Prehypertensive Subjects Research Articles

The role of uric acid in the risk of hypertension developed from prehypertension: a five-year Chinese urban cohort study

BackgroundUric acid as a prominent causal factor in the pathogenesis of hypertension is well recognized. Nevertheless, the influence of uric acid on the transition from prehypertension to hypertension within the Chinese population remains understudied.MethodsA cohort of 1,516 prehypertensive individuals, aged 35 to 84 years, underwent recruitment following a comprehensive health assessment in 2017 and subsequent re-evaluation in 2022. Baseline characteristics and relevant clinical data were collected. The analytical approach encompassed multiple logistic regression and propensity score matching.ResultsOver 5 years, the cumulative incidence of hypertension amounted to 35.1%, with 33.9% in males and 37.3% in females, respectively. Notably, prehypertensive subjects concomitant with hyperuricemia exhibited a higher cumulative incidence of hypertension in comparison to the non-hyperuricemic counterparts (40.7% vs. 34.0%, p = 0.041). Multiple logistic regression unveiled a significant association between hyperuricemia and heightened hypertension risk (adjusted odds ratio [OR] = 1.44; 95% confidence interval [CI], 1.05–1.98; p = 0.022). Nonetheless, this association did not reach statistical significance when examining female subjects (adjusted OR = 1.10; 95% CI, 0.58–2.09; p = 0.781) or participants aged ≥ 60 years (adjusted OR = 1.07; 95% CI, 0.61–1.88; p = 0.814). Further validation through propensity score matching affirmed that subjects afflicted by hyperuricemia experienced a substantially elevated risk of transitioning from prehypertension to hypertension over the course of five years compared with the non-hyperuricemic counterparts (41.3% vs. 32.3%, p = 0.045), after adjusting for 12 covariates including age and gender. Hyperuricemia emerged as an independent risk factor predisposing individuals to the development of hypertension from a prehypertensive state.ConclusionThis observation prompted the formulation of a hypothesis suggesting that ameliorating elevated uric acid levels may potentially mitigate the progression from prehypertension to hypertension.

Risk of heart disease and stroke among individuals with prehypertension or blood pressure progression: a national population-based cohort study.

The purpose of our study was to analyze the association of blood pressure and blood pressure progression with heart disease and stroke among Chinese population. We included a total of 10 122 adults aged 45 years and above free of heart disease or stroke at baseline from the China Health and Retirement Longitudinal Study cohort. We used Cox proportional hazards models to analyze the relationship between cardiovascular risk and prehypertension in subjects with or without progression to hypertension. During a mean follow-up of 6.5 years, 1972 subjects were either diagnosed with heart disease or had a stroke (composite outcome). Compared with individuals with normotension at baseline, the fully adjusted hazard ratio (HR) [95% confidence interval (CI)] was 1.25 (1.10-1.42) and 1.52 (1.34-1.74) for composite outcome in individuals with prehypertension and hypertension at baseline, respectively. The subjects who progressed to hypertension had higher risk of cardiovascular outcomes than those who remained at normal blood pressure or prehypertension in a fully adjusted model. The subjects who progressed from prehypertension to hypertension had 1.72 times higher risk [HR (95% CI): 1.72 (1.37-2.16)] of cardiovascular outcomes than those who remained at normal blood pressure or prehypertension in a fully adjusted model. The cardiovascular risk of subjects with prehypertension is higher than that of subjects with normal blood pressure. After a diagnosis of hypertension, subjects who progressed from normal blood pressure to hypertension had an increased risk of heart disease and stroke.

Comparison of Arterial Stiffness among Prehypertensive and Normotensive Subjects using Photo Pulse Plethysmography: A Pilot Study

