Prehypertensive Group Research Articles

Elevated blood pressure and hyperuricemia risk: a retrospective cohort study from Wuhu, China

Although the relationship between hypertension and hyperuricemia is widely recognized, there is still a relative lack of research on prehypertensive individuals and the individual associations of systolic and diastolic blood pressure with the risk of hyperuricemia. From 2011 to 2016, we conducted a study on 53,323 individuals at Wuhu City Hospital in China. Based on initial blood pressure readings, participants were categorized into normal, prehypertension, or hypertension groups. We used Cox regression to analyze the associations with baseline factors. In subgroup analyses, systolic and diastolic pressures were treated as continuous variables, and their relationship with the risk of hyperuricemia was examined using restricted cubic spline analysis. The risk increased in the prehypertension and hypertension groups compared to the normal blood pressure group, with hazard ratios of 1.192 and 1.350, respectively. For each unit increase in blood pressure, the risk of hyperuricemia rose by 0.8% (systolic) and 0.9% (diastolic), especially when blood pressure levels exceeded 115/78 mmHg. Additionally, we observed that factors such as gender, alcohol consumption habits, obesity, and dyslipidemia might further influence this association. These findings emphasize the importance of early risk assessment and intervention in these patient populations in clinical practice.

Association of Microalbuminuria with Glucose Levels, Microvascular and Macrovascular Complications in Relation with Blood Pressure in Diabetes Mellitus Type 2

Objectives: Determine the association of Microalbuminuria (MAU) with glucose markers, micro vascular and macrovascular complications in relation with blood pressure in patients with type 2 diabetes mellitus. Material and Method: This study was cross sectional study and data collected in Chemical laboratory of pathology department of Dr Akbar Niazi Teaching Hospital. It carried out during the time period of December 2021 to January 2022. Patients were divided into 2 groups which fulfill the inclusion and exclusion criteria patients having diabetes mellitus type 2 with good glucose control, HbA1c < 7% (n=33) patients having diabetes mellitus type 2 with bad control HbA1c ≥7% (n=33) each group were further divided into 2 sub-groups Patients with Pre-hypertension (n) and patients with HTN (n). The sampling technique of this study was non-probability convenience sampling was done. Data/Documentation was collected by Performa and laboratory investigation. Spss version 21 used to analyze the data. Normality of data was assessed by KS test. Quantitative test was measured as mean and standard deviation. Qualitative variables were calculated as number percentage. ANCOVA test and chi square test were used for comparison of quantitative and qualitative variables respectively. Pearson correlation was applied to determine the association of MAU with glucose levels and diabetes related complications. Result: Among total 66 patients, the sample of patients were included 47 males (71.2%) and 19 females (28.8%). Patients of type 2 diabetes mellitus in HbAlc ≥7% group showed higher levels of Blood Glucose level, MAU, Systolic BP and Diastolic BP as compared to HbA1c < 7% group. The comparison of the variables between 2 groups showed statistical differences in nephropathy and cardiovascular complications. In HbA1c ≥ 7% group, correlation of MAU with Systolic BP, Diastolic BP, Fasting Blood Glucose (FBG), HbA1c, Nephropathy, and Cardiovascular events were statistically significant. In Pre-HTN group, MAU was significantly correlated with Fasting blood glucose level, HbA1c, Nephropathy and cardiovascular complications. Patients of HTN showed more significant association with blood pressure (BP), Blood Glucose, HbA1c, Cardiovascular events with MAU as evident by higher r-values as compared to pre-HTN group. Regarding nephropathy, r-value was slightly higher in Prehypertensive group. Conclusion: Patients with uncontrolled diabetes mellitus have increased risk of developing HTN, MAU as well as diabetes related complication including nephropathy and cardiovascular events. More over MAU showed significant positive association with BP, blood glucose levels, nephropathy and cardiovascular events. Both pre- hypertensive and hypertensive patients showed significant positive association of MAU with blood glucose levels and diabetes related complication including nephropathy and cardiovascular events. This study suggested that Prehypertensive and hypertensive patients with altered blood glucose levels have increased risk of MAU, that why proper evaluation and treatment of MAU may lead to early diagnosis and decrease progression of HTN, diabetes mellitus type 2 and its related complications.

Can Galanin Be Used as a Marker of Microvascular Dysfunction in Prehypertensives?

