Positive History Of Hypertension Research Articles

LIPOPROTEIN ASSOCIATED PHOSPHOLIPASE A2 ACTIVITY IS NEGATIVELY ASSOCIATED WITH DECREASED BAROREFLEX SENSITIVITY IN HIGH NORMAL BLOOD PRESSURE

Objective: The relationship between baroreflex sensitivity (BRS) and inflammatory vascular biomarker Lipoprotein associated phospholipase A2 (Lp-PLA2) in subjects with high normal blood pressure (HNBP, prehypertensives) with a positive family history of hypertension (FHH+) to hypertension history free control subjects (FHH-) was evaluated. Design and method: A total of 24 HNBP participants (age 39.5 ± 2.5 years, 18 male/ 6 female) were studied. 14 HNBP subjects FHH+ were compared to 10 HNBP participants FHH-, being of similar age and body mass index. BRS (ms/mmHg) and BRSf (Hz/mmHg) were determined by the sequence and spectral methods (five-minute non-invasive beat-to-beat recording of blood pressure and inter-beat interval, controlled breathing at a frequency of 0.1 Hz). Venous blood was analysed for Lp-PLA2 biomarker of vascular inflammation and atherothrombotic activity. Results: A significant negative correlation between spontaneous BRS obtained by both methods and blood pressure (BP) was present (BRS spect r = –0.54, p<0.001, BRS seq r = –0.59, p<0.001). BRS obtained by sequence and spectral methods were reduced in HNBP FHH+ compared to group of HNBP without history of hypertension (P= 0.0317 BRS seq, P = 0.0395 BRS spect). There was no difference between both groups of HNBP subjects in BRSf values. Lp-PLA2 was significantly higher in HNBP FHH+ compared to FHH- controls (P = 0.025). Lp-PLA2 was negatively correlated with BRS obtained by sequence method (r = - 0.6758, P = 0.00028) and BRS obtained by spectral method (r = - 0.5935, P = 0.00031). Conclusions: Lipoprotein associated phospholipase A2 is negatively associated with decreased baroreflex sensitivity in subjects with high normal blood pressure and positive family history of hypertension. These findings demonstrate that reduced baroreflex sensitivity as marker of autonomic dysfunction is linked with vascular inflammation predominantly in otherwise healthy participants with positive history of hypertension that could predispose to increased risk of hypertension. Further research is needed.

COVID-19 Chest Manifestation on CT Scan and Associated Risk Factors for Developing Pulmonary Fibrosis.

This retrospective study describes the imaging findings on chest computed tomography (CT) scans of coronavirus disease 2019 (COVID-19) patients as well as the prevalence of pulmonary fibrosis and the potential risk factors for the disease. One of the major COVID-19 centers in the western province of Saudi Arabia,the King Abdullah Medical Complex in Jeddah, was the site of this study. All adult COVID-19 patients who got a CT chest scan between January 2020 and April 2022 were included in the trial. The imaging findings and pulmonary severity scores (PSS) were obtained from the patients' CT chest. Patients were divided into two groups according to the evidence of fibrotic-like lung changes; clinical and radiological data between the two groups were subsequently compared. Data from the patients' electronic records was collected. The average patient age was 56.4 years, and most (73.5%) patients were men. Two-thirds of the patients had comorbidities (69.1%). CT scans revealed that diffuse lung infiltration is reported in 61% of cases, followed by lower lobes in 19.9%. Ground glass opacity (94.1%), consolidation (76.5%), septal thickening, and/or reticulation (24.4%) were the main chest findings during the initial CT scan. Fibrotic-like lung changes were developed in 9.6% of patients. Patients known to have a positive history of hypertension (p-value = 0.031) and coronary artery disease (CAD) (p-value = 0.011) were found to be significantly more likely to develop lung fibrosis. The patients' pneumonia severity score was significantly higher among the lung fibrotic patients (p-value = 0.026). Also, patients who were diagnosed with pulmonary fibrosis stayed longer in the hospital (p-value 0.001). Sex and age did not correlate significantly with risk of lung fibrosis. Pulmonary fibrosis was observed in 9.6% of COVID-19 patients. A close follow-up of patients with severe pneumonia, prolonged hospitalization, and pre-existing CAD and hypertension was necessary, as pulmonary fibrosis was more likely to occur as a result of these factors. There is a need for a thorough, long-term investigation with a large sample size.

