Incidence Of Hypertension Research Articles

Meta-analysis of phase II/III randomized controlled trials (RCTs) to determine the incidence of hypertension and proteinuria in patients with gastrointestinal (GI) cancers treated with fruquintinib.

119 Background: Fruquintinib is a selective inhibitor of vascular endothelial growth factor receptors which impedes angiogenesis associated with tumor growth. On November 8th, 2023, the US FDA approved fruquintinib for use as a third-line treatment for metastatic colorectal cancer (mCRC). With the introduction of novel cancer therapies, monitoring for adverse events is critical. This meta-analysis aims to assess the risk of hypertension (HTN) and proteinuria in patients with GI cancers treated with fruquintinib. Methods: We conducted a comprehensive search of MEDLINE, EMBASE, and COCHRANE databases from inception through August 12th, 2024, identifying Phase II/III RCTs that employed fruquintinib in GI cancers and reported HTN and proteinuria as adverse effects. The Mantel-Haenszel method was used to calculate pooled risk ratios (RR) with 95% confidence intervals (CI). Heterogeneity was assessed using Cochran’s Q-statistic, and a random effects model was applied. Results: Our analysis included 1872 patients, 1131 (60%) of whom received fruquintinib, from three Phase III RCTs (FRESCO, FRESCO-2, FRUTIGA) and one Phase II RCT. FRESCO, FRESCO-2, and the phase II trials compared fruquintinib to placebo in patients with mCRC. FRUTIGA trial involved patients with gastric or gastroesophageal junction adenocarcinoma, comparing fruquintinib + paclitaxel to placebo + paclitaxel. The incidence of any-grade HTN was higher in the fruquintinib group, 34.92% vs 7.55% (RR 3.96; 95% CI: 3.05-5.13; P<0.00001); the rate of high-grade HTN was 13.96% vs 1.21% (RR 9.01; 95% CI: 4.67-17.40; P<0.00001). In the mCRC subgroup, incidence of any-grade and high-grade HTN was 43.02% vs 10.45% (RR 3.97; 95% CI: 2.95-5.33; P<0.00001), and 17.28% vs. 1.27% (RR 12.06; 95% CI: 5.19-28.01; P<0.00001), respectively. Incidence of any-grade proteinuria was also found to be statistically significant and higher in the fruquintinib arm in both GI cancer cohort and mCRC subgroup: 27.3% vs 16.19% (RR 1.89; 95% CI: 1.30-2.74; P=0.0008), and 25.22% vs 11.73% (RR 2.29; 95% CI: 1.17-4.51; P=0.02). The rate of high-grade proteinuria was not statistically significant in both cohorts. In GI cancer group, 1.85% vs 0.53% (RR, 2.49; 95% CI: 0.86-7.16; P=0.09), and mCRC subgroup 2.17% vs 0.51% (RR, 2.87; 95% CI: 0.74-11.12; P=0.13). Conclusions: This meta-analysis revealed a higher incidence of any-grade and high-grade HTN with fruquintinib in GI cancer patients, with significant association in the mCRC subgroup. Fruquintinib was also noted to be associated with increased risk of any-grade proteinuria, however, incidence of high-grade proteinuria was not different in patients treated with fruquintinib compared to placebo. Prompt identification and early management of these adverse events are crucial.

Diet quality and cardiometabolic health in breast cancer survivors: the Pathways Study.

Breast cancer (BC) survivors experience higher rates of cardiometabolic conditions, partly due to treatment. While healthy eating decreases the risk of these conditions in the general population, its association in BC survivors is unclear. We included 3415 participants from the Pathways Study, a prospective cohort of women diagnosed with invasive BC between 2005 and 2013 and followed through 2021. Concordance of food intakes from food frequency questionnaires was estimated for five healthy eating patterns at BC diagnosis: Dietary Approaches to Stop Hypertension (DASH), healthy Plant-based Dietary Index (hPDI), 2020 Healthy Eating Index (HEI), American Cancer Society nutrition guidelines (ACS), and the alternate Mediterranean Diet Index (aMED). Incident hypertension, diabetes, and dyslipidemia were identified through electronic health records. Cumulative incidence rates (CIRs) were estimated accounting for the competing risk of death. Covariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Fine and Gray regression models, stratified by BC treatment status. Over an average 11.5years (range = 0.3-16.3) of follow-up, 554 (16.2%) participants developed hypertension, 362 (10.6%) developed diabetes, and 652 (19.1%) developed dyslipidemia. CIRs for any cardiometabolic condition 15years after BC diagnosis were 39.2% for women in the highest HEI quartile compared to 49.3% in the lowest. After adjustment, women in the highest HEI quartile had lower risks of any cardiometabolic condition (HR = 0.70, 95% CI 0.54-0.91,Ptrend = 0.006), including hypertension (HR = 0.71, 95% CI 0.54-0.94,Ptrend = 0.007), diabetes (HR = 0.57, 95% CI 0.41-0.79,Ptrend < 0.001), and dyslipidemia (HR = 0.77, 95% CI 0.59-0.99,Ptrend = 0.04). Similar associations were observed for DASH, hPDI, and ACS with diabetes incidence. Healthier diets at BC diagnosis, particularly those aligned with the HEI, were associated with lower cardiometabolic risks.

