Independent Risk Factor For Hypertension Research Articles

Association of Body Fat Mass and Fat Distribution With the Incidence of Hypertension in a Population-Based Chinese Cohort: A 22-Year Follow-Up.

BackgroundThere have been few studies on the association between the incidence of hypertension and the presence and distribution of body fat. The aim of this article was to evaluate this association.Methods and ResultsData were obtained from the China Health Nutrition Survey, a 22‐year cohort study of 12 907 participants. Body mass index and triceps skinfold thickness were used as markers of body fat, whereas waist circumference (WC) was used as a marker of fat distribution. Cox regression was used to examine the association of body mass index, WC, and skinfold thickness with the incidence of hypertension. The interval between the baseline and hypertension diagnosis was the time variable, and hypertension was the end event. The mean age and proportion of men and women were 38.29 and 38.03 years and 45.63% and 54.37%, respectively. Compared with normal WC, abdominal obesity was associated with hypertension (P<0.001; crude hazard ratio, 2.11; 95% confidence interval, 1.89–2.37). Similarly, overweight (crude hazard ratio, 1.75; 95% confidence interval, 1.64–1.87) and obesity (crude hazard ratio, 3.19; 95% confidence interval, 2.80–3.63) were risk factors for hypertension (all P<0.001). When stratified by sex, the results confirmed that WC and body mass index predicted the development of hypertension in both men and women but not skinfold thickness in women.ConclusionsBody mass index and WC were independent risk factors for hypertension, but skinfold thickness was a poor marker of body fat and could not be used to predict hypertension.

Prevalence, Awareness, Treatment, and Control of Hypertension and Its Risk Factors in (Central) Vietnam.

Introduction The objective of this study is to describe the prevalence, awareness, treatment, and control of hypertension and its associated risk factors in (Central) Vietnam. Methods In this cross-sectional study, a multistage sampling was used to select 969 participants from the general population aged from 40 to 69 years. The cardiovascular risk factors were collected throughout the interviews with a standardized questionnaire. Multivariate logistic regression analysis was conducted to test the relationship between the prevalence, awareness, treatment, and control of hypertension and the prevalence of risk factors. Results The prevalence of hypertension was 44.8%. It was higher in men than in women (51.3% versus 39.7%, p < 0.001). In total 67.3% (74.5% in women, 60.1% in men; p = 0.001) of the participants were aware of their hypertension, 33.2% (37.5% in women, 28.9% in men; p = 0.01) of the participants were treated, and 12.2% (16.7% in women, 7.8% in men; p < 0.001) of the hypertensive participants' hypertension was controlled. Age, gender, place of residence, body mass index, and diabetes were found to be independent risk factors for hypertension. Conclusion The prevalence of hypertension in Vietnam is high, and the proportion of treated and controlled patients is rather low.

The Association of ADRB1 and CYP2D6 Polymorphisms With Antihypertensive Effects and Analysis of Their Contribution to Hypertension Risk

BackgroundGenetic factors have a vital influence on the pathogenesis of hypertension. In this retrospective study, we aimed to evaluate the association of ADRB1 and CYP2D6 polymorphisms with antihypertensive effects and perform an analysis of their contribution to hypertension risk. MethodsA total of 261 healthy individuals and 261 essential hypertension patients treated with metoprolol for 12 weeks were enrolled. ADRB1 and CYP2D6 genotypes were identified by xTAG liquid chip technology. We used multivariate logistic regression and a generalized linear mixed model to assess hypertension-related risk factors. ResultsThe allele frequencies of ADRB1 and CYP2D6 variants were 59.8% and 64.6% in the essential hypertension group and 70.3% and 65.9% in the controls, respectively. The genotype and allele distribution of ADRB1 were significantly different between the 2 groups (P < 0.05), but there was no significant difference in CYP2D6 distribution (P = 0.91 and 0.88). By logistic regression analysis, high fasting plasma glucose, smoking, high triglyceride and the Gly/Gly polymorphism in Arg389Gly ADRB1 all emerged as independent risk factors for hypertension. Additionally, the ADRB1 genotype played a major role in the antihypertensive effect of metoprolol and the patients with the Gly389Gly genotype showed a significantly better response to metoprolol than did those with a heterozygous ADRB1 mutation (Arg389Gly) (P = 0.027). ConclusionsThe results demonstrate that Gly/Gly polymorphism in Arg389Gly ADRB1 was an independent risk factor together with high fasting plasma glucose, smoking and high triglyceride; moreover, the patients who carried the Gly389Gly genotype had a significantly improved metoprolol antihypertensive effect than those with ADRB1.

