Independent Predictor Of Hypertension Research Articles

Prevalence and associated risk factors of hypertension among pregnant women in rural areas of Dibrugarh District, Assam.

Hypertension is one of the most common medical disorders complicating pregnancies and complicates 5 to 10% of all pregnancies. To estimate the prevalence of hypertension among pregnant women and to determine the associated obstetric risk factors of hypertension among them in rural areas of Dibrugarh district, Assam. Community-based cross-sectional study. The present study was conducted on pregnant women of villages under two health blocks at that point of time from May 2017 to April 2018. The sample size was calculated to be 384. The estimated number of pregnant women in each block was noted, and the pregnant women to be included from each block and from each sub-centre was determined by proportional allocation. Data were collected by house-to-house survey in the villages of the respective sub-centre. A pre-designed and pre-tested proforma was used to collect the data. Data were analysed using Chi-square test, Fisher's exact test, and logistic regression. A total of 384 pregnant women gave consent for participation. The prevalence of hypertension in pregnancy was 9.1%. Among the obstetric factors, multigravidity, multiparity, period of gestation >20 weeks, history of hypertension in previous pregnancy, and history of prior still birth were statistically significant risk factors of hypertension in pregnancy. Logistic regression analysis showed period of gestation >20 weeks to be independent predictor of hypertension in pregnancy. The awareness of obstetric risk factors for hypertension in pregnancy may give ways for prevention in this population.

Comorbidities in Privately Insured South Africans With Systemic Lupus Erythematosus.

Introduction Comorbidities in systemic lupus erythematosus (SLE) impact negatively on health-related quality of life (HRQoL) and life expectancy. We investigated the frequency and spectrum of comorbidities in privately insured South Africans with SLE. Methods The data of SLE patients based on International Classification of Diseases, Tenth Revision (ICD-10) codes and insured with Discovery Health Medical Scheme (DHMS), South Africa, aged ≥16 years at diagnosisand with ≥6 months of follow-up were reviewed. Demographics, comorbidities listed in the Charlson comorbidity index (CCI), other common comorbidities, intercurrent illnesses, and drug therapy were documented. Results Of the 520 patients coded as SLE, 207 met the inclusion criteria. Most were females (90.8%), with a median (interquartile range {IQR}) age and follow-up duration of 39 (30.3-53.0) and 6.1 (3.7-8.1) years, respectively. All patients had at least one comorbidity; the most frequent CCI comorbidities were pulmonary disease (30.9%), congestive heart failure (CHF, 15%), and renal disease (14.0%). Other common comorbidities were hypertension (53.1%) and mood and anxiety disorders (46.9%). Urinary tract infections (UTIs, 37.7%) and pneumonia (33.8%) were common intercurrent illnesses. The independent predictors of CHF were renal disease (odds ratio{OR}=855), dyslipidemia (OR=15.3), and male gender (OR=43.0); the independent predictors of hypertension were age at diagnosis (OR=1.03), type 2 diabetes (OR=4.45), and renal disease (OR=4.34); and the independent predictors of mood and anxiety disorders were female gender (OR=3.98), stroke (OR=3.18), UTI (OR=2.39), and chloroquine use (OR=1.94). Conclusion In this study of privately insured South Africans with SLE, comorbidities were common, and all patients had at least one comorbidity. Hypertension, infections, and mood and anxiety disorders were the leading comorbidities overall, and pulmonary disease was the most commonCCI comorbidity. There is an obvious need to formally study the burden of mental health disorders inSouth African SLEpatients.

Central and peripheral blood pressures in relation to the triglyceride-glucose index in a Chinese population

BackgroundThe triglyceride-glucose (TyG) index has been proposed as a surrogate marker of insulin resistance. However, the relationship between the TyG index and central blood pressure (BP), has not been well studied in adults.MethodsA total of 715 Chinese adult participants were enrolled in this study. Anthropometric and BP were assessed. The TyG index was calculated as ln[fasting triglycerides(mg/dL) × fasting glucose(mg/dL)/2]. Central BP was measured using SphygmoCor system.ResultsThe participants were stratified into three groups based on the TyG index, and significant differences were observed in metabolic and cardiovascular parameters and the prevalence of hypertension among the groups. Both brachial (β = 1.38, P = 0.0310; group highest vs. lowest, β = 2.66, P = 0.0084) and aortic (β = 2.38, P = 0.0002; group highest vs. lowest, β = 3.96, P = 0.0001) diastolic BP were significantly and independently associated with the TyG index and increasing TyG index tertile. However, there was no independent association between the TyG index and systolic BP. A one-unit increase in the TyG index was associated with a 46% higher risk of hypertension (P = 0.0121), and compared with the lowest group, participants in the highest group had a 95% higher risk of hypertension (P = 0.0057).ConclusionsOur study demonstrates a significant and independent association between the TyG index and both brachial and aortic diastolic BP in Chinese adults. Furthermore, the TyG index was found to be an independent predictor of hypertension.

