Prevalence Of Essential Hypertension Research Articles

Relationship of fluoride in drinking water with blood pressure and essential hypertension prevalence: a systematic review and meta-analysis

Previous studies showed controversial results of the relationship between fluoride exposure through drinking water and elevated blood pressure. We conducted a systematic review and meta-analysis to assess the direct relationship of drinking water fluoride exposure with blood pressure and essential hypertension prevalence in general populations. We conducted a systematic search in databases including Web of Knowledge, PubMed, Scopus, and Embase by MeSH and non-MeSH terms for relevant studies with any design published until August 2019, with no limitation in time and language. The pooled effect measure was calculated within a 95% confidence interval (CI). Our search retrieved 630 journal articles, six of which were eligible for data extraction. The random-effects model found significantly higher systolic blood pressure (mean difference = 6.49mmHg; 95% CI 3.73-9.25; p value < 0.01) and diastolic blood pressure (mean difference = 4.33mmHg; 95% CI 1.39-7.26; p value < 0.01) in groups exposed to high-fluoride drinking water than in groups exposed to normal/low-fluoride drinking water. A significant relationship was also found between high-fluoride drinking water and essential hypertension (odds ratio = 2.14; 95% CI 1.02-4.49; p value = 0.045). The risk of elevated blood pressure increases in the general population of fluoride endemic areas. However, more research is needed to make a firm conclusion about the adverse effects of excess fluoride intake on the cardiovascular system at the individual level.

[Infantile arterial hypertension: A diagnostic challenge in paediatrics].

Arterial Hypertension prevalence (HTN) has significantly increased in paediatric patients, mainly in older children and teenagers. In these subjects the most common type is essential or primary HTN. However, in infants HTN prevalence is significantly lower and is almost always due to secondary causes, which can be potentially severe. Hence the importance of its detection, in order to establish an etiological diagnosis and provide an appropriate treatment, which usually requires a specialist physician. In addition to the technical difficulties of blood pressure measurement in infants, the lack of recommendations to perform a systematic screening in this age range and the absence of well-established normal values turns infancy-onset HTN into a diagnostic and therapeutic challenge for the physician. By means of the exposition of three infancy-onset HTN cases, the aim is to increase the paediatrician's awareness of this pathology and also to provide information about its diagnostic and therapeutic approach, dealing also with pharmacological measures of treatment.

Infantile arterial hypertension: A diagnostic challenge in paediatrics

Arterial Hypertension prevalence (HTN) has significantly increased in paediatric patients, mainly in older children and teenagers. In these subjects the most common type is essential or primary HTN. However, in infants HTN prevalence is significantly lower and is almost always due to secondary causes, which can be potentially severe. Hence the importance of its detection, in order to establish an etiological diagnosis and provide an appropriate treatment, which usually requires a specialist physician. In addition to the technical difficulties of blood pressure measurement in infants, the lack of recommendations to perform a systematic screening in this age range and the absence of well-established normal values turns infancy-onset HTN into a diagnostic and therapeutic challenge for the physician. By means of the exposition of three infancy-onset HTN cases, the aim is to increase the paediatrician’s awareness of this pathology and also to provide information about its diagnostic and therapeutic approach, dealing also with pharmacological measures of treatment.

Abstract IA20: Potential insights into COVID-19 disparities from the science of cancer health disparities