Is the Effect of Body Mass Index on Hypertension Modified by the Elevation? A Cross-Sectional Study of Rural Areas in Japan.

Obesity is an established independent risk factor for developing hypertension. A recent study showed that the effect of obesity on hypertension varies by the elevation of the residence area. Thus, we hypothesized that the interaction effect of body mass index (BMI) and elevation has a significant association with hypertension. The first aim of this cross-sectional study was to examine whether BMI was associated with hypertension, after adjustment for covariates. The second aim was to examine whether the interaction term between BMI and elevation was associated with hypertension, after adjustment for covariates. Data were collected from a cross-sectional study conducted in a rural area of Japan in 2016. After excluding participants with missing data (n = 2), data from 729 participants were analyzed. We found that BMI was significantly associated with hypertension. In addition, the interaction term between BMI and elevation had a significant association with hypertension. The findings of the present study support the recent evidence that high BMI is an independent risk factor for hypertension, but its effect varies by elevation. Thus, context-specific interventions could be an effective approach to prevent hypertension in this area.

The prevalence of risk factors of cardiovascular diseases in persons with arterial hypertension exposed to occupational&#x0D; stress

Based on the literature data and the results of their own research, the authors emphasize the importance of studying adverse effects of high emotional load during stress-induced hypertension and draw attention to the high prevalence of modifiable risk factors of cardiovascular disease among servicemen exposed to occupational stress. It has been shown that lifestyle of hypertensive subjects under heavy stress is characterized by irrational changes in eating behavior, high prevalence of smoking, increased alcohol consumption, and low physical activity. The leading role of long-term emotional stress was demonstrated as an independent risk factor of hypertension in servicemen exposed to long-term occupational psycho-emotional stress. Analysis of the intima-media complex thickness in brachiocephalic arteries, depending on the level of psychosocial stress demonstrated that the group of the examined servicemen with hypertension showed changes that might be due to the development of atherosclerotic process, the response to increased flow, and arterial wall tension at a high level of stress. These changes are unidirectional regardless of the duration of hypertension history. Results of evaluation of the overall risk of developing cardiovascular complications based on the SCORE scale in the servicemen with established and newly diagnosed hypertension under heavy stress suggest its enhancement in the next 10 years which makes necessary implementation of a system of measures for preventing and correcting pathological conditions caused by stressful loads. Stratification of risk factors is essential for early diagnosis of hypertension and the choice of adequate therapy in subjects undergoing high psycho-emotional stress.

Fructose Intake, Serum Uric Acid, and Cardiometabolic Disorders: A Critical Review

There is a direct relationship between fructose intake and serum levels of uric acid (UA), which is the final product of purine metabolism. Recent preclinical and clinical evidence suggests that chronic hyperuricemia is an independent risk factor for hypertension, metabolic syndrome, and cardiovascular disease. It is probably also an independent risk factor for chronic kidney disease, Type 2 diabetes, and cognitive decline. These relationships have been observed for high serum UA levels (>5.5 mg/dL in women and >6 mg/dL in men), but also for normal to high serum UA levels (5–6 mg/dL). In this regard, blood UA levels are much higher in industrialized countries than in the rest of the world. Xanthine-oxidase inhibitors can reduce UA and seem to minimize its negative effects on vascular health. Other dietary and pathophysiological factors are also related to UA production. However, the role of fructose-derived UA in the pathogenesis of cardiometabolic disorders has not yet been fully clarified. Here, we critically review recent research on the biochemistry of UA production, the relationship between fructose intake and UA production, and how this relationship is linked to cardiometabolic disorders.