Incidence and Risk of Thromboembolic and Cardiovascular Adverse Events with PARP Inhibitor Treatment in Patients with Metastatic Castration-resistant Prostate Cancer: A Systematic Review and Safety Meta-analysis.

PARP inhibitor (PARPi) treatment is an effective option for patients with metastatic castration-resistant prostate cancer (mCRPC). There are few data on the cardiovascular and thromboembolic safety of these agents in mCRPC, as cardiovascular and thromboembolic adverse events (AEs) are uncommon. Our aim was to analyze the incidence and risk of major adverse cardiovascular events (MACEs), thromboembolic events, and hypertension with PARPi therapy in mCRPC. We conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We systematically searched the PubMed, EMBASE, and Cochrane databases and the American Society of Clinical Oncology and European Society of Medical Oncology meeting abstracts for clinical trials on PARPi use in mCRPC up to March 31, 2024. We analyzed the pooled incidence of all-grade and high-grade MACEs, thromboembolic events, and hypertension, and calculated risk ratios (RRs) for PARPi versus non-PARPi treatment. We included 11 phase 2 or 3 trials in our meta-analysis. Hypertension was the most common AE for both any-grade (17.2%) and high-grade (9.3%) events. In comparison to other treatments, PARPi was associated with significantly higher risk of high-grade MACEs (RR 2.03; p=0.03) and thromboembolic events (RR 2.15; p=0.002), especially venous thromboembolism (VTE; RR 2.13; p=0.004) and pulmonary embolism (RR 3.60; p=0.001). The risk of hypertension, any-grade MACEs, and thromboembolic AEs was not significantly higher, apart from VTE (RR 2.17; p=0.01). There is higher risk of high-grade cardiovascular and thromboembolic toxicity with PARPi use in comparison to other treatments in mCRPC, although these toxicities are rare. Clinicians should be aware of this risk, especially in a population that often has comorbidities and concomitant treatments, for correct monitoring and management of these AEs. Drugs called PARP inhibitors are very effective in the treatment of metastatic prostate cancer that does not respond to hormone treatment. However, their use is associated with some cardiovascular adverse events, although these are rare. Our study shows that these events seem to be more frequent with PARP inhibitors than with other treatments, especially for severe grades. Doctors and patients should be aware of this risk to help in preventing, recognizing, and managing the occurrence of these rare complications.

P-575. Evaluation of Weight Gain on Incident Hypertension among People Living with HIV-1 Receiving Dolutegravir (DTG)-Based Regimens or Comparator Antiretroviral Therapy (cART) in Randomized Clinical Trials through 96 Weeks

Abstract Background Weight gain has been observed with integrase strand transfer inhibitor (INSTI)-based treatment with an association between INSTI use and hypertension (HTN) in some studies. We observed no difference in odds of incident HTN and minimal weight increase in participants receiving DTG-based or comparator antiretroviral therapy (cART) through Week (W)96. Here, we evaluated the relationship between ART use, weight gain, and HTN risk among participants without baseline (BL) HTN receiving DTG or cART in pooled phase 2/3 studies. Methods Data from ART-naive participants randomized to either DTG-based ART (+ ABC/3TC or TDF/FTC), or cART (EFV/TDF/FTC, RAL + 2 NRTIs, or DRV/r + 2 NRTIs), were pooled from the SPRING-1 and -2, SINGLE, and FLAMINGO trials. HTN at BL, W24, W48, and W96 was defined as a single systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg, HTN history or HTN adverse event, and/or antihypertensive use. Mixed-models repeated-measures (MMRM) analyses evaluated adjusted change from BL in weight. Bayesian Joint Models (JM) evaluated the associations between treatment, weight change, and treatment and weight change interaction with HTN risk. Models were adjusted for key BL variables and pooled treatment. Results Among 2345 participants, 23% (n=530) were excluded for BL HTN; of the remaining, 927 received DTG-based ART and 888 received cART. At W96, adjusted mean (SE) change in weight was 1.98 (0.242) kg for DTG-based ART vs 1.59 (0.212) kg for cART (treatment difference: 0.39 kg; 95% CI: −0.25, 1.04; P=0.230). From JM, treatment (DTG-based ART vs cART) was not independently associated with HTN risk through W96 (mean, M [hazard ratio, HR]: 1.099; 95% credible interval [CrI]: 0.876, 1.370). On average, a 1-kg increase in weight was estimated to increase HTN risk (HR) by 1.012 (CrI: 1.004, 1.020). No evidence of treatment separation was observed through the treatment-weight interaction (DTG-based ART HR: 1.013 [1.003, 1.022]; cART HR: 1.009 [0.998, 1.020]). Conclusion Weight gain was moderately associated with HTN risk through W96. ART was not an independent risk factor for HTN. Weight gain attributed to treatment effect impacted HTN risk similarly. Disclosures Clifford B. Jones, BSc MSc MB ChB, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Sofia Pozsonyiova, MS, GSK: Employee|GSK: Stocks/Bonds (Public Company) Richard Grove, MSc, GSK: Employee|GSK: Stocks/Bonds (Public Company) Michael McKenna, MBChB, GSK: Employee|GSK: Stocks/Bonds (Public Company) Parul Patel, MSW, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee

