Poor Blood Pressure Research Articles

Insufficient blood pressure control is independently associated with increased arterial stiffness.

Hypertension is a risk factor for atherosclerosis. Achieving the therapeutic target value of blood pressure (BP) prevents the onset of cardiovascular events; however, it is not clear how antihypertensive drug use and BP control status relate to arterial stiffness. The purpose of this study is to investigate the relationship between BP control status with or without antihypertensive drugs and arterial stiffness. Nine hundred eighty individuals (mean age: 68 ± 11 years) who participated in a community-based cohort study were enrolled. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI). Higher BP was defined as a systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg. Participants were divided into four groups: normal, non higher BP without antihypertensive drugs (n = 421); untreated, higher BP without antihypertensive drugs (n = 174); good control, non higher BP with antihypertensive drugs (n = 209); and poor control, higher BP with antihypertensive drugs (n = 176). In multivariable logistic analysis adjusted for age, sex, dyslipidemia and diabetes mellitus medication use, obesity, smoking, alcohol drinking, and heart rate at the CAVI measurement for a high CAVI-using a borderline cutoff value of 8.0-the other three groups were significantly associated with a high CAVI when compared with the normal group. By contrast, multivariable logistic analysis of a high CAVI using an abnormal cutoff value of 9.0 demonstrated that the poor control and untreated groups were significantly associated with a high CAVI, whereas the good control group was not. In conclusion, even with antihypertensive drugs, poor BP control is independently associated with a high CAVI.

Type-2 Diabetes and the Clinical Importance of Exaggerated Exercise Blood Pressure.

Exaggerated exercise blood pressure (EEBP) during clinical exercise testing is associated with poor blood pressure (BP) control and cardiovascular disease (CVD). Type-2 diabetes (T2DM) is thought to be associated with increased prevalence of EEBP, but this has never been definitively determined and was the aim of this study. Clinical exercise test records were analyzed from 13 268 people (aged 53±13 years, 59% male) who completed the Bruce treadmill protocol (stages 1-4, and peak) at 4 Australian public hospitals. Records (including BP) were linked to administrative health datasets (hospital and emergency admissions) to define clinical characteristics and classify T2DM (n=1199) versus no T2DM (n=12 069). EEBP was defined as systolic BP ≥90th percentile at each test stage. Exercise BP was regressed on T2DM history and adjusted for CVD and risk factors. Prevalence of EEBP (age, sex, preexercise BP, hypertension history, CVD history and aerobic capacity adjusted) was 12% to 51% greater in T2DM versus no T2DM (prevalence ratio [95% CI], stage 1, 1.12 [1.02-1.24]; stage 2, 1.51 [1.41-1.61]; stage 3, 1.25 [1.10-1.42]; peak, 1.18 [1.09-1.29]). At stages 1 to 3, 8.6% to 15.8% (4.8%-9.7% T2DM versus 3.5% to 6.1% no-T2DM) of people with 'normal' preexercise BP (<140/90 mm Hg) were identified with EEBP. Exercise systolic BP relative to aerobic capacity (stages 1-4 and peak) was higher in T2DM with adjustment for all CVD risk factors. People with T2DM have higher prevalence of EEBP and exercise systolic BP independent of CVD and many of its known risk factors. Clinicians supervising exercise testing should be alerted to increased likelihood of EEBP and thus poor BP control warranting follow-up care in people with T2DM.

