Hypertensive Group Research Articles

Chronic kidney disease and its association with cerebral small vessel disease in the general older hypertensive population

BackgroundCerebral small vessel disease can be identified using magnetic resonance imaging, and includes white matter hyperintensities, lacunar infarcts, cerebral microbleeds, and brain atrophy. Cerebral small vessel disease and chronic kidney disease share many risk factors, including hypertension. This study aims to explore an association between chronic kidney disease and cerebral small vessel disease, and also to explore the role of hypertension in this relationship.MethodsWith a cross sectional study design, data from 390 older adults was retrieved from the general population study Good Aging in Skåne. Chronic kidney disease was defined as glomerular filtration rate < 60 ml/min/1,73m2. Associations between chronic kidney disease and magnetic resonance imaging markers of cerebral small vessel disease were explored using logistic regression models adjusted for age and sex. In a secondary analysis, the same calculations were performed with the study sample stratified based on hypertension status.ResultsIn the whole group, adjusted for age and sex, chronic kidney disease was not associated with any markers of cerebral small vessel disease. After stratification by hypertension status and adjusted for age and sex, we observed that chronic kidney disease was associated with cerebral microbleeds (OR 1.93, CI 1.04–3.59, p-value 0.037), as well as with cortical atrophy (OR 2.45, CI 1.34–4.48, p-value 0.004) only in the hypertensive group. In the non-hypertensive group, no associations were observed.ConclusionsIn this exploratory cross-sectional study, we observed that chronic kidney disease was associated with markers of cerebral small vessel disease only in the hypertensive subgroup of a general population of older adults. This might indicate that hypertension is an important link between chronic kidney disease and cerebral small vessel disease. Further studies investigating the relationship between CKD, CSVD, and hypertension are warranted.

Clinical diagnosis of pheochromocytoma and paraganglioma-induced secondary hypertension through UPLC-MS/MS analysis of plasma catecholamines and their metabolites.

This study aimed to elucidate the clinical diagnostic value of plasma catecholamines and their metabolites for pheochromocytoma and paraganglioma (PPGL)-induced secondary hypertension using ultraperformance liquid chromatography-mass spectrometry (UPLC-MS/MS). The study population included 155 patients with PPGL that were divided into the PPGL with hypertension (n=79) and a PPGL without hypertension (n=76) groups, and 90 healthy volunteers and 90 patients with primary hypertension as the control groups. UPLC-MS/MS was performed to detect plasma levels of catecholamines and their metabolites, including dopamine, vanillylmandelic acid (VMA), norepinephrine, metanephrine, and normetanephrine. Receiver operating characteristic curves were generated to analyze the diagnostic value of the plasma levels of catecholamines and their metabolites in PPGL-induced secondary hypertension. Patients in the primary hypertension and PPGL without hypertension groups had higher levels of dopamine, VMA, norepinephrine, metanephrine, and normetanephrine than patients in the normal group (all p<.05). On the other hand, patients in the PPGL with hypertension group had higher levels of dopamine, VMA, norepinephrine, metanephrine, and normetanephrine than patients in the normal, primary hypertension, and PPGL without hypertension groups (all p<.05). Collectively, our findings showed that dopamine, VMA, norepinephrine, metanephrine, and normetanephrine are all effective biomarkers for the diagnosis of PPGL and PPGL-induced secondary hypertension.

Comparative study on ultrasonic placental grading among normotensive pregnancy and pregnancy-induced hypertension and its correlation with fetal outcome

