Prevalence Of Diastolic Hypertension Research Articles

The association between serum folate and elderly diastolic hypertension: results from the NHANES (2007–2018)

Aim To explore the association between serum folate concentration and the prevalence of elderly diastolic hypertension. This study aims to identify potential relationships that could inform further research into the mechanisms underlying hypertension management. Methods Data from six NHANES cycles (2007–2008, 2009–2010, 2011–2012, 2013–2014, 2015–2016, and 2017–2018) were analysed for individuals aged over 60. Weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and restricted cubic spline (RCS) regression explored the serum folate concentration and elderly diastolic hypertension relationship. Results This study included 9,419 participants (4,734 females and 4,685 males) with a mean age of 70.0 ± 7.0 years. Among them, 360 were diagnosed with diastolic hypertension. In the fully adjusted model, there was a negative correlation between serum folate concentration and the prevalence of diastolic hypertension (OR 0.65; 95% CI: 0.52–0.82). When serum folate concentration levels were divided into quartiles (in μg/dL), the ORs for diastolic hypertension corresponding to Q2 (1.29–1.98), Q3 (1.99–3.08), and Q4 (3.09–5.56) levels compared to Q1 (0.18–1.28) were 1.41 (95% CI: 0.60–3.33), 0.48(95% CI: 0.20–1.16), and 0.35 (95% CI: 0.16–0.74), respectively, with a P for trend <.05. Restricted cubic spline plots showed a negative correlation between serum folate concentration and the prevalence of diastolic hypertension (non-linearity: p = .495). Subgroup analysis indicated that the negative correlation between serum folate concentration and the prevalence of diastolic hypertension was more significant in female participants (interaction p = .009). Conclusion Higher serum folate concentration is associated with a lower prevalence of diastolic hypertension in the elderly.

Prevalence and risk factors for hypertension among school children in Ilorin, Northcentral Nigeria.

BACKGROUND:The global prevalence of childhood hypertension has increased from 1% to 2% to 4%–5%, with a value as high as 9.8% reported in Nigeria. However, the various risk factors associated with childhood hypertension in Nigeria are less explored. The aim of this study was to determine the prevalence of hypertension and related risk factors (sociodemographic, family history of hypertension, history of snoring, birth order, and anthropometric indices) in primary school children in Nigeria.MATERIALS AND METHODS:A total of 1745 school children aged 6-12 years were selected using systematic random sampling method. Blood pressure (BP) was measured using the fourth report guideline. Those with BP higher than 90th percentile had repeated BP measurements on two more occasions (2 and 4 weeks after initial measurement). Relevant history was obtained, and anthropometric measurements were taken by the standard methods. Data were analyzed using SPSS version 20.RESULTS:Prevalence of systolic and or diastolic hypertension at the third visit was 3.0%. Prevalence of systolic hypertension (3rd visit) was more in females (3.3%) than males (1.3%), P = 0.004. Prevalence of diastolic hypertension (3rd visit) was higher in females (1.4%) than males (0.3%), P = 0.019. Hypertension showed no significant relationship with socioeconomic class, family history of hypertension, birth order, and history of snoring. Of the anthropometric indices (weight, height, body mass index (BMI), hip circumference, waist circumference, waist-to-hip ratio, and waist-to-height ratio, and only obesity (BMI ≥ 95th centile) was related with hypertension (odd ratio 8.3, 95% confidence interval 1.7, 40.3).CONCLUSIONS:Prevalence of hypertension is low (3.0%), and only obesity (BMI ≥ 95th centile) is associated with hypertension.

Relationship between serum uric acid levels and hypertension among Japanese individuals not treated for hyperuricemia and hypertension