Coronary microvascular dysfunction is present in large percentage of the population, and it has been shown to have a pathological and prognostic role in many conditions. Therefore, early detection of microvascular dysfunction is important, especially in selected populations. The aim of this study was to investigate the association of galanin with coronary flow reserve (CFR) in prehypertensive individuals to determine whether it can be used as a marker to detect microvascular dysfunction. A total of 100 participants, 50 prehypertensive and 50 normotensive were included in this prospective study. Serum galanin levels were measured and CFR was calculated by detailed transthoracic echocardiography. CFR was significantly lower in the prehypertensive group (p<0.001). Also, galanin values were numerically lower in the prehypertensive group, but the difference between the groups did not reach statistical significance (p=0.062). There was no significant correlation between CFR and galanin (r=-0.161, p=0.11). Lower CFR values in prehypertensives suggest that microvascular dysfunction starts above normotensive values even if hypertension does not develop. The reason why low galanin levels were not statistically significant in prehypertensives and no correlation was found between galanin and CFR may be due to the small study population. Relationship between galanin, prehypertension and microvascular dysfunction will become clearer if large-scale population studies are carried out.

Reclassification of Adolescent Ambulatory Prehypertension and Unclassified Blood Pressures by 2022 American Heart Association Pediatric Ambulatory Blood Pressure Monitoring Guidelines

To describe the epidemiology of reclassification of prehypertensive and unclassified adolescents by 2022 American Heart Association pediatric ambulatory blood pressure monitoring (ABPM) guidelines, and to evaluate the association of the new diagnostic categories with left ventricular hypertrophy (LVH). A single-center, retrospective review of ABPM reports from adolescents 13-21years old, from 2015 through 2022, was performed. Adolescents with prehypertension or unclassified by 2014 guidelines were reclassified by 2022 definitions. Logistic regression models evaluated the association of reclassification phenotypes with LVH. A majority of prehypertensive adolescents reclassified to hypertension (70%, n=49/70). More than one-half (57%, n=28/49) of the hypertension was isolated nocturnal hypertension, and 80% was systolic hypertension. Reclassification to hypertension was more common in males. The majority (55.6%) of unclassified adolescents were reclassified to normotension. No demographic or clinical variables were associated with reclassification categories. LVH was not associated with hypertension in the reclassified prehypertensive or unclassified groups. The 2022 ABPM guidelines clearly define blood pressure phenotypes. However, reclassification to hypertension was not associated with an increased odds of LVH. Because most prehypertensive adolescents reclassified as hypertensive by nighttime BPs alone, this study highlights the lowered threshold for nocturnal hypertension. Prospective studies in larger, well-defined cohorts are needed to describe better the predictive value of 2022 BP phenotypes for target organ damage.

Practical Application of a New Cuffless Blood Pressure Measurement Method.

This study involved 167 patients aged 31 to 88 years (mean 64.2 ± 7.8 years) with normal blood pressure, high blood pressure, and compensated high blood pressure. During each session, three routine blood pressure measurements with intervals of 30 s were taken using a sphygmomanometer with an appropriate cuff size, and the mean value was selected for comparison. The measurements were carried out by two observers trained at the same time with a reference sphygmomanometer using a Y-shaped connector. In the minute following the last cuff-based measurements, an electrocardiogram (ECG) with an I-lead and a photoplethysmocardiogram were recorded simultaneously for 3 min with the CardioQVARK device. We compared the systolic and diastolic BP obtained from a cuff-based mercury sphygmomanometer and smartphone-case-based BP device: the CardioQVARK monitor. A statistical analysis plan was developed using the IEEE Standard for Wearable Cuffless Blood Pressure Devices. Bland-Altman plots were used to estimate the precision of cuffless measurements. The mean difference between the values defined by CardioQVARK and the cuff-based sphygmomanometer for systolic blood pressure (SBP) was 0.31 ± 3.61, while that for diastolic blood pressure (DBP) was 0.44 ± 3.76. The mean absolute difference (MAD) for SBP was 3.44 ± 2.5 mm Hg, and that for DBP was 3.21 ± 2.82 mm Hg. In the subgroups, the smallest error (less than 3 mm Hg) was observed in the prehypertension group, with a slightly larger error (up to 4 mm Hg) found among patients with a normal blood pressure and stage 1 hypertension. The largest error was found in the stage 2 hypertension group (4-5.5 mm Hg). The largest error was 4.2 mm Hg in the high blood pressure group. We, therefore, did not record an error in excess of 7 mmHg, the upper boundary considered acceptable in the IEEE recommendations. We also did not reach a mean error of 5 mmHg, the upper boundary considered acceptable according to the very recent ESH recommendations. At the same time, in all groups of patients, the systolic blood pressure was determined with an error of less than 5 mm Hg in more than 80% of patients. While this study shows that the CardioQVARK device meets the standards of IEEE, the Bland-Altman analysis indicates that the cuffless measurement of diastolic blood pressure has significant bias. The difference was very small and unlikely to be of clinical relevance for the individual patient, but it may well have epidemiological relevance on a population level. Therefore, the CardioQVARK device, while being worthwhile for monitoring patients over time, may not be suitable for screening purposes. Cuffless blood pressure measurement devices are emerging as a convenient and tolerable alternative to cuff-based devices. However, there are several limitations to cuffless blood pressure measurement devices that should be considered. For instance, this study showed a high proportion of measurements with a measurement error of <5 mmHg, while detecting a small, although statistically significant, bias in the measurement of diastolic blood pressure. This suggests that this device may not be suitable for screening purposes. However, its value for monitoring BP over time is confirmed. Furthermore, and most importantly, the easy measurement method and the device portability (integrated in a smartphone) may increase the self-awareness of hypertensive patients and, potentially, lead to an improved adherence to their treatment. The cuffless blood pressure technology developed in this study was tested in accordance with the IEEE protocol and showed great precision in patient groups with different blood pressure ranges. This approach, therefore, has the potential to be applied in clinical practice.