Introduction: Increased arterial stiffness is a marker of Cardiovascular Disease (CVD), even before clinical signs and symptoms become evident. Hypertension is an established risk factor for CVD. However, recent studies have revealed increased arterial stiffness even among prehypertensives. Photo Pulse Plethysmography (PPG) is an efficient non-invasive, and cost-effective technique to measure arterial stiffness. Studying arterial stiffness using PPG can serve as a surrogate marker of Cardiovascular (CV) risk among prehypertensives. Aim: To compare arterial wall stiffness among prehypertensives and normotensives using PPG. Materials and Methods: This pilot study was conducted at the Sri Ramachandra Institute of Higher Education and Research, Chennai, TamilNadu, India from December 2022 to February 2023. The study population included 10 non diabetic prehypertensives and 10 normotensives, aged between 30- 50 years, with normal lipid profiles. The peripheral pulse was recorded using a PPG module and digitised using AUDACITY software. The Arterial Stiffness Index (SI) was calculated and compared between the two groups. The correlation between anthropometry and arterial SI was also determined. Pearson’s correlation test was used to assess the association using Statistical Package for Social Sciences (SPSS) version 24.0. Results: The SI was found to be higher in prehypertensives compared to normotensives, and this difference was statistically significant (p-value=0.04). SI showed a positive correlation with increasing Blood Pressure (BP) and anthropometric variables (Body Mass Index [BMI] and Waist-Hip Ratio [WHR]; r=0.2 and r=0.15, respectively); however, no significant relationship was observed among these variables. Conclusion: This study concludes that the SI, an important CV risk marker, shows a significant increase in prehypertensive subjects compared to normotensive subjects. However, SI showed mild positive correlation with BP and other anthropometric measurements, though not statistically significant.

Association of blood pressure with frequency of different blood groups and body mass index among medical students.

Objective: To determine the association of blood pressure with frequency of different blood groups and body mass index among medical students. Study Design: Cross-Sectional study. Setting: Ameer-ud–Din Medical College /Postgraduate Medical Institute, Lahore, Pakistan. Period: May 2022 to August 2022. Material & Methods: Comprised 105 healthy both male and female medical students of 1st year and 2nd year MBBS. Participants were divided into groups following ABO blood grouping and body mass index criteria. Blood grouping was done by using conventional slide method. Manual auscultatory method consisting of mercury sphygmomanometer was used for estimation of blood pressure. Blood Pressure of female students was measured during follicular phase (days 7-11) of menstrual cycle to exclude role of emotional state and endocrinological factors for causing variation in blood pressure. Data was analysed by using SPSS 26. Results: There were 105 students with an overall mean age of 19.7±1.2 years. Blood group B&O found most predominant with equal prevalence of 35(33.3%). Prevalence of prehypertension among our study subjects was found 17.4%. Mean systolic, diastolic and mean arterial pressure were not found statistically significant among blood groups; p values 0.39, 0.28 and 0.25 respectively. No statistically significant difference of pre hypertensive subjects (n=18) were noted among ABO blood groups. (p=0.201). Statistical analysis showed significant association of DBP and MAP with BMI, p=0.014 and p=0.011 respectively. 38.5% of obese subjects were found prehypertensive. Highest percentage of obese subjects with pre-hypertension was noted among blood group O. Among underweight and normal weight subjects highest of pre- hypertensives were found to have blood group AB., but no significant association of pre-hypertensive subjects among different groups of BMI (p=0.184). Conclusion: B&O blood group were found predominant with equal prevalence. No statistically significant association of prehypertensive subjects were found among different ABO blood groups and different groups of BMI.

Echocardiographic Assessment of the Left Ventricle in Young Prehypertensive Nigerians.

Prehypertension is associated with an increased risk of cardiovascular morbidity and mortality. This risk could partly be explained by the early compromise in left ventricular (LV) structure and function. This study investigated the LV geometry and function in young black prehypertensive subjects. This cross-sectional descriptive study was conducted at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Echocardiography-derived LV geometry and function were assessed using standardized methods. Prehypertensive subjects had higher mean systolic blood pressure (BP) (130.78 ± 3.57 mmHg vs 111.42 ± 3.54 mmHg, P<0.001), diastolic BP (79.32 ± 4.13 mmHg vs 66.39 ± 4.42 mmHg, P<0.001), body mass index (BMI) (26.24 ± 3.45 kg/m2 vs 22.20 ± 2.21 kg/m2, P<0.001), waist circumference (WC) (86.93 ± 8.73 cm vs 76.73 ± 6.66 cm, P<0.001), fasting blood glucose (FBG) (93.84 ± 7.28 mg/dl vs 90.08 ± 6.26 mg/dl, P<0.001), and dyslipidemia (21.5% vs 6%. P<0.001) compared to normotensive subjects. LV mass index (LVMI) was greater in prehypertensive subjects compared to normotensive subjects {male (106.84 ± 12.34 g/m2 vs 76.07 ± 10.25 g/m2, P<0.001); female (92.06 ± 8.80 g/m2 vs 66.53 ± 7.21 g/m2, P<0.001)}, with abnormal LV geometry recorded in 17.5%. Linear regression analysis showed that waist circumference, systolic BP, serum creatinine level, and urea level were determinants of LVMI. The prevalence of LV diastolic dysfunction was higher in prehypertensive subjects than in normotensive subjects (14.5% vs. 0.5%, P<0.001), with systolic BP {odds ratio (OR) 0.928, confidence interval (CI) 0.834 - 0.969; P=0.016)} and diastolic BP (OR 0.832, CI 0.722 - 0.958; P=0.011) being independent predictors. This study showed that prehypertension in young Black subjects was associated with altered LV geometry and impaired diastolic function, and these changes demonstrated linear progression with increasing systolic BP.

