Positive History Of Hypertension Research Articles

Stent-assisted coiling of ruptured wide-necked intracranial aneurysms: A single-center experience of 218 consecutive patients

Stent-assisted coiling (SAC) in the treatment of ruptured intracranial aneurysms (RIAs) remains controversial. In this study, we report our experience of SAC of wide-necked RIAs and evaluate the risk factors contributing to periprocedural complications. 218 patients underwent SAC for ruptured, wide-necked saccular intracranial aneurysms at our center between 2011 and 2014. Multivariate logistic regression analysis was performed to evaluate the risk factors contributing to the periprocedural complications. Follow-up angiography was available in 178 (84.8%) patients. Clinical outcome was measured using the Glasgow Outcome Scale (GOS) through telephonic interviews. Periprocedural complications occurred in 33 (15.1%) patients out of which 17 were thromboembolic (7.8%) and the remainder were hemorrhagic complications (n = 16, 7.3%). Multivariate logistic regression analysis showed that a positive history of hypertension (odds ratio [OR] 4.899, 95% confidence interval [CI] 1.266-18.951; P = 0.021), and daughter blebs (OR 12.165, 95% CI 3.247-45.577; P = 0.0001) were the major risk factors for the periprocedural hemorrhagic complications, but not for the thromboembolic complications. Angiographic follow-up (mean, 19.5 ± 11.9 months) showed Raymond scale (RS) 1 in 158 (88.8%) patients and RS2 in 20 (11.2%) patients without any angiographic recurrence. At a mean clinical follow-up of 29.1 ± 16.2 months, 201 out of the 210 surviving patients had a good functional outcome (GOS score of 4 or 5). SAC is an effective treatment option for selected ruptured wide-necked aneurysms, especially in patients who do not require external ventricle drainage for acute hydrocephalus. The periprocedural hemorrhagic complications tend to be more common in the hypertensive patients and in those with daughter blebs in the aneurysm sac.

Application of latent class analysis to estimate susceptibility to adverse health outcomes based on several risk factors

Background: The study demonstrates the use of latent class analysis (LCA) to segregate population in two latent classes e.g. susceptible or not susceptible to adverse health outcomes according to the observed risk factors as a method of medical diagnosis. Methods: The present study uses a secondary data set on 420 patients referred to the University of California, Los Angeles (UCLA). Adult Cardiac Imaging and Hemodynamics Laboratories for Dobutamine stress echocardiography (DSE) between March1991 & March1996. LCA is used for estimating the individual item-response probabilities in each latent group and also the latent class sizes. The observed variables or indicators of the latent subgroups are the common risk factors viz. history of smoking, history of cardiac issues etc. The interaction effect of hypertension & diabetes is also included in the analysis. Results: Based on the behaviour of the estimates of latent class model parameters, the unobserved groups are identified and named. Proportion of individuals falling in each latent class are approximately 0.20 & 0.80 respectively. The susceptibility to adverse health outcomes in future is the most in male individuals having a positive history of hypertension and/or diabetes, as the corresponding indicators have higher positive item-response probabilities (0.72 & 0.83 respectively) than the rest. Conclusions: The study briefly explains the application of LCA for identifying subgroups according to susceptibility to adverse health effects in a large population. Assessment of common risk factors in predicting latent class sizes provides estimates of probabilities for being a member in each class. The importance of the combined effect of hypertension & diabetes in predicting future health problems related to cardiac issues is highlighted. Class assignments of individuals according to their pattern of response are also listed.