Birth History and Cardiovascular Disease Risk Among Youth With Significant Obesity.

Children born prematurely have greater lifetime risk for hypertension. We aimed to determine (1) the association between prematurity and cardiovascular disease (CVD) risk factors among 90 children with obesity and elevated blood pressure and (2) if dietary sodium intake modified these associations. Multivariable regression analysis explored for associations between prematurity (<37 weeks gestation; early gestational age) and low birth weight (<2.5 kg) with hypertension, left ventricular mass index (LVMI), and left ventricular hypertrophy (LVH). Effect modification by dietary sodium intake was also explored. Patients were predominately male (60%), black (78%), adolescents (13.3 years), and with substantial obesity (body mass index: 36.5 kg/m2). Early gestational age/low birth weight was not an independent predictor for hypertension, LVMI, or LVH. There was no effect modification by sodium load. Our results suggest the increased CVD risk conferred by prematurity is less significant at certain cardiometabolic profiles. Promoting heart-healthy lifestyles to prevent pediatric obesity remains of utmost importance to foster cardiovascular health.

Epidemiology of hypertension among adults in Addis Ababa, Ethiopia

The public health significance of hypertension is increasing in low- and middle-income countries. However, there is limited epidemiological evidence in Ethiopia. We assessed the prevalence of hypertension and explored its predictors among adults in Addis Ababa, Ethiopia. A community-based cross-sectional study was conducted from April to May 2021 among randomly selected adults aged 18–64 years. A face-to-face interview using an adapted STEPwise Approach to NCD Risk Factor Surveillance (STEPS) questionnaire was conducted. Multilevel mixed-effects logistic regression model was fitted to determine factors associated with hypertension. The sample consisted of a total of 600 adults (mean age: 31.2 ± 11.4 years, 51.7% women). The overall age-standardized prevalence of hypertension was 22.1% and 47.8% according to the Seventh Joint National Commission (JNC7) and the 2017 American Heart Association (AHA) guidelines, respectively. About 25.6% were newly diagnosed with hypertension. The age groups of 40–54 years (AOR = 8.97; 95% CI: 2.35,34.23), and 55–64 years (AOR = 19.28; 95% CI: 3.96,93.83) as compared to the 18–24 age group, male sex (AOR = 2.90; 95% CI: 1.22,6.87), obesity (AOR = 1.92; 95% CI: 1.02,3.59), abdominal obesity (AOR = 4.26; 95% CI: 1.42,12.81), and very poor sleep quality (AOR = 3.35; 95% CI: 1.15,9.78) were independent predictors of hypertension. This study revealed that the burden of hypertension among adults is very high. Hypertension is independently associated with older age group, male sex, obesity, abdominal obesity, and poor sleep quality. Therefore, the study highlights the need to develop regular blood pressure surveillance programs, weight loss intervention, and improvement of sleep quality.

Autosomal dominant polycystic kidney disease in young adults.