Impaired fasting glucose predicts the development of hypertension over 6 years in female adults: Results from the rural Chinese cohort study

AimsTo investigate whether impaired fasting glucose (IFG) is an independent risk factor for incident hypertension in a rural Chinese population. MethodsWe selected 9583 eligible participants 18 to 75years old, who were without hypertension and diabetes at baseline (from 2007 to 2008) and were from a rural area in the middle of China. Concentration of fasting glucose at baseline was assessed in quartiles to predict hypertension risk by gender. Odds ratios (ORs) and 95% confidence intervals (CIs) for IFG (fasting glucose of 100 to 125mg/dl) associated with hypertension were estimated by logistic regression models. ResultsRisk of hypertension was increased for females with glucose levels in quartile 2 (90–96mg/dl), quartile 3 (96–102mg/dl), and quartile 4 (102–125mg/dl) versus quartile 1 (<90mg/dl): OR=1.27 (95% CI=1.01–1.60), 1.30 (1.04–1.63), and 1.55 (1.24–1.93), respectively. During the 6-year follow-up, the cumulative incidence of hypertension was greater for people with IFG than normal fasting glucose (NFG) at baseline (23.9% vs 18.4%, p<0.001 for males and 23.8% vs 16.4%, p<0.001 for females). Risk of incident hypertension was significantly increased for females with IFG versus NFG (OR=1.23 95% CI=1.05–1.45). ConclusionsIFG may be an independent risk factor for hypertension in normotensive nondiabetic Chinese females.

Hypertension in treated and untreated patients with HIV: a study from 2011 to 2013 at the Jos University Teaching Hospital, Nigeria.

Individuals with HIV, especially those on antiretroviral therapy (ART), may have increased risk of hypertension. We investigated the prevalence of hypertension at enrolment and 12 months after commencing ART in a Nigerian HIV clinic. Data from patients enrolled for ART from 2011 to 2013 were analysed, including 2310 patients at enrolment and 1524 re-evaluated after 12 months of ART. The presence of hypertension, demographic, clinical and biochemical data were retrieved from standardized databases. Bivariate and logistic regressions were used to identify baseline risk factors for hypertension. Prevalence of hypertension at enrolment was 19.3% (95% CI 17.6-20.9%), and age (p<0.001), male sex (p=0.004) and body mass index (BMI) (p<0.001) were independent risk factors for hypertension. Twelve months after initiating ART, a further 31% (95% CI 17.6-20.9%) had developed hypertension. Total prevalence at that point was 50.2%. Hypertension among those on ART was associated with age (p=0.009) and BMI (p=0.008), but not with sex. There were no independently significant associations between hypertension and CD4+ counts, viral load or type of ART. Hypertension is common in HIV infected individuals attending the HIV clinic. Patients initiating ART have a high risk of developing hypertension in the first year of ART. Since BMI is modifiable, life-style advice aimed at weight reduction is strongly advisable.

Incidence and risk factors for hypertension among HIV patients in rural Tanzania - A prospective cohort study.

IntroductionScarce data are available on the epidemiology of hypertension among HIV patients in rural sub-Saharan Africa. We explored the prevalence, incidence and risk factors for incident hypertension among patients who were enrolled in a rural HIV cohort in Tanzania.MethodsProspective longitudinal study including HIV patients enrolled in the Kilombero and Ulanga Antiretroviral Cohort between 2013 and 2015. Non-ART naïve subjects at baseline and pregnant women during follow-up were excluded from the analysis. Incident hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg on two consecutive visits. Cox proportional hazards models were used to assess the association of baseline characteristics and incident hypertension.ResultsAmong 955 ART-naïve, eligible subjects, 111 (11.6%) were hypertensive at recruitment. Ten women were excluded due to pregnancy. The remaining 834 individuals contributed 7967 person-months to follow-up (median 231 days, IQR 119–421) and 80 (9.6%) of them developed hypertension during a median follow-up of 144 days from time of enrolment into the cohort [incidence rate 120.0 cases/1000 person-years, 95% confidence interval (CI) 97.2–150.0]. ART was started in 630 (75.5%) patients, with a median follow-up on ART of 7 months (IQR 4–14). Cox regression models identified age [adjusted hazard ratio (aHR) 1.34 per 10 years increase, 95% CI 1.07–1.68, p = 0.010], body mass index (aHR per 5 kg/m2 1.45, 95% CI 1.07–1.99, p = 0.018) and estimated glomerular filtration rate (aHR < 60 versus ≥ 60 ml/min/1.73 m2 3.79, 95% CI 1.60–8.99, p = 0.003) as independent risk factors for hypertension development.ConclusionsThe prevalence and incidence of hypertension were high in our cohort. Traditional cardiovascular risk factors predicted incident hypertension, but no association was observed with immunological or ART status. These data support the implementation of routine hypertension screening and integrated management into HIV programmes in rural sub-Saharan Africa.