Hypertension screening during healthcare pediatric visits

Guidelines in both Europe and the United States recommend screening for hypertension during child care pediatric visits in children above 3 years old. The aims of the study were to assess the frequency of blood pressure (BP) measurement during preventive or chronic care pediatric visits and determine the factors that may associate with screening. We prospectively included in the study consecutive children hospitalized in our department. Anthropometric measurements were performed in all children. Office BP was measured in children above 5 years old and mothers and/or fathers. Personal and family history, and self-reported BP screening during pediatric visits were recorded. Hypertension screening had been performed at least once in 45.3% of the children during pediatric visits. Fifty per cent of the children with elevated BP levels had never been screened for hypertension. Low birth weight, history of prematurity, or chronic disease was not associated with increased frequency of screening, whereas screening was more likely in children above 3 years old with positive personal history (odds ratio 2.35, 95% confidence interval 1.07-5.15, P < 0.05). Obesity tended to increase the frequency of hypertension screening in all ages (odds ratio 2.60, 95% confidence interval 0.93-7.28, P = 0.06). Moreover, 37.5% of children without positive personal history exhibited BP levels above the 90th percentile, and 13.5% of mothers and 31.1% of fathers were not aware of their own elevated BP levels. These findings suggest that hypertension screening does not occur during pediatric visits for a considerable percentage of children, although a significant number of children and adolescents without positive history of hypertension or chronic disease may have elevated office BP levels.

Association of Major Coronary Risk Factors and Gender

Aims: The aim of this study is to compare major risk factors in Coronary Artery Disease patients with significant atherosclerotic lesions in both genders. Study Design: Cross-Sectional study. Place and Duration of Study: From Aug 2012 to Dec 2013, 299 consecutive patients who underwent angiography at the coronary angiography laboratory in Ghaem hospital were enrolled in this study. Original Research Article Sadr-Nabavi et al.; BJMMR, 9(8): 1-8, 2015; Article no.BJMMR.16427 2 Methodology: Demographic data was collected by an interviewer based on a checklist. Moreover, a member of our research group examined patients for weight, height, and blood pressure. For each patient a blood sample was taken and angiography was done by an expert. Statistical analysis was performed by SPSS version 11.5, using descriptive statistics, one-way ANOVA, and non-parametric equivalent, KruskalWallis. p<0.05 was considered as statistically significant. Results: Participants in this study were Iranian and 52.8% were female. The females were older than males (mean age 59±10.14 vs 58±12.4); and the majority of them were married and lived in urban areas. Among 169 patients that were recruited in the study, 95 (55.6%) had a positive history of hypertension (HTN), 77 (46.4%) hyperlipidemia, and 55 (32.5%) type 2 Diabetes Mellitus (T2DM). The observed differences in these parameters between two genders were significant (P<0.001, P=0.001 and P=0.001), respectively. Among the participants, 40 (46.4%) were smokers (at present or in the past). Conclusion: Our results show that the prevalence of HLP, HTN and T2DM among Iranian women who belong to the CAD patients’ population is more than men.

The importance of association between angiotensin-converting enzyme (ACE) Gene I/D polymorphism and diabetic peripheral neuropathy

BackgroundDiabetic peripheral neuropathy (DPN) is a microvascular complication of diabetes mellitus (DM) due to decreasing quality of life. In the present study, it is aimed to evaluate angiotensin-converting enzyme (ACE) Gene I/D polymorphism in Turkish population. Materials and methodsTwo hundred and thirty-five DPN patients and two hundred and eighty-one controls were enrolled in this study. Genomic DNA was isolated and genotyped using polymerase chain reaction (PCR) analyses for the ACE gene I/D polymorphism. ResultsBaseline characteristics of the DPN patients according to ACE genotypes were similar, except for history of hypertension. The frequency of II genotype was significantly higher in patients with positive history of hypertension than the patients with negative history of hypertension (p=0.013). DD genotype of I/D polymorphism was found to be a susceptibility factor for DPN in homozygous form (p=0.032). According to allele frequencies, D allele of I/D polymorphism was found to be a susceptibility factor for DPN (p=0.031). ConclusionACE gene I/D polymorphism may research in DM patients to determine genetic predisposition for DPN. It can be useful for taking early measures and avoiding DPN in a Turkish population.

