Management Of High Blood Pressure Research Articles

Progressive Muscle Relaxation Therapy to Lower High Blood Pressure in the Elderly Through Community Service Midwifery Lecturer Unand

Background: Elderly health is an increasingly urgent aspect in today's social dynamics. With the increasing number of elderly people in the population, healthcare challenges specific to them are increasingly important to discover. Purpose: This study aims to analyze Progressive Muscle Relaxation Therapy to Lower High Blood Pressure in the Elderly Through Community Service Method: A series of activities were carried out in several stages, with active participation from the elderly Results: The results are in line with previous research that has also shown the effectiveness of this therapy in lowering blood pressure and relieving stress in the elderly population. Increased understanding of progressive muscle relaxation therapy is an important first step in the management of high blood pressure. Participants who better understand these relaxation techniques can use them as aids to maintain their health in the long term. Conclusion: Community service by applying progressive muscle relaxation therapy has proven its benefits in lowering high blood pressure in the elderly. Increased understanding of this therapy, decreased blood pressure, and increased feelings of relaxation are encouraging results

Validity and reliability of the Romanian version of the Hill-Bone compliance to high blood pressure therapy scale.

Romania is considered a country with high cardiovascular risk, arterial hypertension and its complications accounting for about 60% of total deaths. The management of high blood pressure often involves a combination of both therapeutic regimens as well as lifestyle changes, to which patients have to be adherent. In order to assess patients adherence to professionals' recommendations, validated tools are needed. The aim of our study was to translate, culturally adapt and validate the Hill-Bone Compliance to High Blood Pressure Therapy Scale into Romanian. The study included 215 participants from Iasi, North-Eastern Romania. The internal consistency of the instrument was measured with Cronbach's alpha coefficient, while the construct validity was determined using exploratory factor analysis and principal component extraction with promax rotation. Sampling adequacy and appropriateness of data for factor analysis was measured using Kaiser-Meyer-Olkin (KMO) statistics and Bartlett's test of sphericity. Our statistical analysis revealed a Cronbach's alpha coefficient of 0.733 (73.3%) and a Kaiser-Meyer-Olkin (KMO) Measure of Sampling Adequacy of 0.697. The chi square test demonstrated that the overall perfect adherence was not significantly associated with the number of medications taken per day variable (p = 0.721). The Romanian version of the Hill-Bone Compliance to High Blood Pressure Therapy Scale demonstrated suitability for its use in evaluating adherence in the intended population.

Elevated blood pressure among children born to women with obstructed labour in Eastern Uganda: a cohort study

BackgroundGlobally, high systolic blood pressure accounts for 10.8 million deaths annually. The deaths are disproportionately higher among black people. The reasons for this disparity are poorly understood, but could include a high burden of perinatal insults such as birth asphyxia. Therefore, we aimed to assess the incidence of elevated blood pressure and to explore associated factors among children born to women with obstructed labour.MethodsWe followed up children born to women with obstructed labour aged 25 to 44 months at Mbale regional referral hospital that had participated in the sodium bicarbonate trial ( Trial registration number PACTR201805003364421) between October 2021 and April 2022. Our primary outcome was elevated blood pressure defined as blood pressure (either systolic or diastolic or both) ≥ the 90th percentile for age, height, and sex in the reference population based on the clinical practice guideline for screening and management of high blood pressure in children and adolescents. We used logistic regression to estimate odds ratios between selected exposures and elevated blood pressure.ResultsThe incidence of elevated blood pressure was (39/140, 27.9%: 95% (CI: 20.6–36.1)). Participants aged three years and above had twice the odds of elevated blood pressure as those aged less than three years (Adjusted odds ratio (AOR) 2.46: 95% CI (1.01–5.97). Female participants had 2.81 times the odds of elevated blood pressure as their male counterparts (AOR 2.81 95% CI (1.16–6.82). Participants with reduced estimated glomerular filtration rate had 2.85 times the odds of having elevated blood pressure as those with normal estimated glomerular filtration rate (AOR 2.85 95% CI (1.00–8.13). We found no association between arterial cord lactate, stunting, wealth index, exclusive breastfeeding, food diversity and elevated blood pressure.ConclusionOur findings show a high incidence of elevated blood pressure among children. We encourage routine checking for elevated blood pressure in the pediatric population particularly those with known risk factors.