Prevalence of Anemia in Chronic Kidney Disease

Objective: Chronic kidney disease is usually associated with anemia and the level of anemia correlates with the severity of the renal failure. The kidneys help in maintaining electrolyte balance and blood pressure. They produce the active form of vitamin D and a substance called erythropoietin, which stimulates production of red blood cells. Chronic kidney disease has adverse consequences on almost all body systems resulting in high rate of complications i.e. anemia, cardiac, vascular pulmonary etc. This study was carried out to evaluate the prevalence of anemia in chronic renal failure patients. Material and Methods: It is across sectional study and the data was collected from department of pathology and dialysis unit of Dr. Akbar Niazi Teaching Hospital, Islamabad from January 2021 to December 2021. All the patients who presented with sign and symptoms of chronic kidney disease were included in the study. Data was recorded in specially designed proforma and statistical analysis was performed using SPSS version 21. Results: Total 89 chronic kidney disease patients were included in the study among them 58 (65%) were males 31 (35%) were females. The average age of patients was 55 ± 16.409. Based on eGFR values the CDK patients that belonged to stage 1-5 were 5% (n=4), 6% (n=5), 9% (n=8), 18% (n=16) and 63% (n=56) respectively. The prevalence of anemia in chronic kidney disease patients was 95.5% (n=85) among which 62% (n=56) were males and 32% (n=29) were females. Normocytic normochromic anemia was the most common type with prevalence of 72% (n=64). Mild anemia was recorded in 41(46%) of the CKD patients while severe anemia was recorded in 3(3%) of patients. Besides CDK, diabetes mellitus was present as a comorbid feature in 4 (5%) of the patients, 16 (18%) had positive history of hypertension and 1 (1%) was positive for cardiovascular disease. Conclusion: Mild degree of anemia was seen in CKD patients. Most common type of anemia was normocytic normochromic. Most of the patients presented at stage 5. Comorbidities associated in CKD patients were hypertension, diabetes mellitus and cardiovascular disease.

Complications of Implantable Cardioverter Defibrillator and Their Potential Risk Factors in Patients with Hypertrophic Cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) has different complications such as cardiac arrhythmia and sudden cardiac death (SCD). Insertion of an implantable cardioverter defibrillator (ICD) is recommended for HCM patients who are at high risk of SCD and malignant arrhythmias, despite having their own potential complications. Hypothesis. We aimed to investigate the prevalence of different complications of ICD insertion and the impact of the potential influential baseline characteristics in a one-year follow-up period. This was a retrospective study with a total of 71 HCM patients with ICD insertion. We evaluated the prevalence of different complications of ICD implantation and the impact of baseline characteristics on the occurrence of ICD complications using multivariate regression analysis in three 4-month periods. In a one-year follow-up, 13 patients (18.3%) experienced at least one of the complications including pneumothorax, lead failure, ICD infection, inappropriate shocks, perforation, and upper limb deep vein thrombosis (DVT) with no mortality. Inappropriate shocks were reported as the most common (11.3%) complication during this period, with a gradual increase in the second (4.2%) and third (5.6%) follow-up sessions. Among all of the baseline characteristics that were investigated in this study, a positive history of hypertension was the only risk factor with significant impact on the occurrence of complications (P = 0.01). We demonstrated the occurrence of complications during a one-year follow-up as 18.3% in HCM patients with ICD insertion. A positive history of hypertension was the only baseline characteristic affecting the occurrence of complications, and inappropriate shocks were the most common complication.

Frequency Of Primigravida In Patients With Eclampsia.

