Hypertension In People Research Articles

Inflammation markers and the risk of hypertension in people living with HIV.

The incidence of hypertension is high in people living with HIV (PLWH). High-sensitivity C-reactive protein (hsCRP), systemic inflammation response index (SIRI), and neutrophil-to-monocyte ratio (NMR) are considered economic and convenient parameters that reflect the levels of inflammation in patients. Our aim was to explore whether indirect inflammation markers are associated with hypertension in PLWH. This was a case-control study. The case group (hypertension) comprised PLWH with hypertension, and the control group (non-hypertension) comprised sex- and age-(± 3 years)-matched PLWH without hypertension. Demographic parameters, hsCRP, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune- inflammation index (SII), SIRI, lymphocyte-to-monocyte ratio (LMR), platelet-to-neutrophil ratio (PNR), platelet-to-monocyte ratio (PMR), NMR, time to HIV diagnosis, antiretroviral therapy (ART) duration, recent CD4+ and CD8+ cell counts, recent CD4+/CD8+ ratio, recent HIV viral load (HIV-RNA),and recent ART regimen were obtained from the patients' electronic medical records. A t-test or Wilcoxon rank-sum test was performed to compare differences between the two groups, and conditional logistic regression was used to analyze the risk factors of hypertension. Correlations between inflammation markers and CD4+ cell counts, CD8+ cell counts, and CD4+/CD8+ ratio were analyzed using Spearman's correlation. In the hypertension group, body mass index (BMI), hsCRP, NLR, SII, SIRI, NMR, time to HIV diagnosis, ART duration, CD4+ and CD8+ cell counts, and CD4+/CD8+ ratio, the ratio of HIV-RNA < 100 copies/mL were all higher than those in the non-hypertension group, while the PNR was lower than that in the non-hypertension group. ART duration, CD4+ cell counts, HIV-RNA < 100 copies/mL, hsCRP, SIRI, and NMR were positively associated with hypertensive risk in PLWH. CD8+ cell counts and CD4+/CD8+ ratio was negatively associated with hypertensive risk in PLWH. SIRI was negatively correlated with CD4+ cell counts and CD8+ cell counts, but positively correlated with CD4+/CD8+ ratio. We identified positive associations between inflammation markers hsCRP, SIRI, NMR and hypertensive risk in PLWH. Alleviating inflammation may help control or delay the occurrence of hypertension in PLWH.

Knowledge on hypertension in Myanmar: levels and groups at risk.

Background: Non-communicable diseases, specifically the burden of hypertension, have become a major public health threat to low- and middle-income countries, such as Myanmar. Inadequate knowledge of hypertension and its management among people may hinder its effective prevention and treatment with some groups at particular increased risks, but evidence on this is lacking for Myanmar. The aims of this study were therefore to assess the level of knowledge of risk factors, symptoms and complications of hypertension, by hypertension treatment status, community group-membership, and sociodemographic and socioeconomic factors in Myanmar. Methods: Data was collected through structured questionnaires in 2020 on a random sample of 660 participants, stratified by region and existence of community groups. Knowledge of hypertension was measured with the 'Knowledge' part of a validated 'Knowledge, Attitude and Practice' survey questionnaire and categorised into ill-informed and reasonably to well-informed about hypertension. Results: The majority of respondents seem reasonably to well-informed about risk factors, symptoms and complications of hypertension. This did not vary by hypertension treatment status and community group membership. People with jobs (B=0.96; 95%-confidence interval 0.343 to 1.572) and higher education (B=1.96; 0.060 to 3.868) had more hypertension knowledge than people without jobs or low education. Adherence to treatment among hypertensive people was low. Conclusion: This study shows a majority of participants in this study in Myanmar seem reasonably to well-informed, with no differences by hypertension status, treatment status, and community group-membership. People without jobs and low education have less hypertension knowledge, making them priority groups for tailored education on health care level as well as community level, lowering the burden of hypertension. Almost half of the hypertensive patients did not take their medicines and therefore, adherence to treatment of hypertension should be an important element for future health education.