Abstract 18388: Hypertension Identification and Management in the USA: Adherence of the 2017 ACC/AHA High Blood Pressure Guidelines

Background: The 2017 ACC/AHA Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults changed the criteria for a diagnosis of hypertension and provided new recommendations goals and management. We aimed to investigate the prevalence of hypertension identification, treatment, and adherence in the US population. Methods: We analyzed the 2017-2020 pre-pandemic National Health and Nutrition Examination Survey for participants between 18 and 79 years of age. Participant data was used to assess for a hypertension diagnosis and eligibility for AHA/ACC’s primary or secondary prevention hypertension strategies. Current hypertension medication usage was stratified if prescribed for hypertension management or a non-hypertension indication. Participants with a current hypertension-indicated medication were identified as “Undergoing Treatment”; all other participants were stratified into “No Indication”, “Primary Prevention”, or “Secondary Prevention”, based on the AHA/ACC guideline. Complex survey methodology with weighting was utilized for national estimates. Results: Our study included 236,621,712 participants, of which 22.4% (n=53,064,773) were undergoing treatment for hypertension, 67.0% (n=158,613,605) had no indication for management, 8.9% (n=21,158,544) qualified for primary prevention, and 1.6% (n=3,784,790) qualified for secondary prevention. A known hypertension diagnosis was reported in 26.0% of the primary prevention group, 45.0% of secondary prevention, and 94.8% of those undergoing treatment. In patients undergoing treatment, 57.9% of participants had mean blood pressure readings above goal. Conclusion: One in ten adults under 80 qualify for hypertension management but may not be undergoing treatment. Of patients qualifying without current treatment, most did not know they would qualify for a hypertension diagnosis. More than half of treated patients did not meet blood pressure goals.

FORMULATION AND EVALUATION OF NANOPARTICLE DRUG DELIVERY SYSTEM FOR TREATMENT OF HYPERTENSION

Objective: The aim of the current research is to formulate and evaluate Trandolapril loaded solid lipid nanoparticles (SLNs) for the management of high blood pressure. Methods: SLNs were formulated using Glyceryl monostearate and poloxamer 188 by hot homogenisation and ultrasonication method. Different concentrations of lipid and surfactant were used for the preparation adopting 32 full factorial design. The prepared formulations were initially evaluated for particle size, PDI, zeta potential and entrapment efficiency to obtain the optimised formulation. Results: The optimised formulation TF 6 reported the particle size of 212.6±5.39 nm and entrapment efficiency of 91.02±0.57%; this was further characterised for FT-IR, DSC and scanning electron microscopy. The in vitro release of drug for the prepared formulations was performed for 24 h and the optimised formulation showed better-controlled drug release compared to other formulations. Conclusion: The pure Trandolapril solution was collated with the optimised formulation TF 6 and the result concluded that the formulation showed controlled drug release compared to pure drug. This study proves that Trandolapril SLNs can be prepared for increasing the release of drug for prolonged period.

To Estimate the Prevalence of Obesity and High Blood Pressure among Undergraduate Students at a University Medical Institution in North India.

Background: Hypertension is a major public health issue in India. Early detection and management of high blood pressure (BP) is crucial, especially among young adults. This study aimed to estimate the prevalence of obesity and hypertension among undergraduate medical students. Materials and methods: A cross-sectional study was conducted among 450 first year undergraduate medical students aged 18-25 years in S.M.S. Medical and Hospital Jaipur, Rajasthan after clearance from institutional ethics committee and written consent from participants. Anthropometric measurements like height, weight, BMI, waist circumference, hip circumference and blood pressure were recorded. Hypertension was defined as per JNC VIII guidelines. Data was analyzed using appropriate statistical tests. Results: Overall, 15.56% students were hypertensive and 40.67% were prehypertensive. Hypertension was more prevalent in males (18.83%) compared to females (12.33%) (p = 0.002). Overweight/obesity was present in 29.33% students, more common in males (37.67%) than females (21.15%) (p < 0.001). Obese students had higher rates of prehypertension (47%) and hypertension (28.8%). Abnormal waist-hip ratio and waist-stature ratio were significantly associated with hypertension (p < 0.001). Conclusion: Overweight/obesity and hypertension are highly prevalent among undergraduate medical students, especially males. Unhealthy lifestyles and risk factors need to be addressed to prevent long term morbidity. Routine screening and health promotion activities should be conducted for this high risk group. How to cite this article: Sharda K, Saxena P, Yadav SK, et al. To Estimate the Prevalence of Obesity and High Blood Pressure among Undergraduate Students at a University Medical Institution in North India. J Assoc Physicians India 2023;71(11):30-35.