Abstract Older age as well as health comorbidities that include metabolic syndrome, cardiovascular disease, hypertension, asthma, and chronic kidney disease are listed by the Centers for Diseases Control and Prevention (CDC) as strong risk factors for severe disease and mortality from COVID-19. Since the outbreak began throughout the world and the United States, both gender and race/ethnicity have additionally become associated with infection and severe COVID-10 disease and mortality. While all humans lacked immunity at its onset to the new SARS-CoV-2 virus, the cause of COVID-19, older-age individuals are likely more susceptible due to age-weakened immune systems, the presence of health comorbidities, and are the most likely group to be housed within skilled nursing facilities (SNFs) where outbreaks and death from COVID-19 have been frequent. SNFs often lacked isolation protocols, initial viral testing, and lacked personalized protection equipment (PPE) that was prioritized to hospitals. People with health comorbidities regardless of age are more susceptible to severe COVID-19 likely because of weakened health and immunity. Indeed, patients on immunosuppression for medical conditions were among the first susceptible to severe infection when the outbreak began. The association of severe COVID-19 and race/ethnicity shows the strongest rationale with socioeconomic inequalities. Those from minority-population backgrounds are often in more urban crowded areas where mitigating factors of social distancing and opportunities to avoid virus exposure are less realized. Many minority populations, as a result of socioeconomic inequality, have more difficult access to health care, hold lower-paying jobs, reside in lower-income neighborhoods with grocery store deserts, have higher use of tobacco and alcohol and demonstrate lower physical activity, and have lower use of preventive medicine. This in turn has the physiologic consequences of alteration of the gut microbiome, increased localized inflammation, and compromised immunity, leading to higher frequencies of health comorbidities, the exact conditions that have been shown to place an individual at much higher risk for mortality from COVID-19. Other COVID-19 risk factors such as blood group type A and the use of angiotensin-converting enzyme (ACE) inhibitors for the high prevalence of essential hypertension and cardiovascular disease in racial populations appear not to play a role. Specific spike protein variants that have proved to be more virulent have not been evaluated among racial groups. The use of hydroxychloroquine might play a role in sudden death if used for treatment or prophylaxis of COVID-19 in some African Americans because of the common presence of a cardiac sodium channel polymorphism. The higher risk for men over women for severe COVID-19 disease is intriguing; the SARS-CoV-2 virus requires the use of cell ACE2 receptors and the cell serine protease TMPRSS2, both regulated by androgens for expression. Differences in expression levels as well as trials of antiandrogen therapy are both being explored to assess if these permissive cell factors are the cause for gender differences. Citation Format: John M. Carethers. Potential insights into COVID-19 disparities from the science of cancer health disparities [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr IA20.

[Gene-environment interactions between polymorphic loci of MMPs and obesity in essential hypertension in women.]

The prevalence of essential hypertension (ЕH) is increasing every year, both in Russia and around the world. Genetic and environmental risk factors are involved in the development of hypertension, and obesity plays an important role. Therefore, the study of gene-ecological interactions in the development of hypertension seems to be relevant. to study the gene-environment interactions between polymorphic loci of MMP and obesity in essential hypertension in women. The study was conducted in a case-control design. The sample included 584 subjects: 375 patients with EH and 209 women in the control group. All individuals included in the study were genotyped for eight polymorphic loci of MMPs. The study of the gene-environmental interactions during the formation of hypertension was performed using the GMDR method (Generalized Multifactor Dimensionality Reduction, http://www.ssg.uab.edu/gmdr). rs11568818 MMР7 and rs11225395 MMР8 polymorphic loci were found to be involved in the development of arterial hypertension in women without obesity (p&lt;0.050). Fifteen three-, four-, and five-factor models of gene-environmental interactions of 8 MMPs with obesity, associated with EH (p=0.01), were found. It is shown that the analyzed SNPs are located in the DNA regions that bind to histones, marking promoters and enhancers, in the region of hypersensitivity to DNAse-1, in the binding sites of regulatory proteins and transcription factors. The loci of MMPs rs17577, rs11568818, rs1320632 and rs11225395 have cis-eQTL-value. They affecting the expression of the genes of MMP7, SNX21, SLC12A5 and RP11-817J15.3. SNP rs11568818 MMP7 and rs11225395 MMP8 and gene-environmental interactions of MMPs rs1799750, rs243865, rs3025058, rs11568818, rs1320632, rs11225395, rs17577, rs652438 with obesity are involved in the development of essential hypertension in women.

Potential Beneficial Effects of Vitamin D in Coronary Artery Disease.

Vitamin D plays a pivotal role in bone homeostasis and calcium metabolism. However, recent research has indicated additional beneficial effects of vitamin D on the cardiovascular system. This review aims to elucidate if vitamin D can be used as an add-on treatment in coronary artery disease (CAD). Large-scale epidemiological studies have found a significant inverse association between serum 25(OH)-vitamin D levels and the prevalence of essential hypertension. Likewise, epidemiological data have suggested plasma levels of vitamin D to be inversely correlated to cardiac injury after acute myocardial infarction (MI). Remarkably, in vitro trials have showed that vitamin D can actively suppress the intracellular NF-κB pathway to decrease CAD progression. This is suggested as a mechanistic link to explain how vitamin D may decrease vascular inflammation and atherosclerosis. A review of randomized controlled trials with vitamin D supplementation showed ambiguous results. This may partly be explained by heterogeneous study groups. It is suggested that subgroups of diabetic patients may benefit more from vitamin D supplementation. Moreover, some studies have indicated that calcitriol rather than cholecalciferol exerts more potent beneficial effects on atherosclerosis and CAD. Therefore, further studies are required to clarify these assumptions.