Polycythemia, Thrombocythemia, and Hyperfibrinogenemia are Associated With Streptozotocin-induced Diabetes and Salt-induced Hypertension in Male Wistar Rats

Background: Diabetes mellitus and anaemia are frequently reported to be associated with polycythemia in several studies. Furthermore, some studies also have linked polycythemia with hypertension. However, whether hypertension and diabetes comorbidity had polycythemia/erythrocytosis, thrombocythemia, or hyperfibrinogenemia is unknown. Objectives: This study investigated the incidence of polycythemia, thrombocythemia, and hyperfibrinogenemia in diabetic and hypertensive male Wistar rats. Methods: Thirty male Wistar rats were categorized into five groups, each with six animals: negative control (zero-salt diet), positive control (standard salt diet – 0.3% salt), high salt diet – 8% salt (HSD only), Streptozotocin (STZ)-induced diabetes fed with normal salt diet (STZ only), and high salt diet with STZ-induced diabetes (HSD+STZ). Hematological variables and fibrinogen concentration were measured after a 4-week experimental period. One-way ANOVA was used for statistical analysis and a P&lt;0.05 was considered significant. Results: The heart rate and mean arterial pressure increased significantly in the HSD, STZ, and HSD+STZ groups, suggesting salt-induced hypertension. Compared to the controls, the STZ and HSD +STZ groups had significantly higher hematocrit, platelet estimate, and fibrinogen concentration. The STZ and HSD+STZ groups had a shorter clotting period, which correlated with higher platelet counts and fibrinogen levels. Compared to the controls, the HSD group had a lower platelet count and fibrinogen concentration, as well as a longer clotting time. Conclusion: This study suggests that polycythemia, thrombocythemia, and hyperfibrinogenemia are potential risk factors for hypertension in people with diabetes mellitus.

Abstract P321: Prevalence of Hypertension Among People Diagnosed With Diabetes in Africa, a Systematic Review and Meta-Analysis

Background: Hypertension (HTN) and diabetes (DM) share common pathophysiological mechanisms and hence have a high likelihood of co-occurring. The co-existence of HTN and DM increase increases CVD risk and exponentially increases health spending. Little is known about the burden of HTN in people with DM in Africa. Objective: To estimate the pooled prevalence of HTN in people with DM in African countries. Methods: This review was registered in the International Prospective Register of Systematic Reviews. We searched PubMed, Embase, and Hinari databases to identify peer-reviewed articles which provided data on the prevalence of HTN in people diagnosed with DM in Africa. We included studies that defined DM diagnosis as hemoglobin A1(HbA1c) &gt;7.0 and HTN diagnosis as BP≥140/90mmHg. We quantified the prevalence of HTN using random-effects models. We applied generalized linear mixed models with logit transformation to compute regional and overall pooled prevalence and estimated heterogeneity (I 2 ). Results: Out of 3810 studies retrieved from the databases, 27 met the inclusion criteria with sample size between (80 - 4122). The mean age was 58 (± 11) years and 56% were women. The pool prevalence of HTN in people diagnosed with DM was 59.8% [95% CI: 52.8% - 66.5%]. By African region, Central Africa recorded the highest 77.6% [95% CI: 53.01% - 91.4%], South Africa 74.5% [95% CI: 67.4% - 80.5%], North Africa 65.5% [95% CI: 54.7% - 75.0%], West Africa 55.7% [95% CI: 44.0% - 66.7%] and East Africa 50.7% [95% CI: 43.7% - 57.3%]. Increasing age, being overweight/obese, being employed, longer duration of DM, urban residence, and male sex were associated with a higher likelihood of HTN diagnosis. Conclusion: The high prevalence of HTN among people with DM in Africa, supports an integrated differentiated service delivery to improve primary healthcare-level cardiovascular disease response mechanisms. The data generated from this review may inform the delivery of interventions to avert premature cardiovascular disease mortality among Africans.

Prevalence and incidence of hypertension in a heavily treatment-experienced cohort of people living with HIV in Uganda.