Impact of Therapeutic Education on the Management of High Blood Pressure: A Quasi-experimental Survey From Southern Tunisia.

The prevalence of arterial hypertension (HTA) was continuously increased with a low percentage of pressure control blood pressure among treated patients. Therapeutic education (TE) was one of the inventive methods in the management of high blood pressure (HBP) worldwide. The objective was to assess the impact of TE on the control and management of HBP. This was a quasi-experimental study consisting of an intervention, a pretest, and a post-test evaluation. This study was conducted in the external consultation service of cardiology CHU HEDI CHAKER of Sfax during over a period of 4 months (November 2021-March 2022). In total, 35 of the patients (50%) were women with a sex ratio of 1. The mean age was 63.33 ± 8.91 years. We noted a statistically significant decrease on both systolic and diastolic blood pressure blood pressure values after TE among educated patients (135.3 ± 9.77 vs. 141.9 ± 10.9; P  = 0.010) and (75 [70-80] vs. 80 [75-80]; P  = 0.002), respectively. We found a significantly good knowledge about HBP definition (Odds ratio [OR] = 3.4; P  = 0.022), HBP symptoms (OR = 9.1; P  < 0.001), and HBP complications (OR = 12.3; P  < 0.001) among educated patients. A significant association was noted between educated patients and low daily salt consumption after TE (OR = 2.7; P  = 0.048). Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation Educated patients had significantly more adequate auto-control devise use (OR = 1.01; P  = 0.028). Moreover, the respect of therapeutic compliance was statistically more important among educated patients (OR = 3.7; P  = 0.028). Our results showed that the TE training session is an operative intervention to improve HBP management. Thus, integrating TE therapy in daily care should be continuous and should be exhaustive to all cardiovascular and all chronic diseases.

Ubiquity of Hypertension- Systematic Review

The prevalence, knowledge, diagnosis, treatment, and control of hypertension in an adult population-representative group were alldiscussed in this review. Due to its high prevalence and link to anincreased risk of developing a number of diseases, hypertension is asignificant health concern around the globe illness of the heart.Recent dramatic decreases in the mortality rates from coronary heartdisease and stroke in industrialized nations are largely attributable toimprovements in the diagnosis and management of hypertension. Therates of high blood pressure management in many of these nationshave, however, actually slowed over the past few years. Globally, 1.2billion individuals are anticipated to have hypertension by the year2010. About 125 million people in the Eastern Mediterranean regionsuffer from hypertension, which has a frequency of 26% on average.More concerning is the rise in the frequency of heart failure, stroke,and other cardiovascular complications of high blood pressure,including end-stage renal disease.

Lifestyle Medicine as a Treatment for Resistant Hypertension.

Approximately 10% of the adults with hypertension fail to achieve the recommended blood pressure treatment targets on 3 antihypertensive medications or require ≥ 4 medications to achieve goal. These patients with 'resistant hypertension' have an increased risk of target organ damage, adverse clinical events, and all-cause mortality. Although lifestyle modification is widely recommended as a first-line approach for the management of high blood pressure, the effects of lifestyle modifications in patients with resistant hypertension has not been widely studied. This review aims to provide an overview of the emerging evidence on the benefits of lifestyle modifications in patients with resistant hypertension, reviews potential mechanisms by which lifestyles may reduce blood pressure, and discusses the clinical implications of the recent findings in this field. Evidence from single-component randomized clinical trials demonstrated that aerobic exercise, weight loss and dietary modification can reduce clinic and ambulatory blood pressure in patients with resistant hypertension. Moreover, evidence from multi-component trials involving exercise and dietary modification and weight management can facilitate lifestyle change, reduce clinic and ambulatory blood pressure, and improve biomarkers of cardiovascular risk. This new evidence supports the efficacy of lifestyle modifications added to optimized medical therapy in reducing blood pressure and improving cardiovascular risk biomarkers in patients with resistant hypertension. These findings need to be confirmed in larger studies, and the persistence of benefit over extended follow-up needs further study.