Epidemiology of Hypertension in the Prefecture of Figuig, Morocco

&#x0D; &#x0D; &#x0D; BACKGROUND: Hypertension continues to be a public health problem with devastating consequences globally, particularly in developing countries where there is an acute paucity of hypertension data.The aim of this study was to describe the epidemiological, clinical, and treatment characteristics of hypertensive patients in the prefecture of Figuig, Morocco.&#x0D; METHODS: Retrospective analysis of hypertensive patients’ medical records from 2010 to 2020. The diagnosis, treatments, and complications were reported by physicians and cardiologists. Data analysis was made according to epidemiological, clinical complications, and treatments. RESULTS: Hypertension progressed from 871 cases in 2010 to 1785 cases in 2020 with an average annual incidence rate of 105.56/100,000 person-year, affecting more women than men (68% vs 32%). Hypertension was higher among rural residents compared to urban residents (54.0%vs 46%). Hypertension was noted in 65.4 % of patients aged 60+, and in 30.49% of patients aged 40-59. The incidence proportion of clinical complications is Ipcomplications=18.35/1000 person- year, principally cardiovascular diseases (45.42%), stroke (25.55%), retinopathy (17.98%) and nephropathy (10.41%). The most antihypertensive drugs used were Calcium channel blockers (33.39%), Angiotensin-converting enzyme inhibitors (21.13%), Angiotensin receptors blockers (21.21%), diuretics (19.4%), beta-blockers (5.38%) and central antihypertensive (10.46%) with an average coverage needs of treatments in the prefecture as (47.29%).&#x0D; CONCLUSION: Hypertension progresses gradually in the prefecture, higher among older individuals, women and rural residents. Large proportion of patients cannot find their treatments in health care structures which lead to poor blood pressure control, accelerating the appearance of complications.&#x0D; &#x0D; &#x0D;

Association of Social Risk Domains With Poor Cardiovascular Risk Factor Control in US Adults With Diabetes, From 2006 to 2016

Few studies have examined the association between social risk factors and poor control of cardiovascular disease (CVD) risk factors. To examine the sequential association between social risk domains and CVD risk control over time in older adults with diabetes. This cohort study analyzed core interviews from 4877 US adults with diabetes who were participating in the Health and Retirement Study, a national longitudinal survey of US adults. Participants were older than 50 years, completed the social risk domain questions, and had data on CVD risk factor measures from January 2006 to December 2016. Data were analyzed from June to July 2022. Five social risk domains were created: (1) economic stability, (2) neighborhood or built environment, (3) education access, (4) health care access, and (5) social or community context. The 4 primary outcomes were (1) poor glycemic control (hemoglobin A1c [HbA1c] level ≥8.0%), (2) poor blood pressure (BP) control (systolic BP≥140 mm Hg and diastolic BP ≥90 mm Hg), (3) poor cholesterol control (total cholesterol/high-density lipoprotein ratio ≥5), and (4) a composite of poor CVD risk control (≥2 poorly controlled glucose level, BP, or cholesterol level). Among this cohort of 4877 older adults with diabetes (mean [SD] age, 68.6 [9.8] years; 2715 women [55.7%]), 890 participants (18.3%) had an HbA1c level of 8% or higher, 774 (15.9%) had systolic BP of 140 mm Hg or higher and diastolic BP of 90 mm Hg or higher, 962 (19.7%) had total cholesterol/high-density lipoprotein ratio of 5 or higher, and 437 (9.0%) had at least 2 poorly controlled CVD risk factors. Neighborhood or built environment (ie, adverse social support) was independently associated with poor glycemic control (odds ratio [OR], 1.31; 95% CI, 1.06-1.63), whereas economic stability (ie, medication cost-related nonadherence) (OR, 1.40; 95% CI, 1.04-1.87) and health care access (ie, lack of health insurance) (OR, 1.58; 95% CI, 1.20-2.09) were independently associated with poor BP control after full adjustment. Education access (ie, lack of education) (OR, 1.24; 95% CI, 1.01-1.52) and health care access (ie, lack of health insurance) (OR, 1.31; 95% CI, 1.02-1.68) were independently associated with poor cholesterol control. Health care access (ie, lack of health insurance) was the only social risk domain that was independently associated with having at least 2 poorly controlled CVD risk factors (OR, 1.72; 95% CI, 1.26-2.37). Results of this study suggest that certain social risk domains are associated with control of CVD risk factors over time. Interventions targeting domains, such as neighborhood or built environment, economic stability, and education access, may be beneficial to controlling CVD risk factors in older adults with diabetes.