The effect of long-term exposure to antiretroviral therapy (ART) on hypertension in sub-Saharan Africa remains unclear. We aimed to determine the prevalence and incidence of hypertension in people living with HIV (PLWH) with more than 10 years of ART in Uganda. The analysis was performed within a cohort of adult PLWH with more than 10 years of ART at an HIV clinic in Kampala, Uganda. Participants were eligible for this analysis if they had ≥2 follow-up visits. Hypertension was defined as two consecutive systolic blood pressure (SBP) measures greater than 140 mmHg and/or diastolic blood pressure (DBP) greater than 90 mmHg, and/or documented diagnosis and/or the initiation of antihypertensives. We determined the proportion of PLWH with hypertension at baseline and used multivariable logistic regression to determine the factors associated with prevalent hypertension. To determine the incidence of hypertension, follow-up began from the cohort baseline date and was censored at the last clinic visit or date of the event, whichever occurred earlier. Multivariable Poisson regression was used to determine the adjusted incidence rate ratios (aIRR) of hypertension according to demographic, ART, and clinical characteristics. Of the 1000 ALT participants, 970 (97%) had ≥2 follow-up visits, and 237 (24.4%) had hypertension at baseline. The odds of prevalent hypertension were 1.18 for every 5-year increase in age (adjusted odds ratio (aOR) 1.18, 95% CI 1.10-1.34) and were higher among males (aOR 1.70, 95% CI 1.20-2.34), participants with diabetes mellitus (aOR 2.37, 95% CI 1.10-4.01), obesity (aOR 1.99, 95% CI 1.08-3.60), high cholesterol (aOR 1.47, 95% CI 1.16-2.01), and those with prior exposure to stavudine (aOR 2.10, 95% CI 1.35-3.52), or nevirapine (aOR 1.90, 95% CI 1.25-3.01). Of the 733 participants without hypertension at baseline, 116 (15.83%) developed hypertension during 4671.3 person-years of follow-up (incidence rate 24.8 per 1000 person-years; 95% CI 20.7-29.8). The factors associated with incident hypertension were obesity (adjusted incidence rate ratio (aIRR) 1.80, 95% CI 1.40-2.81), older age (aIRR 1.12 per 5-year increase in age, 95% CI 1.10,1.25), and renal insufficiency (aIRR1.80, 95% CI 1.40-2.81). The prevalence and incidence of hypertension were high in this heavily treated PLWH cohort. Therefore, with increasing ART coverage, HIV programs in SSA should strengthen the screening for hypertension in heavily treated PLWH.

The relationship between hypertension and angina pectoris; physiological &amp; Biochemical study of patients Samarra city

This study was conducted for the period from 09/2013 to 02/2014 at Samarra General Hospital labs with patients admitted in the corridors of recovery for the patients with angina pectoris; ratio to the disease of hypertension is the pressure measurement during a hospital, (50-65) age nonsmoker. Reveiew as results showed high significant in hypertension for people in hypertension , angina pectoris compared with the control group in,as well as high significant in lipid profile (cholesterol, triglycerides). the high increase in angina pectoris group compared hypertension with group compared with control group at the level( P &lt;0.05 ). As for the lipoproteins, a decrease significant in the concentration of HDL-C was the largest decrease in angina pectoris when compared with hypertension group and the control group. at the same time high LDL-C concentration in a angina pectoris when compared with the control group, as to the biochemical variety results for increase significant in the concentration of blood sugar in the two study groups .show results high in angina pectoris when compared with hypertension group and the control group ,uric acid show results high in angina pectoris when compared with hypertension group and the control group.

Traditional Chinese Medicine constitution types of high-normal blood pressure: A meta-analysis