The cause and effect relationship between serum uric acid levels and hypertension can be difficult to evaluate because antihypertensive drugs sometimes affect uric acid levels. This cross-sectional study investigated the relationship between serum uric acid levels and hypertension in a general, healthy Japanese population who were not receiving medication for hyperuricemia or hypertension. We retrospectively analyzed the medical records of 90 143 Japanese people (men, 49.1%; age, 46.3±12.0 years) undergoing an annual medical examination at St Luke's International Hospital Center for Preventive Medicine, Tokyo, between January 2004 and June 2010. Of these individuals, 82 722 (91.8%) who had never taken medications for gout, hyperuricemia or hypertension were enrolled. We compared the participant characteristics and prevalence of diastolic hypertension (⩾90 mm Hg) and/or systolic hypertension (⩾140 mm Hg) by serum uric acid quartile. The odds ratio (OR) of hypertension was 1.20 for each 1 mg dl(-1) increase in serum uric acid level after adjustment for age, sex, body mass index (BMI), dyslipidemia, diabetes, smoking and estimated glomerular filtration rate (eGFR). Compared with the lowest serum uric acid quartile, participants in the highest quartile had a 3.7-fold higher OR for hypertension. After adjustment for age, BMI, dyslipidemia, diabetes, smoking and eGFR, these ORs were 1.79 (1.62-1.98) in the total study population, 1.58 (1.44-1.75) in men and 1.60 (1.39-1.84) in women. The results were similar for both systolic and diastolic hypertension. Elevated serum uric acid levels may be as important as obesity, dyslipidemia, diabetes, smoking and reduced kidney function for the development of hypertension and should be considered in hypertension prevention programs.

Body mass index trend and its association with blood pressure distribution in children

The aim of the study was to examine the association of a trend in body mass index (BMI) status with current blood pressure in a cohort of school children from South India. A population of 25,228 children was selected using stratified random sampling method. Height and weight were measured in 2003-2004. Height, weight and blood pressure were measured in 2005-2006. A total of 12,129 children aged 5-16 years having paired data were analysed. Blood pressure and BMI values were converted to Z scores using International paediatric reference values. An increase in Z BMI meant that the child is moving to a higher BMI level with respect to his or her age and sex. In the cohort, 62.4% children had a higher Z BMI at follow-up than at baseline. Children with higher Z BMI at follow-up were labelled as positive BMI status group (PBSG) and the remaining as negative BMI status group (NBSG). The positive trend in BMI was more in rural areas, government schools and girls. In all subgroups, PBSG showed significantly higher systolic blood pressures (SBPs) than NBSG. PBSG showed significantly higher diastolic blood pressures (DBPs) in urban area, government schools and girls when compared with NBSG. Prevalence of first instance systolic hypertension was more in PBSG in all the subgroups except in rural children. Prevalence of diastolic hypertension was significantly higher in PBSG in urban subgroup only. BMI status trends are associated with blood pressure distribution in children.

Association of exclusive smokeless tobacco consumption with hypertension in an adult male rural population of India

IntroductionTobacco consumption is a major source of mortality and morbidity in India . Prevalence of smokeless tobacco (ST) consumption in India is around 20%. Studies have shown increased prevalence of cardiovascular disease risk factors and an increased incidence of adverse cardiovascular events among the ST consumers. This is a cross-sectional study done to look into the association of exclusive smokeless tobacco consumption with hypertension, in an adult male rural population of north India.MethodsAll male residents of a village in north India above 15 years of age, who did not have any acute or chronic morbidity were included after taking an informed consent. Subjects were interviewed regarding their demographic profile, socioeconomic status and tobacco consuming habits. Current smokeless tobacco user was defined as one who has ever consumed tobacco orally in past 1 month. Blood pressure of the subjects was also recorded. Cut offs used for systolic and diastolic hypertension were 140 mm hg and 90 mm Hg respectively.Results443 subjects were included in the study. Prevalence of exclusive ST users was 21% while 19.4% consumed both forms and 26.6% did not take any form of tobacco. Mean systolic and diastolic BP were significantly higher in exclusive ST users(systolic BP=139.2+17.4,diastolic BP = 86.8+11.5)as compared to the non users(systolic BP= 135.7+18.8 , diastolic BP= 82.6 +11.5; p value < 0.05). The prevalence of diastolic hypertension was significantly higher in exclusive ST users as compared to non users ( 40.9%, 22.9% ;p value = 0.01) . The OR for diastolic hypertension in male ST users was 2.3( 95% C.I. = 1.3-4.3). Prevalence of systolic hypertension was higher in exclusive ST users too though this was not statistically significant (43%,36.4%;p value = 0.39.).ConclusionST consumption is associated with increased prevalence of high BP in the adult male rural population.This is an indicator of increased predisposition to major adverse cardiac events later in their life time. Prevention of ST consumption could be an important intervention in preventing the ongoing upswing in prevalence of chronic heart disease.

