Incidence Rates Of Hypertension Research Articles

A Study to Assess the Effectiveness of Deep Breathing Exercise on Blood Pressure and Heart Rate Among Hypertensive Patients in Selected Area of Kheda District

Background of Study: Despite the significance of the problem with respect to overall health and its undesirablehealth consequences, high blood pressure still is not adequately controlled and far from being optimal. Anestimated 1.13 billion people worldwide have hypertension (WHO may 2019). In India incidence rate ofhypertension is 29.8% (WHO September 2018). In Gujarat incidence rate of hypertension is 27.1% (JNC-7). Quasi experimental research design (pre test post test research design), Quantitative research approachwas used to assess the effectiveness of deep breathing exercise on blood pressure and heart rate amonghypertensive patients in selected area of Kheda district. The collected data was tabulated and analyzed usingdescriptive and inferential statistics. Mean, and standard deviation was calculated by the obtained data inwhich mean score of blood pressure was 127.46 in pre test and 78.63 in post test and score of standarddeviation was 5.44 in pre test and 4.88 in post test. The mean score of heart rate was 86.2 in pre test and63.01 in post test and score of standard deviation was 3.86 in pre test and 2.59 in post test.

Incidence and Predictors of Hypertension Among HIV Patients Receiving ART at Public Health Facilities, Northwest Ethiopia: A One-Year Multicenter Prospective Follow-Up Study.

BackgroundThe introduction of highly active retroviral therapy has dramatically reduced mortality and improved survival among HIV patients. However, there is a possible risk of comorbid complications such as hypertension. Little evidence is available regarding the incidence of hypertension among HIV patients receiving anti-retroviral therapy in Ethiopia.PurposeTo assess the incidence and predictors of hypertension among HIV positive patients receiving ART at Public Health Facilities, Northwest Ethiopia.Patients and MethodsA one-year prospective follow-up study was conducted among a cohort of 302 new adult individuals initiating on a standard anti-retroviral therapy regimen with a median (IQR) age of 35 years (IQR=30–41). A pretested data extraction checklist was used to extract baseline patient records. The collected data were entered into Epi-Data version 3.1 and exported to STATA version 14 for analysis. The incidence rate was calculated, and a Kaplan–Meier survival curve was used to estimate the survival probabilities of developing hypertension. Cox proportional hazards model was fitted to identify the predictors of hypertension.ResultsAbout 40 (13.25) new hypertensive cases were observed during the follow-up period, and the remaining 262 (86.75%) were censored. The overall incidence rate of hypertension was 16.35 per 1000 person-month with 2447 patient-month observations. Male sex (AHR = 2.45, 95% CI: 1.02, 6.14), old age (AHR = 2.83, 95% CI: 1.08, 7.45), high BMI (AHR = 6.54, 95% CI: 2.03, 21.13), diabetic comorbidity (AHR = 2.36, 95% CI: 1.07, 5.22), and patients who were on Zidovudine (AZT)-based ART regimen (AHR =3.47, 95% CI: 1.10, 10.94) were significant predictors for the development of hypertension.ConclusionThe findings of this study revealed that incident hypertension is a common problem among HIV patients receiving ART. Routine monitoring of blood pressure and screening and treating high blood pressure should be an integral part of follow-up for HIV patients in ART clinics.

Abstract 48: Military Sexual Trauma Is Associated With Incident Hypertension In A 16-year Cohort Study Of 1.2 Million Young And Middle-aged Men And Women

Introduction: Exposure to traumatic events and the sequelae [e.g., posttraumatic stress disorder (PTSD) and poor health] are linked to incident cardiovascular disease (CVD) in military and community samples. Veterans, especially women, are 3-times as likely to experience sexual harassment and assault [military sexual trauma (MST)] compared to civilian populations. It is unknown if exposure to MST is independently associated with risk of incident hypertension. Methods: We conducted a retrospective analysis to assess the effect of MST on the risk of incident hypertension, defined as a medical record diagnosis, meeting clinical threshold based on blood pressure in vital sign records, or use of antihypertensive medication, in a cohort of 1,177,944 young and middle-aged veterans (mean age= 30.2 [SD:9.2], 12% women) using nationwide data from the Veterans Health Administration from 2001 to 2017. Time-varying multivariate Cox models were computed to estimate hypertension risk by MST status while sequentially adjusting for demographics, lifestyle factors, CVD comorbidities, and psychiatric disorders. Sensitivity analyses controlled for healthcare utilization based on the number of primary care visits over two years after military discharge. Results: During 16 years of follow-up (mean=9.6 years [SD:4.0]), 33,881 veterans screened positive for MST (65% women) and 307,332 patients were diagnosed with hypertension. The overall incidence rate of hypertension was 305.1 events per 1,000-person years. MST was associated with a 30% greater risk of hypertension in unadjusted models (hazard ratio [HR], 1.30 [95% CI, 1.28-1.33]) and remained significantly associated with hypertension in models that adjusted for demographics, lifestyle factors, CVD comorbidities, PTSD, anxiety, and depression (adjusted HR, 1.10 [95% CI, 1.08-1.12]. In sensitivity analyses, the effect of MST remained significant when controlling for healthcare utilization (HR, 1.11, [95% CI, 1.09-1.13]). Conclusions: In this large prospective cohort of young adults, MST was associated with an increased risk of hypertension after controlling for established risk factors. Further research is needed to determine if early identification of MST improves cardiovascular risk management.