ObjectiveWe determined the distribution of constitutional types of high-normal blood pressure in Traditional Chinese Medicine (TCM) and provided evidence for the prevention of high-normal blood pressure and hypertension. MethodsEight digital databases were searched from January 2011 to November 2022, including PubMed, EMBASE, Web of Science, EBSCOhost, CNKI, CBM, Wangfang, and CQVIP. We performed a meta-analysis with the random-effects model or fixed-effects model to describe the distribution of constitutional types of high-normal blood pressure in TCM. The studies were assessed based on heterogeneity testing and the potential for publication bias. The meta-analysis was performed on Stata software 15.0. ResultsA total of 17 studies with 8118 participants were included in this meta-analysis. The proportion of the biased constitution (82.3%; 95% CI: 75.6%–89.1%, p < 0.001) was higher than the balanced constitution (17.3%; 95% CI: 10.7–23.8%, p < 0.001). Phlegm-dampness constitution, Yin-deficiency constitution, and damp-heat constitution accounted for 16.0% (95%CI: 10.5–21.5%, p < 0.001), 14.8% (95% CI: 11.0–18.6%, p < 0.001), 11.3% (95% CI: 8.0–14.5%, p < 0.001) of the total high-normal blood pressure cases, respectively. The subgroup analyses performed that region, age and gender were positively associated with the distribution of constitution types of high-normal blood pressure in TCM. Compared with the general population, the risk of high-normal blood pressure in people with the phlegm-dampness constitution, Yin-deficiency constitution, and blood-stasis constitution was 2.665 (95%CI: 2.286–3.106, p < 0.001), 2.378 (95%CI: 1.197–4.724, p = 0.013), 1.965 (95%CI: 1.634–2.363, p < 0.001) times of the general population, respectively. Meanwhile, the risk of high-normal blood pressure was lower in people with a balanced constitution (0.248, 95%CI: 0.165–0.372, p < 0.001). ConclusionsPhlegm-dampness constitution, Yin-deficiency constitution, and damp-heat constitution were the common constitution types of high-normal blood pressure. There might also be differences in the distribution characteristics of TCM constitution among people with high-normal blood pressure in different regions, ages, and genders. Finally, a balanced constitution might be a protective factor for hypertensive people.

PS-P12-3: RELATIONSHIP BETWEEN SOCIOECONOMIC STATUS AND HEALTH LITERACY AMONG HEALTHY JAPANESE PEOPLE

Objective: In today's society, people are encouraged to take more active roles in their own health. For that purpose, a wide range of health information has become available to the public, and increased attention is being paid to health literacy worldwide. The World Health Organization defines health literacy as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand, and use information in ways which promote and maintain good health. On the other hand, low socioeconomic status is associated with higher blood pressure. Clarifying the relationship between socioeconomic status and health literacy could be useful to develop appropriate interventions to prevent hypertension in people with low socioeconomic status. This study clarified the relationship between socioeconomic status and health literacy among healthy Japanese people. Design and Method: This cross-sectional mail survey was conducted in 2020 that involved all community residents with municipal National Health Insurance aged 40–64 years in five cities in three areas of A Prefecture, Japan. This survey included 33,902 community residents, and 12,446 (36.7%) agreed to participate in the survey. After exclusion of those with regular visits to medical institutions (n = 8,174) and those with missing data (n = 690), the analysis included 3,582 participants. Socioeconomic status (education level, self-reported economic status, and occupation) and health literacy were obtained using the self-administered questionnaire. Health literacy was measured using the Communicative and Critical Health Literacy (CCHL) scale. Participants were classified into two groups, low and medium/high health literacy groups, by their CCHL scale scores. The study protocol was approved by the Institutional Review Boards. Results: In this study, 53.0% of those had &lt; = 12 years of education, and 14.4% of those did not have an occupation. Regarding self-reported economic status, 18.3% were categorized as good, 22.3% as average, and 59.4% as poor. After adjusting for confounding factors, low education level [multivariable-adjusted odds ratio (OR) 1.61, 95% confidence interval (CI) 1.38–1.88, &lt; = 12 years vs. &gt; 12 years], poor economic status [multivariable-adjusted OR 1.75, 95% CI 1.39–2.19, poor vs. good], and no occupation [multivariable-adjusted OR 1.45, 95% CI 1.18–1.78, absence vs. presence] were positively associated with low health literacy. Conclusions: Low socioeconomic status was associated with low health literacy among healthy Japanese people. In order to prevent hypertension in people with low socioeconomic status, it may be useful to develop easy-to-understand materials.