Association of Gamma-glutamyl transferase with severity of hypertensive retinopathy in the Indian population

: Hypertension is the condition of elevated blood pressure and is a serious medical condition that significantly increases risk of diseases associated with the heart, brain, kidney, eyes, etc. and its most common ocular presentation is Hypertensive retinopathy (HR). Oxidative stress has been extensively studied for its role in the pathophysiology of Hypertensive retinopathy. Through this study, we want to establish an association between the severity of Hypertensive retinopathy and Gamma-glutamyl transferase (GGT).: After obtaining clearance from the ethics committee, an analytical study was carried out comprising 100 individuals having Hypertensive retinopathy. Patients were divided into four groups according to the Keith Wagener classification. The patients underwent thorough clinical examinations. The ocular examination included visual acuity evaluation, IOP measurement by Goldmann tonometry, and fundoscopy. Biochemical investigation of Serum Gamma-glutamyl transferase was done using a CORAL Colorimetric assay kit and SPSS Version 21.0 was used for statistical analysis.: The majority of Grade I HR people belonged to either normal or prehypertensive group, while the majority of Grade IV, II &amp; III were from the Stage I hypertensives group, followed by Grade II and Grade III hypertension. Statistically, a significant association between the increasing severity of retinopathy and the rise in BP was observed. Most patients with Grade I retinopathy (66.7%) had GGT levels &amp;#60; 40 U/l, while all the patients in Grade II, III &amp; IV (100.0% each) had GGT &amp;#62;40 U/L. Statistically, it was also noted that the GGT levels increased with increasing grades in HR.

Identifying Pre-hypertensives in the Community: At Risk Approach for Prevention of Hypertension

Introduction: Pre-hypertension is a borderline health state of increased blood pressure (BP) that falls short of the measurable parameters at which surveillance and/or therapy would be required. The approach of identifying people “At Risk” of developing hypertension can be more cost-effective and feasible for applying lifestyle interventions. Objectives: The objective of the present study is to find the prevalence of pre-hypertensives and associated bio-socio-demographic factors Materials and Methods: A cross-sectional study was conducted among 1946 participants aged 19 years and more in the Doiwala block of Dehradun, Uttarakhand. Multistage sampling was used to arrive at desired sample size. A pre-validated, structured questionnaire was used for data collection. The questionnaire included information on the socio-demographic profile (age, sex, education etc.), awareness about hypertension and its associated risk factors. Statistical Analysis: The chi-square test was used to compare proportions and draw inferences. Results: 958 (49.2%) study participants out of a total 1946 were found to be pre-hypertensives. A statistically significant association was found between pre-hypertension and factors such as male gender, age, education, occupation and waist-hip ratio. (p&lt;0.05) Conclusion: It is recommended that identification on the pre-hypertensive group and subjecting them to lifestyle modification could be a fruitful strategy for preventing them from becoming hypertensive.