Pregnancy-induced hypertension (PIH) occurs in about 5% of pregnancies and is a major cause of high perinatal and maternal morbidity and mortality. In several international studies, primigravidas were associated with a significantly higher incidence of eclampsia. The local studies so far have a small sample size and mainly focus on preeclampsia in all pregnant women. limited data is available on the frequency of eclampsia in primigravidas in our population. This study aims to determine the frequency of primigravidas in patients with eclampsia after 20 weeks of gestation. This descriptive Cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Ayub Teaching Hospital Abbottabad from 7/10/2020 to 7/4/2021. A total of 134 patients were observed. Diagnosis of eclampsia was based upon obstetrical history, presence of fits or coma, raised blood pressure and presence of proteinuria on urine complete examination. Immediate management included stabilizing the patient and delivery by Induction of labour or Caesarean section. The guardians of the patients explained the purpose and the benefits of the study and informed written consent was taken. : Our study shows that among 134 patients, 96 (72%) patients were in the age range of 18-27 years while 38 (28%) patients were in the age range of 28-35 years. The mean age was 30 years with SD±10.94. Eighty two (61%) patients had a POG range ≤34 weeks while 52 (39%) patients had a POG range >34 weeks. Forty-eight (36%) patients had BMI <27 Kg/m2 while 86 (64%) patients had BMI >27 Kg/m2. Fifty-six (42%) patients had a positive history of hypertension while 78(58%) patients had a negative history of hypertension. Out of 134 patients, 102(76%) were primigravidas while 32 (24%) were multigravidas. Our study concludes that the frequency of primigravidas was 76% in patients with eclampsia after 20 weeks of gestation presenting at tertiary care hospital Abbottabad.

Construct Validity and Reliability of the Arabic Version of Hypertension Knowledge-Level Scale Among Saudi Population.

Background Knowledgeable people are more likely to follow their treatment plan and reduce hypertension morbidity and mortality. This study aimed to construct the validity and reliability of the Arabic version of the Hypertension Knowledge-Level Scale (HK-LS) among Saudis. Methods This cross-sectional questionnaire research targets hypertensives and non-hypertensives. Cronbach's alpha and Spearman's correlation matrix analysis measured the questionnaire's construct validity. Wilcoxon rank sum tests examined HK-LS tools' discriminant validity. A p<0.05 was considered significant. Results A total of 1424 responses were received. However, the 1419 individuals were evaluated after applying exclusion criteria. About 60% of the participants were female, with the most common age groups being 18-29 years (38.5%) and 40-49 years (24.0%). A personal history of hypertension was reported by 26.1%, and a family history of hypertension by73.3% of the subjects. Cronbach's alpha for the whole HK-LS was 0.883, suggesting that the tool was reliable.All the items of the HK-LS questionnaire were significantly correlated with each other, except for a non-significant correlation between statements two and seven (r=0.05, p=0.091). The strongest correlations were apparent between items 19 and 20 (r=0.70, p<0.0001), items one and two (r=0.64, p<0.0001), and items 18 and 19 (r=0.56, p<0.0001). However, the weakest associations were reported among items two and six (r=0.06, p<0.05), items two and nine (r=0.07, p<0.05), and items one and 19 (r=0.07, p<0.05). The discriminant validity showed that a personal history of hypertension was associated with significantly higher scores of two HK-LS subscales, including definitions and complications. In addition, the overall knowledge score was significantly higher among participants with a positive history of hypertension among family and/or friends. Conclusions The Arabic version of the HK-LS was found to be a reliable and valid tool for measuring knowledge about hypertension among the Saudi population. This reliable instrument can assist medical professionals in establishing education programs.

Role of single nucleotide polymorphisms of the HSD3B1 gene (rs6203 and rs33937873) in the prediction of prostate cancer risk

3-β-hydroxysteroid dehydrogenase 1 (HSD3B1) is shown to affect dihydrotestosterone level in prostatic tissue which is a risk factor for prostate cancer (PC). The present study aimed to determine whether rs33937873 (G313A) and rs6203 (C338T) single nucleotide polymorphisms (SNP) in HSD3B1 gene was a potential risk factor for PC susceptibility and can predict the recurrence of PC in Egyptian patients. A total of 186 Egyptian patients were selected with incident primary PC and compared with 180 age healthy controls. The frequencies and the main effect of rs33937873 and rs6203 in HSD3B1 were compared and investigated between the patients and control using genotyping technique and statistical analysis. The mutant GA genotype of G313A in rs33937873 SNP was considered as an independent risk for PC in the multivariate regression analysis [odds ratio (OR)=2.7, 95% confidence intervals (CI): 1.2-5.5, P=0.01] together with positive history of hypertension (HTN) (OR=6.2, 95% CI: 3.2-12.1, P=0.0001) and begin prostatic hyperplasia (BPH; OR=8.9, 95% CI: 4.5-17.5, P=0.0001). Conversely, in rs6203 (C338T), C allele is considered as major risk allele in the development of PC (OR=1.8, 95% CI: 1.3-2.4, P=0.0003). The univariate logistic regression analyses indicated that CC genotype of rs6203 was a PC risk factor (OR=1.9, 95% CI: 1.3-2.9, P=0.002). In addition, the frequency of the A-C haplotype established by rs33937873-rs6203 was also significantly higher for PC (P=0.013). The predication of PC recurrence was associated only with positive family history (OR=7.7, 95% CI: 2.3-25.9, P=0.001) and not for The G313A and C338T SNPs. These results suggested that the two HSD3B1 polymorphisms rs33937873 and rs6203 may modify the risk of PC, particularly among patients with HTN and history of BPH, suggesting them as prominent future markers for prediction of PC risk.