Association of serum uric acid and risk of hypertension in adults: a prospective study of Kailuan Corporation cohort

Whether hyperuricemia is an independent risk factor for hypertension in adults is still under debate. To determine the association between serum uric acid and risk of hypertension in the Chinese population, we conducted a prospective study using the "Kailuan Corporation cohort." A total of 39,233 adult subjects with available data on serum uric acid were enrolled from 2006 to 2007. Subjects with established hypertension were excluded and were then grouped based on the gender and baseline quartile serum uric acid into F1-4 for women and M1-4 for men with F1 and M1 being the lowest quartiles. Incidence of newly described primary hypertension was reevaluated in 2010-2011. The median (interquantile range) baseline uric acid (UA) was 290 (243-344)μmol/L in men and 230 (194-274)μmol/L in women. During a 4-year follow-up period, 12,844 subjects (31.31%) were newly diagnosed with hypertension. The incidence of hypertension was 14.36, 16.57, 19.06, and 22.35% in F1 to F4 and 33.64, 33.97, 36.54, and 40.74% in M1 to M4, respectively. Multiple logistic regression analysis showed that the odds ratios (ORs) of incident hypertension were 1.17 [95% confidence interval (CI) 1.00-1.37, P=0.055], 1.24 (95% CI 1.06-1.45, P=0.009), and 1.20 (95% CI 1.02-1.41, P=0.027) in F2 to F4 compared to the F1 and 0.98 (95% CI 0.91-1.05, P=0.534), 1.05 (95% CI 0.98-1.13, P=0.190), and 1.13 (95% CI 1.05-1.22, P=0.002) in M2 to M4 compared to the M1. Elevated level of serum uric acid is associated with an increased risk of hypertension in adults.

Prevalence of hypertension and its associated risk factors in adults: a nique study at field practice area of urban health training centre

Background: The theme for World Health Day 2013 based on controlling high blood pressure, a condition which affects more than one in three adults and leads to more than nine million deaths worldwide every year. There is a felt need for the community based studies in urban and rural areas of our country with a view to determine the geographic differences in the prevalence of hypertension. The knowledge about the existing risk factors of hypertension in the local community helps in developing prevention programs tailor-made to modify behavioral changes and promoting healthy lifestyles among the target groups. The present study was undertaken to estimate the prevalence of hypertension and examine its associated risk factors in an urban area. The aim and objectives were to find out the prevalence of hypertension in the field practice area of Urban Health Training Centre and to study the risk factors associated with hypertension.Methods:A case control study after community based cross sectional study was conducted in the field practice area of Urban Health Training Centre of Government Medical College, Aurangabad, India. Subjects were examined with the help of pretested proforma. The blood pressure, weight, height of the subjects were measured and recorded according to standard protocol. Data was entered and analyzed using Epi Info statistical software.Results: 305 study subjects were examined. The overall prevalence of hypertension was 26.2%. Prevalence of hypertension was more in females 33.3% than in males 16.8% which was found to be statistically significant. All risk factors were subjected to multiple logistic regression analysis. Out of fourteen risk factors submitted for multivariate analysis, five out to be significant and independent risk factors for hypertension i.e. (higher socioeconomic status, Mixed diet, Additional dietary salt intake, &lt;8hrs of sleep and restless sleep).Conclusions:These observations re-emphasize the need for tailor-made hypertension awareness programs. It also brings to light the need for follow-up, counselling and monitoring of hypertensive’s to reduce non-compliance to anti-hypertensive medication and lifestyle modification in urban areas.

Association of hematocrit with blood pressure and hypertension.

Hypertension (HTN) is a risk factor for stroke, renal failure, and cardiovascular disease. The association between biochemical and hematological parameters with high blood pressure may provide a more precise approach to risk prediction conferred by HTN in these patients. The aim of current study was to explore whether biochemical and hematological parameters are associated with HTN in a cohort study with a 7-year follow-up. A total of 9808 individuals were enrolled and recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study, and biochemical and hematological factors were measured in all subjects. Univariate and multivariate logistic regression analysis were performed to determine the association of biochemical and hematological parameters with HTN. Several biochemical parameters including fasting plasma glucose (FBG), serum high-sensitivity C-reactive protein (hs-CRP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and uric acid were increased in hypertensive participants. In contrast, serum high-density lipoprotein cholesterol (HDL-C) was lower in hypertensive individuals. Furthermore, we demonstrated that hematological parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (HGB), hematocrit (HCT), and mean corpuscular hemoglobin (MCH) were higher in the hypertensive group compared to the control group. But mean corpuscular volume (MCV), and red cell distribution width (RDW), were decreased in the hypertensive group. Furthermore, our results strongly suggested that among these parameters, hematocrit was the independent risk factor for hypertension in the population. We demonstrated the association of altered biochemical and hematological factors with hypertension supporting the value of emerging markers for early prediction of high blood pressure in prone individuals.