A comparison of Lipid Profile and Highly Sensitive C Reactive Protein (HsCRP) levels between prehypertensive individuals and those with normal blood pressure.

Objective: In the current study, hsCRP and lipid profile levels in prehypertensives were assessed and compared with those in normal subjects, as well as blood pressure and lipid profile correlations were examined. Study Design: Cross-sectional. Setting: Department of Physiology, Liaquat University of Medical &amp; Health Sciences (LUMHS) in Jamshoro. Period: Six months 1st November 2022 to 30th April 2023. Material &amp; Methods: From the general population, 50 pre-hypertensive and 50 normotensive subjects ranging in age from 25 to 55 were enrolled. A blood pressure measurement and an anthropometric measurement were taken. Student t tests were used to compare serum hsCRP with lipid profiles. In order to correlate blood pressure with hsCRP and lipid profile, Pearson correlation was used. Results: A significant correlation was not found between blood pressure (SBP and DBP) and hsCRP in either group. When compared to normal individuals, pre-hypertensives had significantly higher cholesterol and LDL (P-value &lt;0.001). Among prehypertensive patients, blood pressure and lipid parameters did not seem to be significantly correlated. Conclusions: We conclude that in both prehypertensive and normal subjects, hsCRP levels are not significantly different. Therefore, pre-hypertensive patients do not have inflammation. Prehypertensive patients have significantly higher total cholesterol and LDL levels than normal individuals. There is an alteration in the lipid profile of prehypertensive individuals.

VARIATIONS IN SYMPTOMATIC ACTIVITY AMONG NORMOTENSIVE, PREHYPERTENSIVE, AND HYPERTENSIVE INDIVIDUALS

The differences in sympathetic nervous system activity between people with normotension, prehypertensive, and hypertension are examined in this study. Heart rate variability, plasma norepinephrine levels, and muscular sympathetic nerve activity were used to quantify sympathetic activity. 150 participants in all were split into three groups according to the results of their blood pressure tests. The results suggest that sympathetic activity increases from normotensive to hypertension patients, with intermediate values seen in prehypertensive subjects. These findings imply that increased sympathetic activity might be a major factor in the onset and course of hypertension. The creation of focused strategies for blood pressure control and hypertension prevention may benefit from an understanding of these variations.

Interventions for reducing blood pressure in prehypertension: A meta-analysis.

We aimed to address which interventions best control blood pressure (BP) and delay disease progression in prehypertension and to give recommendations for the best option following a quality rating. A Bayesian network meta-analysis was used to assess the effect of the intervention on BP reduction, delaying hypertension progression and final outcome, with subgroup analyses for time and ethnicity. Recommendations for interventions were finally based on cumulative ranking probabilities and CINeMA. From 22,559 relevant articles, 101 eligible randomized controlled trial articles (20,176 prehypertensive subjects) were included and 30 pharmacological and non-pharmacological interventions were evaluated. Moderate-quality evidence demonstrated that angiotensin II receptor blockers, aerobic exercise (AE), and dietary approaches to stop hypertension (DASH) lowered systolic blood pressure (SBP). For lowering diastolic blood pressure (DBP), AE combined with resistance exercise (RE) or AE alone provided high quality evidence, with calcium channel blockers, lifestyle modification (LSM) combined with drug providing moderate quality evidence. LSM produced the best BP lowering effect at 12 months and beyond of intervention. In Asians, TCD bubble was moderate quality evidence for lowering SBP and RE may have had a BP lowering effect in Caucasians. No recommendation can be given for delaying the progression of hypertension and reducing mortality outcomes because of low to very low quality of evidence. AE combined RE are preferentially recommended for BP control in prehypertension, followed by DASH. Long-term BP control is preferred to LSM. Asians and Caucasians add TCD bubble and RE to this list as potentially effective interventions. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022356302, identifier: CRD42022356302.

