Increased Incidence Of Hypertension Research Articles

Cardiovascular risks of Asian patients on androgen-receptor-targeted agents for prostate cancer: a systematic review and meta-analysis

BackgroundProstate cancer is now one of the most prevalent cancers in men in Asia. As the average life expectancy of Asian males with prostate cancer increases with the availability of treatment options, the possible risk of cardiac-related adverse effects arising from androgen-receptor-targeted agents (ARTAs) may be increased due to the greater exposure. We aim to perform a meta-analysis on the incidence of cardiac-related adverse events in Asian patients with prostate cancer treated with ARTAs. Materials and methodsDatabases were thoroughly searched for relevant articles. The Patient Intervention Comparison Outcome Study type model was used to frame our clinical question, and 2 independent authors went through several rounds of screening to select the final included studies. A meta-analysis was conducted using the Cochran–Mantel–Haenszel method. Quality assessment was carried out with the Cochrane risk-of-bias tool RoB 2. ResultsSeven randomized controlled trials were included for the final meta-analysis. Use of ARTA in Asian men did not show any significant increase in the total number of cardiac-related adverse events (risk ratio [RR]: 1.66 [0.84–3.26], p = 0.14). However, there was increase in incidence of hypertension (RR: 2.30 [1.41–3.73], p = 0.0008) and hypertension crises (RR: 16.87 [2.13–133.34], p = 0.007). A subgroup analysis of the type of ARTA used showed enzalutamide having the highest risk of hypertension (RR: 5.86 [2.10–16.38], p = 0.0008). Conclusion:Although ARTAs did not show any significant increase in incidence of cardiac-related adverse events, there is an increased risk of hypertension especially with the use of enzalutamide. With this knowledge, closer blood pressure monitoring is needed for patients started on ARTA, especially enzalutamide.

Pattern of Cardiovascular Disease among Admitted Patients in Tertiary Care Teaching Hospital

Cardiovascular diseases are the dominant cause of morbidity and mortality worldwide. In 2008, cardiovascular deaths represented 30% of all global deaths, with more than 80% of deaths in developing countries. There is increase in incidence of hypertension, atherosclerosis, stroke, chronic heart failure and atrial fibrillation. The objective of this study is to find the pattern of cardiovascular diseases among patients admitted in cardiac ward. A retrospective analysis of records of admitted patients from 1st January 2016 - 30th December 2017 was conducted in Cardiology ward of Manipal Teaching Hospital, Pokhara, Nepal. A total of 2268 patients' data were taken from the ward register. The data was collected and analyzed with descriptive and inferential statistics using SPSS 18.0 version during the period from 1st June to 30th August 2018. The age ranged between 12 to 95 years with a mean (SD) is 61.23(16.34 years). More than half (51%) of the patients were female gender. Forty-six percentages of the patients were in the age group of 56 - 75 years. More than 1/3rd (35%) were diagnosed with Ischemic heart disease (IHD) followed by hypertension (22.8%) and arrhythmia(13.4%). There was a significant association between age and gender with the pattern of cardiovascular disease. Ischemic heart disease, hypertension and arrhythmia were the major causes of hospitalization. Preventive measures at community and personal level focusing on the risk factors management of ischemic heart disease will alleviate the burden of ischemic heart disease.

Abstract P287: The Rising Trend of Hypertension in Pediatric and Adolescent Patients

Background: A concerning trend in society today is the development of lifelong diseases, such as hypertension, at an early age. The sequelae of prolonged uncontrolled hypertension are devastating and include the development of vascular disease, kidney disease, and ultimately increased mortality among other things. Though it is thought that today’s children are affected by chronic conditions such as hypertension more frequently than in previous generations, this has not been thoroughly analyzed. This study aimed to evaluate incidence of hypertension, as well as mortality rates in patients with a diagnosis of hypertension in 2 different hospitalized patient populations, children ages 0-12 and adolescents ages 13-18 over the course of a 7-year period from 2005-2012. Methods: An NIS database was queried from 2005-2012. Exclusion criteria included patients greater than >18 years old and patients with secondary causes of hypertension, as this study was looking at essential hypertension only. Analysis was performed via chi square or t test with SAS 9.4, all values were significant when p<0.05. Results: As per our analysis, the incidence of hypertension in the pediatric populations had a decline in 2006, but since then it has been on the rise while hypertension in the adolescent age group showed a consistent upward trend. Furthermore, our data also revealed that the incidence of hypertension was highest in the Caucasian race in comparison to the other races, with a p-value of < 0.001. Lastly, the likelihood of mortality in hospitalized pediatric populations with a diagnosis of hypertension was 2.03 while in adolescents it was 0.84 with a p value of <0.001. Discussion: It is thought that the increase in incidence of hypertension in these patient populations could potentially be due to the high sodium, high fat, and low fiber diets of most American citizens. It is well documented that obesity is an epidemic in the youth of America and we believe an analysis of the correlation between hypertension and obesity in these patient populations is warranted, as it is possible that dietary modification in these patients could result in a lower incidence of hypertension, and thus lower mortality and morbidity rates.

Isoflavones, calcium, vitamin D and inulin improve quality of life, sexual function, body composition and metabolic parameters in menopausal women: result from a prospective, randomized, placebo-controlled, parallel-group study.