ETIOLOGICAL AND CLINICAL FEATURES OF PEDIATRIC HYPERTENSION IN A TERTIARY HOSPITAL OF CENTRAL INDIA

Background: Hypertension (HTN) in children and adolescents seems to have increased in the past few decades. Although the prevalence of essential HTN has increased, secondary causes account for majority of childhood HTN. Essential HTN in childhood is a diagnosis arrived at by excluding the known causes of secondary HTN. Objectives: The objectives of this study were to study the etiology and clinical features of childhood HTN in admitted children. Materials and Methods: This observational prospective study was carried out at a tertiary care referral center of Central India. All children of 1–12 years of age admitted in hospital in the study period were screened for HTN. Those found to be hypertensive were studied for etiology and clinical features. Results: A total of 112 children were found to be hypertensive, 54 were in 1–6 years of age group and 58 were in 7–12 age group. Male-to-female ratio was 62:50, 95 had secondary HTN and no definitive cause of HTN could be found in 5% of patients. Mean blood pressure was 124/84. Majority (75%) of patients were in Stage II HTN, 25% of patients were in hypertensive crisis. About 69% had renal etiology, 25% central nervous system (CNS), 1% endocrine, and unidentified 5%. Conclusion: The most common etiology of hypertensive emergency is chronic kidney disease followed by acute glomerulonephritis.

Association between social determinants and the presence of essential hypertension in type 2 diabetes mellitus patients.

The purpose of this study was to analyse the association between social determinants and the presence of essential hypertension in type 2 diabetes mellitus patients in one rural county (Jintan) of China. A health survey of Jintan residents was conducted in 2013, applying a cluster sampling method. Three hundred and fifty-seven type 2 diabetes mellitus patients were selected as research subjects. Among the patients selected, essential hypertension prevalence was 45.4% (n=162). After univariate analyses and logistic regression analyses, an association was observed between the presence of essential hypertension in type 2 diabetes mellitus patients and marital status, described as 'others (unmarried, divorce, widower, etc.)', and participating in active physical activity. Both of these two significant variables were positively associated with the higher prevalence of essential hypertension in type 2 diabetes mellitus patients. In conclusion, the patients suffering from type 2 diabetes mellitus combined with essential hypertension often reported an association with more negative social determinants (with the exception of participation in physical activity). Further strengthening the comprehensive multi-disease management to control and reduce the prevalence of essential hypertension in type 2 diabetes mellitus patients is required.

PREVALENCE AND RISK FACTORS OF ESSENTIAL HYPERTENSION AND NEW ONSET OF DIABETES IN ESSENTIAL HYPERTENSION IN RURAL POPULATION OF HARYANA

Objective: We conducted a well-designed prevalence study in a rural population of Haryana in Mullana rural area to find out the latest prevalence of essential hypertension, the prescription pattern of antihypertensive drugs and the associated risk of new onset of diabetes.Methods: A retrospective study was carried out on the patient data (2672 patients) from the years 2009 to 2013 at OPD of M. M. University hospital, Mullana to find the previous year’s prevalence of different diseases, including essential hypertension, new onset of diabetes and associated risk factors, prescription pattern of antihypertensive drug therapy. Based on the above results, a prospective study was conducted from January 2015 to December 2016 and total 510 patients (270 essential hypertension and 240 essential hypertension with new onset of diabetes) and 270 normal individuals were recruited in the study.Results: The retrospective study, a total of 2672 patients' data was evaluated which showed 41.21% prevalence of essential hypertension, 11.83% new onset of diabetes in Essential hypertension patients and 15.87% diabetic patients. Antihypertensive monotherapy was prescribed to 59.85% patients and combination therapy to 40.15% patients while that of a prospective study showed 40.37% patients of monotherapy and 59.63% patients of combination therapy. The prospective study also showed that different anthropometric parameters were significantly associated with risk of hypertension and new onset of diabetes except for age and height.Conclusion: An increase in the prevalence of essential hypertension and associated risk factors was observed when compared with previous studies and retrospective study. It is clearly seen by the change in drug therapy pattern and different anthropometric parameters. Implementation of a large scale awareness program is needed to combat these metabolic diseases.

