Normal Blood Pressure Levels Research Articles

Abstract 17296: Autonomic Dysfunction in Metabolic Syndrome With Normal Blood Pressure is Associated With Exacerbate Response of Blood Pressure During Maximal Exercise

Introduction: Hypertensive patients presented impairment in the blood pressure (BP) response during maximal exercise test. Sympathetic hyperactivation and decreased baroreflex sensitivity (BRS) are involved in the progression of metabolic syndrome (MetS) in cardiovascular disease. Hypothesis: (1) MetS patients with normal level of clinical BP show exaggerate peak and recovery systolic BP in response to maximal exercise; (2) Muscle sympathetic nerve activity (MSNA) and BRS are associated with these impairments. Methods: We selected MetS (ATP III) patients with normal BP (ASH/ISH criteria; MetS= 27, 46±1 y) and a healthy control group without MetS (C= 19, 48±2 y). We evaluated MSNA(microneurography), BRS (spontaneous BP and HR fluctuations) and auscultatory BP measures at pretest, peak, 1 st , 2 nd , 4 th min of recovery during cardiopulmonary exercise test. Results: Compared to C, MetS had higher BMI and impairment in all MetS risk factors. MetS had higher BP at pretest, peak, 1 st , 2 nd , 4 th min of recovery (P<0.05). Interestingly, we found that even MetS patients with normal BP had lower spontaneous BRS for decreases (9.38 + 0.7 vs. 12.33 + 1.25 msec/mmHg, P=0.03) and higher levels of MSNA (27 + 1 vs. 18 + 1 bursts/min, P<0.001) compared to C. Further analyses showed association between BRS for decreases with peak BP (r=-.32; P=0.04). Moreover, the MSNA had association with peak BP (r=.40; P=0.03) and BP at 1 st min of recovery (r=.48; P=0.01). Fascinatingly, a subgroup of MetS patients with normal BP but exaggerate peak BP (systolic BP >190 mmHg for women and >210 mmHg for men) showed strong association between BRS for decreases with peak BP (r=-.70; P<0.02) and BRS for decreases with BP at 1 st min of recovery (r=-.73; P<0.04). Conclusion: MetS patients even with normal BP, already show sympathetic hyperactivity and decreased baroreflex sensitivity which could explain, at least in part, the exacerbated BP response during maximal exercise.

Patient-Specific Oscillometric Blood Pressure Measurement.

Most automatic cuff blood pressure (BP) measurement devices are based on oscillometry. These devices estimate BP from the envelopes of the cuff pressure oscillations using fixed ratios. The values of the fixed ratios represent population averages, so the devices may only be accurate in subjects with normal BP levels. The objective was to develop and demonstrate the validity of a patient-specific oscillometric BP measurement method. The idea of the developed method was to represent the cuff pressure oscillation envelopes with a physiologic model, and then estimate the patient-specific parameters of the model, which includes BP levels, by optimally fitting it to the envelopes. The method was investigated against gold standard reference BP measurements from 57 patients with widely varying pulse pressures. A portion of the data was used to optimize the patient-specific method and a fixed-ratio method, while the remaining data were used to test these methods and a current office device. The patient-specific method yielded BP root-mean-square-errors ranging from 6.0 to 9.3 mmHg. On an average, these errors were nearly 40% lower than the errors of each existing method. The patient-specific method may improve automatic cuff BP measurement accuracy. A patient-specific oscillometric BP measurement method was proposed and shown to be more accurate than the conventional method and a current device.