SAGE Score in Normotensive and Pre-Hypertensive Patients: A Proof of Concept.

The SAGE score was developed to detect individuals at risk for increased pulse wave velocity (PWV). So far, studies have been focused on hypertensive patients. To assess the ability of the score to detect non-hypertensive and pre-hypertensive patients at risk for increased PWV. Retrospective cross-sectional study of analysis of central blood pressure data and calculation of the SAGE score of non-hypertensive and pre-hypertensive patients. Each score point was analyzed for sensitivity, specificity, positive and negative predictive values, using the cut-off point for positive diagnosis a PVW ≥ 10m/s, ≥9.08 m/s (75thpercentile) and ≥7.30 m/s (50thpercentile). A p<0.05 was considered statistically significant. The sample was composed of 100 normotensive and pre-hypertensive individuals, with mean age of 52.64 ± 14.94 years and median PWV of 7.30 m/s (6.03 - 9.08). The SAGE score was correlated with age (r=0.938, p<0.001), glycemia (r=0.366, p<0.001) and glomerular filtration rate (r=-0.658, p<0.001). The area under the ROC curve was 0.968 (p<0.001) for PWV ≥ 10 m/s, 0.977 (p<0.001) for PWV ≥ 9.08 m/s and 0.967 (p<0.001) for PWV ≥ 7.30 m/s. The score 7 showed a specificity of 95.40% and sensitivity of 100% for PWV≥10 m/s. The cut-off point would be of five for a PWV≥9.08 m/s (sensitivity =96.00%, specificity = 94.70%), and two for a PWV ≥ 7.30 m/s. The SAGE score could identify individuals at higher risk of arterial stiffness, using different PWV cutoff points. However, the development of a specific score for normotensive and pre-hypertensive subjects is needed.

Supplementation of Water-Soluble Vitamins Reduces Hyperhomocysteinemia, Insulin Resistance, and High-Sensitivity C-reactive Protein in Prehypertension Subjects.

Prehypertensives are at higher risk of developing cardiovascular diseases. Hyperhomocysteinemia, insulin resistance, and increased high-sensitivity C-reactive protein (hs-CRP) are independent risk factors for the development of cardiovascular complications. In prehypertensives, specific therapeutic approaches can be implemented at the earliest to prevent the onset of overt hypertension. So the present study was performedto study the effect of supplementation of water-soluble vitamins on cardiovascular risk factors like homocysteine, insulin resistance, and C-reactive protein in prehypertensive subjects. Sixty prehypertensive subjects were recruited into the study based on inclusion and exclusion criteria and randomized into two groups of 30 each. One group was given a placebo and the other was given water-soluble vitamins for four months. Serum homocysteine, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and hs-CRP were assayed. After four months of treatment with water-soluble vitamins, there was a significant decrease in levels of serum homocysteine, hs-CRP, and HOMA-IR when compared to placebo treatment. After four months of treatment, there was a significant decrease in the levels of hs-CRP, homocysteine, and HOMA-IR in groups treated with water-soluble vitamins compared to the basal levels. In subjects with prehypertension, supplementation of water-soluble vitamins decreases the level of homocysteine, insulin resistance, and hs-CRP.

Assessment of Cardiac Autonomic Functions in Prehypertensive Individuals with and without a Family History of Hypertension: A Cross-sectional Study