Association of left atrial strain with hypertension in pregnancy: a prospective observational study.

Abstract Introduction Maternal hypertension, be it gestational or pre-existing, has been a health concern throughout the modern world. Although advances in healthcare have drastically improved the outcome of pregnancies in the past decade or so, the increasing age of expectant mothers, as well as the prevalence of hypertension in the general population and its associated complications, have dealt a different dilemma for current medical practitioners. Hypertension was documented as the 3rd third leading cause of maternal mortality in the Philippines. Studies also showed that Filipinos, when compared to their other Asian counterparts, have a higher incidence of maternal hypertension and its complications. Left atrial strain, a non-invasive, early marker of diastolic dysfunction, has been studied as predictor of chronicity of cases of gestational hypertension. As of writing of this paper, no local study using left atrial strain has been conducted on Filipino people, less so for pregnant women. Hence, further investigation to determine the baseline values and the effect of hypertension in left atrial strain in this population is warranted. Objectives This study aims to determine the relationship between left atrial strain using 2D echocardiogram and the presence of hypertension in pregnant Filipino women. Methods This was a single center, prospective, cross-sectional observational study involving pregnant patients seen at a tertiary hospital. The primary endpoint was the difference in left atrial strain and compliance between hypertensive and non-hypertensive subjects. For comparison, demographics and other systolic and diastolic echocardiographic parameters were evaluated. A sub-analysis between gestational and chronic hypertensive patients was also done. Results Twenty-six pregnant patients between 20 to 38 weeks age of gestation were divided into hypertensive (n=7) and normotensive (n=19) groups. Age (p=0.938), gestational age (p=0.909), and other co-morbidities were comparable between both groups. The left atrial reservoir strain (LASr) was significantly lower in hypertensive patients (32.15 ± 6.17%) compared to normotensive patients (43.85 ± 4.50%), indicating impaired left atrial function in hypertensive individuals (p&amp;lt;0.001). Left atrial compliance was also significantly lower in the hypertensive group (p=0.006), suggestive of elevated filling pressure. Comparison between gestational (n=2) and chronic hypertensive patients (n=5) yielded minimal difference in strain values. Conclusion Aside from the physiologic decrease in left atrial strain in pregnancy, the presence of hypertension further decreases left atrial function, specifically, the left atrial reservoir strain and compliance, despite normal standard echo parameters. Its implication on the future cardiac complication requires further investigation. LA strain: Normotensive pregnant woman LA strain: Hypertensive pregnant woman

Comparative safety profile of tyrosine kinase inhibitors in NSCLC: a network meta-analysis of hypertension and thrombotic risks

BackgroundThis study examines the risks of hypertension and thrombotic events in NSCLC patients treated with Tyrosine Kinase Inhibitors (TKIs).ObjectiveTo compare the safety profiles of TKIs used in NSCLC treatment, focusing on hypertension and thrombotic risks.MethodsA comprehensive search identified randomized controlled trials evaluating the effects of TKIs in NSCLC patients. Bayesian network meta-analysis was employed to construct a comparative network of treatments.ResultsThirty studies involving 11,375 patients were included. Erlotinib had the lowest incidence of hypertension (SUCRA: 91.1%), followed by chemotherapy (88.8%). For thrombotic events, Erlotinib had the lowest risk (SUCRA: 66.1%), while Anlotinib and Cabozantinib had the highest thrombotic risks (SUCRA: 26.9%).ConclusionErlotinib presents the lowest risk for hypertension and thrombotic events, making it a preferred choice for NSCLC patients with cardiovascular concerns.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42024530770.

