertension is a leading risk factor for cardiovascular diseases, affecting millions globally. Previous studies have suggested an inverse relationship between hand grip strength (HGS) and hypertension, indicating the potential of HGS as a non-invasive marker for cardiovascular health. However, research exploring this relationship within the middle-aged population of Pakistan remains limited. Objective: This study aims to compare hand grip strength between hypertensive and non-hypertensive middle-aged individuals and to assess the potential of HGS as a predictive marker for hypertension. Methods: A comparative cross-sectional study was conducted over six months, from August 2022 to February 2023, involving 220 participants (110 hypertensive and 110 non-hypertensive), aged 35-45 years, at PSRD and Jinnah Hospitals in Lahore, Pakistan. Hand grip strength was measured using a CAMRY digital dynamometer, and blood pressure was assessed with a Certeza sphygmomanometer. Participants were excluded if they had wrist joint problems, neurological disorders, a history of frozen shoulders, limb fractures, cognitive impairments, diabetes, or were pregnant. Data were analyzed using SPSS version 25, employing independent sample t-tests with a significance level set at p<0.05. Results: The mean age of participants was 39.81±3.16 years. Hypertensive individuals showed significantly lower hand grip strength compared to non-hypertensive individuals, with mean dominant HGS at 34.10±8.75 kg for hypertensives and 39.40±7.37 kg for non-hypertensives. Non-dominant HGS followed a similar pattern, with hypertensives at 31.87±8.75 kg and non-hypertensives at 36.97±7.57 kg. Additionally, a higher proportion of males was observed in the hypertensive group compared to the non-hypertensive group. Conclusion: The study found a significant association between lower hand grip strength and hypertension among middle-aged individuals, supporting the potential of HGS as a screening tool for hypertension risk. This finding underscores the importance of incorporating hand grip strength assessment into routine health evaluations to identify individuals at higher risk of hypertension.

Abstract WP239: Apolipoprotein E4 Allele Effect on the Prevalence of Intracranial Large Artery Stenosis

Introduction: Apolipoprotein E4 (ApoE4) allele is linked to increased LDL-Cholesterol, one of the main risk factors for intracranial large artery stenosis (ICAS). Evidence shows that in diabetic men, intima-media thickness is significantly higher in those with ApoE4 than those with ApoE3. While the link between ApoE4 and extracranial atherosclerosis and vascular risk factors is established, the association of these vascular factors with ICAS is unknown. This study investigates the relationship between ApoE4 carrier status and ICAS and whether vascular risk factors influence this relationship. Methods: We rated intracranial large arteries on MR-angiography for their degree of stenosis as 0=no stenosis, 1=<50% stenosis, 2=50-69%, 3=70% or flow gap. We added the score of each of the 11 intracranial arteries to reflect a composite measure of the severity of ICAS. We then related ApoE4 carrier status to the ICAS score using generalized linear models with a Poisson link, adjusting for demographics, vascular risk factors, and cohort. We ran pre-specified interaction models with demographics and vascular risk factors. Results: 4099 individuals from six cohorts were included; 58% were women, the prevalence of hypertension was 76%, diabetes 31%, dyslipidemia 64%, and current smoking 13% (Table). There was no association between ApoE4 carrier and ICAS score (B= 0.08+0.06, p=0.19), but we found statistical interactions between ApoE4 carrier and male sex (p=<0.001), current smoking (p=0.05), and hypertension (p=0.003). ApoE4 carrier status was associated with higher ICAS score among hypertensive men (B=0.52±0.11, P=<0.001) and hypertensive people who smoke (B=0.58±0.20, p=0.01. Conclusion: ApoE4 carrier status was not associated with ICAS overall, but there were associations in subgroups defined by sex, hypertension, and smoking. Whether these interactions influence the risk of stroke and dementia should be further investigated.