Introduction: Individuals with prehypertension are at an increased risk of developing hypertension. Family history is one of the paramount non modifiable risk factors for developing hypertension. Hence, it becomes mandatory to assess the cardiac autonomic functions, which play an important role in the regulation of Blood Pressure (BP), in prehypertensive individuals with a family history. Aim: To compare the variations in parameters of cardiac autonomic function tests in prehypertensive individuals with and without a family history of hypertension. Materials and Methods: This cross-sectional study was conducted at the Institute of Physiology and Experimental Medicine, Madras Medical College, Chennai, Tamil Nadu, India from October 2020 to October 2021. The study included 30 prehypertensive individuals without a family history of hypertension and 30 prehypertensive individuals with a family history of hypertension, aged between 20 and 50 years, of both genders. They were recruited from the non communicable diseases Outpatient Department (OPD) at Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India. The prehypertensive range refers to a Systolic Blood Pressure (SBP) of 120-139 mmHg or a Diastolic Blood Pressure (DBP) of 80-89 mmHg. After obtaining informed consent, baseline parameters such as resting Heart Rate Variability (HRV) using AD instruments powerlab recorder, deep breathing test, Valsalva maneuver, isometric handgrip test, and Cold Pressor Test (CPT) were evaluated. The data obtained was statistically analysed using a Student’s t-test. Results: The mean age of prehypertensive individuals without a family history was 36.90±4.6 years, and in prehypertensive individuals with a family history, it was 36.43±5.3 years. The male to female ratio was higher. The resting SBP and DBP, as well as the basal heart rate, were significantly increased in the prehypertensive subjects with a family history. Time domain variables such as the mean RR, Root Mean Square of Successive Difference (RMSSD), and pRR50 were reduced in prehypertensive individuals with a family history. Among the frequency domain variables, the total power was reduced, while the low-frequency component and LF:HF ratio were significantly increased. The E/I ratio and Valsalva Ratio (VR) were also significantly reduced in prehypertensive individuals with a family history. Thus, the results emphasise that there is significant autonomic dysfunction in prehypertensive individuals with a family history of hypertension compared to prehypertensive individuals without a family history. Conclusion: Cardiac autonomic function tests in prehypertensive individuals with a family history indicate a definite sympathovagal imbalance in the form of sympathetic overactivity. This may substantiate the role of genetic predisposition in them. Chronic activation of the sympathetic nervous system makes them more prone to developing early hypertension.

UROMODULIN - A LINK BETWEEN SODIUM EXCRETION AND ALTERATION IN CIRCADIAN BLOOD PRESSURE PATTERN IN PREHYPERTENSIVES.

Although changes in dietary sodium intake alter blood pressure (BP) in salt-sensitive individuals, pathophysiological mechanisms are still unknown. It has been reported that uromodulin is involved in sodium tubular transport, and genome-wide association studies pointed to UMOD gene as one of the most important gene candidates for arterial hypertension. Our aim was to analyze urinary uromodulin, salt intake and BP in 326 young middle-aged subjects (mean age 36±8 years, 49.4% male). In a subgroup of 175 individuals, ambulatory blood pressure monitoring and echocardiogram were performed. Uromodulin was determined by ELISA. According to the JNC-7 criteria, subjects were classified as optimal BP (n=103, men 72%), prehypertension (PHT) (n=143, men 43%) and hypertension (HT) (n= 80, men 38%). There were no differences in age, salt intake, estimated glomerular filtration rate, sodium excretion and uromodulin among BP groups. However, in PHT subjects, uromodulin was positively associated with fractional sodium excretion and negatively with 24-h sodium excretion and diastolic BP dip. These findings point to the effect of uromodulin on sodium reabsorption along the nephron and consequently circadian BP alteration in prehypertensives.

Association of the mean platelet volume and heart rate variability in pre-hypertensive and hypertensive cases

Background: Hypertension is a multifactorial disease and pre-hypertension increases the risk of ischemic diseases. Alteration in the autonomic nervous system led to the development of prehypertension. Evaluating the heart rate variability is the effective tool to determine autonomic dysfunction in pre-hypertensive and hypertensive individuals. Aims and Objectives: The aim of the study was o determine the association between autonomic function and mean platelet volume (MPV) in pre-hypertensive and hypertensive individuals. Materials and Methods: A total of 120 participants of pre-hypertensive (n = 40, Group A), hypertensive (n = 40, Group B), and healthy control subjects (n = 40, Group C) between age group 31–50 years were recruited. All the study participants were subjected to blood pressure measurement either by palpatory or auscultatory method, variability of heart rate, and MPV. Results: The MPV was 9.76, 7.98, and 6.40 in Group A, B, and C, respectively, and the difference was statistically significant (P &lt; 0.05). The mean levels of RMSSD, SDNN, mean RR, NN50, and pNN50 were comparatively low in hypertensive group and high in pre-hypertensive participants and the difference was statistically significant (P &lt; 0.05). The mean levels of LF nu, HF nu, and LF/HF was statistically significant among study groups (P &lt; 0.05). There was a negative correlation between heart rate variables (HRV) and MPV in hypertensive group except between MPV and LFnu. Conclusion: The MPV was significantly high in hypertensive and pre-hypertensive participants that denote the risk of evolving cardiovascular diseases and cerebrovascular diseases. Timely assessment of HRV and adding this in a routine screening tool to predict the risk of hypertension at early stage.