The clinical manifestations of autosomal dominant polycystic kidney disease (ADPKD) usually appear in adulthood, however pediatric series report a high morbidity. The objective of the study was to analyze the clinical characteristics of ADPKD in young adults. Family history, hypertension, albuminuria, estimated glomerular filtration rate (eGFR) and imaging tests were examined in 346 young adults (18-30 years old) out of 2521 patients in the Spanish ADPKD registry (REPQRAD). A literature review searched for reports on hypertension in series with more than 50 young (age <30 years) ADPKD patients. The mean age of this young adult cohort was 25.24 (SD 3.72) years. The mean age at diagnosis of hypertension was 21.15 (SD 4.62) years, while in the overall REPQRAD population was aged 37.6 years. The prevalence of hypertension was 28.03% and increased with age (18-24 years, 16.8%; 25-30 years, 36.8%). Although prevalence was lower in women than in men, the age at onset of hypertension (21 years) was similar in both sexes. Mean eGFR was 108 (SD 21) mL/min/1.73 m2, 38.0% had liver cysts and 3.45% of those studied had intracranial aneurysms. In multivariate analyses, hematuria episodes and kidney length were independent predictors of hypertension (area under the curve 0.75). The prevalence of hypertension in 22 pediatric cohorts was 20%-40%, but no literature reports on hypertension in young ADPKD adults were found. Young adults present non-negligible ADPKD-related morbidity. This supports the need for a thorough assessment of young adults at risk of ADPKD that allows early diagnosis and treatment of hypertension.

Relationships of hyperchloremia with hypertension and proteinuria in patients with chronic kidney disease.

A few previous clinical studies have shown that chloride (Cl) contributes to the progression and development of hypertension or proteinuria. Therefore, we aimed to determine whether hyperchloremia is associated with hypertension or proteinuria in patients with chronic kidney disease (CKD) and to define the relationships between the reduction in serum Cl concentration associated with CKD treatment and improvements in hypertension and/or proteinuria. We performed a retrospective observational study of new or referred patients with CKD who had hyperchloremia, moderate proteinuria, renal dysfunction, and hypertension. Patients taking medication for metabolic acidosis or with a history of dialysis were excluded. The participants' systolic and diastolic blood pressure (BP), serum sodium (Na) and Cl concentrations, and urinary protein (UP) concentration were measured at baseline and after 1month of CKD treatment. Fifty-one patients with CKD were included in the study. Their serum Cl concentration independently correlated with sBP and UP at baseline (P = 0.022 and P = 0.033, respectively). After 1month's CKD treatment, their serum Na and Cl concentrations, sBP, and UP were significantly lower. The change in sBP during the month (ΔsBP) correlated with the change in serum Cl (ΔCl) (P = 0.012) but not with the change in serum Na. Multivariate analysis showed that ΔsBP was independently associated with ΔCl (P = 0.029). Hyperchloremia is an independent predictor of hypertension and proteinuria for patients with CKD.

MO179: Cardiovascular Disease and Mortality in ANCA-Vasculitis. Importance of Overadded Hypertension and Kidney Function: A South of Spain's Experience

Abstract BACKGROUND AND AIMS Cardiovascular disease (CVD) is one of the principal causes of death in antineutrophil cytoplasmic antibody-(ANCA)-associated vasculitis (AAV), partly due to the vascular inflammation itself, the associated organic damage and the treatment [1]. AAV has been associated with traditional risk factors, such as hypertension (HTN), diabetes mellitus (DM) or impared renal function [2], which also contribute to accelerated atherosclerosis. However, there are not specific recommendations about CVD treatment in AAV patients [3], and the vascular risk scores used for general population have not been extrapolated yet. Our objective is to assess the frequency of cardiovascular events (CVE) and mortality in AAV patients and to explore the possible vascular risk factors (VRF) and the therapeutic intervention on them. METHOD A descriptive and retrospective study of a multidisciplinary cohort of AAV patients followed prospectively was performed in 12 hospitals of the 8 provinces of Autonomous Community of Andalusia. Factors that presumably may influence in CVD and mortality were collected. Two CV risk scores were measured [4, 5]. The presence of a strategy carried out by clinicians on CV risk was analysed according guides ESC/ESH and KDIGO guides. Data was analysed using Chi-square, ANOVA and Cox proportional hazards regresion as uni and multivariate test with a 95% confidence interval. RESULTS A multicentre cohort of 220 AAV patients followed up from 1979 until June 2020 was studied, during a mean ± standard deviation follow-up of 96.79 ± 75.83 months. The mean age at diagnosis was 59.92 ± 16.25 years, 45% were female and all but one caucasians. Sociodemographic and clinical characteristics are shown in Table 1. After AAV diagnosis, 30/224 (13%) patients presented at least one CVE (Figure 1A and B), 37% IHD, 43% CVA and 50% PVD. Independent prognostic factors of CVE were age (HR 1.042, P = .005) and the presence of hypertension (HTN) 6 months after diagnosis (HR 4.641, P = .01). Regarding classic VRFs, 81% had HTN [33% already presented it before diagnosis and 48% after (35% in the first 6 months)]. Thirty-four patients presented DM at the end of following [12% already presented it before diagnosis and 22% presented it after (16% in the first 6 months)]. The independent predictor for HTN at 6 months was renal involvement at BVAS baseline, and DM in the first 6 months for HTN at the end of following. Attending to the ESC Vascular Risk scale, 8.4% presented low risk, 16.9% moderate, 29.8 high and 44.4% very high risk. According to the REGICOR scale, the mean value of suffering a CV event in the next 10 years was 4.6%±3.32%, with 59%, 34% and 7% of patients presenting low, moderate and high risk, respectively. Regarding VRF management strategies, just 14% of hypertensive patients, 16.2% of those that needed dyslipidemia treatment, and 8.6% of diabetic patients were not within the target guidelines recommendations. Fifty-one patients (23%) died (Figure 1C and D), 23.5% due to infectuous disease, 19.6% to cancer, 17.6% to CVD,13.7% to AAV relapse and 13 due to organic deficit, other or an unknown cause. In our final model of multivariate analysis, just age and renal function at baseline were independent predictors of mortality. Independent prognostic factors of mortality were age (HR 1.083, P = .00) and baseline creatinine (HR 4.41, P = .01). CONCLUSION Age and early HTN are risk factors for having a CVE, and age and renal function are predictors of mortality. HTN are more frecuent in AAV patients than in general population. CVD screening in AAV patients is demanded. The REGICOR and ESC scores could be extrapolated as a predictor of cardiovascular risk in AAV patients.