Transforming blood pressure control in primary care through a novel remote decision support strategy based on wearable blood pressure monitoring: The NEXTGEN-BP randomized trial protocol

Despite high blood pressure being the leading preventable risk factor for death, only 1 in 3 patients achieve target blood pressure control. Key contributors to this problem are clinical inertia and uncertainties in relying on clinic blood pressure measurements to make treatment decisions. The NEXTGEN-BP open-label, multicenter, randomized controlled trial will investigate the efficacy, safety, acceptability and cost-effectiveness of a wearable blood pressure monitor-based care strategy for the treatment of hypertension, compared to usual care, in lowering clinic blood pressure over 12 months. NEXTGEN-BP will enroll 600 adults with high blood pressure, treated with 0 to 2 antihypertensive medications. Participants attending primary care practices in Australia will be randomized 1:1 to the intervention of a wearable-based remote care strategy or to usual care. Participants in the intervention arm will undergo continuous blood pressure monitoring using a wrist-wearable cuffless device (Aktiia, Switzerland) and participate in 2 telehealth consultations with their primary care practitioner (general practitioner [GP]) at months 1 and 2. Antihypertensive medication will be up-titrated by the primary care practitioner at the time of telehealth consults should the percentage of daytime blood pressure at target over the past week be <90%, if clinically tolerated. Participants in the usual care arm will have primary care consultations according to usual practice. The primary outcome is the difference between intervention and control in change in clinic systolic blood pressure from baseline to 12 months. Secondary outcomes will be assessed at month 3 and month 12, and include acceptability to patients and practitioners, cost-effectiveness, safety, medication adherence and patient engagement. NEXTGEN-BP will provide evidence for the effectiveness and safety of a new paradigm of wearable cuffless monitoring in the management of high blood pressure in primary care. ACTRN12622001583730.

Editors' Commentary on the 2023 ESH Management of Arterial Hypertension Guidelines.

Clinical practice guidelines are ideally suited to the provision of advice on the prevention, diagnosis, evaluation, and management of high blood pressure (BP). The recently published European Society of Hypertension (ESH) 2023 ESH Guidelines for the management of arterial hypertension is the latest in a long series of high BP clinical practice guidelines. It closely resembles the 2018 European Society of Cardiology/ESH guidelines, with incremental rather than major changes. Although the ESH guidelines are primarily written for European clinicians and public health workers, there is a high degree of concordance between its recommendations and those in the other major BP guidelines. Despite the large number of national and international BP guidelines around the world, general population surveys demonstrate that BP guidelines are not being well implemented in any part of the world. The level of BP, which is the basis for diagnosis and management, continues to be poorly measured in routine clinical practice and control of hypertension remains suboptimal, even to a conservative BP target such as a systolic/diastolic BP <140/90 mm Hg. BP guidelines need to focus much more on implementation of recommendations for accurate diagnosis and strategies for improved control in those being treated for hypertension. An evolving body of implementation science can assist in meeting this goal. Given the enormous health, social, and financial burden of high BP, better diagnosis and management should be an imperative for clinicians, government, and others responsible for the provision of health care services. Hopefully, the 2023 ESH will help enable this.