THE PHARMACISTS’ AND MOBILE APPLICATIONS’ ROLE IN THE TREATMENT OF HYPERTENSION

Objective: Poor adherence is the main reason for inadequate blood pressure control. Pharmacists are highly accessible healthcare professionals, and it has been reported that community pharmacist-led interventions improved patients’ BP control and outcomes. Some authors reported on the beneficial effects of mobile applications on better drug adherence. The aim of this study was to identify subjects in the general population who may benefit from such interventions. Design and method: A total of 1228 subjects enrolled in the EHUH 2 study (a random sample, nationwide survey) and 424 participants of the Hunt on the Silent Killer (HSK) (opportunistic screening on islands) were included in this analyses. The same questionnaire was applied containing questions about health issues, therapy, habits, and opinion on pharmacists’ and mobile applications’ (MA) role in hypertension treatment. Results: The binomial logistic regression analysis showed a significant model when comparing positive and negative answers for the following: the participants were more likely to be in favour of pharmacists’ role if they had a positive history of angina pectoris ( = 1.333, p = 0.016), diabetes mellitus ( = 1.125, p &lt; 0.001), dyslipidemia ( = 1.326, p &lt; 0.001), or being treated for hypertension ( = 1.326, p &lt; 0.001) in the HSK, and in the EHUH 2 study if they suffered a stroke (100%). Socio-demographic factors had no impact on the pharmacists’ role in the general population. However, at islands significantly enhanced negative responses in case of lower household income (35%), married state (29%) and employed subjects (17%) were observed. The participants were more likely to be in favour of MA if they had a positive history of hypertension, have higher income and were married. Interestingly, the history of cardiovascular diseases indicated more negative responses. Conclusions: The participants were generally in favour of MA, which may confirm the need to digitalise the healthcare system, but it was more enhanced in participants with a higher socio-demographic status. Pharmacists-led interventions (lifestyle support and adherence increasing programs) have to be individualized.

Homocysteinemia in Heart Failure

Background: Heart failure represents a major health problem leading to considerable mortality morbidity. High total homocysteine concentrations have been related to increased risk of atherosclerosis and its sequel, including coronary heart disease, cardiovascular mortality, and stroke. Brain Natriuretic peptide is a member of a group of peptide hormones similar in structure, used as a specific marker for diagnosing heart failure. This marker increases gradually with the progression of the grade of heart failure. Objective: The current study aims to measure and investigate the difference in the level of homocysteine between patients with heart failure and without, to find the relationship between the level of homocysteine and grade of heart failure, and to find out the correlation between homocysteine levels with Brain Natriuretic peptide levels. Patients and Methods: This case-control study involved 200 participants, 100 patients with a history of chronic heart failure, and 100 control participants.A self-constructed questionnaire form prepared to collect selected variables, the participant’s weight, height, temperature, electrocardiography measured by trained staff, Brain Natriuretic peptide used as a specific marker for diagnosing heart failure. Blood samples were taken early in the morning from the patient and control groups, after at least 12-hours of fasting and a 20-minute rest. Analysis of all samples of blood was performed in the Biochemistry Laboratory of Baqubah teaching hospital to measure the levels of homocysteine by Human Homocysteine ELISA kit. Results: The sample was selected homogenously in terms of age and gender. Overweight, obesity, current and ex-smoker, history of hypertension, and history of diabetes mellitus were significantly higher in patients with heart failure than control. The fasting mean homocysteine level was significantly higher in patients (20.049nmol/ml) than in control (2.734nmol/ml). The fasting mean homocysteine level was significantly elevated in the patients with a positive history of hypertension and diabetes mellitus (p-value ≤0.05) than patients with a negative history. The level of homocysteine was correlated significantly and positively with the level of Brain Natriuretic peptide(r=0.39, p=0.001). The fasting mean homocysteine level was significantly increased with an increase in the severity (grades) of the heart failure (p-value = 0.001). Conclusion: There was a relationship between the homocysteine level with the development, and severity (grades) of the heart failure as well as significantly and positively correlated with the Brain Natriuretic peptide level. Keywords: Heart Failure; Homocysteinemia; Brain Natriuretic peptide