Parameters Predicting Poor Blood Pressure Control among Male Hypertensives in A Primary Care Setting, Kwara State Nigeria

Background: Poor blood pressure control is a global challenge and male hypertensives constitute an important group of patients that should be treated with utmost priority because previous studies have associated male gender with high prevalence of hypertension and poor blood control. Aim: This was to determine the level of blood pressure (BP) control and to find the relationship between the demographic, clinical and laboratory parameters that can predict uncontrolled BP among male hypertensives. Material and Method: This study was a hospital-based descriptive cross-sectional descriptive study done in Family Medicine department of the University of Teaching Hospital, Ilorin, Kwara State, Nigeria. The study population was male hypertensives. Interviewers’ questionnaires were used to obtain information and clinical measurements such as BP and body mass index were taken with appropriate instruments. Laboratory measurement including fasting blood glucose and fasting lipid profile were also carried out. Data was collected using the Version 20 software packages of the Statistical Package for Social Sciences (SPSS-20). Result: About half (48%) of the respondents had control atBP ≤140/90 mmHg, 34.9% at ≤130/80 and only 15.7% had optimum BP control. The diastolic BP control 154(67.2%) was higher than those with systolic BP control 107(46.2%). Multiple regression analysis shows that only increasing age (P value = 0.003) and low level of education (P value = 0.009) can predict the development of uncontrolled hypertension. Conclusion: This study shows that there is poor BP control among male hypertensives and increasing age and low level of education can predict uncontrolled hypertension.

Global Burden, Regional Differences, Trends, and Health Consequences of Medication Nonadherence for Hypertension During 2010 to 2020: A Meta-Analysis Involving 27Million Patients.

BackgroundNonadherence to antihypertensive medications is the leading cause of poor blood pressure control and thereby cardiovascular diseases and mortality worldwide.Methods and ResultsWe investigated the global epidemiology, regional differences, and trend of antihypertensive medication nonadherence via a systematic review and meta‐analyses of data from 2010 to 2020. Multiple medical databases and clinicaltrials.gov were searched for articles. Observational studies reporting the proportion of patients with anti‐hypertensive medication nonadherence were included. The proportion of nonadherence, publication year, year of first recruitment, country, and health outcomes attributable to antihypertensive medication nonadherence were extracted. Two reviewers screened abstracts and full texts, classified countries according to levels of income and locations, and extracted data. The Joanna Briggs Institute prevalence critical appraisal tool was used to rate the included studies. Prevalence meta‐analyses were conducted using a fixed‐effects model, and trends in prevalence were analyzed using meta‐regression. The certainty of evidence concerning the effect of health consequences of nonadherence was rated according to Grading of Recommendations, Assessment, Development and Evaluations. A total of 161 studies were included. Subject to different detection methods, the global prevalence of anti‐hypertensive medication nonadherence was 27% to 40%. Nonadherence was more prevalent in low‐ to middle‐income countries than in high‐income countries, and in non‐Western countries than in Western countries. No significant trend in prevalence was detected between 2010 and 2020. Patients with antihypertensive medication nonadherence had suboptimal blood pressure control, complications from hypertension, all‐cause hospitalization, and all‐cause mortality.ConclusionsWhile high prevalence of anti‐hypertensive medication nonadherence was detected worldwide, higher prevalence was detected in low‐ to middle‐income and non‐Western countries. Interventions are urgently required, especially in these regions. Current evidence is limited by high heterogeneity.RegistrationURL: www.crd.york.ac.uk/prospero/; Unique identifier: CRD42021259860.

In-Clinic Measurements of Vascular Risk and Brain Activity

Background: Cardiovascular disease and dementia represent two health problems that may be causally connected. Studies have shown patients with dementia to have reduced cardiovascular health measures, where patients with dementia also have reduced electrophysiological brain activity as measured by event-related potentials (ERP’s). Few studies have attempted to correlate the two: cardiovascular health and ERP brain activity. The objective of this study is to determine if there are ERP differences between patients with lower versus higher measures of cardiovascular risk. Methods: For 180 patients ages 53 (16) years, Audio P300 ERP amplitudes and latencies (speeds) were measured upon initial patient visit alongside other clinical evaluations. Cardiovascular risk was categorized into good versus poor levels for blood pressure resting and stressed, E/A Ratio, atherosclerosis, and carotid intima-media thickness. Results: Groups with good levels had lower latencies (faster P300′s) and higher amplitudes than those with poor levels across all cardiovascular risk measures, significant to p &lt; 0.05 for most parameters. While both cardiovascular health and P300 metrics decline with age, poor blood pressure and plaque was seen to affect P300 performance across all age groups in this study. Conclusion: These data suggest correlation between brain activity, as measured by the P300, and five standard measures of cardiovascular health and this correlation may begin at an early age. While further explorations are warranted, these results could have implications on the management of preventative medicine by bringing preventative cardiology and brain health together.