Coronary Artery Disease Risk Factors in Urban Areas of Yazd City, Iran

Coronary artery disease (CAD) is a major cause of mortality and morbidity with high health care cost in both developed and developing countries. CAD accounts for nearly 50% of all yearly deaths in Iran. The aim of this study is to explore the main CAD risk factors in the urban areas of Yazd in the Islamic Republic of Iran. A hospital-based case-control study was conducted to investigate the role of the important CAD risk factors in urban area of Yazd city from December 2007 to June 2008. A total of 436 subjects in the age group of 30 to 75 years (218 cases and 218 controls) were included in this study. The tools of enquiry were a pretested and precoded questionnaire, physical examination, and laboratory findings. A confidence level of 95% and study power of 80% were considered for the interpretation of possible significant findings. Gender-wise stratified analysis was separately done for men and women using multiple conditional logistic regression. A total of 75.5% of the participants were men and 24.5% were women. Five variables, including unskilled jobs, physical inactivity, giving positive history of hypertension, high levels of waist/hip ratio, and low levels of high-density lipoprotein (HDL) were the factors that could account for significant predictors of CAD in males on the logistic model (P < .05). No such significant CAD predictors were found for women. The findings showed that categories of nonprofessional, physical inactivity, positive history of hypertension, wais/hip ratio ≥0.9 and HDL levels ≤40 mg/dL are the significant risk factors that can predict CAD in male residents of Yazd.

EFFECT OF BODY MASS INDEX ON LEFT VENTRICULAR MASS

Background: Increased left ventricular mass (LVM) as determined by 2-dimensioned M-mode echocardiography is a predictor of cardiovascular morbidity and mortality. Objective: The aim of this study was to investigate the relationship between LVM and body mass index (BMI) categories in cross section study. Methods: LVM were measured by using M-mode echocardiography in a sample of 160 individuals (male = 71, female = 89) with age ranging from 16-80 years, referred by a physician. Those with a positive history of hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD) constituted 82 individuals; the remaining 78 were regarded as a control group negative for cardiac apparent problems. Results: Mean interior ventricular septum diastolic (IVSd), left ventricular posterior wall diastolic (LVPWd) and LVM were increased in cases group (the subjects with one or more of the following illness ((HT), (DM), and (CAD)) compared to normal control. The mean IVSd, LVPWd showed a statistical of significant weak positive linear correlation with BMI while the mean of the left ventricular interior dimension diastolic (LVIDd) and LVM was significantly higher among obese subjects compared to the subjects with normal BMI among the total sample. Among the subgroup of controls, only the LVM retained its positive linear correlation with BMI. Conclusions: LVM was positively associated with BMI and this association seems to be independent of other cardiac diseases associated with BMI.The remaining three parameters showed a weak association after adjusting for age, gender, and presence problems.

Risk factors for arm lymphedema following breast cancer diagnosis in Black women and White women

Purpose Lymphedema of the arm is a potential complication of breast cancer therapy. This study examines pre-disposing factors that may operate in conjunction with treatment-related factors in the development of arm lymphedema in a large cohort of White and Black breast cancer survivors. Methods 494 women (271 White and 223 Black) with in situ to Stage III-A primary breast cancer completed a baseline interview within 18 months of diagnosis. Information on lymphedema was collected during a follow-up interview, conducted on average 50 months after diagnosis. Self-reported data were used to classify women with or without lymphedema. Multivariable logistic regression models were developed to identify risk factors for arm lymphedema. Results Arm lymphedema was associated with younger age at diagnosis (odds ratio, OR per year of age = 0.96; 95% confidence interval, CI = 0.93-0.99), positive history of hypertension (OR = 2.31; 95% CI = 1.38-3.88), obesity (OR for body mass index, BMI> or =30 = 2.48; 95% CI = 1.05-5.84) and having had surgery where 10 or more lymph nodes were excised (OR = 2.16; 95% CI = 1.12-4.17). While Black women had higher prevalence of arm lymphedema than White women (28% vs. 21%), race was not associated with lymphedema risk in models adjusted for multiple factors (adjusted OR = 1.01; 95% CI = 0.63-1.63). Conclusion Risk of arm lymphedema did not differ significantly for Black and White women. Risk factors identified in this study offer opportunities for interventions (weight loss, control of blood pressure, use of sentinel node biopsy where possible) for reducing incidence of lymphedema or controlling the symptoms associated with this condition.