CLINICAL EFFICACY OF HIGH DOSE WATER-SOLUBLE VITAMINS SUPPLEMENTATION ON LIPID PROFILE IN PRE-HYPERTENSIVE SUBJECTS

Background: Hypertension (HTN) is one of the preventable cardiovascular diseases (CVD) but it causes significant morbidity and mortality. Recently, incidence of pre-hypertension is increasing and it has a greater chance of developing into HTN. Dyslipidemia is one of the main risk factors for the development of CVD among the pre-hypertensive subjects. Water soluble vitamins display potent antioxidant and anti-inflammatory effects and also elicits favorable effect on lipid profile in HTN. In this backdrop, the present study was carried out to evaluate the supplementation of water-soluble vitamins on lipid profile in pre-hypertensive patients. Methods: This was a randomized, single blinded, and placebo-controlled study conducted on 60 pre-hypertensive subjects and was allocated into water soluble vitamins group (n=30) and received Becosules capsule for 4 months and placebo group (n=30) received starch capsule for 4 months. The blood was withdrawn at 2–4 months and the lipid profiles such as total cholesterol, triacylglycerol, HDL cholesterol (HDL-C), low-density lipoprotein (LDL)-C, and VLDL were measured. Then, the lipid profiles were compared with in the group and between the groups at 2–4 months using two-way repeated measures ANOVA. Results: In this study, the triglycerides and VLDL level were significantly (p&lt;0.05) decreased in water soluble vitamin groups as compared to the placebo groups. Meanwhile there was no significant alteration in the total cholesterol, HDL-C, and LDL-C level between the groups. Conclusion: Thus, the study shows that water soluble vitamins displayed significant anti-dyslipidemia effect in pre-hypertension and might also confer protection in the future progression of HTN.

SERUM HEPATOCYTE GROWTH FACTOR CONCENTRATION IS ASSOCIATED WITH BLOOD PRESSURE IN SUBJECTS WITH PREHYPERTENSION

Objective: Hepatocyte growth factor (HGF) is a pleiotropic factor that regulates cellular processes such as cell survival, proliferation, migration, and differentiation. Serum HGF concentration is associated with systolic blood pressure (BP) and is higher in hypertensive than in normotensive individuals, especially if complications of arterial hypertension are developed. Our aim was to determine the association of serum HGF concentration in subjects with prehypertension. Design and method: Data from 612 subjects (57,8% women, average age 41 years) was nalysed. After clinical examination, fasting blood and urine samples were drawn. HGF was measured using a commercial test. BP was measured according to the ESC/ESH guidelines. Based on BP values, subjects were divided into two groups: OBP - subjects with optimal blood pressure (BP &lt; 120/80 mmHg, N = 295), and PHT (subjects with BP 120/80–140/90 mmHg N = 317). Results: Subjects with PHT were significantly older and had higher values of body mass index, waist circumference, serum total cholesterol levels, triglyceride levels, and fasting glucose levels (all p &lt; 0.001). The prevalence of metabolic syndrome was significantly higher in PHT group (4.3% vs. 30.4%, p &lt; 0,001). Serum HGF concentrations were higher in PHT subjects, but the difference was not significant (270.8 vs. 277.9 pg/ml, p = 0.651). Serum HGF concentration showed a significant positive correlation to systolic and diastolic BP in PHT (r = 0,226, p &lt; 0,05 and r = 0,232, p &lt; 0,01, respectively), but not in OBP group (p &gt; 0.05). Conclusions: Serum HGF is associated with BP in prehypertensive subjects, but not in subjects with optimal BP. In our cohort, the correlation is more pronounced for diastolic blood pressure.