Involvement of Maternal and Socioeconomic Risk Factors in the Incidence of Fetal Growth Restriction in a Large Maternity Hospital in Romania

Background: Fetal growth restriction (FGR) refers to a condition in which a fetus does not reach its genetically predetermined growth potential due to various pathological factors of maternal or fetal origin, with potential long-life consequences, such as elevated blood pressure, type 2 diabetes mellitus, obesity, dyslipidemia, atherosclerosis. Aim: The purpose of our research is to delve into the intricate relationship between economic and social factors and the occurrence of FGR. Methods: We analyzed risk factors previously associated with FGR and aimed to compare them between two cohorts of infants with FGR: a historical cohort of infants born from 2010 to 2012 and a contemporary cohort of infants born from 2020 to 2022. Results: The global incidence of FGR in our study was 5.13%, with non-significant differences between the two time periods: 5.03% in the historical cohort and 5.25% in the contemporary cohort. More mothers of FGR infants receive formal education and are employed in the contemporary group and thus have a more stable income. There was a major decrease in the number of preterm infants with FGR, from 23.9% in the historical cohort to 5.9% in the contemporary cohort (p &lt; 0.001). Compared to the historical cohort, we found significant increases in the incidence of pregnancy-induced hypertension, Cesarean sections, and prenatal follow-up in the contemporary cohort (8.3% vs. 3.8%, p &lt; 0.001; 59.2% vs. 49.9%, p &lt; 0.001; 67.7% vs. 49.6%, p &lt; 0.001, respectively) and we also found significant correlations between prenatal care on one side and maternal smoking, urban residence, higher maternal education, and prematurity on the other. Conclusions: Certain socioeconomic factors show definite improvements over the ten-year timespan, which results in an increase in prenatal care and a decrease in the rate of prematurity. However, the incidence of FGR remains constant over the considered period, meaning that other factors, apart from socioeconomic factors, play a substantial role. Recognizing these risk factors is crucial for developing effective public health strategies aimed at reducing the incidence of FGR and improving maternal and child outcomes.

Childhood body size, adulthood adiposity, underlying mechanisms, and risk of incident hypertension: a prospective cohort study of 180,527 participants

BackgroundMechanisms underlying the association of life-course adiposity with incident hypertension in adulthood have not been comprehensively investigated. In this study, we aimed to investigate the potential biochemical and metabolomic mechanisms underlying the association between adiposity and incident hypertension.MethodsA total of 180,527 participants from the UK Biobank aged 37 to 73 years were included. Associations of childhood body size or adulthood adiposity status as well as child–adult weight status change with incident adulthood hypertension were estimated by multivariate Cox proportional regression models.ResultsParticipants with childhood thinner body size and adulthood obesity had the highest risk of incident hypertension (hazard ratio, HR = 3.09, 95% CI = 2.88–3.32) compared with those with “average → normal” pattern, followed by those with “average → obese” pattern (HR = 2.45, 95% CI = 2.31–2.61) and “plumper → obese” pattern (HR = 2.82, 95% CI = 2.62–3.02). Of note, those with “plumper → normal” pattern (HR = 1.11, 95% CI = 1.00–1.23) and “thinner → normal” pattern (HR = 1.17, 95% CI = 1.10–1.24) had the second and third lowest risk of incident hypertension. Adulthood overweight (mediation proportion: 58.7%, 95% CI: 40.4–74.8%) or obesity (mediation proportion = 46.7%, 95% CI: 29.4–64.9%) largely mediated the association between childhood plumper body size and hypertension. The association between adiposity and hypertension was mediated by biochemical indices (e.g., liver function, immunometabolism) and metabolites (e.g., alanine aminotransferase, apolipoprotein A) (mediation proportions ranging from 3.2 to 23.4%).ConclusionsThinner or plumper body size in childhood increases the risk of incident adulthood hypertension, and adulthood adiposity partly mediated this association, suggesting the importance of maintaining normal weight across the life course. Several biochemical indices and metabolites mediated these associations providing clues to underlying biological mechanisms.

The link between the atherogenic index of plasma and the risk of hypertension: Analysis from NHANES 2017-2020.

The atherogenic index of plasma (AIP) is a newly identified metabolic marker for atherosclerosis. However, there are inconsistent conclusions regarding the relationship between AIP and hypertension. The study subjects were sourced from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020. Logistic regression analyses were employed to explore the correlation between AIP and hypertension. The value of AIP in predicting hypertension was assessed using ROC curves, and their nonlinear relationship was described using restricted cubic splines (RCS). Subgroup analyses, interactions, and sensitivity analyses were also conducted. The study included 7,067 participants who were sourced from the NHANES database. There were 2723 participants diagnosed hypertension. We observed a notable correlation between AIP and hypertension (OR:1.89, 95%CI: 1.11-3.22, P = 0.019). ROC curve showed AIP had a good predictive value for the onset of hypertension, with the AUC of 0.652 (95% CI:0.639-0.664, p<0.001). RCS found that there existed a nonlinear association between AIP and the incidence of hypertension (p<0.001). Even after excluding individuals under the age of 40 years old, the results still indicate a strong association between AIP and hypertension. AIP may serve as an early biological marker for identifying hypertension, facilitating early screening of susceptible populations.