The Effect of Classical Music Therapy on Blood Pressure Reduction in Hypertension in the Elderly at Tresna Werdha Budi in South Kalimantan Province

Hypertension is an increase in blood pressure. Management of high blood pressure can be carried out with pharmacological and non-pharmacological therapies. Pharmacological therapy is reducing stress by listening to classical music. The purpose of this study was to determine the effect of classical music therapy on reducing blood pressure in the elderly with hypertension. The research design was pre-test experimental with a one-group pre-test and post-test design approach. The population was all elderly people with hypertension at the Tresna Werdha Budi Sejahtera Social Institution, South Kalimantan Province, amounting to 52 people. The sample was 15 people with a purposive sampling technique. Data analysis through Wilcoxon test using 95% confidence level. The results of the study before being given classical music therapy had an average systolic blood pressure of 142 mmHg and after being given classical music therapy the average systolic blood pressure was 124 mmHg. There was an influence between classical music therapy on reducing blood pressure in the elderly with hypertension at the Tresna Werdha Budi Sejahtera Social Institution Banjarbaru, South Kalimantan Province (p value = 0.001). Nurses can provide nursing care interventions to the elderly with hypertension to reduce blood pressure through the provision of classical music.&#x0D; Keywords: Classical Music, Blood Pressure, Hypertension

1249-P: Lack of Concordance of Blood Pressure Control among Heterosexual Couples with Diabetes—An Analysis of Aging Cohorts from USA, China, and India

Background: Previous studies observed high concordance of diabetes and hypertension among married or partnered couples globally due to assortative mating and cohabitation. However, whether there is concordance in controlled blood pressure (BP) among couples with diabetes, an important risk factor for micro/macrovascular complications, is unknown. Methods: Using cross-sectional data from Health and Retirement Study (HRS 2016-17, n = 1749) and its international partner studies from China (CHARLS 2015-16, n = 923) and India (LASI 2017-19, n = 4582), we identified couples (aged 21-97 years) among whom at least one partner had diabetes and both partners had standardized BP measurements. We defined controlled BP as systolic BP &amp;lt; 140 mmHg and diastolic BP &amp;lt; 90 mmHg. We used multiple imputation and survey-weighted modified Poisson regression to study the association of controlled BP between couples for wives and husbands respectively. We adjusted for current medication use, individual and household characteristics. We additionally examined between-country differences in the association. Results: Our analytic sample consisted of 3802 wives and 4504 husbands with diabetes. The proportion of wives with controlled blood pressure were 76.6% [73.2, 80.1] in the USA, 67.5% [63.3, 71.8] in China and 65.1% [62.6, 67.6] in India. The proportion of husbands with controlled blood pressure were 70.8% [67.4, 74.1] in the USA, 63.6% [58.5, 68.6] in China and 60.0% [57.8, 62.3] in India. Partner’s control of BP was not associated with own controlled BP for wives (prevalence ratio, PR: 1.05 [0.97, 1.14]) and husbands (PR: 1.07 [0.94, 1.21]) with diabetes. Estimates of association were null across all countries. Estimates were similar when restricted to couples (n = 1076) when both partners had diabetes. Conclusions: Lack of concordance in BP control among couples with diabetes suggest continuation of strategies for individualized management of high blood pressure. Disclosure J.Varghese: None. C.Li: None. P.Lu: None.

Relationship Between High Sodium Chloride Intake and Obesity in Hypertensive Population A Cross-Sectional Study