Effect of Isometric Exercise on Heart Rate Variability in Prehypertensive Young Adults

Background and Objective: Heart rate variability (HRV) is a sensitive and specific non-invasive tool to evaluate the degree of heart rate variation under the balanced influence of sympathetic and parasympathetic components of the cardiac autonomic nervous system. The aim was to study the effect of isometric hand grip exercise on HRV in prehypertensive young adults and to find a correlation of HRV with body mass index (BMI). Materials and Methods: This observational study was done on 60 healthy young adults aged 18–30 years. All the subjects were divided into three groups of 20 each on the level of their BMI and systolic and diastolic blood pressures. Group I were subjects with BMI &lt;25 and normotensive, group II with BMI &lt;25 and prehypertensive, and group III with BMI &gt;25 and prehypertensive. HRV analysis (Chart HRV module, ADInstruments Pty Ltd) was performed with the following parameters calculated: low-frequency power (LF), high-frequency power (HF), and LF/HF ratio. Results: LF/HF ratio was significantly increased (P&lt;0.001) in prehypertensive subjects (groups II and III) when compared with the normotensive subjects (group I), which indicates a heightened sympathetic discharge in prehypertensives. A positive correlation between anthropometric parameters and cardiac autonomic activity parameters and increased sympathetic activity in obese subjects were noted. Conclusion: An increase in anthropometric indices is associated with a change in cardiac autonomic activity, especially toward sympathetic activity. Regular anthropometric assessment can prevent the development of cardiac abnormalities and the incidence of sudden cardiac death.

The Relationship Between Carotid Artery Structural Abnormality and Stiffness in Patients With Prehypertension

Abstract Background To investigate the difference of carotid structural abnormality and stiffness, and the relationship between carotid structural abnormality and stiffness in prehypertensive and normotensive subjects. Methods A total of 581 participants (270 with prehypertension, 311 normotensive control subjects) from the First Affiliated Hospital of Fujian Medical University were enrolled from January 2017 to March 2019. Body height/weight, resting heart rate, and blood pressure were recorded. Blood biochemical indexes and carotid–femoral pulse wave velocity were determined, and carotid ultrasonography was performed. Carotid intima–media thickness ≥1.0 mm and carotid–femoral pulse wave velocity ≥10.0 m/s were defined as carotid structural abnormality and arterial stiffness, respectively. Results The percentage of patients with carotid structural abnormality (60.7% vs. 51.4%), carotid–femoral pulse wave velocity [(8.78 ± 1.48) vs. (7.92 ± 1.30) m/s], and the percentage of patients with arterial stiffness (13.7% vs. 5.8%) were increased in the prehypertension group compared with the control group (all P &amp;lt; 0.05). In the prehypertension group, the percentage of patients with arterial stiffness in the abnormal carotid structure subgroup (n = 164) was higher than that in the normal carotid structure subgroup (n = 106) (20.1% vs. 3.8%, χ2 = 14.551, P &amp;lt; 0.001). Furthermore, carotid structural abnormality, age, diabetes mellitus, resting heart rate, systolic blood pressure, fasting blood glucose, glycosylated hemoglobin A1c, and hypoglycemic therapy were all correlated with arterial stiffness (all P &amp;lt; 0.05). After adjusting for other cardiovascular risk factors, multiple logistic regression analysis showed that carotid structural abnormality, age, diabetes mellitus, and resting heart rate were independently correlated with arterial stiffness, and patients with carotid structural abnormality had 5.25-fold higher risk of arterial stiffness than those with a normal carotid arterial structure (odds ratio = 5.250, 95% confidence interval 1.580–17.448, P = 0.007). However, in the normotensive group, no such relationships were observed between carotid artery structural abnormality and stiffness. Conclusions In prehypertensives but not normotensives, carotid artery structural abnormalities and stiffness are common, and independently correlated.

Is resistance training alone an antihypertensive therapy? A meta-analysis.

Evidence concerning the prescription of isolated resistance training (RT) to hypertensive individuals is limited. Guidelines are divergent concerning RT inclusion for prehypertensive and hypertensive persons. A meta-analysis investigating data with larger sample sizes provides more robust effect size estimates and allows for inferences on clinical choices concerning the effectiveness of RT alone. In this context, the aim of this meta-analysis was to assess the effects of RT alone on the systolic (SBP) and diastolic (DBP) blood pressures in prehypertensive and hypertensive individuals. Data from 13 studies involving 417 participants (207 assigned to RT and 210 controls) were obtained. The results indicate significant reductions in SBP (-6.16 mmHg CI -8.27 to -4.04; I2: 31.0% P value for heterogeneity = 0.136 and effect size = -0.59) and DBP (-3.70 mmHg CI -5.19 to -2.21; I2: 18.3% P value for heterogeneity = 0.106 and effect size = -0.55) when compared to control groups. In conclusion, RT alone is able to reduce SBP and DBP in prehypertensive and hypertensive subjects, especially in elderly individuals.