The Correlation Between Gravidity and Hypertension in Pregnancy at Baamang 2 Health Center Sampit 2023

Hypertension in pregnancy is still one of the three biggest contributors to maternal mortality and the percentage of cases is still quite high both in the world, nationally, provincially, and district/city. The most common causes of death in Central Kalimantan in 2022 are bleeding at 50.7% and hypertension in pregnancy at 14.2%. The regency/city with the highest number of maternal deaths in Central Kalimantan is East Kotawaringin Regency with 11 cases in 2022, most of these maternal deaths occur due to bleeding, hypertension in pregnancy, and other causes. Some of the factors that cause HDK include age, nutritional status, history of diabetes mellitus (DM), genetics, history of hypertension, multiple pregnancies, stress/anxiety, and related to gravidity. The purpose of this study is to determine the relationship between gravidity and the incidence of hypertension in pregnancy at the Baamang 2 Sampit Health Center in 2023. This research method uses a quantitative method that is analytical with a cross sectional approach. The research samples were taken using a total sampling technique of 55 pregnant women who experienced hypertension in pregnancy at the Baamang 2 Sampit Health Center in 2023. The analysis method used is the Spearman Rank test. Based on the results of data processing through the Spearman Rank test, a ρ value of 0.491 or greater than 0.05 was obtained. The conclusion from the results of data analysis is that there is no significant correlation between gravidity and the incidence of hypertension in pregnancy at the Baamang 2 Sampit Health Center in 2023.

A novel two-stage and combined treatment of primary open-angle glaucoma and cataract: comparative efficacy and complications

Background. The approach to the treatment of patients with primary open-angle glaucoma and cataract is still a subject of debate, because when choosing a particular type of procedure, as well as determining the timing of its performance, it is necessary to consider a significant number of factors that may affect success of treatment. There are limited data on the outcomes of combined treatment of patients with primary open-angle glaucoma and complicated cataract, which includes phacoemulsification with intraocular lens (IOL) implantation and micropulse transscleral cyclophotocoagulation (MP-TSCPC). The purpose is to compare efficacy and to study the nature and frequency of complications when using novel, two-stage and combined surgical and laser methods for treating primary open-angle glaucoma with cataract. Materials and methods. The study includes 112 patients (112 eyes) with primary open-angle glaucoma stage I–IV and complicated cataract. There were 3 observation groups. In the first one (n = 34), phacoemulsification with IOL implantation was performed 1 month prior to MP-TSCPC. The second group (n = 36) included patients who underwent phacoemulsification with IOL implantation a month after MP-TSCPC. In the third group (n = 42), phacoemulsification with IOL implantation and MP-TSCPC were performed in one procedure. These groups did not statistically differ in terms of age, gender, baseline intraocular pressure, stage of primary open-angle glaucoma and nuclear lens density. The primary outcome measure was the normalization of intraocular pressure with or without the use of antiglaucoma medications and without need for repeated laser and incisional procedures after 1, 3 and 6 months. The secondary outcome measure was stabilization or expansion of visual fields 1, 3, and 6 months after treatment. The complication nature and rates were evaluated. Results. In the third group, where combined treatment was performed, the incidence of transient hypertension and inflammatory complications was statistically higher. There was a tendency to a higher incidence of corneal edema, cystoid macular edema, and hypotony as well; 7.1 % of patients required repeated MP-TSCPC, but this was statistically insignificant. According to the survival analysis, a statistically significant difference was found between the three groups in functional (p = 0.036) and hypotensive outcomes (p = 0.046), with the best result in the second group at 6 months of follow-up. Conclusions. The efficacy assessed by hypotensive and functional outcomes at a follow-up period of 6 months appeared to be statistically lower in the group of combined treatment compared to the groups in which two-stage treatment was conducted.

The influence of different forms of apple products on all-cause mortality in patients with hypertension

ObjectiveApple consumption has a positive effect on human health. Some studies have shown that an appropriate amount of apple intake can reduce the incidence of hypertension. However, few studies have investigated whether eating different forms of apples has the same benefits as eating whole apples. This study is aimed to evaluate the effect of different forms of apple on all-cause mortality in patients with hypertension.MethodsThe study included 2,368 patients with hypertension. All participants were followed up for at least 10 years. Cox regression model was constructed to analyze the correlation between apple, apple juice, and apple sauce consumption and all-cause mortality in patients with hypertension.ResultsThe consumption of apples 3–6 times/week was associated with a 48% reduction in the risk of all-cause mortality in patients with hypertension (HR = 0.52, 95% CI: 0.37–0.72, p &amp;lt; 0.001). However, the consumption of apple juice (HR = 1.02, 95% CI: 0.67–1.56, p = 0.930) and sauce (HR = 1.28, 95% CI: 0.59–2.74, p = 0.531) tended to increase the risk of death in patients with hypertension, although this study did not obtain a statistically result.ConclusionModerate consumption of whole apples is associated with a reduced risk of all-cause death in patients with hypertension, whereas apple juice and sauce may increase the risk of death.