Compliance of antihypertensive drug use in patients with hypertension

> To understand the compliance of antihypertensive drug use in patients with hypertension. A retrospective analysis was conducted among 218 patients with hypertension to understand their drug use compliancy and influencing factors, including side effect of the drugs, drug type, educational level, economic status and drug use length. The factors including disease course, drug type, drug use length and drug side effects, the economy status, educational level, awareness of hypertension related knowledge and psychological reaction could significantly influence the compliance of antihypertensive drug use. Among the patients surveyed, 86.67% of them with poor drug use compliance had only an educational level less than senior high school, 77.33% had poor awareness of hypertension related knowledge. The antihypertensive drug use compliance in patients with hypertension is directly related to the outcome of the disease in clinical treatment. It is necessary to take effective measures to improve the treatment compliance and maintain normal blood pressure level of the patients.

Bridging hypertension in children and adolescents with hypertension in adult individuals

There is growing awareness that in children also “essential” hypertension is the most prevalent form of blood pressure (BP) elevation, and that it may be associated with target organ damage. Evidence is also available that suggests that a child with hypertension has a higher probability of being hypertensive at an adult age than a child with normal BP levels. This suggests that pathophysiological mechanisms contributing to the development of hypertension in childhood might contribute to consolidate such a condition at an adult age. As in adults, in children being overweight or obese have become an epidemic problem associated with elevated BP. This is also the case for lack of physical exercise and excessive intake of sodium with food. It has to be emphasized that in children it is not only weight excess that is associated with increased BP, but the distribution of adipose tissue also plays a role. Among young subjects with similar body weight, those with a greater waist circumference are at a greater risk of having high BP, possibly due to humoral factors released by visceral fat. Indeed, increased insulin resistance (assessed through the HOMA index), increased leptin and uric acid levels are positively and independently associated with increased BP values in children and adolescents, while an inverse correlation has been found with plasma adiponectin levels. Another factor which might contribute to hypertension in childhood is a dysfunction of autonomic neural cardiovascular modulation, characterized by an increase in cardiovascular sympathetic and a reduction in cardiac vagal modulation, documented by a reduction of cardiac arterial baroreflex sensitivity, remaining significant even after adjustment for increased body weight. These considerations underscore the importance of using techniques for 24h ambulatory BP and heart rate monitoring in the diagnostic and therapeutic management of children and adolescents with hypertension aimed at assessing their hemodynamic reactivity and the related pattern of cardiovascular autonomic nervous modulation, in daily life conditions. Given the young age of the subjects being addressed, it is possible that pathophysiological factors contributing to hypertension might still be modifiable and that no structural cardiovascular changes have yet occurred in this age range, the appearance of which might make hypertension an irreversible condition. The hypertensive child therefore represents a challenge to the medical community for implementing interventions able to achieve true early cardiovascular disease prevention, besides being a potential model for a better understanding of the pathophysiological mechanisms underlying essential hypertension in adults.

Can office blood pressure readings predict masked hypertension?

Studies in children with chronic kidney disease indicate a high prevalence of masked hypertension detected by ambulatory blood pressure monitoring (ABPM). However, it is not well known if the frequency of masked hypertension is related to the level of normal casual blood pressure (BP). We hypothesized that lower levels of normal casual BP are associated with a lower prevalence of masked hypertension. Data from the chronic kidney disease (CKiD) cohort were analyzed cross-sectionally across multiple visits. The majority of children with normal casual BP also had normal wake and sleep ABP (60%), even at the highest percentiles of casual BP. The frequency of masked hypertension was lower in children with casual BP ≤25th percentile versus those with casual BP in 26-50th percentile and casual BP in 51-90th percentile during both wake and sleep periods. In children with the lowest normal casual BP levels (≤25th percentile), the frequency of abnormal mean wake or sleep ABP was 2-7%, and of abnormal BP load was 6-16%. These data suggest that masked hypertension is unlikely if the casual BP is found to be in the low normal range.

Blood Pressure Levels at the Time of Percutaneous Coronary Revascularization and Risk of Coronary In-Stent Restenosis.