Prevalence of Essential Hypertension and Its Complications Among Chinese Population at High Altitude.

This study examined the prevalence of essential hypertension (EH) and its complications among Chinese population at different altitude regions in Qinghai province. This cross-sectional analysis used data from 2000 residents living in the area with two different latitudes for more than 20 years, using 1:1 pairing mode. The EH patients above were, respectively, found in these two groups by blood osmotic pressure and electrocardiogram (ECG). Then, the plasma renin activity (PRA), urinary albumin, urine protein in 24 hours, urine and blood osmotic pressure, coronary angiography, and cardinal enzyme were measured. The prevalence of hypertension in the highlander (36.3%) was significantly higher than that in the lowlander (19.6%) [OR = 1.85; 95% CI 1.29-2.41; p = 0.015], in which the EH patients in the highlander (20.8%) was also much higher than that in the lowlander (8.4%) (OR = 2.48; 95% CI 1.64-3.32; p = 0.002). Considering the age and gender, the prevalence of EH was higher in the subjects who were men and older than 50 years in both the highlander and lowlander (p < 0.05). The concentration of urinary microalbumin, PRA, cardinal enzyme, and the abnormal occurrence rate of ECG and coronary angiography among EH patients in the highlander was higher than those in the lowlander (p < 0.05), while the urine/blood osmotic pressure ratio in the highlander was lower than that in the lowlander (p < 0.001). Positive correlations were also shown between the blood pressure and renal injury (r = 0.462, p < 0.05) or coronary heart disease (r = 0.353, p < 0.05). The prevalence of EH and its complications such as renal injury and coronary heart disease were all higher in the highlander.

Analysis of indicators of 24-h holter monitoring ECG in elderly hypertensive patients with atrial fibrillation

The prevalence of essential hypertension (EH) defines its significance as the most important population – based risk factor for development  of atrial fibrillation (AF). The heart morphological remodelling – the   development of left ventricular hypertrophy and its diastolic dysfunc  tion, the increase of left atrial sizes is associated with increased risk for the development of atrial and ventricular arrhythmias.The objective: to estimate the rate of arrhythmias in elderly hypertensive patients depending on the form of atrial fibrillation (AF) – persistent or permanent.Patients and methods. Doppler echocardiography and Holter monitoring ECG were investigated in 140 patients aged 60–74 years. The  were 20 patients with uncomplicate EH, 60 patients with persistent (PersAF) and 60 – wits permanent (PermAF) AF.Results. It was established that patients EH have high frequency of single ventricular extrasystoles. The presence of AF in hypertensive patients is associated with the increase of myocardial electrical inhomogeneity, with is most expressed in permanent AF: the high gradation ventricular arrhythmias in patients with uncomplicated EH, PersAF and PermAF were 5%, 28% and 62% respectively. In study population the range of corrected QT interval (QTc) of these patients, 10% in EH, 16% – PersAF and 43% – PermAF, had prolonged QTc  complexes. There were revealed correlations between dispersion of the QT interval (QTd) and parried ventricular extrasystole (r=0,26;  р&lt;0,05), between QTd and grouped ventricular extrasystole (r=0,25;  р&lt;0,05). Conclusions. It was found that groups of patients associated with the increase in the frequency and amount of daily, single ventricular extrasystoles and high gradation ventricular arrhythmias a set of structural and functional changes of the heart in elderly patients with arterial hypertension and atrial fibrillation and their relation to electrical heterogeneity of the myocardium.

Race and Obesity in Adolescent Hypertension.

The overall prevalence of essential hypertension in adolescents may be growing. Differences in blood pressure (BP) are well established in adults, but are less clear in adolescents. We hypothesize that the prevalence of hypertension differs by race/ethnicity among adolescents at school-based screenings. We performed school-based BP screening in over 20 000 adolescents from 2000 to 2015. Race/ethnicity was self-reported. Height and weight were measured to determine BMI, and BP status was confirmed on 3 occasions to diagnose sustained hypertension according to Fourth Working Group Report criteria. We successfully screened 21 062 adolescents aged 10 to 19 years (mean, 13.8 years). The final prevalence of sustained hypertension in all subjects was 2.7%. Obesity rates were highest among African American (3.1%) and Hispanic (2.7%) adolescents. The highest rate of hypertension was seen in Hispanic (3.1%), followed by African American (2.7%), white (2.6%), and Asian (1.7%) adolescents (P = .019). However, obese white adolescents had the highest prevalence of sustained hypertension (7.4%) compared with obese African American adolescents (4.5%, P < .001). At lower BMI percentiles (<60th percentile), Hispanic adolescents actually had the lowest predicted prevalence of hypertension among the 4 groups. The prevalence of hypertension varies among different race/ethnicities. Although obesity remains the strongest predictor of early hypertension, the strength of this relationship is intensified in Hispanic and white adolescents, whereas it is lessened in African American adolescents.