Background: Placenta is essential for the fetal well-being, growth, and development which can be evidenced as early as possible through ultrasound at 6 weeks of gestation. The placenta mediates the intrauterine interaction between a mother and her baby. Aims and Objectives: This study aims to compare the pattern of placental grading among normotensive and pre-eclampsia mothers in a tertiary care hospital. Materials and Methods: This hospital-based observational analytical study has been conducted in the labor ward and outpatient department of the Department of Obstetrics and Gynaecology, Bankura Sammilani Medical College and Hospital from April 2021 to September 2022. A total of 69 pre-eclampsia mothers (study group) and 69 normotensive mothers (control group) who fulfill inclusion and exclusion criteria were included in the study. Template was generated and analysis was done on Statistical Package for the Social Sciences software. Results: A total of 138 pregnant women with 69 pregnant normotensive and 69 pregnant preeclampsia mothers were included in the study. The mean age of the study participants was 21.3 years (standard deviation=3.6). About 81.2% and 89.9% of the normotensive and hypertensive mothers, respectively, resided in rural areas. Cesarean/instrumental delivery was higher among the hypertensive pregnant women (42.0%) when compared to normotensive pregnant women (27.5%) and it was found to be statistically significant. Birth asphyxia was observed to be higher among the neonates in the hypertensive group (15.9%) when compared to the normotensive group (4.3%) and it was found to be statistically significant. Neonatal intensive care unit admission was more among the neonates of the mother with hypertension and it was found to be statistically significant. There was no significant difference in the birth weight of the newborn with the placental grading among the normotensive pregnant women. Conclusion: Ultrasonographic placental grading could be used as a screening tool for antepartum fetal surveillance in the obstetric population. Placental grading will help us to early diagnosis and to formulate line of management and timely intervention to reduce maternal and perinatal complications.

Altered gut microbiota and metabolite profiles provide clues in understanding resistant hypertension.

Resistant hypertension is a severe phenotype in hypertension that may be driven by interactions between genetic and environmental factors. Specific changes in gut microbiota and metabolites have been shown to influence cardiovascular disease progression. However, microbial and metabolomic changes associated with resistant hypertension remain elusive. In this study, the gut microbiome of 30 participants with resistant hypertension, 30 with controlled hypertension, and 30 nonhypertension was characterized using 16S rRNA amplicon sequencing. In addition, the serum metabolome of the same population was assessed by untargeted metabolomics. The alpha diversity of microbiome in the resistant hypertension decreased, and changes were also observed in the composition of the gut microbiota. The resistant hypertension group was characterized by elevated levels of Actinobacteitia and Proteobacteria. Twenty-three genera were found to have significantly different abundances between resistant hypertension and controlled hypertension, as well as 55 genera with significantly different abundances between resistant hypertension and nonhypertension. Compared with the controlled hypertension group, the genera Rothia and Sharpea in resistant hypertension were more abundant. Compared with the nonhypertension group, the genera Escherichia-Shigella , Lactobacillus , Enterococcus were more abundant. Untargeted metabolomics provided distinctly different serum metabolic profiles for the three groups and identified a range of differential metabolites. These metabolites were mainly associated with the pathway of glycerophospholipid metabolism. Furthermore, correlation analysis provided evidence of new interactions between gut microbiota and metabolites in the resistant hypertension. In conclusion, our study provides a comprehensive understanding of the resistant hypertension gut microbiota and metabolites, suggesting that treatment resistance in resistant hypertension patients may be related to the gut microbiota and serum metabolites.

Correlation Of Placental Changes With Fetal And Maternal Outcome In Mothers With Hypertensive Disorders Of Pregnancy