Baroreflex Sensitivity in Children and Adolescents: Physiology, Hypertension, Obesity, Diabetes Mellitus

The increased prevalence of obesity in children and its complications have led to a greater interest in studying baroreflex sensitivity (BRS) in children. This review of BRS in children and adolescents includes subtopics on: 1. Resting values of BRS and their reproducibility, 2. Genetics of BRS, 3. The role of a primarily low BRS and obesity in the development of hypertension, and 4. Association of diabetes mellitus, BRS, and obesity. The conclusions specific to this age follow from this review: 1. The mean heart rate (HR) influences the measurement of BRS. Since the mean HR decreases during adolescence, HR should be taken into account. 2. A genetic dependency of BRS was found. 3. Low BRS values may precede pathological blood-pressure elevation in children with white-coat hypertension. We hypothesize that low BRS plays an active role in the emergence of hypertension in youth. A contribution of obesity to the development of hypertension was also found. We hypothesize that both factors, a primarily low BRS and obesity, are partially independent risk factors for hypertension in youths. 4. In diabetics, a low BRS compared to healthy children can be associated with insulin resistance. A reversibility of the BRS values could be possible after weight loss.

Obstructive Sleep Apnea – Epidemiology, Consequencies and Prosthetic Rehabilitation. A Review

AbstractObstructive sleep apnea (OSA) is recognized as an important health issue in the last two to three decades. It is characterized by frequent episodes of upper airway collapse during sleep, causing recurrent arousals, intermittent hypoxaemia, sleep fragmentation and poor sleep quality. Obstructive sleep apnea (OSA) is a prevalent disorder with significant co-morbidities. There are evidences that OSA is being considered as an independent risk factor for hypertension, glucose intolerance / diabetes mellitus, cardiovascular diseases and stroke, leading to increased cardiometabolic morbidity and mortality. Early recognition and treatment of obstructive sleep apnea may prevent adverse health consequences. In this sense, treating the patient with obstructive sleep apnea requires a long-term partnership between patient and healthcare providers. With a strong partnership, obstructive sleep apnea may be effectively treated in the growing numbers of patients. In this article some of the epidemiological aspects, consequences, medical and dental treatment options of obstructive sleep apnea are reviewed.

Association between daytime sleepiness and hypertension among patients with obstructive sleep apnea-hypopnea syndrome

Objective: To assess the association between daytime sleepiness and hypertension among patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: A total of 1 958 patients from Sleep Medicine Center of West China Hospital between January 2015 and January 2016 were included in the study. All subjects underwent one night polysomnography (PSG) and Epworth sleep scale (ESS) was estimated. The patients were divided into non-OSAHS group[apnea-hypopnea index (AHI)<5/h]and OSAHS group (AHI≥5/h) based on PSG, and then OSAHS group was further divided into those with and without daytime sleepiness groups according to ESS score (the cut point of ESS was 14). The association between blood pressure and risk of suffering from hypertension among patients with different degree of daytime sleepiness was explored by binary logistic regression. Results: There were 1 580 men and 378 women among the included patients, the mean age was (44.3±11.6) years old and the mean body mass index (BMI) was (26.4±3.8) kg/m2. Among these patients, there were 267 non-OSAHS and 1 691 OSAHS patients (1 275 without daytime sleepiness and 416 with daytime sleepiness). The prevalence of hypertension was higher among OSAHS patients (53.9%vs 28.8%) than non-OSAHS group, and OSAHS patients had higher systolic blood pressure (SBP)[(126.3±0.4) vs (116.3±4.9) mmHg], diastolic blood pressure (DBP)[(82.4±0.3) vs (78.1±3.7) mmHg]and mean arterial pressure (MAP)[(97.0±0.3) vs (90.9±3.9) mmHg]than non-OSAHS group. And OSAHS with daytime sleepiness also had elevated DBP[(84.5±0.6) vs (81.7±0.3) mmHg]and MAP[(98.8±0.6) vs (96.5±0.3) mmHg]than those without sleepiness (all P<0.05). After controlling for age, sex, BMI, smoking, drinking, AHI and related sleep parameters, OSAHS combined with daytime sleepiness increased the odds of hypertension by 23% (OR=1.23, 95% CI: 1.01-1.65) compared to OSAHS without daytime sleepiness. Conclusion: The daytime sleepiness is an independent risk factor of hypertension in OSAHS patients.