PS-P12-1: SELF-CARE MANAGEMENT FOR HYPERTENSION IN SOUTHEAST ASIA: A SCOPING REVIEW

Objective: This scoping review aims to explore the current state of self-care management practices used by hypertension populations based on evidence from the existing scientific literature for SEA. Self-care practices such as lifestyle modifications in diet, exercise, and stress management, are effective in reducing the incidence of and enhancing better management of hypertension. However, little is known about the self-care management practices of people with hypertension in Southeast Asia (SEA) countries where the prevalence of hypertension is sharply increasing. Design and method: A scoping review of research and grey literature (2006–2021) was performed using Scoping Review Frameworks by Arkey and O Malley. For the research literature, ten databases were searched followed by a manual search of the reference lists of relevant topical papers. Results: Results indicate that bodyweight management, physical exercise, dietary intake, and medication adherence were largely poorly practiced by hypertensive people. Stress-relieving methods such as sleep, rest, and spiritual fulfilment was described as alternative self-care management methods. Anecdotal evidence of factors that facilitated or inhibited the implementation of self-care practices were described. Conclusion: While the overall evidence review suggests that hypertensive people in SEA do not adequately implement self-care to better manage hypertension, the anecdotal information provided by several reports indicate that there is individual variation in the facilitators and barriers to implementing self-care practices. The facilitators and barriers are relevant to personal choice [internal factors] or to the environment or context [external factors]. Enhancing self-care management of hypertension in SEA may require a multi-focused approach including targeting personal choice as well as external factors such as cultural relevance, environment and resources. Health workers working in the community in SEA countries should consider a multi-focused approach and cultural aspect in helping hypertensive patients to manage their self-care.

Hipomagnezijemija i dijabetes melitus tipa 2

Hypomagnesemia is a relatively common and often unrecognized electrolyte disorder in type 2 diabetes mellitus. This review presents the pathophysiology of magnesium deficiency in type 2 diabetes mellitus, its role in the development of disease complications, and the effect of magnesium supplementation. The literature search was conducted using the following keywords: magnesium, diabetes mellitus, complications, supplementation, within PubMed, Emabase, Scopus, SCIndex and Hrčak for the period from 2001 to 2023. Type 2 diabetes mellitus causes increased excretion of magnesium in the urine. On the other hand, reduced concentrations of magnesium in the blood of people with type 2 diabetes mellitus predispose to complications of the disease. A significant number of randomized, controlled studies and meta-analyses indicate the beneficial effect of magnesium supplementation in the control of hyperglycemia, dyslipidemia, and hypertension in people with type 2 diabetes mellitus. Routine monitoring and correction of magnesium concentrations in the blood of people with type 2 diabetes mellitus can help control and delay complications. diseases. Further research is needed to establish firm guidelines for clinical practice.

Drug Therapy Problems and Associated Factors Among Hypertensive Patients in North Wollo Public Hospitals, Northeast Ethiopia: Institutional-Based Cross-Sectional Study.

Drug therapy problems (DTPs) are common in people with hypertension and may threaten the effective management of the disease. The purpose of this study was to determine the prevalence and predictors for DTPs in hypertensive people in North Wollo public hospitals. On patients with hypertension, a cross-sectional study based in a health institution was carried out using an interviewer-administered structured questionnaire and medical record review from 6 November 2022 to 18 January 2023. All hypertensive patients, ages 18 and older, who underwent regular follow-ups for at least 12 months were included in the study using a simple random sampling method. Multivariate logistic regression analysis was used to establish the association between independent variables and the occurrence of DTPs. Unnecessary drug therapy, the need for additional drug therapy, ineffective drugs, dosage too low, dosage too high, adverse drug reactions, and noncompliance were the outcome variables. The study included 376 hypertensive patients. Of the total participants, 258 (68.6%) were female. The mean number of drug therapy problems per patient was 1.55 ± 0.307, with 298 participants (79.3%) reporting having at least one such problem. This study found that the need for additional drug therapy was the most prevalent problem (149, 39.66%). Polypharmacy (AOR = 2.487, 95% CI = 1.375-4.499, p = 0.003), presence of comorbidity (AOR = 1.886, 95% CI = 1.035-3.439, p = 0.038), and uncontrolled BP (AOR = 2.961, 95% CI = 1.669-5.254, p = <0.001) predicts the development of drug therapy problems. Patients with hypertension who are on follow-up experience drug therapy problems frequently. Promoting the involvement of clinical pharmacists in designing, implementing, and monitoring therapeutic plans is recommended to decrease the occurrence of drug therapy problems.

Vitamin D i hipertenzija

Vitamin D is the name for a group of fatsoluble secosteroids, prohormones. Almost all tissues of the human body have vitamin D receptors. 3% of the human genome is under the influence of vitamin D. A significant number of epidemiological studies confirmed the integral connection of vitamin D and its metabolites with the value of blood pressure. Vitamin D lowers blood pressure by inhibiting the renin-angiotensin-aldosterone system, modulating the tone of vascular smooth muscle cells and influencing the vascular endothelium. The results of randomized controlled trials and meta-analyses of the same do not generally support the widespread use of vitamin D in the prevention and treatment of arterial hypertension. Nevertheless, a large number of experimental studies confirm the antihypertensive effect of vitamin D supplementation predominantly in people aged ≥ 50 years as well as obese people with vitamin D deficiency. Further research is needed to determine the potential benefit of vitamin D replacement therapy in hypertensive people.