High circulating levels of endogenous ouabain in the offspring of hypertensive and normotensive individuals

Impaired diastolic function and left ventricular hypertrophy can occur early in the natural history of essential hypertension. High circulating levels of endogenous ouabain (EO) have been described in essential hypertension and have also been associated with left ventricular hypertrophy. The aim of this study was to investigate whether these cardiac modifications are related to plasma EO levels in the offspring of hypertensive families. The study involved 41 subjects with (FAM+) and 45 subjects without (FAM-) a family history of hypertension. Arterial blood pressure, left ventricular geometry and function, and plasma EO levels were measured in each subject. Plasma EO levels were higher in the FAM+ subjects (221.5 +/- 10.95 versus 179.6 +/- 9.58 pmol/l, P = 0.004), and directly correlated with both systolic (r = 0.417, P < 0.0001) and diastolic blood pressure (r = 0.333, P = 0.002). Plasma EO was inversely related to an index of cardiac diastolic function determined as the ratio between the early and late peak flow velocity (r = -0.286, P = 0.012) and isovolumetric relaxation time (IVRT) (r = 0.32, P = 0.003). The IVRT was also significantly higher in FAM+, correlated with the IVRT (r = 0.32, P = 0.003). The IVRT was also significantly higher in FAM+, whereas the other echocardiographic parameters were similar to FAM-. Among the offspring of families with a positive history of hypertension, circulating EO levels and blood pressure are increased. Plasma EO levels are related to alterations of some indexes of diastolic heart function in these individuals.

Late survival after abdominal aortic aneurysm repair: Influence of coronary artery disease

To evaluate long-term survival in relation to preoperative risk factors, we reviewed 1112 patients undergoing abdominal aortic aneurysm (AAA) repair from 1970 to 1975. A 6-to 12-year follow-up was obtained on 1087 patients (97.7%) by chart review, death certificates, autopsy reports, and questionnaires returned by patients and referring physicians. Preoperatively 24% of patients had a history of prior myocardial infarction, 19.9% had a history of angina, and 40.4% were hypertensive. Emergency operation for ruptured aneurysm was performed in 6.5% and for expanding aneurysm in 3.4% of patients. The survival rate at 5 years was 67.5% and at 10 years was 40.7%. Cardiac-related problems were the most frequent cause of death (38%); 23% died of myocardial infarction and 15% from other heart disease or sudden death. Other causes included neoplasm (14.6%), other ruptured aneurysm (8.2%), and stroke (6.8%). Cause of death was unknown in 19.6%. A significant correlation of reduced survival time was noted in patients with advanced age and those with evidence of heart disease or hypertension. For patients without preoperative evidence of heart disease or hypertension, the 5-year mortality rate from myocardial infarction was 3.7%, compared with 11.7% for those with a positive history of hypertension and heart disease (p = 0.0001). For patients with no preoperative evidence of hypertension or heart disease, the length of survival after AAA repair was the same as that expected for the general population with the same age and sex composition. This study supports the contention that coronary angiography and prophylactic coronary bypass grafting should be performed selectively. Decisions regarding the need for coronary revascularization should be based on symptoms, noninvasive testing, and selective coronary angiography because aneurysmal disease alone is not shown in this study to increase the risk of death from myocardial disease. For patients with clinical findings of coronary artery disease, an aggressive diagnostic approach appears to be justified.