Socio-hygienic portrait of patients with arterial hypertension in Kazakhstan in modern conditions

Introduction. The article notes that the greatest contribution to the structure of causes of death and disability associated with cardiovascular diseases identified as a result of the study falls on patients with arterial hypertension. Social and hygienic portrait of a patient with arterial hypertension. Age – most often occurs in people over 40 years of age, the most common age is 40-60 years, the highest incidence is observed in this age group. At this age, there is a physiological aging of the vessels and an increase in blood pressure. After over 60 years: the incidence increases and the detection of AG among older people increases significantly due to age-related changes in the circulatory system and the presence of concomitant diseases. Among men by gender, the incidence of hypertension is most often observed in men in young and middle age (up to 60 years). This is due to high levels of stress, alcohol consumption, smoking and a sedentary lifestyle. And among women, the difference in morbidity between the ages of 60 and older decreases, and women begin to suffer from hypertension as much as men. This can lead to an increase in blood pressure due to changes in the hormonal background, especially after menopause.In terms of social characteristics, a low level of education may predispose to not being aware of the risks associated with arterial hypertension, as well as a healthy lifestyle.Aim. To characterize the modern socio-hygienic characteristics of the personality of patients with arterial hypertension.Materials and methods. A comprehensive medical and sociological study was conducted from 2020 to 2023 on the basis of Karaganda city polyclinic No. 3. The research program is implemented in accordance with the goals and objectives of the doctoral work, and the research practice is based on specific criteria. Results and discussion. Among the respondents, the largest number were patients aged 54-62 years (N = 241; 58.1%). In addition, the proportion of representatives of this age group among the women surveyed exceeded the statistically significant (p&lt;0.05) similar indicator among men (67.4 and 45.3%, respectively).Conclusion. The results of our study confirm that, like other authors who conducted similar studies when planning and implementing preventive measures related to hypertension, men of working age should be especially attentive as a category of people with more pronounced risk factors for hypertension and rarely spread to medical organizations.

Analysis of clinical characteristics and risk factors for patients with heat stroke in western China in 2022: a multicenter retrospective study

ObjectivesTo analyzed the clinical characteristics and treatment modalities of heat stroke (HS) and to identify risk factors for a poor prognosis of HS and provide reference suggestions for its treatment and prevention.Measurements and main resultsWe enrolled a total of 247 patients, with hypertension, diabetes, and psychosis being the top three comorbidities associated with HS. The incidence of HS was higher among males and older individuals. Compared to the control group, the poor prognosis group experienced higher temperatures, a higher incidence of cerebral edema, and gastrointestinal bleeding (all p &amp;lt; 0.05). The poor prognosis group had significantly higher blood pH, HCO3-, Lac, Scr, AST, ALT, DBIL, CKMB, PT, DD, and PLT (all p &amp;lt; 0.05). Furthermore, logistic regression analysis revealed that Lac, Scr, and APACHE II were risk factors for poor prognosis (p &amp;lt; 0.05). The AUC values for the combined diagnostic model were 0.848 (95% CI: 0.781–0.914). Male morbidity, the number of patients with combined hypertension, the prognosis, and the APACHE II score and ALT level were all greater (p &amp;lt; 0.05) in the CHS group. The Kaplan–Meier analysis revealed that the CHS group had a significantly higher mortality rate than the EHS group.ConclusionA high incidence of hypertension, diabetes, psychosis, men, and older persons may be associated with HS. HS patients with high blood cell counts, impaired coagulation, liver and kidney diseases, and those with a specific type of CHS may face a poor prognosis. In patients with heart failure, APACHE II, Lac, and Scr were independent risk factors for a poor prognosis.

Nd:YAG Laser Iridotomy Versus Surgical Iridectomy in Descemet Membrane Endothelial Keratoplasty: Comparison of Postoperative Outcome and Incidence of Ocular Hypertension.