Background: High Sodium chloride intake and obesity are significant, regarding hypertension in the population which may develop several medical complications. Objective: The aims and objectives of the current study were to introduce lifestyle medicine awareness in people for managing high blood pressure caused by high sodium chloride intake and obesity. Study Design: It was a cross-sectional clinical Study of the management of high blood pressure in a population with the help of nutrition &amp; physical exercise. Place and Duration: The present study was conducted from January to May 2023 and Patients were selected from the community health center and Ghurky Hospital Lahore. Methodology: ToA total of 10 of 0 hypertensive individuals were selected and divided into different groups regarding hypertension, obesity, sodium chloride intake in daily life, and other demographics. People were separated into different groups based on their sodium intake levels and BMI people were separated into different groups. In group- A there was 50 male and female while in group B other 50 male and female were included respectively. Results: Significant (P≤0.05) changes in systolic and diastolic blood pressure were seen in the individuals of both groups regarding NaCl intake. The mean standard deviation levels, BMI, Systolic and Diastolic blood pressure of men in Group-A and Group-B in the beginning (27.03±0.02, 130.01±0.01, 90.01±0.02), (30.01±0.02, 135.01±0.01, 90.01±0.02) after 15 days (27.03±0.02, 125.01±0.01, 83.01±0.01), (30.01±0.02, 140.01±0.01, 90.01±0.02) and after30 days (27.03±0.02, 124.01±0.01, 80.01±0.01), (30.01±0.02, 145.01±0.01, 100.01±0.01) were measured respectively. Similarly the mean standard deviation levels, BMI, Systolic and Diastolic blood pressure of women in Group-A and Group B in the beginning (28.03±0.02, 131.01±0.01, 88.01±0.02), (31.02±0.02, 131.01±0.01, 88.01±0.02) after 15 days (28.03±0.02, 125.01±0.01, 83.01±0.01), (31.02±0.02, 140.01±0.01, 90.01±0.02) and after30 days (28.03±0.02, 120.01±0.01, 84.01±0.01), (31.02±0.02, 150.01±0.01, 92.01±0.01) were calculated. Conclusion: All recommendations suggest limiting dietary salt as one of the tried-and-true ways to lower high blood pressure because there is a well-established link between excessive salt consumption and hypertension. A current study proved that high sodium chloride intake may increase blood pressure in humans. Keywords: Hypertensive, Sodium Chloride, BMI, Systolic and Diastolic blood pressure.

The impact of updated clinical blood pressure guidelines on hypertension prevalence among children and adolescents.

To date, population estimates of hypertension prevalence among children and adolescents in Canada have been based on clinical guidelines in the National High Blood Pressure Education Program's 2004 Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (NHBPEP 2004). In 2017, the American Academy of Pediatrics published updated guidelines in Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents (AAP 2017), followed by Hypertension Canada in 2020 with its publication of Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children (HC 2020). This study compares national child and adolescent hypertension prevalence estimates based on NHBPEP 2004, AAP 2017 and HC 2020. Six cycles of data spanning 2007 to 2019 from the Canadian Health Measures Survey were used to compare blood pressure (BP) categories and the prevalence of hypertension by sex and age group under all sets of guidelines for children and adolescents aged 6 to 17. The impact of applying AAP 2017 across time and selected characteristics, the resulting reclassification into a higher BP category under AAP 2017, and differences in hypertension prevalence resulting from applying HC 2020 versus AAP 2017 were examined. Prevalence of Stage 1 hypertension was higher among children and adolescents aged 6 to 17 under AAP 2017 and HC 2020 than under NHBPEP 2004. Overall hypertension prevalence was also higher, and obesity was a major factor associated with being reclassified into a higher BP category under AAP 2017. Implementation of AAP 2017 and HC 2020 is associated with significant changes in the epidemiology of hypertension. Understanding the impact of applying updated clinical guidelines may help inform population surveillance efforts to track hypertension prevalence among Canada's children and adolescents.

Joint statement for assessing and managing high blood pressure in children and adolescents: Chapter 1. How to correctly measure blood pressure in children and adolescents.

The joint statement is a synergistic action between HyperChildNET and the European Academy of Pediatrics about the diagnosis and management of hypertension in youth, based on the European Society of Hypertension Guidelines published in 2016 with the aim to improve its implementation. The first and most important requirement for the diagnosis and management of hypertension is an accurate measurement of office blood pressure that is currently recommended for screening, diagnosis, and management of high blood pressure in children and adolescents. Blood pressure levels should be screened in all children starting from the age of 3 years. In those children with risk factors for high blood pressure, it should be measured at each medical visit and may start before the age of 3 years. Twenty-four-hour ambulatory blood pressure monitoring is increasingly recognized as an important source of information as it can detect alterations in circadian and short-term blood pressure variations and identify specific phenotypes such as nocturnal hypertension or non-dipping pattern, morning blood pressure surge, white coat and masked hypertension with prognostic significance. At present, home BP measurements are generally regarded as useful and complementary to office and 24-h ambulatory blood pressure for the evaluation of the effectiveness and safety of antihypertensive treatment and furthermore remains more accessible in primary care than 24-h ambulatory blood pressure. A grading system of the clinical evidence is included.