Prevalence of diastolic hypertension among ophthalmic patients in Sagamu, Ogun State

Hypertension a common non communicable disease is often symptom less. It is not uncommon to discover it during a routine medical checkup. Many eye surgeries had to be cancelled because of raised blood pressure. This prospective hospital based study was carried out to determine the prevalence of hypertension in patients attending the eye clinic. It was found that prevalence of hypertension was 37.1%, and affects mainly people above 50years. A total of 66.7% of the known hypertensive patients who were on antihypertensive medications still had elevated blood pressure. Hypertensive retinopathy was found in only 12.8% of the hypertensive. We conclude that routine check of the blood pressure should be an integral part of eye examination; this may help in the long term by reducing the morbidity and mortality from this disease.Nigerian Hospital Practice Vol. 2 (3) 2008: pp. 58-59

Geographical variation in prevalence of hypertension within The Gambia.

Hypertension has become an important public health problem for sub-Sahara Africa. In a previous nationwide study, we observed a high degree of geographical variation in the prevalence of diastolic hypertension. Geographical variation provides essential background information for the development of community randomised trials could suggest aetiological mechanisms, inform control strategies and prompt further research questions. We designed a follow-up study from the nine high-prevalence communities, and from 18 communities where hypertension was found least prevalent (controls). In each community, 50 households were randomly selected. In each household, an (unrelated) man and woman were enrolled. The risk for hypertension (blood pressure > or =160/95 mm Hg) was higher in the high prevalence communities compared to the control villages (adjusted OR = 1.7, 95% CI 1.3-2.2). The observed coefficient of variation in hypertension prevalence, k, was 0.30. Thus we confirmed significant geographical variation in prevalence of hypertension over time, which has implications for planning of interventions.

Diastolic pressure underestimates age-related hemodynamic impairment.

It has been hypothesized that as large arteries become more rigid with age, the pattern of hypertension changes from diastolic to systolic. Thus, diastolic blood pressure (DBP) may lose its ability to reflect the increase in vascular resistance with age. To assess this, we studied the age-related changes in blood pressure pattern and its steady-state and pulsatile determinants. We performed an epidemiological analysis based on a national survey of 10,462 subjects from Argentina. A hemodynamic analysis (impedance cardiography) was then carried out in 636 consecutive hypertensive patients (age, 25 to 74 years). Whereas the rate of increment in the prevalence of mild to moderate hypertension (MMH) reached a plateau after the sixth decade, isolated and borderline systolic forms of hypertension began a steep and sustained rise. Among patients with MMH, DBP remained stable from the third to the seventh decade, whereas SBP maintained a sustained increase. Despite similar DBP, the systemic vascular resistance index increased 47% (P<.01) and the cardiac index decreased 27% (P<.01), whereas the ratio of stroke volume to pulse pressure, an index of arterial compliance, decreased 45% (P<.01). However, there were no significant differences between older patients with MMH and those with isolated systolic hypertension in the level of SBP, vascular resistance, stroke volume, and cardiac index. Compared with age-matched normotensive control subjects, the ratio of stroke volume to pulse pressure was much more reduced in isolated systolic hypertension (48%) than in MMH (30%). In summary, the present study, carried out in a large sample of hypertensive subjects with a wide age range, showed a simultaneous impairment in vascular resistance and arterial compliance associated with aging in different patterns of hypertension. The magnitude of these changes, with opposite effects on DBP but additive effects on SBP, suggests that a hemodynamic mechanism could determine the transition in the prevalence of diastolic hypertension toward a systolic pattern of hypertension with aging. Also, the results suggest that SBP, but not DBP, is a reliable indicator of the underlying hemodynamic abnormalities (high resistance and low arterial compliance) in the elderly.

Hypertension in Israeli adolescents: prevalence according to weight, sex and parental origin.