To evaluate outcome and incidence of ocular hypertension after Descemet membrane endothelial keratoplasty (DMEK) and DMEK combined with cataract surgery (triple DMEK) after Nd:YAG laser iridotomy (IO) and surgical iridectomy (IE). This is a single-center, retrospective cohort study of patients who underwent DMEK or triple DMEK surgery at the Department of Ophthalmology, University Hospital Düsseldorf, Germany, from January 2018 to June 2020 and had received either a prophylactic preoperative IO or an intraoperative IE. Patient demographic data; best corrected visual acuity; central corneal thickness; intraocular pressure (IOP); endothelial cell density; and complications such as occurrence of early postoperative IOP elevation, macular edema, rebubbling rate, and incidence of glaucoma were analyzed. A total of 75 patients were included in each study arm with a follow-up of 22.04 ± 12.8 months. Best corrected visual acuity significantly increased postoperatively in both cohorts without significant differences. Early postoperative IOP elevation due to pupillary block was significantly more common in eyes with IO (33.3%, n = 25) than with IE (2.67%, n = 2, P < 0.001). The incidence of de novo glaucoma was 5.34% in both cohorts without significant differences in prevalence at the last follow-up (YAG IO cohort: 17.3%, IE cohort: 14.7%, P > 0.05). Rebubbling was required in 16% (n = 12) of eyes in each cohort (P > 0.999). Postoperative pupillary block after DMEK occurs significantly more often after preoperative Nd:YAG laser iridotomy compared with surgical intraoperative iridectomy but does not negatively affect long-term visual outcome or glaucoma incidence after DMEK.

Detection of hypertension and blood pressure phenotypes using ambulatory blood pressure monitoring in women with past hypertensive disorders of pregnancies.

To evaluate the incidence of hypertension and blood pressure (BP) phenotypes using 24-hour ambulatory BP (24hr-ABP) in women with past pregnancy complications who were recruited into a Women's Heart Clinic (WHC). We recruited 156 women aged 30-55years with past hypertensive disorders of pregnancy (HDP) and/or gestational diabetes (GDM) to a multidisciplinary six-month WHC that provided cardiovascular risk management in Melbourne, Australia. Women were referred for 24hr-ABP monitoring if clinic BP was ≥130/80mmHg. Primary outcome was incident hypertension, defined by 24hr-ABP monitoring as daytime hypertension ≥135/85mmHg, nocturnal hypertension ≥120/70mmHg, and/or 24hr-average hypertension ≥130/80mmHg. From 156 women, 54 women underwent 24hr-ABP monitoring (mean age 41.3±4.5years; 3.9±2.6years post-partum), with 64.8% HDP and 45.2% GDM. Incidence of hypertension was 61.1% [95% CI 48.2%-74.0%]. Higher proportion of women with past HDP had daytime hypertension compared to those with GDM only (57.1% vs. 26.3%; p=0.05) and higher nocturnal mean systolic-BP [116.0±11.2mmHg vs. 109.6±8.7mmHg; p=0.04]. Women with HDP had increased odds of hypertension [adjusted-OR 5.26 95% CI (1.07-32.76); p=0.05]. Following management at the WHC, women diagnosed with hypertension had significantly improved BP control (6.1% at baseline vs. 75.8% at six-month follow-up; p<0.001). Women with past HDP had five-fold increased incidence of hypertension, with higher daytime hypertension and nocturnal systolic-BP, compared to women with GDM. After attending WHC, BP control significantly improved. Our findings suggest routine postpartum follow-up with 24hr-ABP monitoring, through a WHC, may be useful in early detection and management of hypertension in these women.

ASSOCIATION OF ANTI-KU AUTOANTIBODIES AND SOME ORGAN DAMAGE OF AUTOIMMUNE CONNECTIVE TISSUE DISEASES

Objective: To assess the association between anti-Ku antibodies and organ damage in common autoimmune connective tissue diseases. Materials and Method: This was a descriptive, cross-sectional, retrospective, and prospective study involving 215 patients diagnosed with autoimmune connective tissue diseases, including systemic sclerosis, systemic lupus erythematosus, dermatomyositis, and overlap syndromes of ACTDs, treated at the National Hospital of Dermatology and Venereology from January 2021 to December 2022. Patients were tested for the presence of anti-Ku antibodies using the ANA 23 profile test kit. Result: Out of the 215 patients in the study, 60 (27.9%) tested positive for anti-Ku antibodies, predominantly at a weak level (1+). Among these, 43.3% had systemic lupus erythematosus, 10% had systemic sclerosis, 18.3% had dermatomyositis, and 28.3% had overlap syndromes of ACTDs. The group with positive anti-Ku antibodies exhibited a higher incidence of butterfly rash and mouth ulcers. The positive anti-Ku antibody group had a significantly higher rate of elevated muscle enzymes (53.3%) compared to the negative group (29.7%) (p = 0.001). Additionally, the incidence of pulmonary arterial hypertension was 39.5%, with the positive anti-Ku antibody group having a higher rate (61.7%) than the negative group (31%) (p &lt; 0.05). High-resolution computed tomography revealed interstitial lung lesions in 37.2% of the patients, with no significant difference between the positive and negative groups. Conclusion: Anti-Ku antibodies are relatively prevalent in patients with autoimmune connective tissue diseases, particularly in systemic lupus erythematosus and overlap syndromes of ACTDs. Patients with positive anti-Ku antibodies are at a higher risk of developing acute skin lesions in systemic lupus erythematosus, muscle damage with elevated muscle enzymes, and pulmonary arterial hypertension compared to those without these antibodies. Received 14 August 2023Revised 13 September 2023Accepted 03 November 2023

Characteristics of patients with polymyalgia rheumatica based on glucocorticoid dose in Japan: A cohort study using routinely collected health data.