Hypertension represents one of the most prevalent complications encountered during pregnancy, significantly contributing to both maternal and perinatal morbidity and mortality. The placenta, acting as a crucial feto-maternal organ, plays a pivotal role in sustaining pregnancy and fostering the healthy development of the fetus. Notably, the weight of the placenta holds functional importance, as it correlates with the villous surface area and fetal metabolism. Motivated by this context, the present study endeavors to examine the morphological and histological alterations in the placenta associated with hypertensive disorders of pregnancy and to assess their correlation with maternal and fetal outcomes. Methods: A prospective investigation encompassing 120 cases was conducted, comprising 60 normotensive mothers (Group A) and 60 mothers with hypertensive disorders of pregnancy (Group B). Placental specimens obtained from these participants were subjected to morphological and histological analyses, with subsequent correlation with maternal and fetal outcomes. Results: Our findings revealed a notable reduction in placental weight and dimensions within Group B compared to Group A. Histopathological examination unveiled a significant increase in the incidence of syncytial knots, fibrinoid necrosis, hyalinization, and calcification in placentas from the hypertensive group, directly correlating with neonatal complications. Furthermore, the mean neonatal birth weight was significantly higher in Group A compared to Group B. Conclusion: Hypertensive disorders of pregnancy exert a substantial impact on placental morphology, leading to diminished weight and dimensions, indicative of placental insufficiency attributable to compromised utero-placental blood flow. These alterations ultimately influence neonatal weight and overall neonatal outcomes. Our study underscores the presence of distinct morphological changes in the placenta that detrimentally affect fetal growth.

Leukotriene B4 levels in CHD-associated paediatric pulmonary hypertension.

The aim of this study is to evaluate the role of leukotriene B4, an inflammatory mediator, in the development of pulmonary hypertension in paediatric patients with CHD with left-right shunt. The study included forty patients with CHD with left-right shunts. Based on haemodynamic data obtained from cardiac diagnostic catheterisation, 25 patients who met the criteria for pulmonary arterial hypertension were included in the patient group. The control group comprised 15 patients who did not meet the criteria. The standard cardiac haemodynamic study was conducted. Leukotriene B4 levels were assessed in blood samples taken from both pulmonary arteries and peripheral veins. The median age of patients with pulmonary arterial hypertension was 10 months (range: 3-168), while the median age of the control group was 50 months (range: 3-194). In the pulmonary hypertension group, the median pulmonary artery systolic/diastolic/mean pressures were 38/18/24 mmHg, compared to 26/10/18 mmHg in the control group. Leukotriene B4 levels in pulmonary artery blood samples were significantly higher in the pulmonary arterial hypertension group compared to the controls (p < 0.05). Peripheral leukotriene B4 levels were also elevated in the pulmonary arterial hypertension group in comparison to the control group, though the difference was not statistically significant. The discovery of elevated leukotriene B4 levels in pulmonary artery samples from paediatric patients with pulmonary arterial hypertension secondary to CHD with left-to-right shunt suggests that local inflammation may have a pathological role in the development of pulmonary arterial hypertension.

Evaluation of Patients Diagnosed with Essential Hypertension in Terms of Mental and Personality Disorders.

Recent studies have suggested a link between hypertension and psychiatric disorders. However, the relationship between hypertension and mental health conditions remains unclear. So in this study, it was aimed to compare the prevalence of psychiatric diseases seen in hypertension patients with the healthy group. Psychiatric interviews were conducted with 104 patients in the hypertension group and 102 participants in the control group. The Sociodemographic and Clinical Data Form, Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Disorders, Structured Clinical Interview for DSM-5-Clinician Version, and DSM-5 Structured Clinical Interview for Personality Disorders were implemented for participants. Patients with hypertension were found to have a significantly higher number of psychiatric disorders compared to the control group (χ 2 = 29.389; P = .001). Statistically significant difference in the diagnosis of severe depression, chronic depression disorder, and specific phobia was discovered between the 2 groups (P < .05). The HAM-A and HAM-D scores were also significantly higher in the hypertension group (P < .001). No statistically significant difference was found between the patient and control groups in terms of the frequency of personality disorders. (χ 2 = 0.045; P = .833). The fact that depression and anxiety symptoms are more common in hypertension patients stands out as a subject that needs further investigation in terms of both the pathophysiology of hypertension. In this regard, since essential hypertension is a serious risky disease for mortality and morbidity on its own, it is critical to conduct psychiatric screening and develop new additional treatments to provide patients with supportive care.