Association of Periodontal Disease with Hypertension in Nigerian Patients: A Comparative Study.

Periodontal diseases are chronic and inflammatory in nature, and have been associated with hypertension, a major risk factor for cardiovascular diseases. Hypertension is prevalent among Nigerians. However, controlled studies on the relationship between hypertension and periodontal disease in Nigeria are limited. Here, we investigated the relationship between periodontal diseases and hypertension among Nigerians. This comparative, cross-sectional study assessed the periodontal clinical parameters, and body mass index (BMI) of 75 hypertensives and 75 gender-matched normotensive controls in a teaching hospital in Lagos, Nigeria. Hypertension was categorized as blood pressure ≥140/90 mm Hg based on the WHO guidelines. Sociodemography, periodontal parameters, BMI, and blood pressure were documented in interviewer-administered questionnaires. Periodontal disease was assessed by the highest Community Periodontal Index (CPI) scores, CPI sextants, gingival index (GI), simplified oral hygiene index (OHIS), and number of teeth with gingival recession. Hypertension was the dependent variable, while periodontal disease, obesity, age were the independent variables. P values <0.05 were considered statistically significant. The mean CPI 3 sextant was significantly associated with hypertension (P<0.05). The independent predictors of hypertension were moderate gingival inflammation (OR 3.314, 95% CI 1.156-9.502, p=0.026), older age >60 years (OR 11.527, 95%CI 2.976-44.651, P<0.001), overweight/obesity (OR 3.279, 95%CI 1.414-7.602, P=0.006), and lower education (OR 3.070, 95% CI 1.288-7.319, P=0.011). In addition to the known risk factors for hypertension, moderate gingivitis was a predictor of hypertension, while hypertensives had a greater extent of pockets than non-hypertensives. This study reiterates the association of preventable, low-grade periodontal inflammation with hypertension.

Prevalence and factors correlated with hypertension secondary from obstructive sleep apnea.

BackgroundIn 2003, the JNC 7 reported obstructive sleep apnea (OSA) as a cause of secondary hypertension. The prevalence of OSA in hypertension ranges from 30-80%. There are limited data on the prevalence and risk factors of OSA in hypertensive patients. This study thus aimed to evaluate prevalence and clinical predictors of obstructive sleep apnea (OSA) in these patients.MethodsThis was a cross-sectional study and conducted at the hypertension clinic at Khon Kaen University’s Srinagarind Hospital, Thailand. We enrolled patients with hypertension treated at the clinic. OSA was defined as apnea-hypopnea index of 5 events/hour or over according to cardiopulmonary monitoring. Patients whose hypertension was due to any other causes were excluded. The prevalence of OSA was calculated and risk factors for OSA were analyzed using multivariate logistic regression.ResultsThere were 726 hypertensive patients treated at the clinic. Out of those, 253 (34.8%) were randomly studied and categorized as either non-OSA (147 patients, 58.1%) or OSA (106 patients, 41.9%). There were four independent factors associated with OSA-induced hypertension: age, sex, history of snoring, and history of headache. Headache had an adjusted odds ratio (95% confidence interval) of 3.564 (95% confidence interval of 1.510, 8.411).ConclusionAge, male sex, history of snoring, and headache were independent predictors of hypertension caused by OSA.