Impact of body mass index on primary immunoglobulin A nephropathy prognosis: a systematic review and meta-analysis.

The impacts of body mass index (BMI) on the prognosis of primary IgA nephropathy (IgAN) remain controversial. This systematic review and meta-analysis aimed to solve these issues. We searched the PubMed, EMBASE, and Cochrane Library to screen articles investigating the BMI and primary IgAN. BMI was classified according to the World Health Organization as high (≥ 25.0kg/m2) and low (< 25.0kg/m2). The baseline renal indexes and the incidences of adverse renal outcomes were focused on. Six studies with a total of 1723 patients were included in this study. High BMI was demonstrated to be associated with increased baseline levels of serum creatinine (weighted mean difference (WMD) 9.54, 95% confidence interval (CI) 0.63-18.45), blood uric acid (WMD 19.85, 95% CI 10.11-29.59) and urine protein (WMD 0.37, 95% CI 0.21-0.53). Patients with high BMI also showed compromised eGFR at diagnosis (WMD - 8.39, 95% CI - 11.62 to - 5.16) with a higher incidence rate of hypertension (odds ratios (OR) 2.59, 95% CI 1.44-4.66) and higher global optical scores (WMD 1.22, 95% CI 0.70-1.74). Regarding the prognosis, high BMI was significantly associated with the incidence of adverse renal outcomes (OR 2.43, 95% CI 1.66-3.55, P < 0.001) and deteriorated eGFR at the last follow-up (WMD - 11.10, 95% CI - 16.96 to - 5.25, P < 0.001), with non-significantly poorer renal disease-free survival (hazard ratio 1.79, 95% CI 0.58-5.50, P = 0.31). High BMI was associated with severe onset and poor prognosis of primary IgAN. The management of BMI could be a novel method to promote the therapeutic outcomes of primary IgAN.

Incidence of essential hypertension but not echocardiographic abnormalities at four years with a history of preeclampsia with severe features.

Women with preeclampsia are more likely to have abnormal echocardiographic parameters at the time of diagnosis and are more likely to have hypertension and other cardiovascular diseases (CVD) later in life. Screening for future CVD in preeclamptic women would assist in appropriately risk stratifying and identifying high risk women for preventive management; however, the timing of screening and the screening factors are unknown. The objectives of this project are to 1) assess incidence of essential hypertension 4years after pregnancy in preeclampsia with severe features (PEC) 2) identify predictive echocardiographic variables at the time of PEC diagnosis and 3) assess the rate of echocardiographic abnormalities 4years after developing PEC. This is a prospective longitudinal study observing the incidence of essential hypertension in women within 4years of a pregnancy complicated by PEC. We further looked at echocardiographic variables at the time of PEC diagnosis and at 4years after PEC pregnancy in women with and without subsequent incident essential hypertension. The primary outcome measure is the incidence of essential hypertension within 4years of PEC pregnancy, defined as a systolic blood pressure≥130mmHg or a diastolic blood pressure≥80mmHg. Secondary imaging outcomes include the persistence of abnormal echocardiographic parameters. Clinical secondary outcomes are new diagnoses of severe CVD, including coronary artery disease, stroke, arrhythmia, heart failure, or inpatient hospital admission for CVD. Of the 33 enrolled women with PEC, 48% (16/33) developed incident essential hypertension within 4years of delivery. These women had thicker left ventricular posterior walls on their initial antenatal echocardiogram when compared to the 52% (17/33) who did not develop hypertension (1.0cm [0.9-1.1cm] vs 0.9cm [0.7-0.9cm]. p<0.016). However, these abnormal echocardiographic variables resolved in the 16 women who underwent 4-year follow-up echocardiography. Women who develop PEC have a high incidence of essential hypertension within 4years of delivery. The group who develops essential hypertension are more likely to have evidence of adverse cardiac remodeling at the time of PEC diagnosis; however, neither group have cardiac echocardiographic abnormalities 4years postpartum. Because this is a small study, larger long-term cohort studies are needed to confirm these echocardiographic and clinical findings.