EFEKTIVITAS PUDING JAMBU BIJI MERAH TERHADAP PENURUNAN TEKANAN DARAH PADA PREHIPERTENSI DI PUSKESMAS PADASUKA KOTA BANDUNG

Prehypertension is an early condition that can cause arterial hypertension in its later development into cardiovascular disease. Low intake of vitamin C and high intake of sodium at productive age have the risk of triggering the development of degenerative diseases such as hypertension. This study aims to determine the effectiveness of giving guava pudding on blood pressure in the prehypertension group in the work area of ​​the Padasuka Public Health Center, Bandung City. This type of research is a quasi two group with a control experimental design using pre-test and post-test. The sampling technique used is simple random sampling. Intake data were collected using a Semiquantitative Food Frequency Questionnaire (SFFQ) method while blood pressure data was measured using a Digital Sphygmomanometer. The research data were analyzed using Paired T-Test and Wilcoxon test. The results showed that the average intake of vitamin C in the treatment group increased by 186% and sodium intake decreased by 19.1%, better than the control group, the decrease in systolic blood pressure in the treatment group was 3.2% or higher than the control group and an average The treatment group's diastolic blood pressure decreased 5.2% or lower than the control group. There was an effect of the intervention on the intake of vitamin c and sodium in the treatment group (p&lt;0.05). There was an effect on vitamin c intake (p&lt;0.05) and no effect on sodium intake in the control group (p&gt;0.05). The results of the study on systolic blood pressure in the treatment group showed an effect of giving the intervention product (p&lt;0.05) while the diastolic blood pressure in the treatment group, systolic blood pressure, and diastolic blood pressure in the control group showed no effect on giving the intervention product (p&gt;0.05). The study concluded that there was an effect of giving red guava pudding on systolic blood pressure, but there was no difference in the decrease in systolic and diastolic blood pressure between the two sample groups.

Comparison of the Anthropometric Indices to Identify Prehypertension Among Male Medical Students

The state of prehypertension that is often neglected in young adults is not inferior to hypertension in contributing to a higher risk of cardiovascular diseases. Several simple anthropometric indices may be used as prehypertension prognostic tools, including Body Mass Index (BMI), Body Shape Index (ABSI), Waist Circumference (WC), Weight to Height Ratio (WHtr), and Body Roundness Index (BRI). This study aimed to compare several anthropometric examinations for detecting prehypertension in male medical students. The cross-sectional study design was conducted on 107 male medical students. Direct measurements of the respondents were carried out with blood pressure data collection and anthropometric examination. The area under the receiver-operating characteristic curve (AROC) analysis with a 95% confidence interval (CI) was used to assess all anthropometric measures’ discriminatory power to assess the risk of prehypertension in the participants. Participants with prehypertension were relatively older and had less active physical activity than normotensive (p&lt;0.05). The mean BMI, BRI, WC, and WHtR were significantly higher in the prehypertensive group than in the normotensive group. However, ABSI was not showing any relationship with blood pressure. The process with 95% CI of blood pressure classification related to anthropometric measures indicates that BMI showed the highest AROC values for the prehypertensive state (AROC: 0.73, 95% CI: 0.63–0.82), and WC had the lowest AROCs (AROC: 0.63, 95% CI: 0.52–0.63). BMI, BRI, WC, and WHtr may be applied as prognostic assessments for prehypertension states in young adult males.

Evaluation of Heart Rate Recovery in Obese Children and Adolescents With Prehypertension.

Heart rate recovery (HRR), a noninvasive assessment of autonomic nervous function, is widely studied in adults with hypertension or prehypertension. This study aimed to evaluate whether HRR was independently associated with prehypertension in obese children. A total of 326 obese children aged 7 to 16 years were divided into 2 groups: prehypertension group and normal blood pressure (BP) group (control group). Anthropometric indexes, physical activity (PA) information, biochemical parameters, and HRR were collected. Multiple logistic regression analysis showed that body mass index (BMI) (odds ratio [OR] = 1.116; P < .05), waist-to-hip ratio (WHR) (OR = 1.258; P < .05), homeostasis model assessment (HOMA-IR) (OR = 1.087; P < .01), diastolic blood pressure (DBP) (OR = 1.304; P < .01), and HRR values (OR = 0.892; P < .05) were independent risk factors of prehypertension in obese children. Our findings demonstrated decreased HRR was closely associated with prehypertension in obese children, which indicated studying the role of sympathetic/parasympathetic imbalance might be helpful to explore the underlying mechanism.

Association between periodontitis and hypertension among a sample of adult Egyptian patients: A hospital-based cross-sectional study