We studied the prevalence of hypertension in 57,499 male and 35,803 female Israeli military recruits and its relation with sex, weight, and parents' ethnic origin. The overall prevalence of systolic hypertension (greater than 140 mmHg) was 1.75 per cent for males and 0.32 per cent for females. The prevalence of diastolic hypertension (greater than 90 mmHg) was 0.41 per cent for males and 0.06 per cent for females. For males, the prevalence of systolic and diastolic hypertension increased with weight, exponentially. Males of Ashkenazi origin had a significantly higher prevalence of hypertension (systolic 2.52 per cent, diastolic 0.55 per cent) compared with those of Sephardi origin (systolic 1.12 per cent, diastolic 0.3 per cent). The prevalence of adolescents with systolic or diastolic blood pressure greater than the mean +2SD of each weight group ranged between 1.5-2.3 per cent.

Levels of serum cholesterol, triglyceride, HDL-cholesterol, apoproteins A-l and B, and plasma glucose, and prevalence of diastolic hypertension and cigarette smoking in papua new guinea highlanders

Coronary heart disease (CHD) is rare in Papua New Guinea (PNG) highlanders. Fifty-two men and 69 women randomly selected from three rural communities and a low socioeconomic urban community in the Eastern Highlands Province were assessed for hyperlipidemia, diabetes mellitus, diastolic hypertension and cigarette smoking. There was no significant difference between the findings in the rural and urban groups. The mean fasting levels of serum cholesterol, HDL cholesterol and apoproteins A-I and B were significantly lower (p less than 0.001) than those of rural Australians in a comparative study but the serum triglyceride levels were significantly higher in men less than 30 yr and women less than 40 yr of age. There was no significant difference in the serum cholesterol levels in men and women, and the levels of serum cholesterol and triglyceride did not rise with age. The mean fasting levels of plasma glucose were generally lower in PNG subjects and only two (1.7%) had diabetes mellitus. The proportions of highlanders who had diastolic hypertension or who smoked cigarettes were similar to those of Australian populations generally. The low incidence of CHD in PNG highlanders is probably related to the low serum cholesterol and apoprotein B levels, in turn probably related to their basically vegetarian diet and physically active life-style.

Prevalence and prognostic significance of hypertension in the elderly.

Understanding the problem of hypertension in the elderly calls not only for an understanding of the physiologic phenomenon involved, but of the statistics currently available pertaining to this widespread disorder. In the age group 60 to 69 years, more than 25% of the population screened by the Hypertension Detection and Follow-Up Program (HDFP) had isolated systolic hypertension; ie, a systolic blood pressure greater than or equal to 140 mmHg with a diastolic blood pressure less than 90 mmHg. Setting the criterion for definition at a systolic blood pressure greater than or equal to 160 mmHg, the prevalence in this age group was almost 10%. Prevalence of diastolic hypertension, ie, diastolic blood pressure greater than or equal to 90 mmHg in this age group was more than 40%. Data from that same study show also that elevated systolic blood pressure in the face of a normal diastolic blood pressure was associated significantly with increased mortality. In the HDFP, stepped-care treatment reduced the five-year incidence of fatal and nonfatal stroke in these individuals by more than 50%. These results were achieved with minimum side effects. Reports of this kind surely will overcome the popular tendency to consider elevated blood pressure in the elderly as a natural phenomenon of aging and, hence, acceptable. There is nothing natural about hypertension in the elderly, nor should it be acceptable. Because it is important to control hypertension before it can cause end-organ damage, physicians are urged not to postpone treatment of hypertension in the elderly, but to initiate it promptly, keeping in mind the whole physiologic and psychosocial state of the elderly patient with hypertension.

Patterns of Blood Pressure in Milwaukee

Blood pressure measurements were obtained among 92,074 persons in Milwaukee between 1974 and 1976 by the Milwaukee Blood Pressure Program. Systolic hypertension was more prevalent in young white men than blacks below 25 years of age, was more common in middle-aged blacks than whites, and was equally prevalent among all persons past 65 years. Diastolic hypertension was more prevalent in blacks than whites of all ages. Whereas the prevalence of systolic hypertension in the population increased with age and was present in a majority or near majority of persons past 65 years, the prevalence of diastolic hypertension rose until the sixth decade, after which it declined. Hypertension was primarily of a diastolic variety in young blacks, whereas systolic hypertension was a prominent feature in young whites.