Medication regimen complexity and its association with adherence and blood pressure control among hypertensive patients at selected hospitals of South Gondar Zone: A hospital based cross sectional study.

Despite the availability of effective antihypertensive medications, blood pressure (BP) control is suboptimal. High medication regimen complexity index (MRCI) is known to reduce adherence and may be the reason for poor BP control. However, there is no data in the present study areas. Hence, the aim of this study was to assess MRCI and its association with adherence and BP control among hypertensive patients at selected hospitals of South Gondar Zone. A hospital based cross sectional study was conducted from December 1, 2020 to February 30, 2021 at selected hospitals of South Gondar Zone. Medication regimen complexity and adherence was evaluated using 65-item validated tool called MRCI (Text removed at time of retraction. See retraction notice for more information.). Multivariable logistic regression analysis was done to determine the association between predictive and outcome variables. About 3.3% of participants were classified as having high HTN specific MRCI whereas 34.75% of participants were classified as having high patient level MRCI. (Text removed at time of retraction. See retraction notice for more information.) Being illiterate, and having low HTN MRCI were more likely to have controlled BP in adjusted analyses. On the contrary, (Text removed at time of retraction. See retraction notice for more information.) not having health insurance, and having lower monthly income were less likely to have controlled BP. A considerable proportion of patients had high MRCI. Having low HTN MRCI was more likely to have controlled BP. Simplification of a complex medication regimen for patients with HTN should be sought by physicians and pharmacists to improve BP control.

Cardiovascular Disease Prevention in Patients With Atherosclerotic Renovascular Disease-Induced Resistant Hypertension: Further Considerations for 24-Hour BloodPressure Profiles.

Cardiovascular Disease Prevention in Patients With Atherosclerotic Renovascular Disease-Induced Resistant Hypertension: Further Considerations for 24-Hour BloodPressure Profiles.

Correlation between serum triglyceride to HDL cholesterol ratio and blood pressure in patients with primary hypertension

AbstractHypertension (HT) is associated with significant morbidity and mortality. The efficacy of the treatment in HT patients is mostly depending on the office or home blood pressure monitoring. Triglyceride to high density lipoprotein (HDL) cholesterol ratio (THR) is an inflammatory and metabolic predictor. We aimed to compare THR levels of the HT patients with poorly controlled blood pressure levels to those with well‐controlled hypertensive subjects. In present cross sectional study, we grouped patients with HT either as well or poorly controlled hypertensive subjects according to the blood pressure measurement. THR of the groups compared. The THR of the poorly controlled HT group (3.9 [1.91–88.7]%) was significantly higher than the THR of the well‐controlled HT group (3.07 [0.71–35.8]%), (p &lt; .001). The sensitivity and specificity of THR higher than 3.26% in predicting poor blood pressure control were 72% and 52%, respectively (AUC: 0.64, p &lt;.01, %95 CI: %59–70). High THR levels in HT patients may warrant closer monitorization of blood pressure since it may predict poor blood pressure control in this population.

Pregnancy outcomes in inflammatory bowel disease: Data from a large cohort survey.