Evaluation of Passage Route as Predictor of Outcomes of Tibial Angioplasty in Diabetic Patients

Abstract Background: Diabetes is one of the strongest predictors of Peripheral Arterial Disease (PAD). It is associated with two fold increase of relative risk of PAD. Aim of Study: To evaluate passage route as predictor of outcomes of tibial angioplasty in diabetic patients. Patients and Methods: This prospective study included 67 cases of chronic limb threatening ischemia patients (CLTI 100%) underwentinfra genicular angioplasty. Our main interest was to determine adverse clinical events such as clinical failure, need for redo interventions and/or amputation. Results: Almost 91% of our cases (61/67 patients) had a positive history of hypertension that did not seem to be a significant factor of Major Adverse Clinical Outcome (MACO). Foot lesion i.e. ulcerationmay predict MACO. Intraluminal route was performed in 58 (86.6%) cases and via subintimal route in 9 cases (13.4%). In the patients operated upon via intraluminal route, twelve patients developed MACO. These results were of significant statistical value; p-value; 0.020. Conclusions: Foot lesion i.e. ulceration; the larger the wound size or the volume of tissue loss may predict MACO in addition to successful passage route either transluminal or subintimal route inbelow knee PTA is consideredpredictors of adverse outcome.

Relation of sympathetic activation and stress-induced hypertension in atherosclerosis of the thoracic aorta: a cadaveric study

Background: The autonomic nervous system (ANS) has been associated with numerous atherosclerosis-induced cardiovascular events, such as myocardial infarction and aortic disease. Although evidence suggests a relationship between autonomic dysfunction and atherosclerotic disease, the underlying mechanisms are still under investigation. The purpose of this study is to investigate the effect of ANS to the development of atherosclerosis and vice versa, in human thoracic aorta.Methods: An autopsy analysis from three segments of the thoracic aorta was performed; ascending aorta, aortic arch, descending aorta, using 52 unselected adult cadavers (38 male, 14 female – mean age 64.4 years; age range 19-90 years). Subjects were divided in two age groups (&lt;65 years – N=26, &gt;65 years – N=26). Tissue specimens were macroscopically examined and histopathologically divided into 7 grades of scoring for atherosclerosis (ATHERO, from 0=intact, to 6=thrombi formation). The relationship between ANS and atherosclerosis was depicted by further immunohistochemical analysis for detection of neuron terminals onto the aortic wall. All data were evaluated according to the subjects’ demographic and clinical characteristics.Results: Total 96.2% of all subjects had atherosclerosis of variable degree in one or more segments. No aneurismal change was found. The presence of atheromas were common in all subjects regardless of age and segment, with atherosclerosis increasing by age; ascending aorta (r=0.571, p&lt;0.001), aortic arch (r=0.655, p&lt;0.001), descending aorta (r=0.659, p&lt;0.001). Hypertension was a significant factor in the development of atherosclerosis in adults &gt;65 years (r=0.450, p=0.023). In addition, a positive history of hypertension was statistically significant regarding both the presence of atherosclerosis and neuron terminals in all three aortic wall segments; ascending aorta (p=0.037), Aaortic arch (p=0.046), descending aorta (p=0.045). Furthermore, there was a strong negative correlation between the ATHERO score and the presence of neuron terminals in all three aortic segments; ascending aorta (r=-0.264, p=0.041), aortic arch (r=-0.400, p=0.003), descending aorta (r=-0.234, p=0.047).Conclusions: Human cadaveric studies are extremely useful in understanding the pathophysiology of ANS, along with clinical and animal studies that are most commonly performed. These data suggest that there is a link between autonomic disfunction and the presence of atherosclerosis in human thoracic aorta, especially when hypertension is present. It is therefore possible that stress-induced hypertension can be considered as a potential risk factor for the development of atherosclerosis.