Abstract Aim: The prevalence of hypertension in adult Egyptians is 29.2%. This investigation’s objective is to evaluate the link between periodontitis and hypertension in adult Egyptian outpatients who visit the Oral Medicine and Periodontology Department at Cairo University’s Faculty of Dentistry. Materials and Methods: Periodontal and radiographic assessment of each patient was performed in order to get a consensus along with the newest classification of periodontal disorders published in 2018 and involved only the periodontitis cases. Then, a questionnaire was filled which included sociodemographic and medical data. An automated sphygmomanometer apparatus was implemented to check blood pressure at the clinic. Then, patients were categorized into three groups: prehypertension, hypertension, and hypertension-free groups in relation to their blood pressure records. Results: The present research was conducted on 376 subjects diagnosed with periodontitis, most patients did not have hypertension (240 patients, 63.8%). Prehypertension group included 66 patients (17.6%) while the hypertension group had 70 patients (18.6%). There was a statistically significant difference between probing depth (PD) measurements in patients with different hypertension categories (P value = 0.016, effect size = 0.009). It revealed that patients with hypertension exhibited the statistically remarkably greatest PD. There was no statistically significant difference among the study groups as regards the periodontitis stages (P = 0.161), and periodontitis grades (P = 0.716). Conclusions: In this investigation, there was no connection between periodontitis and hypertension in the Egyptian population where periodontitis is a complex condition with several risk factors. However, hypertensive patients had high significant levels of PD.

Plasminogen Activator Inhibitor-1 as a Marker of Thrombosis among Prehypertensive Patients: A Cross-sectional Study

Introduction: Impaired endogenous fibrinolysis has been shown to play a role in the pathogenesis and complications of hypertension. Plasminogen Activator Inhibitor-1 (PAI-1) is said to be a predictor of impaired fibrinolysis and thrombosis. Prehypertension is a common worldwide condition and is known to be an independent risk factor for Cardiovascular Disease (CVD). Aim: Present study aimed to measure plasma PAI-1 levels in prehypertensive patients and normal subjects and to find the correlation between elevated PAI-1 levels with Blood Pressure (BP), triglycerides, total cholesterol, Low-Density Lipoproteins (LDL) cholesterol, High-Density Lipoproteins (HDL) cholesterol, and urine albumin. Materials and Methods: This cross-sectional analytical study included 100 patients, comprising 50 prehypertensive individuals and 50 controls, aged between 35 and 50 years. The study was conducted at Sapthagiri Institute of Medical Sciences and Research Centre in Bangalore, India. Anthropometric measurements, PAI-1 levels, total cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and urine albumin were measured using standard procedures. The data were statistically analysed using the Statistical Package for Social Sciences (SPSS) version 10.0, applying Student t-test and Chisquare test. Correlation analysis was performed to assess the relationship between PAI-1 and various parameters. Results: A total of 100 patients were included in the study which had 64 men and 36 women with a mean age of 46±7 years. PAI-1 levels were significantly higher in the prehypertensive group compared to the control group (p-value=0.013). Participants with higher plasma PAI-1 levels had significantly elevated BP (p-value=0.001) compared to those with lower PAI-1 levels. Total cholesterol, triglycerides, and LDL cholesterol were significantly increased in prehypertensive individuals (p-value=0.001), whereas HDL cholesterol was significantly lower (p-value=0.001). The study also observed a significant increase in urine albumin in the prehypertensive group with elevated PAI-1 levels compared to the controls (p-value=0.001). The study revealed that elevated plasma PAI-1 levels did not show a significant positive correlation with SBP and DBP (r=0.138 and 0.660, p-value of 0.338 and 0.648, respectively). Plasma PAI-1 levels were weakly correlated with total cholesterol (r=0.145, p-value 0.315), LDL cholesterol (r=-0.068, p-value 0.640), HDL cholesterol (r=0.21, p-value 0.882), and triglycerides (r=0.207, p-value 0.150). There was no significant correlation between increased PAI-1 levels and urine albumin (r=-0.225, p-value of 0.117). Conclusion: Present study demonstrated that plasma PAI-1, total cholesterol, triglycerides, LDL cholesterol, and urine albumin were significantly elevated in prehypertensive individuals, suggesting vascular damage and inflammation. As prehypertension is often asymptomatic, patients with prehypertension should be considered to have an increased risk for CVD.