Indicadores antropométricos de adiposidade como preditores de hipertensão arterial sistêmica em pessoas idosas: uma análise transversal

ABSTRACT Objective: To analyze the association of anthropometric indicators of adiposity in older people, according to sex, with hypertension; to compare the scores of these variables between participants with and without hypertension; and to identify among them those with better predictive ability for screening the outcome. Methods: Epidemiological, population-based, cross-sectional study conducted with 210 older people. The anthropometric indicators analyzed were: body mass index, waist circumference, abdominal circumference, body adiposity index, triceps skinfold, waist-to-hip ratio, waist-to-height ratio, and conicity index. Hypertension diagnosis was self-reported. Results: The indicators of adiposity increased the probability of hypertension. Additionally, hypertensive older people of both sexes showed higher scores on adiposity indicators than non-hypertensive subjects (p &lt; 0.05). For men, the most sensitive indicator for the outcome was conicity index (81.82%; cut-off point: 1.30) and the most specific was body mass index (69.77%; cut-off point: 25.05 kg/m2). For women, the most sensitive indicator for the outcome was the body adiposity index (86.08%; cut-off point: 31.03%), and the most specific was the abdominal circumference (82.82%; cut-off point: 98.70 cm). Conclusion: In both sexes, the indicators of adiposity were positively associated with hypertension; hypertensive participants showed higher values in the scores of the indicators. Additionally, the body adiposity index (women) and conicity index (men) demonstrated greater ability to screen for hypertension, while the abdominal circumference and body mass index demonstrated greater ability to screen for non-hypertensive women and men, respectively.

Effects of dietary salt intake restriction on blood glucose levels: a meta-analysis of crossover study.

To identify modifiable risk factors for type 2 diabetes mellitus and explore the relationship between diet sodium intake and blood glucose levels. Based on inclusion and exclusion criteria, we extracted, analyzed, and assessed the available crossover studies of dietary salt intake restriction and insulin resistance in PubMed, Web of Science, MEDLINE, Embase, Wanfang, and CNKI databases. We included 6 studies with 8 sets of data, covering 485 subjects. I2 statistics results showed insignificant heterogeneity among all data (I2 = 39.2% < 50%). Thus, a fixed-effect model was adopted for the final pooled effect size. Weighted mean difference and its 95% confidence interval (CI) value was 0.193 (95% CI, 0.129-0.257), and the test of the overall effect showed P < 0.001. The results revealed that the blood glucose levels in the subjects in the low-salt intake group were significantly higher than those in the normal or high-salt intake groups. We also found no significant change occurred after the removal of any study through sensitivity analysis, which confirmed that the outcome we calculated was prudent and credible. The quantitative Egger's test (P = 0.109 > 0.05) indicated that insignificant publication bias existed. This meta-analysis highlights the relationship between dietary sodium intake and blood glucose levels. Our findings show that higher blood glucose levels might be expected in hypertensive or normal people with low-salt consumption compared to those with normal or high-salt consumption, although these differences were not clinically significant. PROSPERO Identifier: CRD42021256998.

PS-BPP05-8: THE ACCESSIBILITY OF SUBSIDIZED ANTIHYPERTENSION DRUGS AMONG THE HYPERTENSIVE POPULATION IN MONGOLIA, 2019–2021.