Inflammatory bowel disease (IBD) can affect young and reproductively active patients. Our aim was to analyze pregnancy outcomes in a large cohort of women with IBD. All women with at least one pregnancy were given a questionnaire regarding the outcome of their pregnancy. They were divided into IBD pregnancies and controls depending on whether pregnancy occurred within or over 10 years prior to the diagnosis of IBD. Three hundred questionnaires were analyzed for a total of 478 pregnancies that led to live-born babies. Age at conception was older in IBD women than in the controls. Active smoking was more frequent in the control group. The risk of intrauterine growth restriction(IUGR) was higher in IBD pregnancies (odds ratio [OR] 3.028, 95% confidence interval [CI] 1.245-7.370, P=0.013). The week of gestation at delivery was lower in the IBD population. And the risk of cesarean section was higher in IBD pregnancies (OR 1.963, 95% CI 1.274-3.028, P = 0.002). Among women with IBD pregnancy, the risk of preterm birth was higher in patients with active disease at the time of conception (OR 4.088, 95% CI 1.112-15.025, P=0.030), but lower in patients who continued regular therapy during pregnancy. Similarly, the risk of urgent cesarean section was reduced in the case of disease remission, while the risk of a planned cesarean delivery was higher in patients with perianal disease (OR 11.314, 95% CI 3.550-36.058, P < 0.01). Our study shows a higher risk of IUGR, cesarean section, and poor blood pressure control in IBD pregnancies. We emphasize the importance of achieving disease remission before considering pregnancy.

Population aspects of arterial hypertension therapy. Focus on fixed combinations

High blood pressure (BP) remains the leading risk factor for coronary heart disease, stroke, other cardiovascular diseases, chronic kidney disease, and dementia. Objective. To estimate the frequency of prescribing antihypertensive drugs (AHD) with the allocation of the proportion of fixed combinations (FC) among people aged 25–64 years examined in 16 regions of the Russian Federation as part of the ESSE-RF and ESSE-RF2 studies.Design and methods. The analysis included the results of a survey of representative samples of the population of the Russian Federation in the ESSE-RF studies (2012–2014, men: N = 8376 and women N = 13546 people) and ESSE-RF2 (2017, men: N = 3000 and women N = 3714 people). Each participant signed an informed consent. Arterial hypertension (AH) was defined as systolic BP ≥ 140 mm Hg and/or diastolic BP ≥ 90 mm Hg and/or if the examined reported taking AHD. Under the lack of control of AH, we understood the proportion of patients (%) with BP levels ≥ 140/90 mm Hg of the total number of patients with AH. Information about the AHD taken was recorded from the words of the patient (trade name of the drug) followed by coding according to the International Nonproprietary Names of Drugs.Results. In the Russian population, there was a decrease in the proportion of uncontrolled BP from 78,5 % (95 % confidence interval (CI) 77,7–79,3) in ESSE-RF to 73,0% (95 % CI 71,3–74,6) in ESSE-RF2. FC intake was detected in 15,6 % (95 % CI 13,8–18,0) of patients treated in the ESSE-RF study, while the proportion of such patients in the ESSE-RF2 decreased to 10,9% (95% CI 9,2–12,8), p &lt; 0,001. The most common FC was the combination of an angiotensin-converting enzyme inhibitors (ACEI) and a diuretic (ESSE-RF: 49,1 % and ESSE-RF2: 45,9 %). In second place in ESSE-RF is a diuretic + angiotensin receptor blockers (25,8 %), in ESSE-RF2 — calcium channel blockers (CCB) + ACEI (22,4%). A more modern combination, namely: the combination of ACEI and CCB, was noted only in 8,7% in ESSE-RF, while in ESSE-RF2 the proportion of this FC increased by 2,5 times.Conclusions. In the population of the Russian Federation, only 10 %-15 % of patients with AH receive FC AHD. An increase in FC intake may contribute to an increase in adherence to therapy, which is extremely important for the Russian population with poor BP control.

Determine the Frequency of Blood Pressure Control among Hypertensive Patients and its Relationship with Diabetes Mellitus