Pengaruh Rendam Kaki dengan Air Hangat Campur Kencur terhadap Penurunan Tekanan Darah Lansia Hipertensi Di Desa Pohsanten

<p><em>Elderly is a phase of someone who experiences increasing age where the group is at risk of experiencing health problems. Hypertension is a condition in which a person experiences an increase in high blood pressure which reaches a systolic number of more than 140 mmHg and a diastolic number of more than 90 mmHg. Several treatments for lowering blood pressure can be carried out, one of which is with non-pharmacological actions. This study aims to determine whether or not there is an effect of soaking feet with warm water mixed with kencur on reducing blood pressure in elderly hypertensives in Pohsanten Village. This study used a quasi-experimental design with a non-equivalent control group before-after design. The population in this study were all hypertensive elderly people in Pohsanten Village. Sampling used a purposive sampling technique with 102 research samples, the experimental group totaling 51 people and the control group totaling 51 people were given the intervention of foot soaks with plain water. The analysis of this study used the Wilcoxon test and the Mann-Whitney test. In this study, the results obtained were p value = 0.000 for systolic blood pressure and diastolic blood pressure with a p value = 0.000, meaning that there was an average difference in systolic and diastolic blood pressure before and after the intervention. It can be concluded that there is an effect of soaking feet in warm water mixed with kencur on reducing blood pressure in elderly hypertensives in Pohsanten Village.<strong></strong></em></p>

Association between triglyceride glucose index and depression in hypertensive population.

Growing evidence suggests that hypertensive individuals have a greater risk of developing depression, and depression can also increase the incidence of hypertension. In the hypertensive population, the association between triglyceride glucose (TyG) index and depression remains unclear. This study aimed to assess the association between TyG index and depression in hypertensive people through the cross-sectional study of the National Health and Nutrition Examination Survey (2007-2018). To assess the relationship between TyG index and depression in hypertensive population, we conducted weighted multiple logistic regression models and used a generalized additive model to probe for nonlinear correlations. In addition, we employed a recursive algorithm to determine the inflection point and established a two-piece linear regression model. This study enrolled 5897 individuals. In the model adjusted for all covariates, the ORs (95% CI) for the relationship between TyG index and depression in hypertensive population were 1.32 (1.12-1.54). A nonlinear association was found between TyG index and depression, with an inflection point at 8.7. After the inflection point, the ORs (95% CI) were 1.44 (1.15-1.79). Only the interaction with the obese population was statistically significant. Our study highlighted a nonlinear association between TyG index and depression in American hypertensive adults.

Health-related quality of life and hypertension in people with HIV on long-term antiretroviral therapy in Uganda.

The presence of hypertension could reduce the health-related quality of life (HRQoL) of people with HIV (PWH). Yet, literature describing the HRQoL of PWH who have hypertension in Uganda is scarce making the design of locally adapted interventions cumbersome. In our study, we compared HRQoL scores of people with HIV with and without hypertension on long term antiretroviral therapy (ART) in Uganda. We recruited 149 PWH with hypertension and 159 PWH without hypertension in the long-term ART cohort at an urban clinic in Kampala, Uganda. Data on socio-demographics were collected using an interviewer designed questionnaire while data on the World Health Organisation clinical stage viral load and CD4 count as well as ART duration were extracted from clinic electronic database and a generic EuroQol -5D- 5L (EQ-5D- 5L) and Medical Outcome Study (MOS-HIV) questionnaire used to collect HRQoL data. Data were summarized using descriptive statistics while inferential statistics were used to determine associations between key variables and HRQoL. Mann-Whitney U tests were used to compare HRQoL between groups of interest. One hundred ninety (61.7%) participants were female. PWH who had hypertension were older (Mean ± SD: 53.7 ± 8.3 vs 49.9 ± 8.6, p value <0.001) than those without hypertension. Participants with hypertension had lower overall median health utility scores (0.71 (0.33-0.80) vs 0.80 (0.44-0.80), p value = 0.029) and mean physical health score (48.44 ± 10.17 vs 51.44 ± 9.65, p value < 0.001) as opposed to those without hypertension. Hypertension (p value = 0.023), high income status, >70,000 UGX, (p value = 0.044), disclosure of the HIV status of the participants to their partner (p value = 0.026), and current history of smoking (p value = 0.029) were associated with low HRQoL scores. Among people with HIV, those with hypertension had lower HRQoL compared to those without. This calls for inclusion of quality-of-life assessment in the management of PWH who have been diagnosed with hypertension to identify those at risk and plan early interventions.