Association between HIV and incident pulmonary hypertension in US Veterans: a retrospective cohort study

SummaryBackgroundPulmonary hypertension incidence based on echocardiographic estimates of pulmonary artery systolic pressure in people living with HIV remains unstudied. We aimed to determine whether people living with HIV have higher incidence and risk of pulmonary hypertension than uninfected individuals.MethodsIn this retrospective cohort study, we evaluated data from participants in the Veterans Aging Cohort Study (VACS) referred for echocardiography with baseline pulmonary artery systolic pressure measures of 35 mm Hg or less. Incident pulmonary hypertension was defined as pulmonary artery systolic pressure higher than 35 mm Hg on subsequent echocardiogram. We used Poisson regression to estimate incidence rates (IRs) of pulmonary hypertension by HIV status. We then estimated hazard ratios (HRs) by HIV status using Cox proportional hazards regression. We further categorised veterans with HIV by CD4 count or HIV viral load to assess the association between pulmonary hypertension risk and HIV severity. Models included age, sex, race or ethnicity, prevalent heart failure, chronic obstructive pulmonary disease, hypertension, smoking status, diabetes, body-mass index, estimated glomerular filtration rate, hepatitis C virus infection, liver cirrhosis, and drug use as covariates.FindingsOf 21 314 VACS participants with at least one measured PASP on or after April 1, 2003, 13 028 VACS participants were included in the analytic sample (4174 [32%] with HIV and 8854 [68%] without HIV). Median age was 58 years and 12 657 (97%) were male. Median follow-up time was 3·1 years (IQR 0·9–6·8) spanning from April 1, 2003, to Sept 30, 2017. Unadjusted IRs per 1000 person-years were higher in veterans with HIV (IR 28·6 [95% CI 26·1–31·3]) than in veterans without HIV (IR 23·4 [21·9–24·9]; p=0·0004). The risk of incident pulmonary hypertension was higher among veterans with HIV than among veterans without HIV (unadjusted HR 1·25 [95% CI 1·12–1·40], p<0·0001). After multivariable adjustment, this association was slightly attenuated but remained significant (HR 1·18 [1·05–1·34], p=0·0062). Veterans with HIV who had a CD4 count lower than 200 cells per μL or of 200–499 cells per μL had a higher risk of pulmonary hypertension than did veterans without HIV (HR 1·94 [1·49–2·54], p<0·0001, for those with <200 cell μL and HR 1·29 [1·08–1·53], p=0·0048, for those with 200–499 cells per μL). Similarly, veterans with HIV who had HIV viral loads of 500 copies per mL or more had a higher risk of pulmonary hypertension than did veterans without HIV (HR 1·88 [1·46–2·42], p<0·0001).InterpretationHIV is associated with pulmonary hypertension incidence, adjusting for risk factors. Low CD4 cell count and high HIV viral load contribute to increased pulmonary hypertension risk among veterans with HIV. Thus, as with other cardiopulmonary diseases, suppression of HIV should be prioritised to lessen the burden of pulmonary hypertension in people living with HIV.FundingNational Heart, Lung, and Blood Institute (National Institutes of Health, USA); National Institute on Alcohol Abuse and Alcoholism (National Institutes of Health, USA).

Handgrip strength as a predictor of incident hypertension in the middle-aged and older population: The TCLSIH cohort study