Blood pressure response during treadmill exercise testing and the risk for future cardiovascular events and new-onset hypertension.

The physiologic response to exercise may provide valuable prognostic information. We investigated the association of blood pressure (BP) measurements during exercise stress testing (EST) with long-term risk of myocardial infarction, stroke or death (major adverse cardiovascular event, MACE), as well as the development of new-onset hypertension. A retrospective analysis of treadmill ESTs (years 2005-2019) performed by the Bruce protocol in patients aged 35-75 years without a history of cardiovascular disease (n = 14 792; 48% women). BP was documented at rest, submaximal exercise (Bruce stage-2), peak exercise and recovery (2 min). Association of SBP measures with study outcomes during median follow-up of 6.5 years was investigated. Highest vs. lowest SBP quartile at rest (≥140 vs. <120 mmHg), submaximal-exercise (≥170 vs. <130 mmHg), peak-exercise (≥180 vs. ≤145 mmHg) and recovery (≥160 vs. <130 mmHg) was associated with an increase in the adjusted hazard ratio and 95% confidence interval (CI) for MACE: 1.53 (1.23-1.88), 1.33 (1.01-1.76), 1.30 (1.05-1.61), 1.35 (1.09-1.68), respectively. The association between SBP at submaximal exercise and recovery with MACE displayed a J-shaped pattern. Among nonhypertensive patients (n = 8529), excessive SBP response to peak exercise (≥190 mmHg in women and ≥210 mmHg in men) was an independent predictor of hypertension [hazard ratio (95% CI)]: 1.87 (1.41-2.48), as were SBPs during submaximal exercise [>160 vs. ≤130 mmHg: 2.44 (1.97-3.03)] and recovery [≥140 vs. ≤120 mmHg: 1.65 (1.37-1.98)]. BP measurement during rest, exercise and recovery phases of EST provides incremental prognostic information regarding long-term risk for cardiovascular events and the probability for developing hypertension.

The Relationship Of Arterial Stiffness And Aortic Augmentation Index With Coronary Artery Disease In Patients With Stable Angina Pectoris

Objective : Many studies have indicated arterial stiffness as an independent predictor of hypertension, stroke, cardiovascular events, and mortality. However, the relationship between the severity of coronary artery disease(CAD) and arterial stiffness is still unclear. In this study, it was aimed to examine the relationship between augmentation index which is a marker of arterial stiffness with CAD and its prevalence. Methods: A total of 80 patients (22 women, mean age 59±8) who were scheduled for coronary angiography with a preliminary diagnosis of coronary artery disease by evaluating their symptoms and findings and coronary risk profiles were included. The other group have 20 healthy patients without any chronic disease history. The augmentation index (AIX), which is an indicator of arterial stiffness, was measured in all cases with the BP+ Central Blood Pressure CardioScope II device in all groups. Gensini score of the patient group was calculated. Results: It was found to be 131% (79-198mmHg) in the AIX patient group and 72.5% (69-96mmHg) in the control group (p&lt;0.001). A positive correlation was observed between AIX and Gensini score, LDL-cholesterol, body mass index and HbA1c in the patient group. In the ROC analysis, the area under the curve (AUC) for AIX was calculated as 0.701 (P&lt;0.001). While AIX was 121% above normal, it predicted coronary artery disease with 94.8% sensitivity and 80.9% specificity. Conclusion: In our study, a relationship was found between coronary artery disease with its severity and arterial stiffness. Augmentation index can be used effectively with low cost in predicting coronary artery disease.