CARDIOVASCULAR CHANGES IN SUBCLINICAL HYPOTHYROIDISM: DESCRIPTIVE OBSERVATIONAL STUDY

Thyroid disorders are the most common endocrine disorders in India. Reduced production of thyroid hormone is central feature of clinical state termed as “hypothyroidism”. Iodine deciency remains a common cause of hypothyroidism worldwide. In areas of iodine sufciency, autoimmune disease (Hashimoto's thyroiditis) and iatrogenic causes (treatment of hyperthyroidism) are most common. By denition, subclinical hypothyroidism refers to biochemical evidence of thyroid hormone deciency in patients who have few or no apparent clinical features of hypothyroidism. Subclinical Hypothyroidism is an asymptomatic state in which reduction in thyroid activity is compensated by elevated thyroid stimulating hormone to maintain euthyroid state. Evidence seems to indicate subclinical hypothyroidism is quite prevalent in presumably normal population. Subclinical hypothyroidism is found in 6–8% of women (10% over the age of 60) and 3% of men8. Prevalence increases with age. Methods- This was an observational study done in medical college and hospital. The study was carried out in the duration of 2 years. All OPD and IPD patients of Hospital, diagnosed with subclinical hypothyroidism, during this period, who fullled the inclusion criteria, were included in this study. This study included 54 newly diagnosed patients with subclinical hypothyroidism attending Hospital. Results- In this study maximum patients belong to age group ranging from 18-30 (33.33%). Next to it is age group involving 31-40 (31.48%). While least number of patients comes in age group ranging from 61-70 (9.26%) . Female (74.07%) preponderance compared to males (25.93%). With male having (25.93%). Male to Female ratio is 1:3. Showing female predominance in hypothyroidism. Conclusion- Quite a signicant number of patients were in the prehypertension group. Various life style modications can be advised to prevent them from going to stage I hypertension. Skin changes, Facial pufness, Hoarseness of Voice, cold intolerance, limbs swelling and weight gain these are the symptoms in decreasing order in patients with subclinical hyperthyroidism

Circ_0000284: A risk factor and potential biomarker for prehypertension and hypertension.

CircRNAs have been shown to be involved in the development of certain diseases, but their application in prehypertension and hypertension remains unclear. We aimed to explore the potential role of circ_0000284 in revealing the molecular regulatory mechanisms of prehypertension and hypertension. We enrolled a total of 100 patients with normal blood pressure, 100 patients with prehypertension and 100 patients with hypertension. The expression of circ_0000284 among the groups was detected by real-time fluorescence quantitative polymerase chain reaction (qRT‒PCR). Multivariate logistic models were constructed combining conventional risk factors with circ_0000284. A receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of circRNAs in the clinical model. Spearman correlation was used to analyze the correlation of circ_0000284 and the biochemical characteristics of all subjects. The results showed that circ_0000284 was differentially expressed among the normal blood pressure group, prehypertensive group and hypertensive group and showed a significantly upregulated trend in the progression to hypertension (P < 0.05). The ROC curve revealed a high diagnostic ability of circ_0000284 in hypertension in the clinical model (AUC = 0.812). Circ_0000284 also presented a certain ability for early diagnosis of prehypertension (AUC = 0.628). Spearman correlation showed that circ_0000284 was positively correlated with Na and CKMB. Our study suggested that upregulated expression of circ_0000284 was an independent risk factor for prehypertension and hypertension. Circ_0000284 was a potential fingerprint for the early diagnosis of hypertension and distinguished the intermediate stage of hypertension development. Moreover, our study provided new insight into the correlation between circ_0000284 and cardiac injury in the progression to hypertension.

Quantifying carotid stiffness in a pre-hypertensive population with ultrafast ultrasound imaging.

The aim of this study was to assess carotid stiffening in a pre-hypertensive (PHT) population using ultrafast pulse wave velocity (ufPWV). This study retrospectively enrolled 626 individuals who underwent clinical interviews, serum tests, and assessments of the systolic blood pressure (SBP), diastolic blood pressure (DBP), carotid intima-media thickness (cIMT), pulse wave velocity-beginning of systole (PWV-BS), and pulse wave velocity-end of systole (PWV-ES) between January 2017 and December 2021. The patients were divided into three groups according to their blood pressure (BP)-normal BP (NBP): SBP <130 mmHg and DBP <80 mmHg (n=215); PHT: 130 mmHg≤SBP<140 mmHg and/or 80 mmHg≤DBP<90 mmHg (n=119); hypertensive (HT): SBP ≥140 mmHg and/or DBP ≥90 mmHg (n=292). Correlation analyses and comparisons were performed among the groups and in the cIMT subgroups (cIMT ≥0.050 cm and <0.050 cm). cIMT and PWV-ES significantly differed among the BP groups (P<0.05). The BP groups had similar PWV-BS when cIMT <0.050 cm or cIMT ≥0.050 cm (all P>0.05). However, the NBP group had a notably lower PWV-ES than the PHT (P<0.001 and P=0.024) and HT (all P<0.001) groups in both cIMT categories, while the PWV-ES in the PHT group were not significantly lower than in the HT group (all P>0.05). Carotid morphological and biomechanical properties in the PHT group differed from those in the NBP group. ufPWV could be used for an early evaluation of carotid stiffening linked to pre-hypertension.

Binary cutpoint and the combined effect of systolic and diastolic blood pressure on cardiovascular disease mortality: A community-based cohort study.