ObjectivesThe independent role of muscular strength in the prevention of chronic disease is increasingly being recognized. However, no cohort study has assessed the relationship between handgrip strength and the incidence of hypertension among the middle-aged and older population. The aim of this prospective cohort study was to investigate whether handgrip strength is related to incident hypertension among people aged 40 years and over. Study designThis prospective cohort study (n = 8,480) was performed between 2013 and 2019 as part of the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study, Tianjin, China. Main outcome measuresParticipants without baseline hypertension were followed up for ~6 years (median 4.0 years). Hypertension was defined according to the JNC7 criteria. Handgrip strength was measured using a hydraulic handheld dynamometer. Adjusted Cox proportional hazards regression models were used to assess the relationships between weight-adjusted handgrip strength and the risk of incident hypertension. ResultsThe incidence rate of hypertension per 1000 person-years was 70. The fully adjusted hazards ratios (95% confidence interval) of the incidence of hypertension for increasing quartiles of weight-adjusted handgrip strength were: 1.00(reference), 0.84 (0.75–0.95), 0.78 (0.69–0.88), and 0.66 (0.58–0.75) (P for trend<0.0001). Moreover, the adjusted hazards ratio (95% confidence interval) of incident hypertension for per unit increase in weight-adjusted handgrip strength was 0.17 (0.10–0.27) (P<0.0001). Similar results were observed in males and females. ConclusionsThe present cohort study is the first to find that high weight-adjusted handgrip strength, but not absolute handgrip strength, is significantly and independently related to low risk of incident hypertension among the middle-aged and older population.

The incidence rate of arterial hypertension and high normal blood pressure in students of Medical Faculty at the Kabardino-Balkarian State University

The aim is to assess the incidence rate of arterial hypertension (AH) and high normal arterial pressure (HNAP) in students of the Medical Faculty at the Kabardino-Balkarian State University as well as the relationship between arterial pressure (AP) and behavioral and biological risk factors (RF) of cardiovascular diseases (CVD) to substantiate the need for preventive measures

Influence of placental pathological chorangiosis on neonates: an analysis of 450 cases

OBJECTIVE To study the influence of placental pathological chorangiosis in the mother on the mortality of neonates and the incidence rate of complications. METHODS A retrospective analysis was performed for the neonates who were hospitalized within 3 days after birth in the Department of Neonatology, Xiamen Maternal and Child Health Hospital, from July 2016 to February 2020. According to whether the placental pathology showed chorangiosis, the neonates were divided into an observation group and a control group (n=450 each). The two groups were analyzed in terms of general status, maternal comorbidities during pregnancy, neonatal mortality, and incidence rate of complications in neonates. RESULTS Compared with the control group, the observation group had a significantly higher cesarean section rate (P < 0.05) and a significantly higher incidence rate of maternal gestational hypertension (P < 0.05). The observation group had significantly higher incidence rates of congenital malformation, small-for-gestational-age birth, and low Apgar score than the control group (P < 0.05). The observation group also had significantly higher mortality rate and incidence rates of brain injury, retinopathy of prematurity, and extrauterine growth retardation (P < 0.05). CONCLUSIONS Neonates born to mothers with placental pathological chorangiosis tend to have a higher morbidity rate and incidence rate of complications. It is important to improve the understanding of chorangiosis and provide intervention as soon as possible, in order to reduce complications and improve prognosis.

Long-term Risk of Hypertension After Surgical Repair of Congenital Heart Disease in Children

The long-term risk of hypertension in children after surgery for congenital heart disease (CHD) is unclear. To assess the incidence of hypertension after cardiac surgery in children with CHD. A multicenter retrospective matched cohort study was conducted in Ontario, Canada, using administrative databases. A total of 3600 children with surgical repair of CHD were matched to 10 children (n = 36 000) from the general population without CHD on age, sex, index date, rurality, and neighborhood income. Diagnosis of hypertension over a median follow-up time of 9.8 years (interquartile range, 6.8-12.9 years) after surgery. The last follow-up was March 31, 2019. Overall, in 3600 children with surgical repair of CHD, the median age at first surgery was 150 days (interquartile range, 40-252 days) and 2005 (55.7%) were boys. During follow-up, 445 (12.4%) children with surgical repair of CHD developed hypertension compared with 398 (1.1%) in the matched control group. The incidence rate of hypertension in children who received surgery for CHD was 141.3 (95% CI, 128.8-155.1) per 10 000 person-years compared with children in the matched control group, who had a rate of 11.1 (95% CI, 10.1-12.3) per 10 000 person-years. The risk of hypertension was higher in children with index surgical dates at an age of less 150 days compared with those who had surgical dates at an age of 150 days or older (P = .006 for interaction). The risk of hypertension was increased in children with more complex surgery, particularly children with hypoplastic left heart syndrome (49 of 140 [35.0%]), and in children who received dialysis (22 of 126 [17.5%]; hazard ratio, 1.67; 95% CI, 1.09-2.56) during the index cardiac surgery hospitalization. The incidence of long-term hypertension in this study was 12 times higher in children with surgical repair of CHD compared with children in the matched control group. The findings suggest that interventions aimed at reducing the long-term risk of hypertension after cardiac surgery in this population are needed.