The relationship between morning blood pressure surge and left ventricular hypertrophy in newly diagnosed hypertensive patients

Aim: The main aim of this study is to reveal the relationship between the blood pressure surge pattern in newly diagnosed hypertensive patients and left ventricular hypertrophy (LVH).Materials and Methods: 92 patients (60 female, 32 male) were included in the study. Patients who have not been diagnosed with hypertension or even if they have been diagnosed with it, have not received any medication since the last 3 weeks, and who were newly diagnosed with hypertension were included in the study. Morning Blood Pressure Surge (MBPS) was calculated by subtracting the lowest systolic blood pressure recorded during sleep from the systolic blood pressure value of the 2nd hour after awakening.Results: It was observed that 69 patients were nondippers and 29 patients had LVH. As a result of the comparison of LVH groups, it was determined that patients with LVH had higher night time systolic blood pressure values and morning blood pressure surges. In the consequence of the correlation analysis, it was found out that there was a positive correlation between left ventricular mass index and night and 24-hour systolic blood pressure and morning blood pressure surge. Conclusion: The morning blood pressure surge is a marker and independent predictor of hypertension in terms of cardiovascular incidents and target organ damage. In our study, we found the frequency of LVH to be significantly higher in patients with morning blood pressure surges.

The Burden of Hypertension and Associated Factors Among Adults Visiting the Adult Outpatient Department at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, 2016.

BackgroundHypertension is a global health concern that can lead to cardiovascular disease and death. In Ethiopia, the risks for cardiovascular disease have been increasing dramatically. But due to the high burden of communicable diseases, less emphasis is given to non-communicable diseases like hypertension. This study aimed to fill the information gap by determining the prevalence and the key determinants of hypertension in the study area.MethodsInstitution-based cross-sectional study was conducted in Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia from September to October 2016. A total of 414 adults visiting medical OPDs were selected using systematic random sampling. Data were collected by blood pressure measurements and a pre-tested structured questionnaire. Descriptive statistics were computed. Multivariable logistic regression analysis was used to determine the adjusted odds ratio with a 95% confidence interval. The goodness of fit of the model was also checked by Hosmer and Lemeshow test.ResultsThe overall prevalence of hypertension in the study area was 38.9% (95% CI: 34.1–43.7). Age above 55 years (AOR = 3.33, 95% CI: 1.88–5.90), family history of hypertension (AOR = 2.71, 95% CI: 1.37–5.36), diabetes (AOR = 4.15, 95% CI 1.77–9.72), obesity (AOR = 5.50, 95% CI: 2.07–14.62), knee arthritis (AOR = 1.71, 95% CI: 1.24, 2.36), and not walking at least for 10 minutes continuously on daily basis (AOR = 2.86, 95% CI: 1.15 −7.12) were found to be independent predictors of hypertension.ConclusionPrevalence of hypertension was high in the study area, and a large proportion of them were also newly diagnosed. Factors like age, family history of hypertension, diabetes, obesity, knee arthritis, and exercise were found to be independent predictors of hypertension. Therefore, we recommend people who have these risk factors to have screening for hypertension.

Increased Metabolic Burden Among Blacks: A Putative Mechanism for Disparate COVID-19 Outcomes.

Mounting evidence shows a disproportionate COVID-19 burden among Blacks. Early findings indicate pre-existing metabolic burden (eg, obesity, hypertension and diabetes) as key drivers of COVID-19 severity. Since Blacks exhibit higher prevalence of metabolic burden, we examined the influence of metabolic syndrome on disparate COVID-19 burden. We analyzed data from a NIH-funded study to characterize metabolic burden among Blacks in New York (Metabolic Syndrome Outcome Study). Patients (n=1035) were recruited from outpatient clinics, where clinical and self-report data were obtained. The vast majority of the sample was overweight/obese (90%); diagnosed with hypertension (93%); dyslipidemia (72%); diabetes (61%); and nearly half of them were at risk for sleep apnea (48%). Older Blacks (age≥65 years) were characterized by higher levels of metabolic burden and co-morbidities (eg, heart disease, cancer). In multivariate-adjusted regression analyses, age was a significant (p≤.001) independent predictor of hypertension (OR=1.06; 95% CI: 1.04–1.09), diabetes (OR=1.03; 95% CI: 1.02–1.04), and dyslipidemia (OR=0.98; 95% CI: 0.97–0.99), but not obesity. Our study demonstrates an overwhelmingly high prevalence of the metabolic risk factors related to COVID-19 among Blacks in New York, highlighting disparate metabolic burden among Blacks as a possible mechanism conferring the greater burden of COVID-19 infection and mortality represented in published data.