Prevalence of obesity related hypertension among overweight or obese adults in River Nile State in Northern Sudan: a community based cross-sectional study.

Reducing excess body weight is important for control and management of high blood pressure (BP) in adults. Previous studies showed high prevalence of hypertension in River Nile State-north of Sudan, hence this study to establish whether obesity can be among the main risk factors and to study the prevalence of obesity related hypertension among Sudanese adults in River Nile State. This was a cross sectional community-based study conducted in River Nile State, Northern Sudan from January to June 2021. Obese and overweight, aged 18 years and above and accepted to participate in the study were included in the study. Convenience sampling method was used to select the participants. Data was collected through structured questionnaire filled by the patients after taking informed consent. Anthropometric measurements were taken. Two measurements of BP were obtained. Data was analyzed using SPSS version 23.0 (IBM, Chicago, USA). Chi-square test was used to determine the associations between categorical variables while logistic regression test was used to predict the presence of hypertension among studied population. A total of 1,295 participants were enrolled in this study. Obesity was reported in 1,118 (86.3%) of the participants. The prevalence of hypertension among the participants was 1,027 (79.3%). Central obesity was reported in 951 (92.6%) among hypertensive patients (P<0.001). Moreover, among hypertensive patients 470 (45.8%) were obese class I, 334 (32.5%) overweight, 139 (13.5%) obese class II and 84 (8.2%) obese class III (P<0.001). Obesity, BMI are risk factor of hypertension (P<0.001). Other risk factors were age above 40 years (P<0.001), unemployment (P<0.001), low education level (P<0.001) and being married (P<0.001). Logistic regression analysis showed that increasing age [P<0.001; odds ratio (OR) =1.055; 95% confidence interval (CI): 1.041-1.068], central obesity (P<0.001; OR =5.16; 95% CI: 3.4-7.8) and high body mass index (BMI) (P<0.001; OR =3.7; 95% CI: 1.7-7.9) were associated with uncontrolled hypertension. The study showed that the prevalence of obesity related hypertension was high. Common risk factors were age above 40 years, unemployment, and marriage. Importantly, central obesity, gross obesity and increasing age can be associated with uncontrolled BP management.

Antihypertensive Medications Use among Chronic Hemodialysis Patients Visiting the Outpatient Department of Nephrology of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Anti-hypertensive medications are prescribed for the management of high blood pressure which is the leading cause of mortality in chronic hemodialysis patients. The objective of our study was to find out the prevalence of anti-hypertensive medication use among chronic hemodialysis patients visiting the outpatient Department of Nephrology of a tertiary care centre. This was a descriptive cross-sectional study conducted among chronic hemodialysis patients visiting the Department of Nephrology of a tertiary care centre from 2 April 2022 to 30 September 2022. Ethical approval was taken from the Institutional Review Committee (Reference number: 062-078/079). A convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. The prevalence of anti-hypertensive medications use was present in 102 (97.14%) (93.95-100, 95% Confidence Interval) patient undergoing hemodialysis. The three common drugs prescribed for hypertensive patients were amlodipine 79 (77.45%), torsemide 59 (57.84%), and prazosin 48 (47.05%). The prevalence of antihypertensive medication use among patients undergoing hemodialysis was higher than other similar studies done in similar settings. anti-hypertensive drugs; hemodialysis; prevalence.