PP.16.18] ASSOCIATION BETWEEN HYPERURICEMIA AND ABNORMAL HEART RATE RECOVERY IN HYPERTENSIVE PATIENTS WITH NON-DIPPING PATTERN

Objective: Sympatho-vagal balance, as measured by heart rate recovery (HRR) at the first minute after exercise, is correlated with long-term prognosis in patients with cardiovascular disease. Higher serum uric acid (UA) is an independent risk factor for hypertension; and hyperuricemia is associated with non-dipping pattern (<10% fall in nocturnal blood pressure) among hypertensive patients. Given the importance of nondipper hypertension on cardiovascular outcomes, the present study tested the hypothesis that heart rate recovery is associated with hyperuricemia among hypertensive patients with non-dipping pattern. Design and method: The study included 122 essential hypertensive patients (64% Male, 55 ± 3 years) subdivided into two groups according to 24-hour ABPM resuts: 48 dippers and 74 nondippers. All patients underwent ambulatory blood pressure monitoring and exercise stress testing. HRR was calculated as the difference between the heart rate at peak exercise and after 1-min cooling down. Results: No significant differences in office blood pressure (BP) values were observed between non-dipper and dipper hypertensive patients (Figure 1-2). Compared to dippers, the nocturnal systolic (Figure 3), diastolic (Figure 4), and mean BP levels (Figure 5), were found to be significantly greater among non-dippers, respectively. Non-dippers hypertensive patients showed significantly higher serum UA levels compared to dippers (Figure 6); and high sensitivity C-reactive protein (hsCRP) (Figure 7). Non-dippers hypertensive patients showed significantly lower HRR compared to dippers (Figure 8).Among non-dippers, a significant correlation between UA levels and HRR was observed (r = 0.38, P < 0.001). After adjusting for age, gender, body mass index, smoking habits, creatinine levels, hsCRP and comorbidity, multivariate analysis revealed an independent association between HRR and serum UA levels among non-dippers (ß = 0.312, P = 0.002). Conclusions: Serum UA is independently associated with abnormal heart rate recovery in hypertensive patients with nondipper circadian pattern.

End Organ Damage in Essential Hypertension: An Experience at a Tertiary Level Hospital in Mumbai

Background: Early detection of hypertension and assessment of target organ functions is vital for maintenance of health. Associated comorbid conditions like diabetes mellitus, obesity, hyperlipidemia, smoking and old age increases the risk for early target organ involvement. Our aim was to study the prevalence of target organ damage in essential hypertension, effect of duration and severity of hypertension on target organ damage and to study the effect of comorbid conditions on target organ damage. Methods: We included patients with recently detected hypertension as well known cases of hypertension. Both inpatients admitted in wards as well as outpatients attending the hypertension clinic and admitted in the wards were registered for this study after taking valid informed consent. Patients underwent clinical examinations after detailed clinical, family and medication related history and followed by routine and specific investigations. Results: 100 patients were included in the study, of which 61 were males, mean age of 54 years (±2.4 years). Common modes of presentation of the patients were headache, giddiness and chest discomfort. We observed that controlling hypertension in patients resulted in significant changes when investigated with fundoscopy, electrocardiogram and 2 D echocardiogram. Additionally, duration and severity of hypertension had an effect on target organ damage, which came out as statistically significant. Conclusion: Smoking, alcohol, obesity, diabetes mellitus and dyslipidaemia are independent risk factors for hypertension and target organ damage. As the duration and severity of hypertension increases the incidence of target organ damage increases. Hypertension along with other risk factors like smoking, alcohol, dyslipidaemia, obesity and diabetic mellitus magnifies the risk of complications.