Hypertension prevalence and control among community‐dwelling lebanese older adults

AbstractThere is a high prevalence of hypertension among Lebanese adults, but no evidence is available on its prevalence and control exclusively among older adults (65 + years). This study provides the first evidence on a representative sample of 502 community elderly and presents the basis for future research and policy implications. Results show an overall prevalence of 52% with a significantly higher female‐to‐male ratio. Factors independently associated with hypertension were older age, body mass index, and dementia. More than a third of those with a positive history of hypertension had uncontrolled blood levels. Uncontrolled hypertension was higher among women. Increasing awareness about medication adherence and controlling multi‐morbidities constitute promising measures to lowering the burden of hypertension among Lebanese older adults, especially women.

Awareness, treatment, and control of hypertension and related factors in adult Iranian population

BackgroundHypertension, known as the silent killer, is a major risk factor for cardiovascular disease. Awareness and treatment of hypertension is not appropriate in the world, and this has led to an increase in mortality and morbidity caused by uncontrolled hypertension. This study aims to estimate awareness, treated, and controlled hypertensive and relevant predictors in an adult Iranian population.MethodsThis cross-sectional study was conducted on 10,000 adults aged 20–69 years in Yazd, Iran. They were selected through multi-stage random cluster sampling in 2015–2016. Blood pressure was measured three-time with standard protocol by trained health workers. Those with a positive history of hypertension and using anti-hypertensive drugs, prescribed by a physician, were considered hypertensive. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic BP of ≥90 mmHg. Uncontrolled hypertension was defined in accordance with recommended treatment targets by the Joint National Committee (JNC7). Logistic regression was used to assess the predictors of hypertension awareness, treatment and control.ResultsThe prevalence of hypertension was 37.3%, and the prevalence of pre-hypertension was 46.4%. 49.7% of People with hypertension were aware of their disease, and 71.5% of them were using antihypertensive drugs prescribed by physicians. Blood pressure was controlled in 38.9% of the treated patients. In the adjusted model, older age, female sex, and history of diabetes mellitus were positively associated with higher awareness. High physical activity, tobacco smoking, and diabetes are the only predictors of treated high blood pressure. Younger age, female sex, and higher education were determinants of controlled hypertension. Having health insurance was significantly correlated with awareness and control of hypertension.ConclusionHypertension is a public health problem in this population, which is not well controlled. Half of the patients were unaware. Intervention for increased screening coverage is needed. It should plan to raise public awareness about hypertension and improve hypertension control under the supervision of physicians. Implement a family physician program is recommended in the health system.

Evaluation of the Relationship Between Blood Pressure Control and Epistaxis Recurrence After Achieving Effective Hemostasis in the Emergency Department.

Epistaxis is the most common cause of otorhinolaryngologic emergencies. There is a longstanding controversy regarding the relationship between epistaxis and hypertension (HTN), in terms of blood pressure (BP) control in the emergency department (ED) setting. The objective of this study is to evaluate the association between HTN, BP control, and recurrent epistaxis among patients initially admitted to the ED for epistaxis. This retrospective cohort study was conducted in the EDs of three different hospitals in Taiwan and included a total of 739 patients admitted for epistaxis. Among ED patients with epistaxis, older age was significantly associated with a history of HTN, and a statistically significant difference in age was noted between groups classified according to the systolic BP/diastolic BP (SBP/DBP) at triage. Patients with a history of HTN had higher BP values at triage than did patients without a history of HTN (SBP: 175.68 ± 32.30 mmHg vs. 148.00 ± 26.26 mmHg, DBP: 95.04 ± 20.98 mmHg vs. 83.30 ± 16.65 mmHg; p < 0.0001). Antihypertensive medications were more commonly administered to patients with a history of HTN (p < 0.0001) and in those patients with SBP/DBP: ≥ 140/≥ 90 mmHg at triage (p < 0.0001). Among patients receiving antihypertensive medications, reductions in SBP by the time of discharge were significantly greater in patients with a history of HTN and in patients with SBP/DBP: ≥ 160/≥ 100 mmHg at triage. ED revisits due to recurrent epistaxis within 72 hours were significantly associated with male sex, a positive history of HTN, level of GOT, observation for recurrent epistaxis at ED, and duration of recurrent bleeding. A positive history of HTN is related to recurrent epistaxis among ED patients. The effectiveness of administering antihypertensive agents before achieving hemostasis in patients admitted to the ED for epistaxis warrants further study.