Association between body mass index and blood pressure among children age group 5 to 15 years in a tertiary care centre: a descriptive study

Background: The growing prevalence of obesity is increasingly recognized as one of the most important risk factors for the development of hypertension. Today the problem has started appearing even in developing countries like India. Tackling this epidemic of obesity and obesity-related hypertension requires studies specific for the local population as these vary according to ethnicity, lifestyles and dietary habits which differ among areas in India, for this reason a study was done in our hospital. Methods: The pediatric unit of Kerala Institute of Medical Science (KIMS), which is a referral multispecialty tertiary care hospital in private sector in south India catering to a population of 100 to 200 outpatient/day, children attending OPD between 5-15years were included in the study. Results: Pre-hypertension and hypertension was seen in 1% (2 out of 195) of normal and 0% (0 out of 30) of overweight and 60.9% (9 out of 14 obese children). P value was statistically significant indicating that there is strong association between BMI and blood pressure. Conclusions: There is strong association between BMI and blood pressure. Prevalence of obesity in children aged 5 to 15 years attending to the outpatient department in Kerala Institute of Medical Sciences, Trivandrum is 9.2%. Prevalence of essential hypertension in children aged 5 to 15 years attending to the outpatient department in Kerala Institute of Medical Sciences, Trivandrum is 2%.

Hypertension in adolescents and young adults at a tertiary clinic in Cape Town, South Africa

Background: The prevalence of essential hypertension in children and adolescents has increased dramatically over the past decade attributed to a rising prevalence of obesity, high salt diet and lack of exercise. Traditionally high blood pressure in adolescents required extensive work up to determine a cause, but given the changing demographics this policy needs to be reviewed. Objectives/method: The study aimed describe the risk factors, demographics, target organ damage and aetiology of hypertension in a cohort of young hypertensives (aged 15 - 30 years) referred to a tertiary hypertension clinic at Groote Schuur Hospital, by retrospectively reviewing the folders over a three-month period. Results: Thirty eight patients were identified with a mean age of 22 years. Essential hypertension was diagnosed in 82% of patients, and 71% of patients had a family history of hypertension. The median systolic blood pressure (BP) at first visit was 132 mmHg and diastolic BP 84mmHg.  The median BMI was 25.4 kg/m2 and 68% had some form of target organ damage. Twenty six percent were current smokers and 8% had abused metamphetamines. Recognised secondary causes of hypertension were renal artery stenosis (four) and primary aldosteronism (one). Conclusions: In a cohort of young hypertensives patients the dominant cause was essential hypertension. Although the prevalence of obesity was surprisingly low compared to previously published studies, significant lifestyle issues were identified. 68% had target organ damage suggesting the disease was not benign. These preliminary results indicate that larger cohorts need to be studied to develop new policies for assessment and treatment of young people with hypertension in South Africa.

Evolution of systemic hypertension in Pakistani population.

The prevalence of essential hypertension is alarmingly increasing in Pakistani population inspite of the demographics being of lower BMI and nutrition. In this review, the possible factors responsible for this increase are identified by reviewing the population studies conducted in Pakistan. The prevalence rate is about 3 - 4% in childhood and steeply rises near the middle age. The factors peculiar to Pakistan were increased genetic susceptibility, environmental factors such as gender, females gender, urbanization, obesity and sedentary life styles particularly in middle age, cultural practices promoting sedentary life style in female.

Characteristics of systemic hypertension in preterm children.