High blood pressure (BP) levels expose patients treated with percutaneous coronary interventions (PCI) to very high risk of 10-year cardiovascular morbidity and mortality. To investigate the role of BP levels at the time of PCI on the risk of in-stent restenosis (ISR). We retrospectively included 796 patients previously treated with PCI, who underwent repeated angiography for recurrent angina or reversible myocardial ischemia. Patients were stratified into either case (n = 354) and control (n = 442) groups in the presence or absence of ISR (defined as in-stent diameter stenosis ≥50%). BP levels were measured at the time of first and second procedures. Normal BP levels were defined for <140/90 mm Hg. Patients with normal BP showed significantly higher ISR-free survival (Log-rank: 5.937; P = 0.015). Both systolic (HR (95% CI): 0.731 (0.590-0.906)) and systolic/diastolic BP (HR (95% CI): 0.757 (0.611-0.939)) were significantly and independently associated with lower risk of ISR at Cox-regression analysis, adjusted for potential confounding factors, including stent type and concomitant medications. Patients with ISR showed lower rates of normal systolic/diastolic BP values (166 (47%) vs. 254 (57%); P = 0.003) compared to controls. They also received higher stent number (1.40±0.74 vs. 1.24±0.51; P < 0.001) with higher stent length (24.3±15.6 vs. 21.7±13.9 mm; P = 0.012), and lower rate of drug-eluting stents (DESs) (210 (48%) vs. 139 (40%); P = 0.025) compared to controls. Normal BP at the time of PCI is associated with nearly 24% risk reduction of ISR as evaluated in a new angiography in patients with coronary artery disease.

Prevalence of Hypertension in the Elderly

In 2011, an estimated 524 million people (8% of the world’s population) were aged 65 or older. Until 2050, this number is expected to nearly triple to about 1.5 billion, representing 16% of the world’s population. Between 2010 and 2050, the number of older people in less developed countries is projected to increase more than 250%, compared with a 71% increase in developed countries [1]. Chronic non-communicable diseases (NCDs) such as cardiovascular disease and diabetes are the leading cause of death worldwide, having comprised 60% of all deaths in 2005. Approximately 80% of NCD-attributable deaths are occurring in low and middle-income countries [2]. Hypertension is one of the most powerful contributors to cardiovascular morbidity and mortality. In order to collect more information in this regard, the prevalence of high blood pressure (BP) was assessed among subjects examined in this study. In this cross-sectional study, a total of 1,060 Iranian subjects living in Hamadan, during the period of 6 months starting from March until August 2012 randomly participated. BP was measured in the sitting position after 10 min rest and the mean of three readings from right arm was used in the analysis. High BP was defined according to the JNC VII and WHO guideline criteria; a systolic BP (SBP) > 140 mmHg or a diastolic BP (DBP) > 90 mmHg or being on treatment. Stage I (mild hypertension) was defined as an SBP between 140-159 mmHg and a DBP between 90-99 mmHg. Stage II and III (moderate and severe hypertension) were defined as a SBP ≥ 160 mmHg or a DBP ≥ 100 mmHg. Subjects receiving at least one antihypertensive drug and presenting with a normal BP level (< 140/90 mmHg) were identified. Those subjects having high BP in spite of pharmacological treatment were classified as uncontrolled hypertensive. In this study, the mean age of men and women were 68.9 ± 15.3 and 57 ± 14 years, respectively. Subjects were selected in near equal proportion in both sexes (48% male and 52% female). Women, especially the younger ones, had a mean BP level lower than men, but the difference between genders was shown to decrease with age, especially in the older age groups. The prevalence of high BP in men and women were 16.4% and 19.2% respectively. The severity of hypertension increased with age. Stages II-III of hypertension was more frequent in men than in women, but this difference was not significant and 12.3% of the older patients had moderate to severe hypertension. Hypertension is the most prevalent cardiovascular disease. Data about the prevalence of hypertension, mean levels of SBP and DBP and concomitant risk factors can be helpful in planning preventive strategies [3].

Coronary artery disease risk among obese metabolically healthy young men.