Distribution of the SLC2A9 genotype and its association with the uric acid level in patients with arterial hypertension and atrial fibrillation

Asymptomatic hyperuricemia (HU) is widespread in the population and is one of the main risk factors for cardiovascular diseases. Evidence of numerous studies supports the association between increased uric acid (UA) levels and the risk of arterial hypertension (HTN) and/or atrial fibrillation (AF). One of the causes for an increase in UA levels and a significant risk factor for HU is the polymorphism of the SLC2A9 gene, a highly specific urate transporter in proximal renal tubule cells, encoding the GLUT9 protein.The aim of the study is to investigate the frequency of genotypes and alleles of the SLC2A9 gene rs734553 polymorphic variant and its association with the UA level in patients with HTN and AF, as well as in healthy individuals. 141 patients, including 50 healthy patients (group 1), 68 – with HTN and AF (group 2), 23 – with HTN (group 3) were examined.In the overall group of patients, the frequencies of the SLC2A9 gene rs734553 polymorphism were as follows: AA – 46.1 % (n = 65), AC – 36.2 % (n = 51), CC – 17.7 % (n = 25). According to the genotyping results of patients, in group 1 the AA genotype was 64 % (n = 32), AC – 22 % (n = 11), CC – 14 % (n = 7); in group 2 – 32.4 % (n = 22), 48.5 % (n = 33) and 19.1 % (n = 13); in group 3 47.8 % (n = 11), 30.4 % (n = 7) and 21.7 % (n = 5), respectively. The CC genotype patients (420 [413; 424] μmol/l) and the AC genotype patients (330 [284; 412] μmol/l) had higher uricemia values than those with the AA genotype (310 [281; 341] μmol/l) ( p = 0,003). HU with the AA genotype in group 2 was diagnosed in 2 (2.9 %) patients, with the AC genotype in 12 (17.6 %), and with the CC genotype in 10 (14.7 %) patients; in group 3 – 1 (4.3 %), 1 (4.3 %) and 3 (13 %), respectively. One patient (2 %) with HU in group 1 had the CC genotype.The distribution of genotype and allele frequencies of the SLC2A9 gene rs734553 polymorphic variant and its association with the UA level in patients with HTN and AF, as well as in healthy individuals were established. In patients with HTN and AF, the AC genotype occurred 3 times more often and the CC genotype occurred 2 times more often than in healthy patients. HU occurred significantly more often ( р = 0.003) in the group of patients with HTN and AF and the CC genotype, as well as in patients with the CC genotype.

Urinary protein and coagulation-fibrinolysis indicators in preeclampsia: Expression and significance.

This study investigates the expression and significance of urinary protein and coagulation-fibrinolysis indicators in preeclampsia, categorized into mild preeclampsia (109 cases) and severe preeclampsia (97 cases) based on disease severity. Additionally, 110 patients with gestational hypertension (gestational hypertension group) were included for comparative analysis. General information, laboratory indicators, urinary protein, and coagulation-fibrinolysis indicator levels were collected for each group. Significant differences were observed in blood pressure among groups (P<.05), while uric acid, serum creatinine, aspartate transaminase, alanine transaminase, and triglycerides showed no significant differences (P>.05). Total cholesterol, triglycerides, and low-density Lipoprotein levels in severe preeclampsia were higher than those in mild preeclampsia and gestational hypertension groups, whereas high-density lipoprotein, albumin, and platelet levels were lower in severe preeclampsia. No significant differences were observed in prothrombin time or D-dimer levels among groups (P>.05). Urinary protein, urinary protein quantification, activated partial thromboplastin time, thrombin time, and fibrinogen were identified as influencing factors for adverse maternal and infant outcomes in severe preeclampsia patients. The study concludes that urinary protein and coagulation-fibrinolysis indicators are elevated in preeclampsia, particularly in severe preeclampsia cases, suggesting their potential use as diagnostic influencing factors for severe preeclampsia.

Evaluating the efficacy of balloon pulmonary angioplasty using quantitative analysis of SPECT pulmonary ventilation/perfusion scintigraphy in patients with chronic thromboembolic pulmonary hypertension.