Effects of Ergonomic Exercises on Systolic and Diastolic Blood Pressure of Hypertensive Elderly in Sitopeng Cirebon, Indonesia

Background: Hypertension is a chronic, non-communicable disease that often shows no symptoms but can cause heart failure, stroke, myocardial infarction, atrial fibrillation, and even premature death. The majority of hypertension sufferers in Indonesia are elderly (57.6%). Ergonomic exercise is recommended in the non-pharmacological management of hypertension because it can reduce blood pressure. Aims: To know the effect of ergonomic exercise three times and once per week on systolic and diastolic pressure in hypertensive elderly. Methods: The design is an experiment consisted of two groups before and after intervention; the population is hypertensive elderly in Sitopeng, Cirebon City. The sample sizes were determined by the formula (t-1) (r-1) &gt; 15, where t is the treatment group and r are the replication, so the total sample was 32 hypertensive elderly people who were selected using simple random sampling techniques, and data analysis was carried out using the independent T-test and paired T-test. Results: Ergonomics exercises 3 times per week can reduce systolic pressure in elderly people with hypertension (p = 0.001&lt;0.05), but there was no significant difference between the ergonomic exercise groups 3 times and 1 time per week treatment in systolic (p = 0.520) and diastolic pressure (p = 0.095&gt;0.05). Conclusion: Ergonomic exercise provides good benefits in reducing systole and diastole pressure in elderly people with hypertension. Maximum benefits can be obtained if the elderly perform ergonomic exercise movements perfectly, control medication adherence, and follow a low-salt diet. Recommendation: Give the guidebook to each participant, which they take home and are assisted by family to memorize the movements. Always maintain compliance with taking medication and a low-salt diet.

Blood pressure status in patients with metabolic syndrome

Relevance. Metabolic syndrome (MetS) is existence of many abnormalities, such as abdominal obesity, hypertension, dyslipidemia, and glucose intolerance. The occurrence of MetS in hypertensive people is linked to poorly managed hypertension. One of the parameters for the diagnosis of the syndrome is the presence of increased blood pressure; nevertheless, research shows that MetS patients are likely to experience hypertension often. Materials and Methods. 300 metabolic subjects were selected from the medicine OPD as study participants based on the joint interim statement’s 2009 definition of the metabolic syndrome. They were divided into three groups (normotensive, pre-hypertensive, and hypertensive) based on blood pressure readings that met the American Heart Association’s (AHA) Asian blood pressure criteria. The following parameters were recorded for data collection: anthropometric (Weight, Height, Body Mass Index Waist Hip Ratio), Blood pressure, biochemical (Fasting blood glucose, Lipid profile parameters). Results and Discussion. According to the resting blood pressure readings, out of 300 metabolic syndrome participants, 37 were normotensive [male (40.54 %); female (59.45 %)], 115 were pre-hypertensive [male (58.26 %); female (41.74 %), and 148 were hypertensive [male (52.7 %); female (47.3 %)]. In several parameters, there was no such significant difference between male and female participants across all groups. However, the levels of blood total cholesterol, triglycerides, and low-density lipoprotein were considerably greater in hypertensive and pre-hypertensive metabolic participants than in normotensive subjects, while the levels of high-density lipoprotein were lower. Conclusion. Study findings suggest, hypertension and pre-hypertension were more prevalent in the group with metabolic syndrome. Additionally, hypertensives have a higher chance of manifesting dyslipidemia.