DETERMINANTS FOR THE DEVELOPMENT OF HYPERTENSION AMONG INDONESIAN ADULTS: A PROSPECTIVE COHORT STUDY

Objective: Hypertension is one most important contributors to disability, morbidity and all-cause mortality. The prevalence of hypertension is predicted to increase over time, not least in Indonesia. However, there is no longitudinal study investigating the factors determined the incidence of hypertension in Indonesia. This study aimed to assess the factors associated with the development of hypertension among adult Indonesian population. Design and method: This study used longitudinal data from the Indonesian Family Life Survey study (IFLS-4 and IFLS-5) consisting of individuals aged 15 years and over. We followed respondents who did not have hypertensive at the baseline during a 7-year follow-up period. Mixed method analysis was used to examine the determinants associated with the development of hypertension, controlling for sociodemographic, smoking behaviour, body mass index, and mental health status and socioeconomic status. The principal component analysis was conducted to construct the socioeconomic index Results: Out of the total 18,342 individuals who were followed up, 5,449 individuals (29.7%) were developed hypertension. The annual incidence rate of hypertension was 235.9 per 10,000 individuals. Being older, widow/divorcee, former smoker and had BMI &gt; 25 kg/m2 were significantly associated with the development of hypertension (p &lt; 0.05). Men had higher odds of developing hypertension compared to women (OR = 1.17, 95% CI = 1.02–1.34). In contrast, BMI &lt; 18.5 kg/m2 (OR = 0.62, 95% CI:0.51–0.75) and in the 2nd tertile of mental health (OR = 0.83, 95% CI: 0.75–0.92) were protective factors for developing hypertension. While socioeconomic status, education level, working status, and residence area were not significantly associated with the development of hypertension. Conclusions: This study highlights the high burden of hypertension among Indonesian adults. Understanding factors associated with the development of hypertension in Indonesia setting helps to create a comprehensive preventive health program. Findings from this study suggest the need for strategic programmes and health policies for reducing the burden of hypertension regardless of any socioeconomic condition.

Risk factors for pregnancy morbidity in women with antiphospholipid syndrome

Antiphospholipid syndrome (APS) increases the risk of obstetric complications, but risk factors for pregnancy morbidity in women with APS remain incompletely characterized. This retrospective study included pregnant women with APS and a control group without APS admitted to Peking University People’s Hospital between January 2013 and September 2019. Clinical data were extracted from medical records. Univariate and multivariate logistic regression analyses were used to identify factors associated with adverse pregnancy outcomes (fetal loss, premature birth, fetal growth restriction [FGR], preeclampsia and neonatal death). We included 64 pregnancies in 59 patients with APS (age, 32.3 ± 4.3 years) and 256 pregnancies in 256 women without APS (age, 30.4 ± 3.3 years). Compared with the control group, the APS group had higher incidence rates of preeclampsia (10.9 % vs. 2.3 %, P = 0.002), premature rupture of membranes (17.2 % vs. 3.9 %, P < 0.001), postpartum hemorrhage (23.4 % vs. 4.3 %, P < 0.001), fetal loss (4.7 % vs. 0.8 %, P = 0.024) and premature delivery at ≤34 weeks (7.8 % vs. 2.3 %, P = 0.047). The incidence rates of hypertension during pregnancy, HELLP syndrome, gestational diabetes, oligohydramnios and FGR were similar in both groups. Multivariate logistic regression revealed that three or more prior spontaneous miscarriages (odds ratio [OR], 6.162; 95 % confidence interval [CI], 1.271–29.882; P = 0.024) and double-positivity for antiphospholipid antibodies (OR, 4.024; 95 %CI, 1.025−15.794; P = 0.046) were independently associated with adverse pregnancy outcomes. APS increases the risks of adverse maternal and fetal outcomes during pregnancy. Three or more spontaneous miscarriages and double-positivity for antiphospholipid antibodies are risk factors for adverse pregnancy outcomes in women with APS.