Prevalence and Determinants of Hypertension Among Diabetic Patients in Jimma University Medical Center, Southwest Ethiopia, 2019.

PurposeHypertension is a growing public health problem with a remarkable contribution to morbidity and mortality. It is a common condition which usually coexists with diabetes and aggravates its complications. The objective of this study was to assess the prevalence and determinants of hypertension among diabetic patients attending their follow-up at Jimma University Medical Center (JUMC) from June 1 to August 30, 2019.MethodsA hospital-based cross-sectional study was conducted in diabetic patients attending their follow-up at JUMC. Systematic random sampling and a pretested interviewer-administered structured questionnaire were used to collect information. Data were entered into EPI data 3.1 and exported to SPSS version 20. A variable having a p-value of <0.25 in the bivariate model was subjected to multivariate analysis to avoid the confounding variable’s effect. Adjusted odds ratios were calculated at the 95% confidence interval and considered significant with a p-value of <0.05.ResultsA total of 366 diabetic patients were included in the study. Their mean age was 50.1 ± 14.28 years, and the mean duration of diabetes was 6.8 ± 5.3 years. The study finding showed that the prevalence of hypertension among diabetic patients was 37.4%. According to the multivariate logistic regression analysis, age of ≥50 years [AOR = 4.79; 95% CI: 1.4, 16.4], having body mass index (BMI) of ≥25 [AOR = 3.11; 95% CI: 1.58, 6.12] and khat chewing [AOR =19.34; 95% CI: 10.26, 36.44] were independent predictors of hypertension among diabetic patients.ConclusionOur study found that there is high prevalence of hypertension among diabetic patients. Age of ≥50 years, having BMI of ≥25 kg/m2 and khat chewing were associated with hypertension among participants. Early detection and appropriate interventions should be an important action among patients with age ≥ 50 years, having BMI ≥ 25kg/m2 and khat chewers.

Identification of risk factors for hypertension and tachycardia upon dexmedetomidine discontinuation.

Dexmedetomidine may cause hypertension and tachycardia upon discontinuation. Risk factors are poorly described but may include prolonged infusion, higher doses, a history of hypertension, and abrupt cessation. This study aims to identify risk factors for hypertension and tachycardia upon dexmedetomidine discontinuation. In this single-center, case-control study, critically ill patients requiring dexmedetomidine for 6h or more were screened for hypertension or tachycardia within 24h of discontinuation. We compared baseline and dexmedetomidine-specific data between patients who developed hypertension or tachycardia (cases) and those who did not (controls) and used logistic regression to identify independent risk factors. Of 110 patients, 35 (31.8%) experienced hypertension or tachycardia. When comparing cases to controls, the maximum dexmedetomidine dose was 0.7 and 0.75μg/kg/h (p=.54), cumulative dose was 1174.5 and 1063.5μg/kg/h (p=.43), and duration was 31and 23.25h (p=.22), respectively. Only a past medical history of hypertension was an independent predictor of hypertension or tachycardia upon dexmedetomidine discontinuation. Approximately one third of patients experienced hypertension or tachycardia upon dexmedetomidine discontinuation. A past medical history of hypertension was the only independent risk factor identified in this study based on the clinical data collected.

Can Nesfatin-1 Predict Hypertension in Obese Children?

Objective:The prevalence of childhood obesity is increasing and leads to co-morbidities such as hypertension. However, it is still not clear why some obese individuals are hypertensive and others not. Nesfatin-1 is a recently discovered anorexigenic peptide which also has effects on blood pressure (BP). Our aim was to evaluate the relationship between obesity-related hypertension and Nesfatin-1.Methods:This cross-sectional study comprised 87 obese children. The patients were divided into two groups; hypertensive (n=30) and normotensive (n=57) obese. The American Academy of Pediatrics guidelines were used to diagnose hypertension. Blood samples were collected after 12 hours of fasting to investigate Nesfatin-1 concentrations. We also evaluated serum trace elements in addition to the routine blood tests.Results:Body mass index (BMI), weight and serum Nesfatin-1 concentrations were higher in the hypertensive group (p=0.002, p=0.001, and p=0.007, respectively). There was no difference between serum zinc levels, but Copper (Cu) levels were significantly lower in the hypertensive group (p=0.248, p=0.007, respectively). There were positive correlations between BP and BMI and weight Z-scores and a negative correlation with Cu. The optimal cut-off value of Nesfatin-1 to predict hypertension was found to be >1.8 ng/mL, with a specificity of 71.9% and a sensitivity of 96.7% [area under the curve=0.703, 95% confidence interval (CI): 0.577-0.809; p=0.002]. In multiple logistic regression analysis Nesfatin-1 [Odds ratio (OR)=1.103, 95% CI: 1.039-1.171; p=0.001], Cu (OR=0.947, 95% CI: 0.915-0.979; p=0.001) and BMI for age Z-score (OR=56.277, 95% CI: 5.791-546.907; p=0.001) still remained significant predictors of hypertension.Conclusion:Nesfatin-1 levels are higher and are an independent predictor of hypertension in obese subjects.