Background: Hypertension plays an important role in the development of secondary comorbidity in the patients. It is also noted that it also plays a role in the onset of diabetes among the patients. Objective: To evaluate the blood pressure control among hypertensive patients and its relationship with diabetes mellitus. Study Design: Cross-sectional study Place and Duration of Study: Department of Medicine, Social Security Teaching Hospital, Ferozpur Road Lahore from 1stMarch 2021 to 31stAugust 2021. Methodology: Two hundred and twenty seven patients with hypertension between 16-60 years of age of either gender were enrolled. Two readings of blood pressure of the patient was measured in supine position from brachial artery 20 minutes apart by the researcher himself and control of blood pressure was noted. Patients were assessed for having diabetes mellitus. Results: The mean age was 38.19±8.93 years and 117 (51%) were males and 110 (49%) were females. Forty four (19.4%) cases were having good blood pressure control. Eighty (35%) cases were having the diabetes mellitus. There were 20 (25%) cases who have diabetes and blood pressure control while 24 (16.3%) cases did not have diabetes but have blood pressure control with non-significant difference. Conclusion: Majority of patients had poor blood pressure control and there was a statistically non-significant relationship between diabetes mellitus and blood pressure control among hypertensive. Keywords: Blood pressure, Diabetes mellitus, Hypertension, Smoking

884-P: Associations between Health Care Access/Utilization and Racial/Ethnic Disparities in Diabetes ABC Measures among U.S. Adults

Racial/ethnic disparities exist for both poor ABC measures (A1C &amp;gt; 9%, blood pressure (BP) &amp;gt;= 160/100 mmHg, and non-HDL cholesterol &amp;gt;= 160 mg/dL) and access to care or utilization measures (health insurance coverage, having &amp;gt;= 4 doctor visits in past year, and having a routine place of health care) among U.S. adults with diabetes. Using 2011-2018 National Health and Nutrition Examination Survey, we examined the associations between health care access/utilization and racial/ethnic disparities in poor ABC measures. We estimated the marginal effect of race/ethnicity on each ABC measure by each access-to-care/utilization measure, respectively, using weighted multivariate logistic regressions. Poor ABC measures were more prevalent in non-Hispanic Black (NHB) (A1C: 19%, BP:13%, non-HDL cholesterol: 22%) and Hispanic (25%, 9%, 34%) than non-Hispanic White (NHW) (11%, 7%, 21%) people. Similar disparities were observed for poor access to care/utilization: NHB (uninsured:11%, &amp;lt;4 visits:38%, no routine place for care:4%) , Hispanic (23%, 44%, 11%) , NHW (6%, 34%, 4%) . Effects of access to care/utilization on poor ABC measures varied by measures of both access-to-care/utilization and ABC control. Compared with NHW, having no insurance vs. having insurance was much more likely to be associated with poor A1C level in NHB (16% vs. 5%, p &amp;lt; 0.05) and Hispanic populations (26% vs. 7%, p &amp;lt; 0.01) . However, insurance status was not associated with racial/ethnic disparities on poor BP and cholesterol measures. Having &amp;gt;= 4 doctor visits in the past year and a routine place for care were not associated with racial/ethnic disparities of any poor ABC measures. Closing the insurance coverage gap by increasing insured rate among racial/ethnic minorities could help reduce the racial/ethnic disparity in A1C level. Future studies to explore reasons why other access-to-care/utilization measures were not associated with racial/ethnic disparities in poor ABC measures may be beneficial. Disclosure S.Tang: None. P.Zhang: None.

BLOOD PRESSURE CONTROL IS BETTER IN PRIMARY CARE THAN IN THE GENERAL POPULATION: A CROSS-SECTIONAL STUDY IN A MULTI-PROFESSIONAL RURAL HEALTH CENTER (DOMFRONT, NORMANDY, FRANCE)

Objective: In 2015, more than 11 million patients treated for arterial hypertension in France. According to several studies in the general population, about 50% of hypertensive subjects are treated and about 20% are treated and controlled. There are very few data in general medicine. Our work have studied how these data may have differed in general medicine. Design and method: A cross-sectional observational study was carried out in a rural health center (Domfront, Normandy, France) on subjects aged 18 to 65 in 2018. A subject was considered to be hypertensive if his blood pressure (taken in the office in routine care) was greater than 140/90 or if it was treated with antihypertensive drugs. Results: Of 1,925 subjects, there were 54.3% women, aged 54.6 ± 7.1 years. The mean blood pressure was 127 ± 13/76 ± 8 mmHg, 60.6% (682/1127) were overweight and 5.0% (96/1925) were diabetic. 646 (33.6%) were hypertensive and 410 hypertensive (63.5%) were treated. 39.0% (252/646) were treated and controlled. Conclusions: In general medicine, blood pressure control seems to be better than in the general population, whereas the general practitioner is often the first contact with the healthcare system. Poor blood pressure control in the population can be explained by the lack of general medicine consultations for untreated hypertensive subjects.