Objective: Cardiovascular diseases (CVD) are the leading cause of mortality in Mongolia, and hypertension is the major risk factor for CVD in the country. In this study, we aim to assess the accessibility of subsidized antihypertensive drugs among the hypertensive population in Mongolia to draw a picture of hypertension control and monitoring at Primary Healthcare Centers (PHC). Design and method: For this study, we processed the full national data on subsidized medicine to obtain the number of unique people who had a subsidized antihypertensive medicine prescription at least once every 3 months. This number was compared to the number of hypertensive people in Mongolia, which was estimated using the hypertension prevalence from the 2019 National STEPS survey and the census data. Results: In 2019, the number of people who consulted their primary physician and had the antihypertensive drugs prescribed at least every 3 months was 60468 which comprised 11.3% of all hypertensive people 15 years of age or older in Mongolia. This percentage increased to 12.7% (68339) in 2020 and 16% (87621). Across the 3 years, the rate of access to the subsidized antihypertensive medicine remains significantly higher among the female hypertensive compared to their male counterparts (2019: 15.5% vs 7.5%, OR = 1.55, P &lt; 0.001; 2020: 17.3% vs 8.3%, OR = 1.55, P &lt; 0.001; 2021: 21.9% vs 10.5%, OR = 1.62, P &lt; 0.001). In addition, across the 3 years, older age groups, especially the oldest group of 55 and older, were significantly more active when accessing the subsidized care, although the gap between the youngest (15–24 years) and older age groups narrowed in 2021 (OR of older age groups decreased in 2021, compared to previous years) (Table 1). Around 30 international non-proprietary names (INN) of antihypertensive drugs were subsidized in the years 2019–2020. Amlodipine, losartan, lisinopril, amlodipine + lisinopril, and bisoprolol were the five most prescribed subsidized drugs. Across the three years, the ratio between fixed-dose combination drugs and single active ingredient drugs subsidized by the Health Insurance Fund was 3:7. The most prescribed classes of subsidized single active ingredient drugs were angiotensin receptor blockers (ARB), followed by calcium channel blockers and ACE inhibitors. Fixed-dose combination drugs, beta-adrenergic blocking agents, and ARBs were significantly more prescribed in Ulaanbaatar (OR = 1.15, P &lt; 0.001; OR = 1.93, P &lt; 0.001; OR = 1.53, P &lt; 0.001), while diuretics, calcium channel blockers, and ACE inhibitors were significantly more prescribed in rural areas (OR = 1.15, P = 0.008; OR = 1.75, P &lt; 0.001; OR = 1.22, P &lt; 0.001). Conclusion: The percentage of the hypertensive population accessing subsidized medicine is insufficient. Subsidization not only increases the affordability of the medicine but also can serve as a tool for monitoring as the subsidy can only be accessed through PHC visits, so it can be inferred that the rate of accessing the subsidized medicine is also the rate of hypertension control at PCCs. We can observe a slight surge in the access rate in 2021, especially among the younger population. In 2021, the National Health Insurance Fund modified their policy, allowing citizens to obtain the subsidized medicine prescription any day of the month, as opposed to the 1st of every month like in previous years. Additional measures need to be taken specifically toward decreasing the gap between sexes, as males are accessing the subsidized care at lower rates, while CVD mortality remains higher among them.

Prevalence and management of hypertension in Central China: a cross-sectional survey.

We aimed to assess hypertension prevalence and management in Central China. In this cross-sectional study conducted from February 2019 to February 2020, we applied stratified multistage random sampling to investigate residents aged 35 to 75 years in Dancheng county of Zhoukou city and Xincai county of Zhumadian city, both in Central China. We enrolled 63,940 participants in this survey. A total of 43.6% (95% confidence interval [CI]: 43.2-44.0) of participants had hypertension. Of these, 49.3% (95% CI: 48.7-49.9) were aware of their diagnosis, 36.5% (95% CI: 35.9-37.1) took antihypertensive medication, and 14.3% (95% CI: 13.9-14.7) had their blood pressure under control. Only 31.4% of hypertensive people receiving antihypertensive treatment had achieved control. The hypertension prevalence was lower in urban areas than in rural areas, with higher rates of awareness, treatment, and control. Among subgroups, rural men had the highest prevalence of hypertension. Prevalence, awareness, and treatment rates all increased with age, except for control rates, which declined in the 65- to 75-year-old group. People in Central China have a high hypertension prevalence but low rates of awareness, treatment, and control. Great effort is needed to improve the prevention and management of hypertension in this region.