This study aimed to describe the characteristics, inflammatory markers as surrogates for disease activity, and treatment of patients with polymyalgia rheumatica (PMR) in Japan. This cohort study analysed the data of 373 patients with PMR retrieved from an electronic medical records database in Japan. Patients were classified into quartiles, based on the daily glucocorticoid dose over the initial 90 days of treatment (Q1-Q4). The low glucocorticoid dose group (Q1) had more patients aged ≥90 years (11.7%), and a higher prevalence of comorbidities. At 52 weeks, glucocorticoid-free remission was achieved in 10% of patients, and higher C-reactive protein levels were observed during the follow-up period. In contrast, the high glucocorticoid dose group (Q4) exhibited a slower decline in C-reactive protein levels and more events of increased glucocorticoid dose compared to Q1-Q3. The introduction of methotrexate was low, with 4.3% to 7.3% of patients. The incidence of osteoporosis and diabetes was higher in patients <75 years, whereas the incidence of hypertension was higher in patients ≥75 years. Patients refractory to high glucocorticoid doses were identified. Patients receiving inadequately low doses of glucocorticoids were older with more comorbidities. This study highlights the unmet medical needs for PMR.

Additive interaction of conjoint tobacco smoking and heavy drinking on hypertension prevalence in rural Uganda: a community-based cross-sectional study

BackgroundThe prevalence of hypertension is high in Uganda, which places a significant burden on an already strained healthcare system. The behavioural risk factors, such as unhealthy diet, tobacco use, physical inactivity, and heavy drinking, contribute to hypertension development and complications. This study explored the associations of combined tobacco smoking and heavy alcohol consumption with existing hypertension in a community-based cross-sectional study conducted in two rural districts of Uganda.MethodsWe analysed data collected between December 2018 and January 2019 from 4,372 adults aged 25–70 from 3,689 random households in the Mukono and Buikwe districts, Uganda. Using logistic regression, crude, and adjusted odds ratios were calculated to describe the associations between participant characteristics, smoking, drinking behaviours, and high blood pressure (HBP). To determine effect modification due to combined tobacco smoking and heavy drinking, the relative excess risk due to interaction (RERI) was computed. All analyses were performed via R programming software version 4.2.3.ResultsHBP was prevalent in 23% of the participants. Smokers were 1.36 times more likely to have HBP than non-smokers (Crude OR, 1.36; 95% CI, 1.04–1.76). Compared with non-drinkers, moderate alcohol drinkers were 1.45 times more likely to have HBP (AOR, 1.45; 95% CI, 1.18–1.79), and heavy drinkers were 2.53 times more likely to have HBP (AOR, 2.53; 95% CI, 1.92–3.32). The RERI indicated an additive interaction effect between smoking and heavy drinking, with conjoint smokers and heavy drinkers having 45% higher odds of having HBP than the summation of the individual risk due to smoking and heavy drinking.ConclusionTobacco smoke interacts with heavy alcohol consumption to increase the risk of increased blood pressure (BP) when it cooccurs. Integrated intervention strategies targeting both smoking and heavy drinking are essential for reducing the incidence of hypertension in rural Uganda.

Depression and Incident Hypertension: The Strong Heart Family Study.

Compared with White Americans, American Indian adults have disproportionately high depression rates. Previous studies in non-American Indian populations report depression as common among people with uncontrolled hypertension, potentially interfering with blood pressure control. Few studies have examined the association of depressive symptoms with hypertension development among American Indians despite that population's high burden of depression and hypertension. We examined the association of depressive symptoms with incident hypertension in a large cohort of American Indians. We studied 1,408 American Indian participants in the Strong Heart Family Study, a longitudinal, ongoing, epidemiologic study assessing cardiovascular disease and its risk factors among American Indian populations. Depressive symptoms were assessed by using the Center for Epidemiological Studies-Depression (CES-D) scale, 2001-2003. At each study examination in 2001-2003 and 2007-2009, blood pressure was measured 3 times. The average of the last 2 measurements taken at baseline and follow-up examinations was used for analyses. Incident hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure of ≥90 mm Hg, or use of hypertension medications at follow-up. To account for within-family correlation, we used generalized estimating equations to examine the association of depressive symptoms with incident hypertension. During follow-up, 257 participants developed hypertension. Participants with symptoms consistent with depression (CES-D ≥16) at baseline had 54% higher odds of developing hypertension during follow-up (OR = 1.54; 95% CI, 1.06-2.23) compared with those without depression (CES-D <16) at baseline after adjustment for other risk factors. These data suggest that participants who experienced symptoms consistent with depression were at increased odds of incident hypertension.