CAROTID ARTERY CALCIFICATIONS DETECTED BY CBCT IN PATIENTS WITH A HISTORY OF HYPERTENSION

<h3>Background</h3> One of the most common sites for the formation of vascular calcifications is in the branches of the common carotid artery. More frequently, these are formed by the calcification of existing plaques along the vascular wall. Numerous studies utilizing other modalities have revealed a positive correlation between vascular calcifications and hypertension; however, there is a need for investigation of the incidence of these pathologies using cone beam computed tomography (CBCT) technology and for exploring the factors that influence their presence or detection. <h3>Objective(s)</h3> The aim of this study was to determine the proportion of patients who have a positive history of hypertension and a positive finding of carotid artery calcification (CAC) and to determine if there are factors that predispose certain groups of patients to carotid artery calcifications, including patient age, gender, and history of antihypertensive medication use. <h3>Study Design</h3> This retrospective study focused on 608 randomly selected patients who received dental CBCT imaging studies at Stony Brook School of Dental Medicine. Relevant patient demographic characteristics and medical history were extrapolated from the patients' electronic health records. The data were analyzed for statistical significance using Pearson's correlation and logistic regression. <h3>Results</h3> A total of 608 patient records (mean age = 62.6 years) with equal gender distribution were screened. Of these, 108 (17.76%) cases showed an incidence of CAC. 240 records indicated a positive history of hypertension (HTN), and 87 patient records (36.25%) showed a positive history of HTN and presence of carotid calcification. A strong male predilection (2:1) was observed for the concurrent positive history of HTN and presence of CAC. The mean age for the presence of a CAC in patients with and without HTN were 71.5 and 71.8, respectively. <h3>Discussion/Conclusions</h3> Our findings suggest a significant correlation between history of hypertension and the presence of CAC, with a strong predilection for men. No significant correlation was observed between antihypertensive medications and CAC.

Factors Associated with Overweight and Obesity in an Urban Area of South East Nigeria

Background: Overweight and obesity present a growing health problem among Africans from all socioeconomic status. In Sub Saharan African, obesity is not only a consequence of overnutrition but possibly from excessive consumption of unbalanced diet dominated by carbohydrates and saturated fats. Characteristics of the distribution of obesity/overweight in Nigeria include its high prevalence along with socioeconomic class and in mid-life. Methods: Using the WHO STEP-wise approach to surveillance of noncommunicable diseases, we conducted a cross-sectional descriptive study of the adult population living in two urban slums in Enugu. The study was carried out in 2013. Statistical analysis was done using SPSS version. Results: A total of 605 (414 women (68.4%) and 191 (31.6%) men were recruited and analysed. The mean body mass index was 25.8 kg/m2 higher in females (26.7 kg/m2) than males (24 kg/m2) p < 0.01. The prevalence of overweight and obesity is 29.4% (178/605) and 19.5% (118/605) respectively. There also a modest prevalence of underweight 4% (24/605) among the population. All classes of obesity were significantly more prevalent in females. Significant positive correlates of BMI were: female sex (r = 0.21, p < 0.001), systolic blood pressure (0.25, p < 0.001), DBP (0.27, p < 0.001), fasting blood glucose (0.19, p < 0,001) and positive history of hypertension (0.23, P < 0.001). Negative correlates were physical activity and use of tobacco (0.2 (<0.001) and -0.16 (<0.001) respectively). Conclusion: The prevalence of obesity is relatively high in two urban slums in Enugu and co-exists with a modest rate of underweight. Public health and community-based approaches should be used to tackle these two-opposing social/health problems.

A purple urine bag syndrome in a CKD patient

Purple urine bag syndrome is a rare disorder, in which the plastic disposable urinary catheter bag turns purple or blue following hours or days of urinary catheterization. This investigation reports the case of a 58 years woman was previously diagnosed with CKD resulting from diabetic nephropathy and also had a positive history of hypertension who presented with purple urine bag syndrome.