The Lifestyle of Hypertensive People and its Health Effects

Lifestyle changes have brought many problems in people like hypertension, hyperacidity, diabetes, heart disease, liver disease, kidney disease, cancer etc. Therefore, this study has been done to find out the effect of lifestyle on some people with high blood pressure in Kawasoti Nawalpur. This study was conducted using a convenient survey method and using an interview schedule. In this study, a sphygmomanometer and stethoscope were used to find out the blood pressure and a weighing machine and measuring tape were used to find out the body mass index (BMI) of the hypertensive people.A study of 320 people found that 108 people had high blood pressure. After analyzing the data, found that the analyzing main causes of hypertension in hypertensive people are; obesity (38.89%), alcohol consumption (55.56%), smoking (81.48%), more salt and junk food intake (74.07%), and living a sedentary lifestyle (35.19%) etc. The effects of hypertension on hypertensive people are; headache (82.40%), having trouble sleeping (50.92%), Dizziness (49.07%), shortness of breath (13.89%), epistaxis (8.33%), and feel palpitation (33.33%). They have tried to reduce hypertension by losing weight by doing many tasks like fasting once a week (68.51%), yoga or physical exercise (33.33%), reducing alcohol drinking and smoking habits (85.18%) etc. So, after finding out the main causes of hypertension, the researcher wants to suggest to hypertensive people to change their lifestyle including losing weight.

Reducing Blood Pressure on Elderly with Hypertension with Progressive Muscle Relaxation Therapy

Elderly is a process of life's journey of getting old. Physiological changes in the cardiovascular system experienced by the elderly are hypertension which occurs due to decreased elasticity of the arteries in the aging process. The purpose of this research was to analyze the effect of progressive muscle relaxation on reducing blood pressure in hypertensive elderly in Banjarejo Village. Pre-experimental research design with One group Pre-Post Test Design approach. The research sample is 30 elderly hypertension people with Quota Sampling. Research variables are progressive muscle relaxation therapy and blood pressure. Collecting data using observation sheets, using the Wilcoxon statistical test. The results showed that there were changes in blood pressure before and after therapy, namely systolic blood pressure -7.82 mmHg and diastolic blood pressure -5.54 mmHg. Wilcoxon statistical test showed p value = 0.000 which means there is a change in blood pressure in the elderly after doing progressive muscle relaxation therapy. The conclusion of this research shows that progressive muscle relaxation is a therapy that can be used to lower blood pressure in hypertensive patients.

Pharmacological Management of HIV Infection and Hypertension and its Impact on Disease Control in Hypertensive People Living with HIV

Pharmacological Management of HIV Infection and Hypertension and its Impact on Disease Control in Hypertensive People Living with HIV

783 RELATIONSHIP BETWEEN PULSE WAVE VELOCITY AND MYOCARDIAL WORK IN UNTREATED HYPERTENSIVE PATIENTS WITH PRESERVED LVEF

Abstract Introduction Hemodynamic interaction between left ventricular (LV) and arterial system is a key determinant of cardiovascular performance. The non-invasive carotid-femoral Pulse Wave Velocity (PWV), obtained with applanation tonometry, is considered the most precise way of estimating arterial stiffness. The LV myocardial work (MW), based on non-invasive LV pressure-strain loop (PSL), is a new promising tool to assess LV function. Aims The aim of the study was to evaluate the correlation between PWV and MW parameters in a population of non-hypertensive and newly diagnosed untreated hypertensive people. Materials and methods 80 people (M=48), divided in hypertensive (group 1 n=40, 45±10 years) and non-hypertensive (group 2 n=40, 40±12 years), were prospectively enrolled. All underwent conventional transthoracic echocardiogram and at the same day carotid femoral PWV was calculated with applanation tonometry (SphygmoCor® XCEL). MW parameters were obtained using 2D Speckle-tracking technique. Results Comparing the two groups, PWV and Global Work Wasted (GWW) were significantly higher in the hypertensives group (9,73±2,4 vs 7,79±1,1; p=0,001 and 146±50 vs 85±27, p=0,001), as shown in Figure 1, whereas Global Work Efficiency (GWE) and Global Work Constructive (GWC) were significantly lower (93,6±2,5 vs 95,6±1,2, p=0,001 and 2410±122 vs 2167±65, p=0,002). We found a linear and positive correlation of PWV with GWW (r=0,271, p=0,016), as seen in Figure 2, and a linear and negative correlation of PWV with GWE (r=-0,282, p=0,012). Conclusion This study highlights the role of PWV and MW evaluation in hypertensives. Higher PWV and GWW could be considered as red flags of myocardial damage suggesting the need of an early appropriate antihypertensive therapy.