独協学園における循環器疾患の健康管理に関する研究 ＩＩ 健診成績の経時的観察

Health and clinical examinations of circulatory organs on 1, 400 high-school boys aged 12 to 17 years have been conducted from 1967 to 1981. The followed up data of health examination and clinical tests of cardiovascular disorders were analyzed, and the following conclusions were obtained. 1. Annual Fluctuation of Blood Pressure (observed number: 1, 061) 1) The annual blood pressure fluctuation are shown differently in high and low pressure groups which are divided at 120mmHg of systolic pressure and 70mmHg of diastolic pressure. In the higher blood pressure group, many boys had rather lower pressures at the second year than at the first year, while many boys in the lower blood pressure group had rather higher pressures at the last than at the former. It seems roughly that blood pressures in both groups are gathering to the average of the group. 2) Using both a erage blood pressures and the standard deviations in data for two years, the boys were categorized into three groups according to their blood pressure levels: high blood pressure groups (2.0%), increasing blood pressure group (1.1%), and decreasing blood pressure group (1.3%). 3) The incidence of families with a positive history of hypertension was significantly higher for the high blood pressure group than for the normal blood pressure and low blood pressure groups, thus suggesting that genetic factors give also school-age males some loading of the high blood pressure disposition. 2. Development of Ventricular Conduction Defect in 931 Boys Followed up. 1) After three years' observation, percentage figures for persistent fixation of cardiac ventricle conduction defect were obtained 83.3% for CRBBB, 62.5% for IRBBB, and 43.8% for IRBBB (R>R'), with a clear tendency for the more serious codes to be more fixed. 2) The number of improved cases (39.1%) was greater than that of the deteriorated (19.6%). Such a difference is more evident in cases with a short history of the disease, (improving group: 29.4% and deteriorated group: 8.8%). 3. Time-Course Results of A-V Conduction Defect (observed number: 1, 396) 1) Three years' observation showed that the incidence of I A-V block was 0.64%, WPW syndrome 0.14%, and P-R shortening 0.07%. 2) The fluctuations of this defect in the course of time showed that the unchangeable type with a constant code was 59.7%, the improving type whose symptoms disappered completely was 22.6%, and the subjects newly developping the condition was 17.7%. 3) The results of Master's two-step test (double) conducted for I A-V block (observed number: 22) (except for temporary and intermittent cases) showed that the improving type in which the P-R interval tends to be shorter after physical exertion accounted for 77.3%, while the deteriorating type in which this interval tends to be longer after physical exertion for accounted for 9.1%.

Characteristics of representative male survivors of myocardial infarction compared with representative population samples.

A series of 299 men, aged 27-67, who had survived their first myocardial infarction (MI), have been compared with representative population samples with respect to tobacco consumption, alcoholic intemperance, physical activity during work and leisure time, occurrence of hypertension, and cholesterol and triglyceride levels in serum. The infarction patients comprised 90% of all surviving, diagnosed cases of primary MI in men aged 67 years or below during 1968-70 in Göteborg, Sweden. The comparison between infarction patients and general population samples revealed that the patients smoked more, and were less physically active during leisure time but not during work. They had more often a positive history of hypertension and treatment for high BP and their serum cholesterol and serum triglyceride values were higher. For all these variables the difference decreased with increasing age and was generally not statistically significant above the age of 60 years. Alcoholic intemperance was more common among infarction patients who died outside hospital, but there was no difference in this respect between surviving patients and the general population.

PREVALENCE OF HYPERTENSION IN ADULT POPULATION OF HAYATABAD PESHAWAR

BACKGROUND: Hypertension is one of the common non communicable disease and is reported to beprevalent in 20% to 50% of the adult population, hypertension is one of the major contributor ofmortality and morbidity in developing and developed countries. The cross-sectional descriptive studywas formulated to find the prevalence and to assess different etiological factors of hypertension.MATERIAL &amp; METHODS: This cross-sectional study among 400 adults of age 25-75 years wasconducted in months of June to December 2014 in Phase 5, Hayatabad Peshawar. A detailed structuredproforma having important questions was used to collect important data regarding various variables.RESULTS: Our study results showed that 22.75% of the study people were hypertensive i.e. 10.25% ofmales and 12.5% of females; and the prevalence of hypertension showed positive association withadvancing age. Out of all respondents; 60.25% were males while 39.75% were females; 28.5% weresmokers; 5.25% consume predominantly meat; 32.5% were obese &amp; overweight; 36.75% checked theirB.P regularly; and 19.75% had positive history of hypertension in family.CONCLUSION: We conclude that hypertension prevalence was high among our study population andwas associated with various modifiable and non modifiable risk factors thus population based preventivestrategies are needed to control and prevent hypertension.KEY WORDS: Hypertension, Age, Diet, Smokers, Hayatabad, Peshawar.