The aim of this study was to assess coronary artery disease (CAD) risk among obese young men without metabolic risk factors. A longitudinal study in a historical cohort. Incident CAD during a median follow-up of 6.1 years was assessed among 31,684 young men (mean age 31.2 ± 5.7 years) of the Metabolic, Lifestyle and Nutrition Assessment in Young Adults (MELANY) cohort. Participants were categorized by BMI and the number of metabolic abnormalities (based on the Adult Treatment Panel-III). Metabolically healthy (MH) obesity was defined as BMI ≥ 30 kg/m(2) in the presence of normal blood pressure (BP) and normal levels of fasting glucose, triglyceride, and HDL-cholesterol (HDL-c) levels (n = 599; 1.9%). Cox proportional hazard models were applied. There were 198 new cases of CAD that were diagnosed during 209,971 person-years of follow-up, of which six cases occurred among MH obese. The incidence of CAD among MH lean, overweight, and obese participants was 0.23, 0.45, and 1.0/1000 person-years respectively. In a multivariable model adjusted for clinical and biochemical CAD risk factors, a higher CAD risk was observed among MH-obese (hazard ratio = 3.08; 95% CI = 1.10-8.68, P = 0.033), compared to MH-normal weight subjects. This risk persisted when BMI was treated as a time-dependent variable, or when fasting glucose, HDL-c, triglycerides, or BP were added to the model. Similar results were also obtained when a more permissive definition of MH was used. Obesity may continue to contribute to increased risk for incident CAD in young men even in the presence of a healthy metabolic profile.

Blood pressure control for diabetic retinopathy.

Blood pressure control for diabetic retinopathy.

White coat hypertension: improving the patient-health care practitioner relationship.

White coat hypertension is characterized by the variability of a patient’s blood pressure measurements between the physician’s office and the patient’s home environment. A patient with white coat hypertension has high blood pressure levels in the physician’s office and normal blood pressure levels in their typical environment. This condition is likely caused by the patient’s anxiety within the physician’s office and in the presence of the physician. Research has shown that improving the relationship between a patient and their health care provider can decrease the patient’s anxiety, with the implication of decreasing the patient’s likelihood of demonstrating white coat hypertension. This review provides an overview of the previous literature regarding white coat hypertension, its prevalence, and the consequences for those who develop persistent hypertension. Furthermore, this review discusses the implications of improving patient and health care provider interactions through effective communication, empathy, and trust, as well as the implications for future research studies in improving the patient and health care provider’s relationship.

Uso de stents recobertos no tratamento da coarctação da aorta

Background:The wide morphological variety of coarctation of the aorta (CoA) and some complications resulting from the implantation of conventional stents has made the utilization of covered stents (CS) desirable. We describe our experience with the use of CS to treat CoA in children and adults. Methods:The records of patients that received CS were retrospectively reviewed. The procedures were performed according to the established technique. Use of CS as primary treatment were assessed, as well as those deployed due to complications resulting from the initial procedure. Results:Between 2007 and 2014, CS were used in 14 patients, 9 (64.3%) of whom were males. The mean age was 19.5 ± 10.5 years, and the mean weight 61.7 ± 25.5kg. Bicuspid aortic valve was present in 74% of cases, and two patients had patent ductus arteriosus. Subatretic aortic coarctations were found in five patients. Eleven patients had systemic arterial hypertension, and 73% had normalized blood pressure levels after stent dilation. Implantation was possible in all cases. Primary implants were performed in ten (71.4%) patients with native coarctation and in four patients as a second device to correct problems originating from previous procedures. The mean time of follow‐up was 51.7 ± 29.8 months. Three minor complications were related to procedures, and there were no deaths. Conclusions:The use of CS was safe and effective in this small case series. Further studies focusing on the long‐term evolution and the possibility of CS redilation are needed to support its use in children.