The prevalence of essential hypertension (EH) among preterm children is unknown. The authors evaluated consecutive children with a diagnosis of hypertension and prematurity (gestational age <37weeks) in a tertiary pediatric hypertension clinic and identified 36 preterm hypertensive children. Among these preterm children, 23 were diagnosed in the neonatal intensive care unit (NICU; infantile) and 13 were diagnosed at an older age (childhood). When compared with patients with a childhood diagnosis, patients with an infantile diagnosis had a significantly lower gestational age, longer duration of hospitalization in the NICU, and a higher incidence of perinatal risk factors for hypertension. None with infantile diagnosis had EH, whereas 46% with childhood diagnosis had EH. Among premature children, systemic hypertension was either diagnosed in infancy or in childhood, with each age at diagnosis having unique risk factors and clinical course. Although 83% of preterm children had secondary hypertension, EH was diagnosed in 17% and was only seen in those diagnosed beyond infancy.

Association of physical activity, nature of job, and exercise with the prevalence of essential hypertension in the Tharparkar desert

Background: The prevalence of essential hypertension (EHTN) is quite low in individuals who perform more body activities and exercise as opposed to those who spend a sedentary lifestyle. Regular physical activity reduces the risk of obesity, adverse lipid profile, hypertension, and type 2 diabetes mellitus. Many studies are carried out globally to assess the prevalence of EHTN related to grades of physical activity and lifestyle patterns but fewer studies are been conducted for the desert areas. The present study was conducted at the Tharparkar desert characterized by shortness of rainfall and dry weather, which might affect sodium and water balance in the body and eventually blood pressure. Objectives: To study the association of physical activity, nature of job, and exercise with prevalence of EHTN in the people living in the Tharparkar desert. Materials and Methods: A randomized, descriptive population-based study was carried out in the Tharparkar desert, Pakistan. After getting approval from ethics review committee of the Aga Khan University, a total of 563 participants were selected randomly (295 males, 268 females) in 2012 from the Tharparkar desert, Pakistan. We recorded demographic and anthropometric data, levels of blood pressure, levels of daytime and on job physical activities, and exercise. Statistical analysis of the prevalence of EHTN and its association with various grades of physical activity in relation to the sedentary and active occupation and with exercise was carried out. Data were analyzed descriptively and categorically by using SPSS-21 for comparing the prevalence of EHTN with increased and decreased physical activities, exercise, and job with sedentary versus active lifestyle. The p-values of < 0.05 were considered statistically significant. Results: After getting approval from the ethics review committee, the mean age and prevalence of EHTN among the studied 563 participants from Tharparkar desert were assessed and found to be 37 (±16.4 years, range 10–82 years) and 81 (14.4%), respectively. Participants leading a sedentary lifestyle showed higher prevalence of EHTN (19.2%) than those leading an active lifestyle (1.9%). Participants having job with mild physical activity had higher prevalence of EHTN (19.4%) than those having jobs with active lifestyle (2.9%); p-values were

Abstract 562: Association Of The Heteroplasmic Level Of The Mitochondrial Gene Nd2 5178c&gt;A Variant With Essential Hypertension

BACKGROUND: The mitochondrial genetic variant of nicotinamide adenine dinucleotide dehydrogenase subunit-2 (ND2) 5178C&gt;A (Leu237Met) was previously found to have a protective effect against essential hypertension (EH) in Chinese and Japanese populations. AIM: The present study aimed to determine whether the protective effect of ND2 5178C&gt;A against EH is associated with the mitochondrial heteroplasmy level of the variant. METHODS: This case-control study involved 109 unrelated Chinese-Han matched pairs of essential hypertension and healthy normotensive controls. All consented subjects were recruited consecutively from Institute of Geriatric Cardiology and Health Examination Center in General Hospital of Chinese People’s Liberation Army from February 2013 to January 2014. Demographic and clinical characteristics were recorded. Mitochondrial DNA was isolated from the blood leukocytes for each subject. The level of heteroplasmy for 5178C&gt;A variant occurring in the coding region of ND2 was quantified using real-time polymerase chain reaction (PCR) method. RESULTS: The ND2 5178C&gt;A heteroplasmy level ranged between 27% and 77%, with a median level of 44%. Between the upper and lower quartiles of 5178C&gt;A heteroplasmy distribution, significant differences were observed for systolic blood pressure (116±17 vs. 129±25 mmHg, P=0.004) , body mass index (BMI) (24.6±3.3 vs.26.5±3.6, P=0.008) , total cholesterol (4.0±0.8 vs. 3.4±0.9 mmol/L, P&lt;0.001) , low density lipoprotein (2.5±0.7 vs. 1.5±0.7 mmol/L, P&lt;0.001) and triglyceride levels (1.8±1.6 vs. 4.0±1.6 mmol/L, P&lt;0.001). ND2 5178C&gt;A heteroplasmic level was negatively correlated with the presence of hypertension (r = -0.38, P &lt; 0.001), BMI (r = -0.19, P = 0.007), and the level of total cholesterol (r = -0.18, P = 0.01). Logistic regression analysis showed that participants with higher ND2 5178C&gt;A heteroplasmy level (≥44%) were found to have significantly lower prevalence of essential hypertension (29%, 32 in 109), as compared to those with lower (&lt; 44%) ND2 5178C&gt;A heteroplasmy level (71%, 77 in 109) (OR: 0.18, 95% CI: 0.10-0.31, P&lt;0.001). CONCLUSION: The protective effect of mitochondrial ND2 5178C&gt;A against EH is associated with the heteroplasmy level of the variant.