MPS 17-06 Baseline and change in uric acid concentration over time are associated with incident hypertension in large Korean cohort

Objective: It is uncertain whether high baseline uric acid (UA) or change in UA concentration over time is related to development of incident hypertension. To investigate relationships between: a) baseline serum uric acid concentration and b) change in UA concentration and incident hypertension. Design and Method: 96,606 Korean individuals (with follow up UA data available for 56,085 people) participating in a health check program was undertaken. Cox regression models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CI) for incident hypertension comparing baseline UA quartiles to the lowest UA quartile, and comparing individuals with an increase in UA to those with a decrease in UA concentration over time. Results: 96606 individuals were followed for up to 8 years (median follow-up 3.3 years; IQR, 1.9 to 5.1). 10,405 cases of incident hypertension occurred. In the fully adjusted regression model, there was a significant increase in aHR across increasing UA quartiles at baseline (p value for trend < 0.001 and 0.001 in men and women, respectively), with aHRs comparing the highest to the lowest UA quartiles of 1.29 (95% CI 1.20, 1.39) in men and 1.24 (95% CI 1.09, 1.42) in women. Additionally, stable or increasing UA concentration over time was associated with increased risk of incident hypertension, particularly in participants with baseline UA concentration ≥median (aHRs 1.14 [95% 1.03–1.26] and 1.17 [95% 0.98–1.40] in men and women, respectively). Conclusions: High initial UA concentration and increases in UA concentration over time should be considered independent risk factors for hypertension.

Baseline and Change in Uric Acid Concentration Over Time Are Associated With Incident Hypertension in Large Korean Cohort.

It is uncertain whether high-baseline uric acid (UA) or change in UA concentration over time is related to development of incident hypertension. To investigate relationships between: (i) baseline serum UA concentration and (ii) change in UA concentration and incident hypertension. About 96,606 Korean individuals (with follow-up UA data available for 56,085 people) participating in a health check program was undertaken. Cox regression models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for incident hypertension according to UA quartiles regarding the lowest UA quartile as the reference, and also according to change in UA concentration comparing individuals with an increase in UA to those with a decrease in UA concentration over time. Total follow up time was 8 years (median follow-up 3.3 years; interquartile range, 1.9-5.1). About 10,405 cases of incident hypertension occurred. In the fully adjusted regression models, the HRs (95% CI) for incident hypertension comparing the highest vs. the lowest quartiles of UA were 1.29 (1.19-1.38) in men and 1.24 (1.09-1.42) in women, with statistically significant P for trend for both gender. Additionally, stable or increasing UA concentration over time was associated with increased risk of incident hypertension, particularly in participants with baseline UA concentration ≥median (aHRs 1.14; 95% CI (1.03-1.26) and 1.18; 95% CI (0.98-1.40) in men and women, respectively). High initial UA concentration and increases in UA concentration over time should be considered independent risk factors for hypertension.

Effect of Antihypertensive Medications on the Severity of Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis.

Obstructive sleep apnea (OSA) is an independent risk factor for hypertension (HTN). Increasing evidence from animal and human studies suggests that HTN exacerbates OSA. We performed a systematic review and meta-analysis of studies evaluating the effect of anti-hypertensive medications on the severity of OSA. A literature search of PubMed and Embase was done using search concepts of OSA, HTN, and drug classes used to treat HTN. Studies that reported changes in the severity of OSA objectively by using apnea-hypopnea index (AHI) or respiratory disturbance index (RDI) were included. Pooled mean difference estimates were calculated. Tests for heterogeneity, publication bias, and subgroup sensitivity analysis were conducted. Of 27,376 studies screened, only 11 met inclusion criteria, including 5 randomized controlled trials and 6 single-arm prospective trials. The pooled mean difference estimate (95% confidence interval [CI]), based on a random-effects model, was -5.69 (95% CI -10.74 to -0.65), consistent with an overall decrease in AHI or RDI attributable to antihypertensive medications. The effect size was even more pronounced, -14.52 (95% CI -25.65 to -3.39), when only studies using diuretics were analyzed. There was no significant heterogeneity or publication bias among the studies. Meta-regression indicated neither age, baseline AHI, nor change in systolic/diastolic blood pressure influenced the results. Collectively, findings from these relatively small, short-term studies tend to support the contention that treatment with antihypertensive agents confers a statistically significant, albeit small, reduction in the severity of OSA, which may be more pronounced with the use of diuretics.