Isometric Handgrip Exercise Training Improves Spirometric Parameters and Pulmonary Capacity.

Decline in normal physiological pulmonary function has been attributed to premorbid conditions such as prehypertension. Research evidence suggests that physical activity reduces age-related decline in pulmonary function and improves the efficiency of the lungs in prehypertensive patients. However, there is a scarcity of data evidence relating to isometric exercise and pulmonary function. Furthermore, the interrelationship between the intensity and duration of isometric exercise and pulmonary function in these patients is still uncertain. Therefore, this study was undertaken to investigate the effect of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. To determine the effectiveness of isometric handgrip exercise on pulmonary function capacity in adults with prehypertension. A quasi experiment using a pre- and post-exercise method was carried out in two out-patients hospital settings. The sample comprised 192 sedentary pre-hypertensive subjects, aged between 30–50 years, that were randomly distributed into three groups of 64 participants each. The subjects performed, for 24 consecutive days, an isometric handgrip exercise at 30% Maximum Voluntary Contraction (M.V.C.). At the end of the 24 days, group one (GP1) discontinued, while group two (GP2) continued the exercise protocol for another 24 consecutive days and group three (GP3) continued with the exercise protocol for another 24 consecutive days but at 50% M.V.C. Determinants of lung function (outcomes) were Forced Expiratory Volume in 1 s (FEV1), Forced Vital Capacity (FVC), FEV1/FVC Ratio and Peak Expiratory Flow Rate (PEFR). The study shows that there was no statistically significant difference in the pre- and post-exercise outcomes for FEV1, FVC, FEV1/FVC Ratio and PEFR after 24 days for group 1. In group 2, there was a statistically significant difference in the FVC [(mean = 0.12 ± 0.12), (p = 0.002)], FEV1 [(mean = 0.15 ± 0.17), (p = 0.003)] and PEF [(mean = 0.85 ± 0.35), (p = 0.001)] after 48 days. In group 3, there was a statistically significant difference (p = 0.001) in all the outcomes assessed after 48 days. There was a between groups difference in favour of group 2 compared with group 1 for outcomes of FEV1 [(mean = 0.142 ± 0.68), (p = 0.005)] and PEF [(mean = 0.83 ± 0.19), (p = 0.0031)]. There was statistically significant difference in favour of group 3 compared to group 2, by increasing the exercise intensity from 30% to 50% M.V.C., for outcomes of FVC [mean change = 0.10 ± 0.052), (p = 0.005)], FEV1/FVC [mean change = 3.18 ± 0.75), (p = 0.017)] and PEF [(mean change = 0.86 ± 0.35), (p = 0.001)] after 48 days. Isometric handgrip exercise (after 48 days at 30% to 50% M.V.C.) improves outcomes of pulmonary function capacity in adults with prehypertension. Meanwhile, duration and/or increase in intensity of the isometric effort significantly contributed to the affects attained.

Effects of Tai chi on Cardiovascular Responses and Stress Reduction in Prehypertensive Subjects: A Randomized Clinical Trial

Prehypertension seems to be the precursor to hypertension, and using non-pharmacological methods such as tai chi, can reduce blood pressure and its dangerous consequences. Therefore, this study aimed to examine the effects of 8-form Yang-style tai chi on cardiovascular responses and stress reduction in prehypertensive subjects. Sixty prehypertensive men and women aged 25 to 54 years were selected by purposive sampling, and randomly assigned into two experimental groups (15 males and 15 females) and two control groups (15 males and 15 females). Systolic and diastolic blood pressure, and resting heart rate were measured by digital sphygmomanometer and stress was measured using Markham mental pressure inventory. Then, the experimental groups completed tai chi training for 45 minutes, three days per week for 8 weeks, however, the control groups received no intervention. Twenty four hours after completing the training, the dependent variables were re-measured in the study groups. Factorial multivariate analysis of covariance was used for statistical analysis. The results showed that tai chi significantly decreased systolic blood pressure, resting heart rate, and stress in comparison with control group. Our study encourages and supports that a short style of tai chi is an effective way in improving cardiovascular responses and stress in prehypertensive individuals.