Improving cardiovascular health in rural China and beyond

In 2021, high blood pressure claimed 11·3 million lives globally. 1 Vaduganathan M Mensah GA Turco JV Fuster V Roth GA The global burden of cardiovascular diseases and risk: a compass for future health. J Am Coll Cardiol. 2022; 80: 2361-2371 Crossref PubMed Scopus (4) Google Scholar High blood pressure has ranked consistently as the top modifiable risk factor globally for over 20 years. Although its prevalence is universally high, awareness, management, and control of high blood pressure are particularly poor in low-income and middle-income countries. 2 Geldsetzer P Manne-Goehler J Marcus ME et al. The state of hypertension care in 44 low-income and middle-income countries: a cross-sectional study of nationally representative individual-level data from 1·1 million adults. Lancet. 2019; 394: 652-662 Summary Full Text Full Text PDF PubMed Scopus (199) Google Scholar Several cluster randomised controlled trials have shown that community health worker-led interventions were effective in significantly reducing blood pressure in Argentina (the HCPIA trial), 3 He J Irazola V Mills KT et al. Effect of a community health worker-led multicomponent intervention on blood pressure control in low-income patients in Argentina: a randomized clinical trial. JAMA. 2017; 318: 1016-1025 Crossref PubMed Scopus (98) Google Scholar Malaysia and Colombia (the HOPE 4 trial), 4 Schwalm JD McCready T Lopez-Jaramillo P et al. A community-based comprehensive intervention to reduce cardiovascular risk in hypertension (HOPE 4): a cluster randomised controlled trial. Lancet. 2019; 394: 1231-1242 Summary Full Text Full Text PDF PubMed Scopus (92) Google Scholar and Bangladesh, Pakistan, and Sri Lanka (the COBRA-BPS trial). 5 Jafar TH Gandhi M de Silva HA et al. A community-based intervention for managing hypertension in rural South Asia. N Engl J Med. 2020; 382: 717-726 Crossref PubMed Scopus (68) Google Scholar More recently, in 2022, Sun and colleagues 6 Sun Y Mu J Wang DW et al. A village doctor-led multifaceted intervention for blood pressure control in rural China: an open, cluster randomised trial. Lancet. 2022; 399: 1964-1975 Summary Full Text Full Text PDF PubMed Scopus (11) Google Scholar showed that in the China Rural Hypertension Control Project (the CRHCP trial), a village doctor-led intensive hypertension intervention increased hypertension control by 37% compared with usual care. The 18-month net reduction in systolic blood pressure was as large as 14·5 mm Hg. Effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention versus usual care on cardiovascular disease (CRHCP): an open-label, blinded-endpoint, cluster-randomised trialThe non-physician community health-care provider-led intensive blood pressure intervention is effective in reducing cardiovascular disease and death. Full-Text PDF

Abstract P428: Evaluating a Personalized Low Sodium Diet Intervention for Blood Pressure Control in Hypertensive Patients: A Pilot Study

Introduction: Although many clinical trials tested the effects of a low sodium diet (LSD) on high blood pressure (HBP) management, adherence to an LSD remains challenging. Considerable barriers to adherence to diet modification have been examined, and heterogenous responses to an LSD evolved. We tested the intra-individual response to an LSD to develop an individualized dietary intervention to optimize HBP management. The purpose of this pilot study was to determine the effectiveness of a personalized low-sodium diet (P-LSD), enhanced by mobile health technology for real-time dietary assessment and at-home BP monitoring in hypertensive adults. Methods: A total of 24 hypertensive patients (60.4±10.7 years) were randomly assigned to either PLSD (n=16) or usual care control groups (n=8). Participants in P-LSD went through individual sessions via video conferencing to discuss LSD regimens, patients’ food choices, and BP tracks on mobile apps. The Control group followed their usual care for HBP management. All participants in both groups monitored diet and BP using mobile apps for 8 weeks. A 24-hour urinary sodium excretion for the estimation of dietary sodium intake, SBP, and DBP were measured at the baseline and at 8 weeks. The preliminary effects of P-LSD were tested by paired t-test and analysis of covariance (ANCOVA). Results: Dietary sodium intake ( t = 3.82), SBP ( t = 3.95), and DBP ( t = 3.54) were significantly declined overtime in the P-LSD group (Ps&lt;0.01) but not in control group (Ps&gt;0.05). There were significant differences between the control and intervention groups in changes of dietary sodium intake (F=18.6, p&lt;0.001) and SBP over time (F=4.84, p&lt;0.05) before and after the intervention. No statistically significant difference was revealed in DBP between the two groups before the intervention (p=0.20). Conclusion: The PLSD appears to be effective on the adherence to an LSD and BP control in hypertensive patients. Future studies with larger sample sizes are warranted to examine the long-term effects of PLSD on outcomes.