GLOBAL BURDEN, REGIONAL DIFFERENCES, TRENDS, AND HEALTH CONSEQUENCES OF MEDICATION NON-ADHERENCE IN PATIENTS WITH HYPERTENSION DURING 2010-2020: A SYSTEMATIC REVIEW AND META-ANALYS

Objective: Non-adherence to anti-hypertensive medications (anti-HT non-adherence) is the leading cause of poor blood pressure (BP) control, and thereby cardiovascular diseases and mortality worldwide. This study aims to investigate the global epidemiology of anti-HT non-adherence. Design and method: This study comprises a systematic review and meta-analysis investigating global prevalence, regional differences, and trends of anti-HT non-adherence in 2010–2020. Multiple medical databases and clinicaltrial.gov were searched for articles with a cut-off of December 2020. Observational studies reporting the proportion of patients with anti-HT non-adherence were included. The proportion of non-adherence, publication year, year of first recruitment (for trend analysis), country, and health outcomes due to anti-HT non-adherence were extracted. Two independent reviewers conducted abstract and full text screening, classified countries according to levels of income and locations and extracted data. Meta-analyses were conducted using a random effect model and trends of prevalence were analysed using meta-regression. Results: A total of 161 studies, including more than 27 million participants were included. The global prevalence of anti-HT non-adherence was 43% (95%CI: 40–45%, I2: 99·98%, p &lt; 0·001). Non-adherence was more prevalent in low-to-middle-income countries than in high-income countries (47% vs. 38%, meta-regression p = 0·002), and in non-Western countries than in Western countries (46% vs. 36%, p = 0·002). No significant trend in prevalence was detected during 2010–2020. Patients with anti-HT non-adherence had suboptimal BP control (OR 2·15, 95%CI: 1·84–2·5, I2: 97·4%, p &lt; 0·001), complications from HT (OR 2·08, 95%CI: 0·99–4.35, I2: 94·2%, p &lt; 0.001), all-cause hospitalisation (OR 1·38, 95%CI: 1·35–1·41, I2: 0, p = 0·64), and all-cause mortality (OR 1·38, 95%CI: 1·35–1·41, I2: 0, p = 0·509). Conclusions: While a high prevalence of anti-HT non-adherence was detected worldwide, a higher prevalence was detected in low-to-middle-income and non-Western countries. Interventions are urgently required, especially in these regions. Current evidence is limited by high heterogeneity.

BLOOD PRESSURE CONTROL AMONG AN ELDERLY NORTHERN-ITALIAN POPULATION, EFFECT OF BETA-ADDUCIN POLYMORPHISMS. A CROSS-SECTIONAL STUDY

Objective: Evaluate role of nvironmental and genetic factors on Blood Pressure (BP) control among an Italian elderly population. Design and method: Cross-sectional study on 1250 elderly subjects of north Italy aged over 65y, recruited in recreative centers. BP was measured with an automated device (Omron) and the average of 2nd and 3rd measure was recorded. According to ESC-ESH-2018 guidelines we defined suboptimal BP control for patients presenting with systolic BP&gt;140 or diastolic BP&gt;80 mmHg. Anthropometric measurements were taken, blood and urines samples for biochemical and targeted genetic analysis were acquired. Genotyping was performed by OpenArray system. All participants signed informed consent. The protocol was approved by the Ethical Committee. Results: 746 subjects (59.9%) were on antihypertensive therapy. 385 (51.6%) had a systolic BP over 140 mmHg, and 419 (56.2%) had a diastolic BP over 80 mmHg, thus classified as on suboptimal BP control. Among those, 153 (20.4%) presented SBP&gt; 160 or DBP &gt; 100 (stage 2 hypertension) despite treatment. 28.6% were on optimal BP control. Factors associated with poor BP control on univariate analysis showed gender (p = 0.002), higher waist circonference (p = 0.014), high visceral fact index (p &lt; 0.01) and minor number of total medications (p &lt; 0.01). Age, eGFR, and urine albumin/creatinine ratio were non significantly different between the two groups. Inferential tree analysis showed that urine sodium is relevant on BP level in ‘younger’ and untreated subjects (p &lt; 0.001). Among genetic variants, rs4984 T allele in beta-adducin gene (ADD2) was associated with poor BP control (17.3% vs 11.4%; p = 0.016). Similarly, T allele in the overall elderly subjects showed a high frequency compared to general population (EUR - 1000 Genome Project) (16% vs 12.5%; p = 0.023). Conclusions: Gender, visceral fat and therapies are associated with poor BP control, suggesting the relevant role of clinical management. Surprisingly, even in this elderly population, a genetic factor already associated with salt-sensitive hypertension and response to anti-hypertensive therapy as ADD2 was found related to poor BP control. Most of of elderly patients treated for hypertension have suboptimal control of BP. Moreover, genetic factors besides environmental factors, seem to play a role in BP control even in elderly.