IntroductionMenopause results in metabolic changes that contribute to increase risk of cardiovascular diseases: increase in low density lipoprotein (LDL) and triglycerides and decrease in high density lipoprotein (HDL), weight gain are associated with a correspondent increase in incidence of hypertension and diabetes. The aim of this study was to evaluate the effect of a preparation of isoflavones, calcium vitamin D and inulin in menopausal women.Material and methodsWe performed a prospective, randomized, placebo-controlled, parallel-group study. A total of 50 patients were randomized to receive either oral preparations of isoflavones (40 mg), calcium (500 mg) vitamin D (300 UI) and inulin (3 g) or placebo (control group). Pre- and post-treatment assessment of quality of life and sexual function were performed through Menopause-Specific Quality of Life Questionnaire (MENQOL) and Female Sexual Function Index (FSFI); evaluations of anthropometric indicators, body composition through bioelectrical impedance analyser, lumbar spine and proximal femur T-score and lipid profile were performed.ResultsAfter 12 months, a significant reduction in MENQOL vasomotor, physical and sexual domain scores (p < 0.05) and a significant increase in all FSFI domain scores (p < 0.05) were observed in treatment group. Laboratory tests showed significant increase in serum levels of HDL (p < 0.05). No significant changes of lumbar spine and femur neck T-score (p > 0.05) were found in the same group.ConclusionsAccording to our data analysis, isoflavones, calcium, vitamin D and inulin may exert favourable effects on menopausal symptoms and signs.

Study of Uncontrolled Hypertensive Patients At Sohag University Hospital

Introduction: Hypertension (HTN) is universally accepted as one of the most important risk factors in the development of cardiovascular disease (CVD), stroke and renal disease. There has been a considerable increase in the prevalence of HTN in the Middle East during the last few years. In some Arab countries HTN has become a major health problem. This drastic increase in incidence of HTN is specifically caused by a combination of many parameters, including family history, change in lifestyle, dietary habits and environmental factors. Aim of the work: Investigate the frequency of uncontrolled HTN in sohag university hospital and determine the risk factors that may be responsible for the the poor control in the study participants. Patients and Methods: Cross sectional study, included group of 500 hypertensive patients selected randomly from referral clinics in the Sohag university hospitals. Results: Uncontrolled hypertension is a major health problem and accounts for a large percentage of total hypertensive patients. Conclusion: Improving the awareness of hypertension, its control and causes and management of uncontrolled hypertension are major issues for the management of uncontrolled hypertension.

White Crystals Controversy: Sugar rather than Salt as the Etiology of Hypertension

Traditionally, salt intake is linked to hypertension, and salt restriction forms the foundation for “lifestyle” management of hypertension. Despite an increase in incidence of hypertension in the population, data did not show any increase in salt intake over longer time frame. Increased intake of processed food amounts to increase in sugars especially fructose. Rampant and excessive commercial use of high fructose corn syrup in ready-to-eat “fast” food results in hypertension by various mechanisms. This interesting shift of concept of white crystals from salt to sugar is reviewed in this commentary.

Cardio-respiratory response of young adult Indian male subjects to stress: Effects of progressive muscle relaxation

<b>Background:</b> Stress and anxiety have become an integral part of our lives. Of late, this has resulted in the increase in incidence of hypertension and coronary heart disease. <b>Objectives:</b> To assess the effect of progressive muscle relaxation (PMR) on young adult males and its role in the modulation of cardio-respiratory response on exposure to stress. <b>Materials and Methods:</b> This prospective cross-sectional study was conducted in a tertiary care referral hospital. Undergraduate male students under stress were chosen for the study. Fasting blood samples were drawn to analyze sugar and lipid profile, followed by anthropometric measurements and ECG. In the resting condition, blood pressure, pulse rate, and spirometric parameters; forced vital capacities (FVC), and forced expiratory volume in 1 sec (FEV ₁ %) were measured. Then, they were made to exercise with bicycle ergometer and post exercise, the vital parameters were recorded. All subjects were given a training of Jacobson's Progressive Muscular Relaxation and asked to practice this technique for 3 months. All parameters were re-evaluated. <b>Results:</b> Significant decreases in resting heart rate, systolic blood pressure and diastolic blood pressure, total cholesterol, triglyceride, and low density lipoprotein (LDL) cholesterol levels of subjects were seen after PMR training. Exercise-induced rise in heart rate and blood pressure were also significantly less in subjects following PMR training. <b>Conclusion:</b> Progressive muscle relaxation helps in modulation of heart rate, blood pressure, and lipid profile in healthy normal adult male individuals.

Progression to hypertension in the non-hypertensive participants in the Flemish Study on Environment, Genes and Health Outcomes

To evaluate the consistency between a randomly recruited Western European population and the participants of the Framingham Heart Study, with respect to the rates and determinants of progression to hypertension. Among the non-hypertensive individuals enrolled in the Flemish Study on Environment, Genes and Health Outcomes, we assessed progression from optimal (< 120/80 mmHg), normal (120-129/80-84 mmHg) and high-normal (130-139/85-89 mmHg) blood pressure to hypertension (> or = 140/90 mmHg). Our analysis included 781 women and 675 men (age range 10-77 years) who were followed up for a median of 4.6 years (interquartile range 2.4-8.1 years). Our statistical methods included Kaplan-Meier survival function estimates, the log-rank test and multiple Cox regression. In individuals younger than 50 years, 4-year progression rates associated with optimal, normal and high-normal blood pressure were 7.4% [95% confidence interval (CI) 5.5-9.3], 17.9% (95% CI 14.3-21.6) and 24.5% (95% CI 18.7-30.2), respectively. Corresponding 4-year rates of progression for individuals aged 50 years or older were 16.4% (95% CI 11.2-22.5), 26.3% (95% CI 19.8-32.9) and 54.0% (95% CI 45.7-62.3), respectively. In multivariate Cox regression, blood pressure category and body mass index at baseline were strong predictors of hypertension. Before the age of 50 years, male sex and a fast heart rate were also forerunners of hypertension. The stepwise increase in incidence of hypertension across the three non-hypertensive blood pressure categories in our cohort was similar to that observed in the Framingham Heart Study. The Framingham findings, which have informed several guidelines, can be extrapolated to a Western European population.