Mental Health of Elderly Hypertensive Patients in Primary Health Care: An Integrative Review

Introduction: The global context highlights several challenges and manifestations stemming from population aging, among which mental health care for elderly people stands out. Primary health care (PHC), the largest gateway to Brazil’s health care network, is strategic in promoting health and care, and in preventing diseases such as systemic arterial hypertension (SAH). It is known that elderly people with SAH present various symptoms of psychological distress and mental disorders that can aggravate cardiac symptoms. This can lead to health, social, and financial impacts on the lives of elderly people and their families. Objective: To identify the evidence on mental health care for hypertensive elderly people in PHC. Materials and methods: This is an integrative literature review; data was collected in January 2023 from the following databases: PubMed, BVS/Bireme, Medline, Lilacs, Cinahl, Scopus, and APA PsycINFO. The studies included were those available in full, in Spanish, English, and Portuguese, and which answered the research question elaborated following the PICo strategy. The article’s search and selection processes were performed independently by two trained researchers through peer review. The Prisma guidelines were followed. Results: The studies found were published between 2008 and 2020 and showed two analysis categories: integrated care provided by the multi-professional team and measures that emphasize health-related quality of life. The studies highlighted integrated care management programs, qualification of the bond and territorialization, health measures that have an impact on psychological suffering, and group activities. Conclusions: Mental health care provided in an integrated and shared manner, combined with health activities and groups, is a powerful tool for elderly hypertensive patients in PHC. These strategies still have some challenges in certain contexts, but the review emphasizes the importance of consolidating this form of care, provided in PHC and has outcomes at all levels of care.

Âge vasculaire et risque cardiovasculaire chez les patients hypertendus suivis à l'institut de cardiologie d'Abidjan

ObjectiveTo calculate the vascular age of hypertensive patients and assess the risk at 10 years of occurrence of an absolute cardiovascular event in outpatient consultation of the Abidjan Heart Institute. Patients and methodology: Cross-sectional study with descriptive and analytical purposes from June 2021 to September 2021, i.e. 4 months in patients at least 30 years of age followed in the outpatient department for arterial hypertension without cardiovascular complications. Data were collected using a questionnaire. We considered the parameters established in the D'Agostino chart for the calculation of vascular age. Each parameter was weighted and the total points obtained corresponded to the vascular age. The cardiovascular risk at 10 years was also obtained from another abacus established by D'Agostino by cross-referencing the total points of each patient with pre-established data. ResultsThree hundred hypertensive people were included in this study. The calendar average age was 62.0 ± 10 years with extremes of 30 and 95 years. The gender distribution showed female predominance and there was no significant difference in vascular age by sex. The mean vascular age of all patients was 73.4 ± 9.9 years. The mean difference between actual and vascular age was 11.4 years. Dyslipidemia (p = 0.0002), diabetes (p = 0.0004) and unstandardized BP (p = 0.0000) significantly influenced vascular age. There was no significant difference between smokers and non-smokers (p = 0.1349). All men had a greater than 30% risk of having a cardiovascular accident while women before the age of 35 had no risk. Over the age of 60, almost all patients (both men and women) had a greater than 30% risk of having a cardiovascular accident at 10 years. ConclusionThe calculation of vascular age made it possible to assess arterial aging and calculate the probability at 10 years of occurrence of a cardiovascular event. This study also highlights the importance of cardiovascular risk and vascular age assessment for management adaptation and therapeutic education.

Regional prevalence of hypertension among people diagnosed with diabetes in Africa, a systematic review and meta-analysis.