Evaluation of Serum Urocortin 2 Levels in Patients with Hypertension.

Urocortin 2 (UCN2), is an endogenous stress-related peptide belonging to the corticotropin-releasing factor (CRF) family, has a major role in the pathogenesis of congestive heart failure, ischemic heart disease, and hypertension. To investigate the role of UCN2 levels in patients with hypertension (HTN). Serum UCN2 levels measured by ELISA were compared between patients with HTN (n = 86) and nonHTN (n = 53). Eighty-six patients with HTN [median age 66 (45-76); 38 men] and 53 patients with non-HTN [median age 62 (40-80); 39 men] were included into this study. Serum UCN2 (5.17ng/ml; IQR, 1.26-11.68ng/ml vs 0.79ng/ml; IQR, 0.07-4.10ng/ml, p < 0.0005) levels were found significantly elevated in patients with HTN compared to nonHTN control group.Concentrations of serum UCN2 were positively correlated with left ventricle mass index to body surface area (LV mass index to BSA, r = 0.20, p = 0.03), LV mass index to height2.7 (r = 0.28, p = 0.002) and body mass index (r = 0.24, p = 0.008). Additionally, logistic regression analysis was performed to UCN2, uric acid, creatinine, glomerular filtration rate, age, body mass index, coronary artery disease and diabetes mellitus which are the potential confounders of hypertension. According to logistic regression analysis serum UCN2 values were found out as an independent predictor of HTN. UCN2 levels, correlated with LV mass index were increased in HTN patients compared to nonHTN patients. These data provide evidence that there could be a relationship between high concentrations of UCN2 and HTN. UCN2 may appear as a promising choice of HTN treatment in the future.

Prevalence of Obstructive Sleep Apnoea Syndrome (OSAS) and Its Association with Hypertension in Jatinangor West Java

Background: Hypertension is a global health problem, with the prevalence increasing by 30% from 2013 to 2018 in Indonesia. Furthermore, obesity, a major risk factor for hypertension, has also escalated by 50%. Hence, the incidence of Obstructive Sleep Apnoea Syndrome (OSAS), which is strongly associated with hypertension and obesity, is expected to increase. OSAS is part of the complex sleep disorder breathing syndrome, but there is a lack of data regarding its prevalence and association with hypertension. Objective: To investigate the prevalence of OSAS and its association with hypertension in Jatinangor, West Java, Indonesia. Methods: A cross-sectional study was conducted from September to October 2018 of subjects from two villages in Indonesia selected by purposive sampling. Fifteen neighbourhoods were chosen by the cluster random sampling method, with a total of 1,308 respondents included in this study. Inclusion criteria were age &gt; 17 years old and resident in the village for more than one year. OSAS was determined by a 4-variable screening tool questionnaire (4-V) and hypertension was measured by a standardised method (average of three measurements in each session with a one-minute break using a digital device); both measurements were performed by trained health cadres. All results were statistically analysed using chi-square and logistic regression. Results: Of the total of 1308 respondents included in this study, 33 (2.5%) had OSAS and 299 respondents (22.8%) had hypertension. In the population with OSAS, 18 respondents (54.5%) had hypertension, significantly higher (p&lt;0.001) compared to the non-OSAS group (22%). After adjustment for age, gender, and Body Mass Index (BMI), OSAS was still an independent predictor of hypertension (OR = 4.3, p = 0.000). Conclusion: The prevalence of OSAS in the Jatinangor district of Indonesia is 2.5% and it is significantly associated with hypertension.