Is there any association between mild hypertension and hot flash experience among women?

Objective: To determine the association between ambulatory blood pressure (ABP), heart rate, and hot flash (HF) experience among women. Materials and Methods: The authors recruited 110 women aged 22 to 65 years with mild essential hypertension or normotension confirmed by 24-hour ABP monitoring. None of the women had organ damage, inflammatory diseases, on estrogen replacement therapy or any other risk factors. Participants wore an ABP monitor that both records heart rate during 24 hours and noted their awake and sleep times. HF were assessed using an everyday complaint questionnaire that included symptoms associated with menopause. Each participant was asked whether or not she had experienced each symptom during the two weeks before the interview. Results: Fifty-five of the participants (45%) reported having had HF during the two weeks before they completed the questionnaire. The results show that the prevalence of essential hypertension (EH) in the group of women who had HF was significantly higher than the group of women that did not have HF (p = 0.035). The authors also found that hypertensive women had HF more often than normotensive women (p = 0.035), but other parameters including mean awake and sleep systolic BP values, mean awake and sleep diastolic BP values, heart rates, and nocturnal dipping of BP did not differ statistically among the group of women who had HF and the group of women who did not have HF (p > 0.05). Conclusions: These data suggest that the prevalence of EH in the group of women who have HF is significantly higher than the group of women that does not have HF.

Abstract P088: Obesity, Hypertension and Insulin Resistance in a Primary Pediatric Setting in Southern Italy

Background: Obesity is the main risk factor for essential hypertension (EH) in childhood. The O.Si.Me. study (Obesity and Metabolic Syndrome in children and adolescents) evaluated the prevalence of metabolic syndrome (MetS) and its constitutive traits in a sample of obese children and adolescents living in Campania, southern Italy. Patients and methods: Four hundred and fifteen children and adolescents consecutively referred to the National Health Service participating Outpatient Clinics for minor health problems and found to have a Body Mass Index (BMI) Z-score &gt; 2.0 were enrolled in the study. The entire sample was screened for MetS, which was defined as the presence of at least 2 of the following alterations in addition to obesity: fasting hyperglycemia, low levels of high-density lipoproteins cholesterol, hypertriglyceridemia, and EH. The present analysis evaluated the clinical characteristics of the O.Si.Me subgroup of EH participants (systolic and/or diastolic BP ≥ 95 th percentile for age, gender and height) as compared with normotensive participants. Results: The prevalence of EH in the O.Si.Me population was 23.6 % (98/415, 48M and 50F.) and two-thirds of the EH participants met the MetS diagnostic criteria. The EH participants featured serum insulin and HOMA-IR levels significantly higher compared with normotensive ones (11.6±0.6 vs. 9.5±0.4 μIU/ml, p = 0.014; 2.6±0.1 vs. 2.2±0.1, p = 0.028 for insulin and HOMA-IR, respectively). These differences were common to boys and girls and remained significant after correction for age, pubertal stage, body weight, length, BMI, gestational age at birth, duration of breastfeeding and anthropometric parental parameters. Accordingly, children and adolescents with EH had a a relative risk of being insulin resistant (defined as a HOMA-IR ≥2.5) significantly greater compared to those without. Moreover, they exhibited higher serum creatinine levels (53.8±7.1 vs. 35.4±6.8 μmol/l, p=0.025) accounting for gender and body weight. Conclusions: More than a quarter of obese children and adolescents meet the diagnostic criteria for EH in the Campania region in southern Italy. These obese boys and girls have an increased prevalence of insulin resistance and apparently an initial reduction in renal function compared with obese children and adolescents with normal BP.