Use of covered stents in the treatment of aortic coarctation

BackgroundThe wide morphological variety of coarctation of the aorta (CoA) and some complications resulting from the implantation of conventional stents has made the utilization of covered stents (CS) desirable. We describe our experience with the use of CS to treat CoA in children and adults. MethodsThe records of patients that received CS were retrospectively reviewed. The procedures were performed according to the established technique. Use of CS as primary treatment were assessed, as well as those deployed due to complications resulting from the initial procedure. ResultsBetween 2007 and 2014, CS were used in 14 patients, 9 (64.3%) of whom were males. The mean age was 19.5 ± 10.5 years, and the mean weight 61.7 ± 25.5kg. Bicuspid aortic valve was present in 74% of cases, and two patients had patent ductus arteriosus. Subatretic aortic coarctations were found in five patients. Eleven patients had systemic arterial hypertension, and 73% had normalized blood pressure levels after stent dilation. Implantation was possible in all cases. Primary implants were performed in ten (71.4%) patients with native coarctation and in four patients as a second device to correct problems originating from previous procedures. The mean time of follow-up was 51.7 ± 29.8 months. Three minor complications were related to procedures, and there were no deaths. ConclusionsThe use of CS was safe and effective in this small case series. Further studies focusing on the long-term evolution and the possibility of CS redilation are needed to support its use in children.

Non- Pharmacological Measures for Control of Hypertension in Geriatric Population

Background: Increased prevalence of hypertension in all over the world is well recognized. Hypertension affects almost all body organs and systems. It can be managed by using nonpharmacological measures as well. Objective: To assess knowledge of non-pharmacological measures to control of hypertension and its application in geriatric hypertensive population. Methods: The study was conducted in the Department of Physiology, Sumandeep Vidyapeeth University, Vadodara. Total 108 hypertensive patients had been included for this study. Subjects were administered pre tested ten questionnaires. They responded the questionnaires at the same time, without any discussion. Results: Knowledge about normal level of blood pressure was lacking in 70% of study population. Conclusion: Knowledge about weight reduction, regular exercise, fruits and vegetables intake was poor. About half of the study population said that blood pressure can be controlled by using of drugs only. So, they were not aware of non-pharmacological measures. DOI: http://dx.doi.org/10.3329/jbsp.v9i2.22804 Bangladesh Soc Physiol. 2014, December; 9(2): 94-97

Endothelial Nitric Oxide Synthase 3 (eNOS3) Gene Polymorphisms and Essential Hypertension in Javanese Ethnic Group

Hypertension is still a major public health problem in Indonesia and in several other countries. This disease is caused by multi factorial components involving both environmental and genetic factors. eNOS3 gene is one of the enzymes related to the high prevalence of hypertension. This gene expresses the NOS enzyme which regulates the synthesis of NO. NOS enzyme causes vasodilatation which decreases peripheral resistance and lowers blood pressure. This cross sectional study compared hypertension patients to those with normal blood pressure in the age group of 40-80 years old. The main purpose of this study is to evaluate the influence of eNOS3 gene Glu298Asp allele expression in Javanese ethnic group patients with hypertension. The samples consist of 50 respondents with hypertension and 50 respondents with normotension as control. Data of eNOS3 gene polymorphisms and NO plasma levels from the respondents were analyzed using t-test and chi-square test. Glu298Asp allele genotype variation in eNOS3 gene was detected by PCR-FRLP using primers G894TF and G894TR and the PCR products were cut using Mbol restriction enzymes. Sequencing result of each polymorphism band shows a typical nucleotide sequence compared to the nucleotide sequence of eNOS3 gene in Gen Bank. The results of this study showed no connection between Glu298Asp allele polymorphism in eNOS3 gene with hypertension in Javanese. There was also no relation between eNOS3 gene polymorphisms with high levels of respondents' NO plasma. Average NO plasma level of hypertension patients is 34,53 µmol/L, whereas average NO level of normal blood pressure is 32,5 µmol/L.Keywords: Allele Glu298Asp, eNOS3 gene, G894T, hypertension, Javanese ethnic, NO plasma levelÂ