Hypertension and diabetes comorbidity can increase healthcare expenditure and the risk of coronary heart disease. We conducted a systematic review and meta-analysis to estimate the prevalence of hypertension among people with diabetes in African countries. We searched EMBASE, PubMed and HINARI databases from inception to March 2023. Cross-sectional studies reporting the prevalence of hypertension among people with diabetes and published in English in Africa were eligible for inclusion. The cross-sectional study design component of the mixed method appraisal tool was used to assess the quality of the included studies. We quantified the overall and regional prevalence of hypertension among people with diabetes using random-effects meta-analysis. We assessed heterogeneity and publication bias using I2 statistics and funnel plots. Out of 3815 articles retrieved from the various databases, 41 met the inclusion criteria with sample sizes ranging from 80 to 116726. The mean age was 58 years (± 11) and 56% were women. The pooled prevalence of hypertension in people diagnosed with diabetes was 58.1% [95% CI: 52.0% - 63.2%]. By region, Central Africa had the highest hypertension prevalence; 77.6% [95% CI: 53.0% - 91.4%], Southern Africa 69.1% [95% CI: 59.8% - 77.1%;], North Africa 63.4% [95% CI: 37.1% - 69.1%;], West Africa 51.5% [95% CI: 41.8% - 61.1%] and East Africa 53.0% [95% CI: 45.8% - 59.1%]. Increasing age, being overweight/obese, being employed, longer duration of diabetes, urban residence, and male sex were reported to be associated with a higher likelihood of developing hypertension. The high prevalence of hypertension among people with diabetes in Africa highlights the critical need for an integrated differentiated service delivery to improve and strengthen primary care and prevent cardiovascular disease. Findings from this meta-analysis may inform the delivery of interventions to prevent premature cardiovascular disease deaths among persons in the region.

Salicylic acid improving physiological and phytochemical changes in Stevia rebaudiana under salt stress and estimating steviol glycoside by LC-MS/MS

Almost every area of plant development is negatively impacted by stress. Salicylic acid (SA), when supplied exogenously, has been demonstrated to be a regulatory hormone that may mitigate the harmful effects of salt stress. Diabetics, hypertensive and health-conscious people substitute Stevia rebaudiana for sugar. Salinity is the global problem directly affecting the quality and quantity of stevia. Each group received 100 mM NaCl treatment for seven days followed by 0.1 mM, 0.2 mM and 0.05 mM SA treatment. Salt stress reduces the amount of chlorophyll (P&lt;0.001) and the antioxidant capacity (P&lt;0.001) which is restored by SA treatment. Salt stress increased proline (P&lt;0.001), MDA (P&lt;0.001) and other antioxidant enzymes (P&lt;0.001), with the exception of catalase (P&lt;0.05). Furthermore, salt stress has a negative impact on stevioside production which SA assisted in improving. Salt stress hampered the biology and phytochemistry of Stevia. SA restored antioxidants, chlorophyll, proline and phytochemicals. SA also helped to improve the steviol production in salt stress which is significantly lower in normal plants. Method developed to estimate steviol level can also be helpful to different industries involved in stevia products.

Association of Central Blood Pressure and Carotid Intima Media Thickness with New-Onset Hypertension in People with High Normal Blood Pressure.

People with high normal blood pressure (BP) have a higher risk of cardiovascular events than those with normal BP; therefore, progression to hypertension (HT) should be prevented. We aimed to assess the HT risk using central BP and carotid intima media thickness (CIMT) in people with high normal BP. This prospective cohort study used the Tohoku Medical Megabank Community-Based Project Cohort Study (conducted from 2013 in Miyagi Prefecture in Japan). The participants had a high normal BP, defined as a systolic BP of 120-139 mmHg and diastolic BP ＜90 mmHg using brachial BP measurement during the baseline survey. The outcome was new-onset HT during the secondary survey, conducted four years after the baseline survey. Overall, 4,021 participants with high normal BP during the baseline survey, with an average age of 58.7 years, were included; 1,030 (26%) were diagnosed with new-onset HT during the secondary survey, 3.5±0.7 years after the baseline survey. The multivariable odds ratio (95% confidence interval) for HT in the highest versus lowest quartile of central BP was 1.7 (1.2-2.4, p=0.0030), and that of CIMT was 1.8 (1.4-2.4, p＜0.001). Subgroup analysis according to age (＜60 and ≥ 60 years) and sex revealed that the central BP was influential in groups with younger age and female individuals; CIMT was influential in all groups. Higher central BP and thicker CIMT at the baseline were correlated with new-onset HT in individuals with high normal BP, independent of brachial systolic BP and other cardiovascular risk factors.