Single-photon emission computed tomography (SPECT) ventilation perfusion imaging is the main imaging method for the diagnosis of pulmonary embolism, and its application in the diagnosis and efficacy evaluation of chronic thromboembolic pulmonary hypertension (CTEPH) has been paid more and more attention. In recent years, with the development of computer software technology, ventilation/perfusion (V/Q) imaging quantitative analysis technology has become more and more mature. The objective of this study was to investigate the utility of quantitative analysis of pulmonary V/Q scintigraphy in evaluating the efficacy of balloon pulmonary angioplasty (BPA) in patients with CTEPH. In this retrospective analysis, we collected data of patients diagnosed with CTEPH who underwent BPA at the China-Japan Friendship Hospital from April 2018 to September 2020. The sample consisted of 23 males and 28 females, with an average age of 55.1±12.7 years. All patients underwent V/Q scintigraphy within one week before surgery, and we reviewed the pulmonary angiography within 1-3 months following the last BPA procedure. We repeated V/Q scintigraphy within 1 week before or after the pulmonary angiography, at the time of collecting clinical and hemodynamic parameters of these patients. We divided the patients into two groups based on the presence of residual pulmonary hypertension post-surgery and compared the pre- and post-operative quantitative pulmonary perfusion defect percentage scores (PPDs%) using the t-test. In all, 102 V/Q scintigraphy scans were performed in 51 patients. The quantitative PPDs% were positively correlated with the hemodynamic indexes mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), and mean right ventricular pressure (RVP) (r=0.605, 0.391, and 0.464, respectively, all P<0.001) and negatively correlated with the 6-minute walking distance (6MWD) (r=-0.254, P=0.010). The average preoperative quantitative PPDs% were (49.0±15.6)% which significantly decreased to (33.5±13.9)% after surgery (t=11.249, P<0.001). The preoperative quantitative PPDs% were (54.7±15.7)% and (44.0±13.8)% in the residual pulmonary hypertension group and the non-residual pulmonary hypertension group, respectively (t=2.599, P=0.012). The postoperative quantitative PPDs% were (41.5±12.5)% and (26.3±11.0)%, in the residual pulmonary hypertension group and the non-residual pulmonary hypertension group, respectively (t=4.647, P<0.001). In this study, we found that quantitative analysis of SPECT pulmonary V/Q scintigraphy adequately reflected the pulmonary artery pressure and clinical status in patients with CTEPH. Our results demonstrate its definite utility in predicting residual pulmonary hypertension and in evaluating the postoperative efficacy of BPA in patients with CTEPH.

Pulmonary flow-study can predict in-hospital prognosis of unifocalization and corrective repair of pulmonary atresia/ventricular septal defect with major aortopulmonary collateral arteries

ObjectivesWith the development of perioperative treatment, the results of the unifocalization and corrective repair of pulmonary atresia/ventricular septal defect with major aortopulmonary collateral arteries have been significantly improved. However, the in-hospital recovery is quite different individually. Therefore, it is essential to find prognostic indicators to avoid unsatisfactory recovery. DesignThis was a case-control study. SettingThe study was conducted in the national center for cardiovascular diseases in China. ParticipantsPediatric patients between 2014 and 2022. InterventionsNone. Measurements & main resultsA total of 19 patients were included. The possible prognostic indicators included were commonly used clinical data. Unsatisfactory postoperative recovery was defined as mechanical ventilation≥ 7 days and/or in-hospital death. Satisfactory postoperative recovery was defined as mechanical ventilation<7 days and survival at discharge. We separated patients into two groups and compared the peri-operative data through univariable analysis. There were 8 patients in unsatisfactory recovery group (including 1 death) and 11 patients in satisfactory recovery group. Among all the possible prognostic indicators, through univariable analysis, pulmonary arterial pressure in pulmonary flow study was statistically different (p = 0.027 < 0.05). The ROC curve showed that the area under curve and cut-off values in predicting satisfactory recovery were 0.841 and 22 mmHg; the corresponding sensitivity and specificity were 100% and 72.7%. There was no statistical difference between the two groups in ventricular septal fenestration and pulmonary hypertension targeting drugs. ConclusionA pulmonary arterial pressure <22 mmHg in pulmonary flow study may avoid unsatisfactory in-hospital recovery after unifocalization and corrective repair of pulmonary atresia/ventricular septal defect with major aortopulmonary collateral arteries.