EVALUASI PENGGUNAAN OBAT PADA PASIEN HIPERTENSI RAWAT JALAN DI RUMAH SAKIT UMUM WISMA RINI PRINGSEWU TAHUN 2019

Abstract Hypertension is a non-communicable disease characterized by the increase of systolic blood pressure is &gt;140 mmHg and diastolic blood pressure is &gt;90 mmHg. Hypertension is also the major risk factor of other cardiovascular disease. The incidence rate of hypertension with or without complications increases every year, so the potential for inaccurate use of drugs is increasing. The purpose of this research is to determine the characteristics of hypertension outpatients and the proper hypertension drug use in hypertension outpatients at Wisma Rini General Hospital Pringsewu in 2019 based on the proper patient, the proper indication, the proper drug, and the proper dose using the standard reference of Guidelines JNC VIII. This research is descriptive research, the data was collected retrospectively based on medical records. The sample collection technique in this research is using a purposive sampling technique. The results in this study obtained from 110 patient samples diagnosed with the hypertension showed that most of hypertension patients are women (55,46%), mostly aged 56-65 years old (40%), and the most taken hypertension drug is CCB group amlodipine with 78 patients (71%). The evaluation of antihypertensive drug use obtained is proper patient with 110 patients (100%), proper indication with 110 patients (100%), proper drug with 92 patients (75,6%), and proper dose with 110 patients (100%). Keywords: Antihypertensive, Hypertension, Accuracy drug use.

Incidence and Predictors of Hypertension in a Cohort of Australian Women With and Without Polycystic Ovary Syndrome

There are limited studies in large population-based settings examining the relationship between polycystic ovary syndrome (PCOS) and hypertension. To evaluate incidence of hypertension among women with and without PCOS over a 15-year period. Secondary analysis of longitudinal data from the Australian Longitudinal Study on Women's Health. General community. Women were randomly selected from the national health insurance database. 9508 women, aged 21-42 years, were followed up from 2000 to 2015. We conducted survival analysis using Cox proportional hazards model to identify predictors of hypertension and person-time analysis to calculate incidence rates of hypertension. 9508 women were followed for 145 159 person years (PY), and 1556 (16.37%) women developed hypertension during follow-up. The incidence of hypertension was significantly higher (P = 0.001) among women with PCOS (17/1000 PY) compared to women without (10/1000 PY). Women with known PCOS status totaled 8223, of which 681 women (8.3%) had self-reported physician-diagnosed PCOS. Incidence rate difference of hypertension (cases attributable to PCOS) was 4-fold higher (15.8/1000 PY vs 4.3/1000 PY) among obese women with PCOS compared to age-matched lean women with PCOS. PCOS was independently associated with 37% greater risk of hypertension (hazard ratio 1.37, 95% confidence interval 1.14-1.65), adjusting for body mass index (BMI), family history of hypertension, occupation, and comorbidity with type 2 diabetes. Women with PCOS are more likely to develop hypertension from early adulthood, independent of BMI, which is further exacerbated by obesity. Including PCOS in hypertension risk stratification assessments may aid efforts in early identification of the disorder.

The outcome of patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) and impaired kidney function: a 3-year observational study

BackgroundMyocardial infarction with nonobstructive coronary arteries (MINOCA) constitutes about 10% of the cases of acute coronary syndromes (ACS). It is a working diagnosis and requires further diagnostics to determine the cause of ACS.MethodsIn this study, 178 patients were initially diagnosed with MINOCA over a period of 3 years at the Department of Invasive Cardiology of the University Clinical Hospital in Białystok. The value of estimated glomerular filtration rate (eGFR) was calculated for all patients. The patients were divided into 2 groups depending on the value of eGFR: group 1—53 patients with impaired kidney function (eGFR < 60 mL/min/1.73 m2; 29.8%) and group 2—125 patients with normal kidney function (eGFR ≥ 60 mL/min/1.73 m2; 70.2%).ResultsIn group 1, the mean age of patients was significantly higher than that of group 2 patients (77.40 vs 59.27; p < 0.0001). Group had more women than group 2 (73.58% vs 49.60%; p = 0.003). Group 1 patients had higher incidence rate of arterial hypertension (92.45% vs 60.80%; p < 0.0001) and diabetes (32.08% vs 9.60%; p = 0.0002) and smoked cigarettes (22.64% vs 40.80%; p = 0.020). Group 1 patients had higher incidence rate of pulmonary edema, cardiogenic shock, sudden cardiac arrest (13.21% vs 4.00%; p = 0.025), and pneumonia (22.64% vs 6.40%; p = 0.001). After the 37-month observation, the mortality rate of the patients with MINOCA was 16.85%. Among group two patients, more of them became deceased during hospitalization (7.55% vs 0.80%; p = 0.012), followed by after 1 year (26.42% vs 7.20%; p = 0.0004) and after 3 years (33.96% vs 9.6%; p < 0.0001). Multivariate analysis revealed that the factors increasing the risk of death in MINOCA are as follows: older age, low eGFR, higher creatinine concentration, low left ventricular ejection fraction, and ST elevation in ECG.ConclusionImpaired kidney function is diagnosed in every third patient with MINOCA. Early and late prognosis of patents with MINOCA and renal dysfunction is poor, and their 3-year mortality is comparable to patients with myocardial infarction with significant stenosis of the coronary arteries and impaired kidney function.