The Prevalence of Stroke Survivors in Urban Slums in Enugu, Nigeria

Background: Stroke is one of the commonest non-communicable diseases and the commonest cause of death in adult neurology wards. Stroke preva-lence in sub Saharan Africa has dramatically increased over the past decades possibly due to changing life styles, poverty, poor health infrastructures which had led to increased risk factors for stroke. Poor nutrition and lack of access to standard medical care, predispose to high rates of stroke morbidity and mor-tality hence possible low prevalence. Little is known about the prevalence of stroke in people with low socio-economic status in Nigeria. Objectives: The main objective of this study was to determine the prevalence of stroke in two urban slums in south east Nigeria. Materials and Methods: This was a cross sectional descriptive study carried out in two slums in Enugu, South East Nige-ria. Participants were screened using a stroke specific questionnaire and further examined by two independent neurologists for evidence of focal neurological deficits. Analysis was done by SPSS version 22. Results: A total of 1440 par-ticipants were surveyed in the study; 769 (53.4) females and 671 (46.6%) males. About 22.3% (321) screened positive for various neurological diseases out of which 17 (5.3%) had evidence for stroke giving an overall prevalence of 1.2% (males 9 (1.3%) vs females 8 (1%) p = 0.6). The mean age of stroke sur-vivors was 60.1 years, similar in males and females (p = 0.6). The odds ratio for stroke from 40 years showed progress increment doubling between 60 and 70 years and tripled between 40 and 70 years. Age, lower level of education, positive history of hypertension, sickle cell disease, leg swelling and use of snuff positively are correlated with clinical diagnosis of stroke. Conclusion: The prevalence of stroke in two urban slums in Enugu metropolis was 12/1000. Hypertension, diabetes, use of snuff, and low levels of education were signifi-cant risk factors for stroke. Public health educational measures, promoting prevention and early detection of diabetes should be encouraged.

IMPACT OF GENDER AND AGE ON IN-HOSPITAL OUTCOMES OF CORONARY ARTERY BYPASS GRAFTING

Aim. To evaluate the impact of age and gender on in-hospital outcomes of coronary artery bypass grafting (CABG) in patients with coronary artery disease. Methods. 538 (79.10 %) men and 142 (20.90 %) women ( n = = 680) in the CABG registry of the Research Institute for Complex Issues of Cardiovascular who were referred to CABG in the period from 2011 to 2012 were retrospectively reviewed to assess the prevalence of comorbidities and estimate the in-hospital outcomes. The mean age of patients was 59.12 ± 7.98 (33 to 78 years). All patients were assigned to 4 age groups: Group 1 - 70 years. The statistical analysis was performed using the software package SPSS 20.0.1. A p value of <0.05 was considered statistically significant. Results. Women were commonly older than men and had a positive history of hypertension, chronic heart failure and higher angina class, obesity, type 2 diabetes, impaired glucose tolerance, non-ulcerative lesions of the gastrointestinal (GI) tract (gastritis, cholecystitis and / or pancreatitis). The male group was superior to the female group in the number of smokers and prior myocardial infarction. The incidence of first detected atrial fibrillation, atrial flutter, as well as ischemic strokes, congestive pneumonia increased with aging in both men and women within the in-hospital period. However, women, particularly from the younger age group (<50 years), more frequently suffered from ischemic strokes, GI bleedings, exacerbation of erosive gastritis, compared with men. Women from the older age group commonly had hydrothorax requiring pleural puncture, surgical wound healing complications, and exacerbation or / the first detected duodenal and / or stomach ulcers, compared to men. Conclusion: Female gender is associated with a significantly higher rate of the in-hospital complications compared to men. However, the impact of gender is mediated by age differences between men and women undergoing CABG.

Performance of targeted screening for the identification of hypertension in children

Targeted screening of hypertension in childhood might be more efficient than universal screening. We estimated the sensitivity, specificity, negative and positive predictive values of combined parental history of hypertension and overweight/obesity for the diagnosis of hypertension in 5207 children aged 10–14 years. Children had hypertension if they had sustained elevated blood pressure over three separate visits. The prevalence of hypertension was 2.2%. 14% of children were overweight or obese, 20% had a positive history of hypertension in at least one parent and 30% had either or both conditions. Targeted screening of hypertension to children with either overweight/obesity or with hypertensive parents limits the proportion of children (30%) to screen and identifies up to 65% of all hypertensive cases.