Enlighten the association of Angiotensinogen gene (AGT) polymorphisms and hypertension in Jammu region of north Indian population: A case-control study

BackgroundHypertension is a common cause associated with various life-threatening disorders such as stroke, heart attack, etc. AGT, with its two common polymorphisms, i.e., rs699 and rs4762, has been associated with variation in plasma angiotensinogen concentration and linked to essential hypertension. AimIn the present study, we aimed to find the association between the two polymorphisms, namely rs699 and rs4762 of the AGT gene, with the risk of hypertension in people of the Jammu region of Jammu and Kashmir. MethodTo achieve the aim, an observational with case-control study design was utilized where the descriptive and inferential data were presented in frequency, and an Odds ratio with a 95% Confidence Interval was used for determining the risk association, respectively. Online free statistical tools were used for the statistical analysis. The pairwise linkage disequilibrium (LD) and its respective measures (D′ & r(Mills et al., 2020 (Mills et al., 2020))) for the SNPs among the hypertensive patients and controls were calculated using Haploview software. ResultA total of 180 cases and 350 controls were enrolled, where “rs699” showed an increased risk (OR: 1.72 [1.28–2.31], p-value =0.0003) for hypertension in contrast to “rs4762” which showed a protective role (OR: 0.55 [0.37–0.82], p-value <0.002) in the population of Jammu. After linkage disequilibrium analysis, the risk of disease due to haplotype was also analyzed, and it was found that CC (rs699/ rs4762) significantly (p-value <0.00001) increases the risk by 1.9-fold. ConclusionThe present study concluded that “rs699” showed an increased risk for hypertension in the population of the Jammu region in contrast to “rs4762”.

Pengaruh Isometric Handgrip Exercize Dan Terapi Nafas Dalam Terhadap Penurunan Tekanan Darah Pada Lansia Hipertensi

One of the non-communicable diseases that causes 71 percent of deaths globally, according to a report by The World Health Organization (WHO), is hypertension.. For the treatment of hypertension, there are both pharmaceutical and non-pharmacological options. There are a few non-pharmacological treatment options, including deep breathing exercises and isometric handgrip therapy. The aim of this study was to investigate the effectiveness of deep breathing exercises and isometric handgrip exercises in lowering blood pressure in elderly hypertensive patients in the Sokodadi District, Paiton, Probolinggo. This type of research is pre-experimental with a one-group pre-post design. The population of elderly people with hypertension in Sokodadi Village, as many as 42 respondents, determined the sample using a purposive sampling technique that fit the criteria of 38 respondents. The instrument used is the Isometric handgrip exercise module and deep breathing therapy. This study was analyzed with the Wilcoxon test. The study's findings demonstrated that the typical blood pressure before therapy was 157/97.4 mmHg, and the blood pressure value after therapy was 146.3/89.7 mmHg. According to the analysis test's Wilcoxon results, deep breathing exercises and therapy for hypertensive elderly people in Sokodadi district had a positive impact on lowering blood pressure. (p-value = 0.000 &lt; α = 0.05). In elderly hypertensive patients, isometric handgrip exercise and deep breathing therapy can lower blood pressure.

A Prospective-Comparative Study on Extremity of Stroke in Patients with and Without Atrial Fibrillation as a Clinical Predictor

Background: Atrial fibrillation (AF) is a leading cause of ischemic stroke. It is critical to confirm the impact of AF on stroke outcomes. Objective: To assess the risk factors for stroke in conditions with or without atrial fibrillation. • To compare stroke severity and outcomes in stroke patients with or without atrial fibrillation. • To assess the vascular risk factors and co-morbid conditions Method: Analysis of the patient's medical information, such as age, gender, kind of stroke, location, mode of therapy, severity, and results. antithrombotic therapy) on 100 stroke victims (50 of them who exhibited AF and the other 50 without). Results: Age 61 to 80 were associated with a greater risk of strokes (33% non-AF, 14% AF), while age groups 81 and above were associated with a higher chance of atrial fibrillation (2% AF).men and females had the same incidence of AF (12% each), with the exception that females were more common in the non-AF group (47%) than men (29%). Patients with ischemic stroke were more prevalent (73%), but patients with hemorrhagic stroke (6% AF, 9% non-AF) were more likely to have it. The CHAD2DS2-VASc SCORE and AH showed that hypertensive people had a greater risk of stroke in both the AF (10%) and non-AF (46%) groups. Overall, the AF (10%) and non-AF (46%) groups had hypertension as the most common co-morbid disease, with antihypertensive medications being the commonest prescribed medicine (23% AF, 59% non-AF). Conclusion: The study concluded that if treatment methods for atrial fibrillation and stroke are given, patient outcomes can be improved with sufficient assessment and strict adherence.