This study aimed to examine the risk of cardiovascular disease (CVD) death according to blood pressure levels and systolic and/or diastolic hypertension. From 20,636 cohort participants, 14,375 patients were enrolled after patients with prior hypertension on antihypertensive drugs were excluded. For the combination analysis, participants were divided into four groups (systolic/diastolic hypertension, systolic hypertension only, diastolic hypertension only, and non-hypertension). The risk of CV death was calculated using the hazard ratio (HR) and 95% confidence intervals (95% CI) in a Cox regression model. The risk of CVD death increased in systolic hypertension (HR = 1.59, 95% CI 1.26-2.00) and systolic/diastolic hypertension (HR = 1.84, 95% CI 1.51-2.25). The highest risks of hemorrhagic and ischemic stroke were observed in the diastolic hypertension (HR = 4.11, 95% CI 1.40-12.06) and systolic/diastolic hypertension groups (HR = 2.59, 95% CI 1.92-3.50), respectively. The risk of CVD death was drastically increased in those with SBP≥120 mmHg/DBP≥80 mmHg. The highest risk was observed in those with SBP of 130-131 mmHg and 134-137 mmHg. The combined analysis of systolic and/or diastolic hypertension appears to be a good predictor of CVD death. The risk of CVD death in the prehypertensive group could be carefully monitored as well as in the hypertensive group, presumably due to less attention and the lack of antihypertensive treatment.

ELECTROCARDIOGRAM CHANGES IN PREHYPERTENSIVE SUBJECTS – EPIDEMIOLOGY OF HYPERTENSION IN CROATIA-1 (EH UH-1) STUDY

Objective: The aim of this study was to analyze the characteristics and changes in the ECG findings of adults with prehypertension (PHT) in a random sample of the general population included in the EH-UH 1 project. Design and method: Epidemiology of hypertension in Croatia 1 (EH UH-1) study is nation-wide survey on prevalence, awareness, treatment and control of hypertension (HT) in Croatia. In 2001–2003 a random sample of 1267 subjects were enrolled. Mortality data were analyzed after average period of 17 years. In this sub-analysis we included 189 untreated subjects whom GPs did an ECG. Subjects were divided into 3 groups: optimal blood pressure (OBP) &lt; 120/80 mmHg (N = 42), PHT 120–139/80–89 mmHg (N = 78) and untreated HT (UHT) &gt; = 140/90 mmHg (N = 69). Results: Atrial fibrillation was found in 2%, 3% and 4% in OBP, PHT and UHT group, respectively (PHT vs OBP p &lt; 0.05). QTc interval was prolonged in 2%, 13% and 65% in OBP, PHT and UHT group, respectively (PHT vs OBP p &lt; 0.05; UHT vs PHT p &lt; 0.01). Tpe interval was elevated in 12%, 14% and 17% in OBP, PHT and UHT group, respectively. Left ventricular hypertrophy (Cornell) was diagnosed in 5%, 9%, and 13% in OBP, PHT and UHT group, respectively (PHT vs OBP p &lt; 0.05; PHT vs UHT p &lt; 0.05). Conclusions: Gradual increases in ECG changes were observed across BP groups. Even in this small cohort, we observed significantly more pathological ECG findings in the PHT group than in subjects with OBP. ECG is of utmost importance in risk stratification of subjects with PHT and helpful, simple and cheap tool in making decision how to treat PHT patient. ECG should be recorded in all subjects with PHT.