The association between longitudinal trends of thyroid hormones levels and incident hypertension in a euthyroid population.

Thyroid hormones, including free triiodothyronine (FT3), free thyroxine (FT4), have well-recognized effects on the cardiovascular system. However, the evidence is lacking regarding the relationship between repeated FT3, FT4, and thyroid-stimulating hormone (TSH) measurements and incident hypertension. The aim of this cohort study was to examine how longitudinal trends of serum FT3, FT4, and TSH levels are related to the development of hypertension in a euthyroid population. A prospective study (n = 5926) was performed in Tianjin, China. Participants without a history of hypertension were followed up for ~4 years (median: 3 years). Hypertension was defined according to the criteria of JNC7. FT3, FT4, and TSH were determined by chemiluminescence immunoassay methods. FT3, FT4, TSH, and blood pressure were assessed yearly during follow-up. Adjusted Cox proportional hazards regression models were used to assess the relationships between baseline, means, and annual changes in FT3, FT4, TSH, and hypertension. The incidence rate of hypertension per 1000 person-years was 73. Compared with the lowest quartile, the multivariable-adjusted hazards ratios (95% confidence interval) for hypertension in the highest quartiles of changes in FT3, FT4, and TSH were 1.51 (1.23-1.84), 2.04 (1.67-2.48), and 1.20 (0.99-1.45), respectively. Similar relationships were observed between the means of FT3, FT4, TSH, and hypertension. However, we found no correlations between baseline FT3, FT4, TSH, and incident hypertension. The present study is the first to demonstrate that the annual changes and means, but not baseline FT3 and FT4 values are independently related to the risk of incident hypertension in the euthyroid general population.

Incident hypertension in urban slums of central India: a prospective cohort study

BackgroundNumerous studies have highlighted the burden of hypertension by estimating its prevalence. However, information regarding quantum and characteristics of persons whose blood pressure converts to hypertension range from their previous...

Кардіопротекторна дія індукторів синтезу білка KLOTHO за умов гострого експериментального інфаркту міокарда

Останніми десятиліттями в світі відзначається тенденція до неухильно зростаючого розповсюдження судинних захворювань, що зумовлено загальним старінням населення, збільшенням захворюваності на цукровий діабет, артеріальну гіпертензію й атеросклероз. Сьогодні в лікуванні захворювань серцево-судинної системи гiпоксичного генезу широко використовуються препарати, що відновлюють кровоток, а також препарати, які впливають на метаболізм клітини, а саме, на окремі ланки адаптаційних молекулярно-біохімічних реакцій. Відносно останніх препаратів накопичено багато експериментальних і клінічних даних щодо їхньої ефективності. Однак з точки зору доказової медицини ефекти даних препаратів суперечливі та сумнівні. У зв’язку з цим йде активний пошук препаратів метаболітотропної дії.Мета дослідження – встановлення кардіопротекторної дії індукторів експресії та синтезу білків Klotho (вітамін D, Necrostatin-1) в умовах моделювання експериментального інфаркту міокарда.Експериментальну частину роботи виконано на 40 статевозрілих щурах – самцях масою 170–210 г. Гострий інфаркт міокарда (ГІМ) моделювали шляхом введення впродовж 4 діб пітуїтрину (1 Од/кг підшкірно) та адреноміметика ізопреналіну (200 мг/кг внутрішньом’язово). Досліджувані препарати – Вітамін D (5000 МО/доба) (Гмбх Арцнайміттель, Німеччина) вводили внутрішньошлунково і Necrostatin-1 (Nec-1 25 mg, Sigma-Aldrich) – 1 мг/кг внутрішньоочеревинно через 20 хв після введення ізадрину впродовж 4 днів. Наявність ГІМ підтверджували шляхом визначення його маркерів у плазмі крові імунохемілюмінесцентним методом – Immulate 1000, тропоніну (Siemens), біохімічним методом – загальну активність креатинфосфокінази (КФК ) (Cormay) та імуноферментним методом – ST2 «The Pressage ST2 Assay» (Сritical Diagnostics, № кат. BC-1065E). Детекцію білка Klotho, HSP70 білків, 8-OHdG, ST2 здійснювали на імуноферментному комплекcі Immuno Chem-2100 (США).Моделювання ГІМ в експериментальних тварин призводило до збільшення маркерів пошкодження серцевого м’яза тропоніну, активності загальної КФК. Важливо зазначити, що дослідні маркери мали тенденцію до збільшення в тварин усіх експериментальних груп порівняно з інтактною. На тлівведення вітаміну D і Necrostatin-1 значення ST2 не досягали рівня 35 нг/мл. Крім того, експериментальна терапія вітаміном D і Necrostatin-1 призводила до статистично значущого збільшення вмісту в гомогенаті серця білка Klotho (відповідно на 76,3 % і 78,8 % щодо контролю). Застосування індукторів синтезу білка Klotho сприяло обмеженню оксидативного пошкодження нуклеїнових кислот, що відображалось значним порівняно до контролю зниженням концентрації 8-OHdG як на тлі вітаміну D (на 38,5 %), так і Necrostatin-1 (на 55,8 %).Отримані експериментальні дані зумовлюють перспективність подальших досліджень у цьому напрямі. Особливий інтерес викликає дослідження здатності вітаміну D і Necrostatin-1 впливати на процеси клітинної загибелі та її тип (некроз/апоптоз).