Telenursing-Based Self-Care Management Education Improves The Quality Of Life Of Hypertension Sufferers In The Rural Area Pragaan Health Center

Background: A person's view of their life within the framework of their culture and values, which encompass the areas of physical, psychological, social, and environmental activities, is referred to as their quality of life. In order to raise awareness and promote self-care, intervention measures are desperately needed. The purpose of this research is to evaluate how telenursing education affects hypertension patients' quality of life. Methods: This study used a quasi-experimental methodology. With a simple random sample, the population consisted of sixty hypertensive people. The sixty-person sample was split into two groups: thirty individuals in the treatment group got an educational intervention centered around supportive care, while thirty individuals in the control group were given hypertension pamphlets. Results: The quality of life score in the treatment group following the intervention was p = 0.000, according to research based on the independent t-test. The study's findings demonstrated the effectiveness of telenursing instruction in raising hypertension patients' quality of life; as such, this intervention may catalyze raising hypertensive patients' levels of self-care. Conclusion: In conclusion, telenursing education support has an impact on hypertension patients' quality of life.

The effect of abdominal obesity on the level of inflammatory markers in young people with hypertension

Objective: to investigate pro- and anti-inflammatory blood markers in young people with arterial hypertension (AH) against the background of abdominal obesity (AO).&#x0D; Materials and methods: the study included 530 people, including 267 people with hypertension, of which 169 were with AO. In the control group (without AH) there were 263 people comparable in gender and age, with AO - 106 people. The content of TNF-α, IL-6, IL-8, MCP-1 (monocytic chemoatractant protein), PAI-1 (plasminogen activator inhibitor-1), IL-10, IL-17a, IL-17e, IL-17f were determined in all blood by multiplex analysis. Statistical processing was carried out in the SPSS 13.0 program.&#x0D; Results: The level of IL-17a was 1.64 times higher in patients with hypertension (p0.05) compared to the control. The level of IL-6 in patients with hypertension was higher (p0.0001) by 52.91% compared to the group without hypertension. There was no difference between the control and the group with hypertension for the remaining biomarkers. The influence of AO on the level of the studied markers in the control group was not revealed. In the group with AH, a significantly higher level of PAI-1 (p0.05) was in the subgroup with AO. For subgroups with AO, the difference between patients without AH and with AH was manifested in a decrease in IL-17e and an increase in IL-6 in patients with AH (p0.05). No statistically significant difference was found for the remaining indicators. The relative chance of early hypertension was associated with the presence of AO and an increase in the level of IL-6.&#x0D; Conclusion: From the markers of inflammation studied by us, an increased level of IL-6 and IL-17a can serve as potential biomarkers indicating a high probability of developing early hypertension in people under 45 years of age.

Single-lead ECG based detection of arterial hypertension using artificial intelligence algorithms