Determination of Vitamin K2, Lipoprotein (a) and N-Terminal pro Brain Natriuretic Biomarkers in Diabetic Hypertensive Patients with Acute Myocardial Infarction for Clinical Intervention

Background: Severe Myocardial Infarction is a highly stark manifestation of heart illness, often accompanied with additional complications such as diabetes mellitus (DM) and hypertension (HTN). The hormone within the body enables glucose to enter the cells and burn them up as fuel. HTN is a common vascular disorder that represents a major cardiovascular condition. Methods: The study was conducted at the Biochemistry Department of the College of Medicine from April 2022 to May 2023 and used the Human Vit K2 ELISA Kit, Human Lp(a) ELISA Kit, and Human N-terminal ProBST ELISA Kit to estimate the serum levels of vitamin K2, lipoprotein (a) (Lp(a)), and N-terminal of the Pro brain natriuretic peptide (NT-proBNP). Results: The results showed a important decrease in VK2 levels in AMI patients with DM and HTN than the other two groups (less than AMI patients group with and without HDL-c). On the other hand, Lp(a), and NT-pro BNP levels were significantly increased in AMI patients with DM and HTN than the other two groups (less than AMI patients group with no DM and HTN). As the diagnostic accuracy of tests increased, the area under the ROC curve for NTproBNP for diagnosing AMI achieved the highest 0.988. NTproBNP showed a promising ability to differentiate AMI patients from DM+ HTN group with 0.971 (AUC). Conclusions: In diabetic hypertensive patients with acute myocardial infarction, a low level of vitamin K2 and a high level of lipoprotein(a) might be risk markers for the onset of myocardial infarction.

The Effect of Brain Natriuretic Peptide, and Prothrombin Biomarkers in Pregnant Women With Gestational And Chronic Hypertension

Background: Pregnancy complications, such as gestational hypertension (GH), affect around 5-8% of pregnancies, which may progress to more severe conditions like pre-eclampsia. It is essential to closely monitor various physiological and biochemical markers, including B-natriuretic peptide (BNP), prothrombin time, and iron levels, to detect and manage hypertensive disorders early on during pregnancy. Methods: Our study, conducted from July to October 2023, involved 96 women grouped into four categories: pregnant with GH, healthy pregnant, non-pregnant with chronic HT, and healthy non-pregnant individuals. We utilized techniques such as ELISA, coagulation analysis, and biochemical assays to measure physiological parameters like BNP, prothrombin time, and iron levels. Statistical analysis was performed using ANOVA and the Duncan multiple range test to derive meaningful insights from the data. Results: We observed significant increases in body mass index and blood pressure among pregnant individuals with GH and non-pregnant individuals with HT when compared to their respective control groups. BNP levels were notably elevated in both hypertensive groups, with pregnant individuals with GH exhibiting the highest levels. Furthermore, prothrombin time showed a significant increase in pregnant individuals with GH and non-pregnant individuals with HT. Conversely, iron levels decreased notably in pregnant individuals with GH and non-pregnant individuals with HT compared to their respective control groups. Conclusion: Elevated BNP levels may indicate cardiac stress, while increased prothrombin time suggests alterations in coagulation profiles in hypertensive pregnancies. Implementing routine screenings for pregnant women can help mitigate the risks associated with gestational hypertension and ultimately improve outcomes for both mothers and their babies.