To Study the Biochemical Changes For Prediction of Essential Hypertension

Background: In industrialized countries, hypertension is the fourth leading cause of death, but in underdeveloped countries, it is the seventh leading cause of death. Hypertension, defined as a systolic BP of 140 mmHg or a diastolic BP of 90 mmHg, is responsible for roughly 7.1 million deaths worldwide each year. Hypertension is a crucial independent prognosticator of cardiovascular disease, cerebrovascular accidents and death. In 2008, 17.3 million people died from CVDs, accounting for 30% of all global deaths. Over 80% of CVD deaths occur in low- and middle-income countries, and men and women die in nearly equal numbers. It is predicted that cardiovascular diseases will spread fast in India, with the country accounting for more than half of all heart disease cases in the world within the next 15 years. The current study was conducted to determine the relationship between hyperuricemia and EHT in the Central Indian population.&#x0D; Aim: To establish the significance of Biochemical Changes in the prediction of essential hypertension.&#x0D; Material and Method: A total of 250 people took part in this cross-sectional hospital-based case control study. All of the subjects were recruited at random from the Medicine OPD, attendants or family members of established hypertension patients, and healthy volunteers such as clinical and nonclinical personnel of a tertiary care hospital, as well as people who came to the hospital for a health examination. All of the age and sex matched subjects (20-50 years old) were separated into three groups: 70 subjects with normal blood pressure made up the control group. 90 cases of prehypertension were included in the Pre-HT group. 90 patients of newly diagnosed essential hypertension were included in the HT group. JNC7 criteria are used to determine the diagnosis of PreHT and EHT. Using commercially available reagents or kits, the levels of serum uric acid (SUA), serum malondialdehyde (MDA), lipid profile, serum creatinine, and fasting blood glucose were determined. The levels of serum creatinine and fasting blood glucose were calculated to rule out renal disease and diabetes mellitus, respectively.&#x0D; Results: The significantly increased trend in mean serum uric acid level was observed from control to prehypertensive to hypertensive cases. This study showed that hypertensive cases had significantly higher level of MDA than prehypertensive and control group. Among lipid profile parameters the significantly increasing trend was observed in mean value of TC, LDL, VLDL and TGL from control to prehypertensive to hypertensive cases whereas decreasing trend was observed in mean value of serum high density lipoprotein (HDL) from control to prehypertensive to hypertensive cases.&#x0D; Conclusion: As a result, our findings suggest that regular monitoring of blood pressure, serum uric acid, and lipid levels, as well as preserving oxidative balance in hypertensive patients, could assist to avoid CVD and other hypertension-related disorders. The progression of disease could be slowed by providing proper education to patients about a healthy lifestyle and encouraging them to engage in activities such as yoga, aerobics, and walking, among other things.&#x0D; Keywords: Uric Acid, MDA, CVD and Hypertension

The Importance of the De Ritis Ratio and Glasgow Prognostic Score in prehypertensive patients

Aim: To evaluate Glasgow prognostic score (GPS) and De Ritis ratio in optimal blood pressure and prehypertensive patients, and investigate whether these parameters can predict antihypertensive treatment in the follow-up period.Methods: A total of 402 patients who were followed up with a 24-hour ambulatory blood pressure with a pre-diagnosis of hypertension between January 2018 and December 2018 were included in the study. Routine laboratory parameters of the patients were recorded in the hospital digital system. The common health system data of the patients was analyzed until June 2020, and those who were started on antihypertensive treatment were recorded.Results: 402 patients (mean age 40.16 ± 13.01 years, 49% male) were included in the study. 226 of these were in prehypertension group. The mean GPS and the De Ritis ratio, aspartate transferase levels, mean systolic and diastolic blood pressures were different between the groups (p=0.035, p=0.023, p=0.039, p&amp;lt;0.001 and p=0.012, respectively). When patients whose antihypertensive treatment was started and those who did not receive antihypertensive treatment were compared, age, De Ritis ratio and mean diastolic blood pressure differed between the two subgroups (p&amp;lt;0.001, p=0.015 and p=0.040, respectively). Multivariate logistic regression analysis showed that De Ritis ratio and age were, independently, predictors for antihypertensive treatment (OR:3.064, p=0.015 and OR:1.050, p= 0.001 respectively). In ROC curve analysis, both age and De Ritis ratio were successful at predicting the initiation of antihypertensive treatment with an AUC:0.697 and p&amp;lt;0.001 and AUC:0.630 and p=0.018 respectively.Conclusion: Both GPS and the De Ritis ratio were found to be significantly higher in prehypertensive patients than those with optimal blood pressure. Moreover, the De Ritis ratio, an easily calculated laboratory parameter, can be used as a predictive value for antihypertensive treatment.

Effectiveness of diaphragmatic breathing exercise and Jacobson’s progressive muscle relaxation on cardio pulmonary parameters in pre-hypertensive patients

Background: Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. One of the potential risk factors of prehypertension is anxiety and it has already well known that cortisol is a marker of anxiety. There are some non-pharmacologic methods to relive anxiety; exercise and relaxation. The study was to assess the effect of diaphragmatic breathing exercise and diaphragmatic breathing exercise combined with Jacobson relaxation technique on cardiopulmonary parameters in pre-hypertensive patients. Methodology: A total of 40 subjects aged 18 to 40 years, diagnosed with prehypertension were included in the study. Eligible subjects were allocated to two groups i.e., Diaphragmatic breathing exercise group and Jacobson relaxation with diaphragmatic breathing exercise group. Intervention was given for 8 weeks and after that cardiopulmonary parameters such as blood pressure, heart rate, and respiratory rate were assessed. Results: In pre-hypertensive patients diaphragmatic breathing exercise group found significant difference after giving the intervention within the group (P