Abstract 82: Patient and Hospital Characteristics of Pregnancy-Related Stroke from the Get With The Guidelines Stroke Registry

Background: Stroke accounts for 14% of maternal deaths. Our knowledge of the risk factors and etiologies of pregnancy-related stroke (PRS) is limited, as most data are derived from small, single center series or large, administrative datasets lacking clinical detail. We sought to describe the patient and hospital characteristics of PRS by analyzing the Get with the Guidelines (GWTG) Stroke Registry. Methods: All female patients aged 18-44 entered into GWTG from 2008-2013 with PRS were ascertained by medical history of pregnancy (i.e. pregnant or &lt;6 weeks postpartum) plus a principal diagnosis ICD-9 code (430, 431) (58%), PRS ICD-9 code (671.5x, 673.04, 674.0x) as the principal diagnosis alone (18%), or with a medical history of pregnancy (24%). Proportions for categorical and medians for continuous variables are reported. Results: We identified 46043 patients with stroke from 1554 sites, of whom 668 (1.5%) had PRS. Ischemic stroke (IS) occurred in 338 (51%), intracerebral hemorrhage (ICH) in 178 (27%) and subarachnoid hemorrhage (SAH) in 152 (23%). Many patient and hospital characteristics differed significantly by stroke subtype (Table). Hypertension, smoking and pre-stroke therapy with antithrombotics or antihypertensives were common; 7.4% of IS were recurrent. About 86% of all strokes did not occur in a healthcare setting and only 27% of patients arrived by EMS. Median initial blood pressure (BP) was higher in HS (ICH and SAH) than in IS, and half of all patients had initial BP below the threshold for pre-eclampsia (140/90 mmHg). HS patients were more often treated at larger, academic hospitals. Conclusions: PRS constituted 1.5% of all strokes aged 18-44 in a large contemporary stroke registry and 50% were HS. Most PRS occurred out of hospital, and half of all cases presented with normal BP levels. Further research is needed to better define PRS etiology.

Blood pressure control for diabetic retinopathy.

Blood pressure control for diabetic retinopathy.

Gender differences in preclinical markers of kidney injury in a rural north Carolina african-american cohort.

Introduction: The incidence rate of end-stage renal disease (ESRD) is highest among African-American (AA) males. The reason for this disparity in ESRD for AA males remains unclear, but it is well established that diabetes is the leading risk factor. Prediabetes may also be a risk for kidney disease since prediabetics have increased risk for cardiovascular disease and often do not receive drug interventions unless their hemoglobin A1c (A1c) level is above 6%. Perhaps, AA males are at greater risk because they often are untreated prediabetics and this predisposes them to renal injury. Therefore, we hypothesize that prediabetic AA males have higher albumin:creatinine ratio (ACr), a biomarker of renal injury, than their female counterparts.Methods: Male and female AAs were recruited (53 females and 47 males; 45 ± 2 years old) from a rural northeastern region of NC. Blood and urine samples were collected for A1c and albumin measurements, respectively. Participants were stratified based on their A1c levels: non-diabetic: <5.7%, prediabetic: ≥5.7% but <6.5%, and diabetic: ≥6.5%.Results: The proportion of males that are normal, prediabetic, and diabetic differed from that of females (p = 0.002). Interestingly, prediabetic men tended to be younger (41 ± 4 vs. 51 ± 3, respectively; p = 0.027) than prediabetic females (p = 0.027). A1c and ACr were not associated with blood pressure in males or females. AA males had a relative risk of 0.9, 2.5, and 1.4 for microalbuminuria for non-diabetic, prediabetic, and diabetic, respectively, compared to AA females.Conclusion: These results support our hypothesis that AA males may be predisposed to prediabetes kidney injury compared to their female counterpart. Thus, young AA males should be screened for biomarkers of kidney injury even if they have normal glucose and blood pressure levels.