Effects of hypertensive disorders of pregnancy on the complications in very low birth weight neonates

ABSTRACT Objective This study was designed to investigate the effects of hypertensive disorders of pregnancy (HDP) on the complications in very low birth weight (VLBW) neonates. Methods We retrospectively included VLBW neonates (<37 weeks) who were delivered by HDP pregnant women with a body weight of < 1,500 g (HDP group) hospitalized in our hospital between January 2016 and July 2021. Gestational age matched VLBW neonates delivered by pregnant women with a normal blood pressure, with a proportion of 1:1 to the HDP group in number, served as normal control. Results Then we compared the peripartum data and major complications between HDP group and control. The body weight, prelabor rupture of membrane (PROM), maternal age, cesarean section rate, fetal distress, small for gestational age (SGA), mechanical ventilation, RDS, necrotizing enterocolitis (NEC) (≥2 stage), Apgar score at 1 min, and mortality in HDP group showed statistical differences compared with those of the control (all p < 0.05). To compare the major complications among HDP subgroups, we classified the VLBW neonates of the HDP group into three subgroups including gestational hypertension group (n = 72), pre-eclampsia (PE) group (n = 222), and eclampsia group (n = 14), which showed significant differences in the fetal distress, Apgar score at 1 min, SGA, ventilation, RDS and NEC (≥2 stage) among these subgroups (all p < 0.05). Multivariate regression analysis showed that eclampsia and PE were the independent risk factors for SGA and NEC, respectively. Conclusion HDP was associated with increased incidence of neonatal asphyxia, fatal distress, SGA, mechanical ventilation, RDS, NEC and mortality. Besides, eclampsia and PE were independent risk factors for SGA and NEC.

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&lt;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.

Effect of 10-year cumulative blood pressure exposure on atherosclerotic cardiovascular disease of different age groups: kailuan cohort study.

The level at which cumulative blood pressure (BP) can increase the risk of ASCVD in different age groups remains unclear. This study aimed to investigate the association of 10-year cumulative BP levels with the long-term risk of ASCVD of different age groups. Cumulative BP exposure was assessed using the time-weighted average (TWA) BP divided into four BP groups. The participants were also divided into four groups according to their baseline age (<50, 50-59, 60-69, or ≥70 years). The association between TWA BP and the risk of ASCVD was assessed by age group using multivariate Cox models. The China-PAR prediction model was used to assess the ability of TWA BP to predict ASCVD. In the group aged <50 years, the hazard ratios and 95% confidence intervals for the risk of ASCVD were 2.66 (1.04-6.80), 3.38 (1.54-7.43), and 3.13 (1.36-7.24) for the elevated BP, stage 1 hypertension, and stage 2 hypertension groups, respectively, when compared with the normal BP group. There was a significant difference in the risk of ASCVD between the age groups, with participants aged <50 years having the highest risk, followed by those aged 50-59, 60-69, and ≥70 years. The risk of ASCVD with high cumulative BP exposure was age-dependent, with a gradual decrease in risk with increasing age.

Comparative Effects of Garcinia kola and Garlic Extracts on Some Liver and Haematological Functions in High Salt Diet-Induced Hypertensive Wistar Rats

Garcinia kola is commonly consumed in Nigeria in social ceremonies, while Garlic is commonly used as a spice in the preparation of certain foods. In this study, the protective effects of extracts of the plants against a high salt diet (8% NaCl) induced hypertension were investigated in rats. Extracts prepared from the plants were subjected to phytochemical screening for acute and sub-acute toxicity studies in rats. In the protective study against salt-induced hypertension thirty-five adult male rats assigned to seven groups of five rats were treated such that, group one served as the normal control group, and group two was the hypertensive control group. Groups three to six were administered graded doses of extracts respectively after induction. While group seven received a combination of the two extracts after induction. Treatment commenced after confirmation of hypertension and lasted for two weeks before animals were sacrificed to collect blood for biochemical and haematological analysis. Results obtained showed that G.kola and Garlic feeding produced in rats following liver and haematological assays as values of these parameters in the test groups did not significantly differ from control values (p&lt;0.05).