National Cross-Sectional Data on Ideal Cardiovascular Health Among Adults in Mongolia in 2019.

Background:The study aimed to estimate the prevalence, distribution, and correlates of ideal cardiovascular health (CVH) among individuals (20–69 years) in Mongolia.Method:Cross-sectional data were analyzed from 4,516 individuals (20–69 years, mean age = 42.3 years) who participated in the Mongolia STEPS survey in 2019, who had complete measurement of CVH metrics and no history of cardiovascular disease. Ideal CVH measures included non-smoking, healthy diet, physical activity, fasting blood glucose <100 mg/dL, body mass index (<23 kg/m2), total cholesterol <200 mg/dL, and blood pressure <120/<80 mmHg).Results:The prevalence of five to seven ideal CVH metrics was 27.7% in 2019. Most Mongolians had ideal total cholesterol (77.4%), ideal smoking (67.8%), ideal fasting glucose (73.8%) and ideal physical activity (66.0%), while a lower prevalence was found for ideal blood pressure (42.4%), ideal body mass index (31.4%), and ideal healthy diet (1.8%). The prevalence of poor smoking, poor fruit/vegetable intake, poor fasting glucose, poor blood pressure, and poor total cholesterol was higher in men than in women, while poor physical activity was higher in women than in men, and poor BMI did not differ by sex. In the adjusted logistic regression analysis, older age, male sex, and belonging to the Khalkh ethnic group were negatively associated, and a higher number of adult household members was positively associated with meeting the ideal 5–7 CVH metrics.Conclusions:The proportion of meeting 5–7 ideal CVH metrics was moderate among adults in Mongolia. Primary and secondary prevention programmes should be strengthened to improve CVH in Mongolia, considering identified associated factors.

Epidemiological and clinical data and factors of poor blood pressure control in known hypertensive patients in the Sfax region

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Cross-mapping medical records to NANDA-I to identify nursing diagnoses in a vulnerable population.

To assess the association between vulnerable populations and nursing care needs, using NANDA-I diagnostics, in the population of the Canary Islands, Spain. Nursing social epidemiology study. Cross Mapping of Medical Records to NANDA-I to Identify Nursing Diagnoses in a Population usinga medical, epidemiological follow-up study of a cohort of 7,190 people. The level of vulnerability of the participants was assigned, among those who were also assigned nursing diagnoses, using the "ICE index" to calculate the expected associations. The most prevalent nursing diagnosis in our sample was Sedentary lifestyle (60.5%), followed by Ineffective health self-management (33.8%) and Risk-prone health behaviour (28.7%). Significant differences were found by sex, age group and social class, with the nursing diagnoses included in the study being more prevalent among the most socio-economically disadvantaged social class. The cross-mapping method is useful to generate diagnostic information in terms of care needs, using the NANDA-I classification. The expected associations between high social vulnerability and care needs have been verified in a comprehensive and representative sample of the Canarian population (Spain). From an epidemiological perspective, identifying nursing diagnoses at the population level allows us to find the most prevalent needs in the different community groups and to focus appropriate nursing interventions for their implementation and impact assessment.