Abstract Background Unawareness of arterial hypertension is an important contributing factor to the inadequate control of the disease and the absence of appropriate antihypertension treatments. Population screening programs have shown that more than 50% of hypertensives were unaware they had hypertension. Wearable devices, a ubiquitous accessory in our days, can record single-lead electrocardiograms that are then analyzed by machine learning (ML) algorithms. The recorded signal, most often of lead I, could potentially reveal an undiagnosed hypertension. Purpose The purpose of this study is to create and train a ML algorithm that detects the existence of arterial hypertension using features derived from a single-lead ECG (lead I), Methods We enrolled 1220 consecutive individuals without cardiovascular disease. The participants were classified into hypertensive and normotensive group. Hypertensive patients were recruited from the outpatient clinics of the respective centers. Normotensive healthy individuals were referred either for the investigation of atypical chest pain or for the modification of risk factors for cardiovascular disease such as hyperlipidemia. We trained a Random Forest (RF) model to classify subjects into 2 groups: hypertensive or normotensive. A feature-based machine learning algorithm, such as a RF, can also provide an interpretation of its results in the form of feature importance and interactions between features. Results The prevalence of hypertensive people in our study was 66.5%. Our RF model was able to distinguish hypertensive from normotensive patients on a hold-out test set, with an AUC 0.85, accuracy 81%, sensitivity 80% and specificity 83% (both using a threshold of 0.5), and an F1 score 0.86. When predicting on the subset of the test set containing people younger than 59 years old, it achieved AUC of 0.75, sensitivity of 50% and specificity of 87%. Age, BMI, the area under the T wave divided by the QRS complex area, the area under QRS segment adjusted for BMI, the QT corrected interval, and the PQ interval, were the most important anthropometric and ECG-derived features in terms of the success of our model (Figure 1). Conclusions Our findings indicate that one-lead ECG based detection of arterial hypertension is possible by using ML algorithms. This study demonstrates the huge potential of artificial intelligence to transform smartwatches ECG signals into diagnostic tools.Figure 1

Quality of Life in Hypertensive University students Attending a Health Facility for Care in North Lima

Introduction: Hypertension is one of the most common problems where the quality of life of the person suffering from this disease is compromised, altering their health well-being in the short and long term, so the research objective is to determine the quality of life in hypertensive people who come to a health facility for their care in North Lima.Methods: It is a quantitative, descriptive-cross-sectional study, consisting of 150 participants who answered a questionnaire on sociodemographic aspects and the mini-questionnaire on quality of life in hypertension.Results: In the results, females have a better quality of life than males.Conclusions: It is concluded that educational counseling about the disease should be provided to people who are diagnosed with it.

Insulin resistance is acardiovascular risk factor in hypertensive adults without type2 diabetes mellitus.

Metabolic syndrome refers to the association among several cardiovascular risk factors: obesity, dyslipidemia, hyperglycemia, and hypertension. It is associated with increased cardiovascular risk and the development of type2 diabetes mellitus. Insulin resistance is the underlying mechanism of metabolic syndrome, although its role in increased cardiovascular risk has not been directly identified. We investigated the association between insulin resistance and increased cardiovascular risk in hypertensive adults without diabetes mellitus. We enrolled participants without diabetes from an outpatient setting in aretrospective, longitudinal study. Several demographic, clinical, and laboratory parameters were recorded during the observation period. Plasma insulin and homeostatic model assessment for insulin resistance (HOMA-IR) were used to determine insulin resistance and four cardiovascular events (acute coronary disease, acute cerebrovascular disease, incident heart failure, and cardiovascular mortality) were combined into asingle outcome. Logistic regression and Cox proportional hazards models were fitted to evaluate the association between covariates and outcomes. We included 1899 hypertensive adults without diabetes with an average age of 53years (51.3% women, 23% had prediabetes, and 64.2% had metabolic syndrome). In alogistic regression analysis, male sex (odds ratio, OR = 1.66) having high levels of low-density lipoprotein (LDL, OR = 1.01), kidney function (OR = 0.97), and HOMA-IR (OR = 1.06) were associated with the incidence of cardiovascular events; however, in asurvival multivariate analysis, only HOMA-IR (hazard ratio, HR1.4, 95% confidence interval, CI: 1.05-1.87, p = 0.02) and body mass index (HR 1.05, 95% CI: 1.02-1.08, p = 0.002) were considered independent prognostic variables for the development of incident cardiovascular events. Insulin resistance and obesity are useful for assessing cardiovascular risk in hypertensive people without diabetes but with preserved kidney function. This work demonstrates the predictive value of the measurement of insulin, and therefore of insulin resistance, in an outpatient setting and attending to high-risk patients.