The role of vitamin D deficiency in hypertension development

Background. Increased renin-angiotensin-aldosterone system (RAAS) activity plays an important role in hypertension development. However, the associations between RAAS, hypertension and vitamin D status are not completely elucidated. The aim of this study was to assess the role of vitamin D in hypertension development. Design and methods. We studied blood pressure (BP), plasma aldosterone concentration (PAC) and plasma renin activity (PRA), PAC/PRA ratio, serum 25 (OH)D and parathyroid hormone (PTH) levels in 657 women aged between 30 and 55 years. Results. We did not find differences in PAC, PRA and PAC/PRA ratio in women with hypertension and normal blood pressure level. The serum 25 (OH)D and PTH levels were comparable in hypertensive and normotensive women (48,95 ± 2,09 vs. 47,61 ± 1,03 nmol/l, p > 0,05, and 42,42 ± 2,76 vs. 40,68 ± 1,28 ng/ml, p > 0,05, respectively). A positive correlation between PTH level and PAC/PRA ratio (r = 0,25; p = 0,008) in normotensive subjects was found. There is a negative correlation between 25 (ОН)D level and PAC (r = –0,23, p = 0,01), PRA (r = 0,22, p = 0,02) in women with abdominal obesity, and a positive correlation between PTH level and PAC/PRA ratio (r = 0,51, p = 0,03) in non-obese women. Conclusions. The results of this study demonstrate a possible role of vitamin D deficiency in hypertension development.

Rhabdomyolysis in Primary Aldosteronism: A Case Report and Review of the Literature

ABSTRACT Objective: Primary aldosteronism is one of the most common causes of secondary hepertension. We present here a case of primary aldosteronism in a 38-year-old Chinese male with a 6-year history of uncontrolled hypertension that evaded diagnosis until an attack of rhabdomyolysis due to profound hypokalemia. We also present the results of a comprehensive review of the current literature. Methods: We describe the presentation and symptoms of the patient and review the relevant literature. A thorough literature search disclosed 15 further cases of rhabdomyolysis due to undiagnosed primary aldosteronism reported between 1978 and 2013. We summarized the clinical features, treatments, and outcomes of those cases. Results: Many of the cases presented with previous hint of primary aldosteronism, yet they evaded diagnosis. Three of these patients developed acute renal failure. All patients survived, and many of them were restored to normal blood pressure and normal serum potassium levels after adrenal surgi...

Типовые клинические портреты сотрудников уголовно-исполнительной системы в Саратовской области с позиции положений о первичной профилактике сердечно-сосудистых заболеваний

Purpose ― To study typical models of clinical data among penitentiary system employers in the Saratov region on the basis of health metrics proposed by American Heart Association (AHA). Material and Methods ― Clinical data from 666 penitentiary employers underwent preventive examination in 2012-2013 years were studied. The data allowed evaluation all the seven health metrics proposed by AHA. With the help of cluster analysis typical (frequency >1%) risk factor combinations were separated. Risk factors (blood pressure (BP) ≥140/90 mmHg, body mass index (BMI) ≥25 kg/m 2 , blood glucose ≥6 mmol/l, total cholesterol ≥5 mmol/l, smoking, sedentary lifestyle, unhealthy eating) were opposite to AHA health metrics. Results ― The majority of penitentiary employers were characterized by combinations from two to four risk factors. There was no typical clinical portrait in the study group. The prevalence of the most frequent cluster (subjects who overweight, practice unhealthy eating habits, refrain from smoking, physically active, with normal BP, blood glucose and cholesterol levels) was 13.1%. The other clusters were even rarer. The “ideal” health was identified in only 4.5% of study group. Conclusion ― Primary prevention among penitentiary employers should take into consideration high variability in prevalence of different risk factors combinations in this cohort.