Pharmacological Update and Emerging Treatments of Pulmonary Hypertension.

Pulmonary hypertension (PH) is defined as elevated pressures in the pulmonary artery and is associated with significant morbidity and mortality. The World Health Organization classifies PH into 5 distinct groups based on underlying etiology, pathology, and modality of treatment. Therapeutic approach may be challenging due to the extensive spectrum of causes and underlying mechanisms mediating PH. The 5 groups include pulmonary arterial hypertension (group 1), PH secondary to left heart disease (group 2), PH secondary to chronic lung disease (group 3), chronic thromboembolic pulmonary hypertension (group 4), and PH due to miscellaneous causes (group 5). Although significant progress has been made in the treatment of group 1 PH, there is a continued need to develop new therapies for all types of PH. Additionally, most treatments currently available improve functional capacity and symptoms but without a significant benefit in mortality. In this review, we aim to describe the various etiologies of PH and their established pharmacotherapies, as well as expand on emerging therapeutic options for each group.

Hypertensive and Non-hypertensive Hospital Admission Blood Pressure Association with Cognitive Function in Stroke Patients

Highlight: A comparative study of hypertension and non-hypertension on cognitive function. Hospital admission blood pressure and cognitive function in acute-phase stroke patients. Blood pressure is not associated with cognitive function. ABSTRACT Introduction: Cognitive impairment is one of the many stroke effects. White matter damage, microinfarcts, microbleeding, atrophy, and amyloid buildup in the brain due to stroke are all potential causes of this condition. Cognitive impairment studies have yet to provide a definitive explanation for how this condition develops following a stroke. Blood pressure is one of several risk factors for stroke. Meanwhile, few studies have been conducted on the association between blood pressure and cognitive function in stroke patients, and no definitive results have been established. Objective: This research was designed to examine and evaluate the difference in the measured cognitive function category between hypertensive and non-hypertensive hospital admission blood pressure stroke patients. Methods: This research used a cross-sectional design with a consecutive sampling method on acute stroke patients at Dr. Soetomo General Academic Hospital. The MMSE (Mini Mental State Examination) was carried out to assess the degree of cognitive function. The blood pressure measured is the hospital admission blood pressure. Results: There were 40 patients included in this study. A total of 36 patients (90%) were in the hypertension group (blood pressure ≥ 130/80 mmHg), and 4 patients (10%) were in the non-hypertension group (blood pressure &lt; 130/80 mmHg). The MMSE results showed that 10 patients performed with no cognitive impairment, 12 patients performed with mild cognitive impairment, and 18 patients performed with severe cognitive impairment. Statistical analysis of the Mann-Whitney U test showed that p = 0.561. Conclusion: There was no difference in the measured cognitive function category between hypertensive and non-hypertensive hospital admission blood pressure stroke patients.

Investigation of symptoms and mortality in hypertension patients diagnosed with COVID-19: A retrospective case-control study

It was aimed to determine whether there is a difference in mortality and symptoms between patients, aged 60 years or above, with hypertension (HT) and Coronavirus disease 2019 (COVID-19) infection and those without any chronic disease. The population of the study, which was conducted as a retrospective case-control study, consisted of 2747 HT patients diagnosed with COVID-19 and aged 60 years or above. While 170 patients with HT diagnosis formed the case group, 170 patients without any chronic disease formed the control group from the sample. In this study, the time from diagnosis to death was found to be shorter in the presence of HT in COVID-19 patients, while males diagnosed with COVID-19 had higher rates of intensive care unit admittance, intubation and mortality than females irrespective of HT. The presence of HT was determined not to affect symptoms in patients diagnosed with COVID-19. The most common symptoms were fatigue, cough, body ache, fever, headache, and sore throat in HT and control groups and the symptoms were similar in both groups. Further studies are recommended to reveal the relationship between HT, considered one of the most important risk factors for COVID-19, and adverse outcomes related to COVID-19.