The THE ROLE OF SELF-EFFICACY AND FAMILY SUPPORT IN STABILIZING BLOOD PRESSURE OF PATIENTS WITH HYPERTENSION

Hypertension is a health problem for the majority of people in Indonesia. The Efforts to reduce the incidence rate of hypertension and controling blood pressure by changing the healthy lifestyle and by being in taking. To realize healthy lifestyle and behavior of hypertension, self-efficacy and support of the family as well as health care cooperation with the parties, the family, and society are required. The purpose of this research to know if self-efficacy and family support stabilizing blood pressure of patients with hypertension. This research is a pre-experimental research with One-Group Pre-Post test design approach. The study was conducted in 50 people with the stratified random sampling technique in Ketawang Village, Gondang Districtor 8 weeks. Measurement of the blood pressure was the Spignomanometer merk Onemed was given before and after the patients were given counseling self-efficacy and family support. The data was analyzed SPSS 21 Wilcoxon test. The Statistical test results obtained p value 0.000 to sistole and diatole so that there is a meaningful that self-efficacy counseling and family support stabilizing blood pressure of patients hypertension. Self-efficacy counseling and family support controling blood pressure for patients with hypertension, so they needs to be developed to reduce hypertension complications.

Predicting Noninfectious Pulmonary Complications in HIV Positive Patients based on Persistence of the HIV-Nef Protein

Background and Hypothesis: According to the Veterans Aging Cohort Study, people living with HIV (PLWH) in the era of antiretroviral therapy (ART) have incidence rates of COPD, pulmonary hypertension and pulmonary fibrosis that are 16, 50 and 50% higher than the general population, respectively. Despite effective treatment, the HIV-Nef protein continues to persist in the blood and bronchoalveolar lavage (BAL) fluid of HIV positive patients. Studies have shown that HIV-Nef promotes inflammation and induces apoptosis within pulmonary immune and endothelial cells, respectively. HIV-Nef transgenic mice display pulmonary disease phenotypes including reduced number of alveoli, increased inspiratory capacity and hypoxemia. Nef persistence in lungs could explain the high rates of pulmonary complications in PLWH. We hypothesize that patients with HIV-Nef are more likely to exhibit pulmonary dysfunction. &#x0D; &#x0D; Methods: A secondary data analysis was conducted on samples collected from 34 HIV positive patients with variable HIV-Nef levels in plasma and BAL fluids as detected by ELISA. Using GraphPad Prism 8 and p&lt;0.05 for statistical significance, bivariate analyses were performed, including Spearman correlation, simple linear regression and Welch’s t test. &#x0D; &#x0D; Results: In patients with no detectable HIV-Nef in BAL fluids, pulmonary function test (PFT) parameters, such as FEV1/FVC, FEV1 and FEF 25-75 showed a positive correlation with CD4 counts; however, preservation of CD4 counts did not normalize PFT measures in Nef positive patients. HIV-Nef presence in the lungs resulted in higher levels of chemokines and pro-inflammatory cytokines, which led to increased percentages of infiltrating lymphocytes and neutrophils. &#x0D; &#x0D; Conclusion and Potential Impact: Our findings suggest that HIV-Nef mediates inflammation in the lungs and disrupts the protective effect of preserving CD4 count on pulmonary function. Screening for HIV-Nef could become a routine test to predict risk of pulmonary complications. Therapies that target Nef induced pulmonary inflammation could reduce the prevalence of pulmonary diseases in PLWH.