Primary Hypertensive Research Articles

Smartphone Application to Prescribe Exercise and its Effects on Blood Pressure, Cardiopulmonary Endurance, and Adherence, in Primary Hypertensive Individuals – A Case Series

Abstract This case series assessed a smartphone application for prescribing exercise and its effect on blood pressure (BP), cardiopulmonary endurance, and adherence to the exercise program in individuals with primary hypertension. Five hypertensive individuals completed the home-based exercise program, which included aerobic exercise prescribed using the Google Fit app for 4 weeks. A significant decrease in both systolic and diastolic BP was observed, according to the results (146–124 and 96.4 83.2 mmHg, respectively). In the incremental shuttle walk test, cardiopulmonary endurance increased from 324 m to 510 m, and the mean adherence rate recorded was 95%. The findings suggest that smartphone application-based exercise prescription improves cardiovascular health in hypertensive individuals, positively affecting BP and cardiopulmonary endurance.

Effects of DASH diet with or without time-restricted eating in the management of stage 1 primary hypertension: a randomized controlled trial

BackgroundTime-restricted eating (TRE), a popular form of intermittent fasting, has shown benefits for improving metabolic diseases and cardiometabolic health. However, the effect of TRE in the regulation of blood pressure in primary hypertension remains unclear.MethodsA 6-week randomized controlled trial was conducted, in which a total of 74 stage 1 primary hypertensive patients without high-risk were randomly assigned to Dietary Approaches to Stop Hypertension (DASH) group (n = 37) or DASH + TRE group (n = 37). Participants in the DASH + TRE group were instructed to consume their food within an 8-h window. Scientific research platform in We Chat application was used to track participants. The primary outcome was blood pressure. The secondary outcomes included body composition, cardiometabolic risk factors, inflammation-related parameters, urinary Na+ excretion, other clinical variables and safety outcomes.ResultsThe reduction of systolic blood pressure and diastolic blood pressure were 5.595 ± 4.072 and 5.351 ± 5.643 mm Hg in the DASH group and 8.459 ± 4.260 and 9.459 ± 4.375 mm Hg in the DASH + TRE group. DASH + TRE group improved blood pressure diurnal rhythm. Subjects in DASH + TRE group had decreased extracellular water and increased urinary Na+ excretion. Furthermore, the decrease in blood pressure was associated with a reduction of extracellular water or increase in urinary Na+ excretion. In addition, safety outcomes such as nighttime hunger were also reported.ConclusionOur study demonstrated that 8-h TRE + DASH diet caused a greater decrease in blood pressure in stage 1 primary hypertensive patients than DASH diet. This study may provide novel insights into the benefits of lifestyle modification in the treatment of primary hypertension.Trial registrationhttps://www.chictr.org.cn/ (ChiCTR2300069393, registered on March 15, 2023).

Evaluating Serum Apelin and Nitric Oxide in Primary Hypertensive Patients with or without Microalbuminuria: A Cross-sectional Study

Introduction: Hypertension (HTN) is the third leading risk factor contributing to the disease burden in Southeast Asia. Understanding its underlying mechanism, such as endothelial dysfunction, is very important. Apelin is a recently discovered endogenous peptide hormone that, along with Nitric Oxide (NO), is implicated in endothelial dysfunction and the severity of HTN. This can significantly reduce renal function and lead to microalbuminuria/proteinuria in 5-15% of patients. Aim: To measure serum apelin and NO in patients with newly diagnosed primary HTN with or without microalbuminuria and to investigate the correlation of serum apelin with HTN in the same study population. Materials and Methods: This cross-sectional study was conducted from February 2019 to January 2021 in the Department of Biochemistry In collaboration with the Department of Medicine at SCB Medical College and Hospital, Cuttack, Odisha, India. A total of 180 participants were included in the present study. Among them, 90 were newly diagnosed hypertensive patients, and 90 were non hypertensive. The study comprised of 90 hypertensive patients, with 46 having microalbuminuria (Group-A), 44 without microalbuminuria (Group-B) and 90 normotensive controls (Group-C). All participants underwent evaluation of their biochemical profile which included Fasting Plasma Sugar (FBS), serum urea, creatinine, Total Cholesterol (TC), Triglyceride (TG), High-density Lipoprotein cholesterol (HDL-c), Low-density Lipoprotein cholesterol (LDL-c), Very Low-Density Lipoprotein (VLDL), serum apelin and NO levels, and urine albumin. The comparison between the three groups was done by using Analysis of Variance (ANOVA) test with post-hoc analysis. The Chi-square test was used to compare categorical variables. Results: The mean age of the participants was 50.48±9.73 years. study comprised of 90 hypertensive patients, with 46 having microalbuminuria, 44 without microalbuminuria, and 90 normotensive controls. The mean serum apelin levels were 394.45±84.2, 386.9±86.12, and 62.73±22.87 ng/L, respectively, among patients with microalbuminuria, without microalbuminuria, and normotensive patients. Similarly, the mean serum NO levels were 6.31±2.94, 8.32±2.63, and 20.15±4.37 µmol/L, respectively, among the three groups. The comparison of mean values indicated a significant (p<0.001) positive correlation between the level of serum apelin and HTN and its complications, such as microalbuminuria. Conclusion: The positive correlation between serum apelin levels and blood pressure underscores the potential role of apelin in hypertensive pathophysiology.

Evaluation of the Expression and Localization of the Multifunctional Protein CacyBP/SIP and Elements of the MAPK Signaling Pathway in the Adrenal Glands of Rats with Primary and Secondary Hypertension.

Hypertension is a global civilization disease and one of the most common causes of death in the world. Organ dysfunction is a serious health consequence of hypertension, which involves damage to the heart, kidneys and adrenals. The interaction of recently discovered multifunctional protein-CacyBP/SIP with ERK1/2 and p38 kinases by regulating the activity and intracellular localization of these kinases may play an important role in the signaling pathways involved in the pathogenesis of hypertension. Due to the lack of data on this subject, we decided to investigate the localization, expression and possible relationship between the studied parameters in the adrenals under arterial hypertension. The study was conducted on the adrenals of rats with spontaneous and DOCA-salt hypertension. The expression of CacyBP/SIP, p-ERK1/2 and p-p38 was detected by immunohistochemistry and qRT-PCR. The results show a statistically significant decrease in CacyBP/SIP expression in the adrenal glands of hypertensive rats. With ERK1/2, there was a decrease in cortical immunoreactivity and an increase in the adrenal medulla of primary hypertensive rats. In contrast, in the adrenals of DOCA-salt rats, ERK1/2 immunoreactivity increased in the cortex and decreased in the medulla. In turn, p38 expression was higher in the adrenal glands of rats with primary and secondary hypertension. The obtained results may suggest the involvement of CacyBP/SIP in the regulation of signaling pathways in which MAP kinases play an important role and provide new insight into molecular events in hypertension. Moreover, they show the participation of CacyBP/SIP in response to oxidative stress.

Higher plasma aldosterone concentrations in patients with aortic diseases and hypertension: a retrospective observational study

BackgroundAortic diseases remain a highly perilous macrovascular condition. The relationship between circulating aldosterone and aortic diseases is rarely explored, thus we investigated the difference in plasma aldosterone concentration (PAC) between patients with and without aortic disease in hypertensive people.MethodsWe analyzed 926 patients with hypertension, ranging in age from 18 to 89 years, who had their PAC measured from the hospital's electronic database. The case group and control group were defined based on inclusion and exclusion criteria. The analysis included general information, clinical data, biochemical data, and medical imaging examination results as covariates. To further evaluate the difference in PAC between primary hypertension patients with aortic disease and those without, we used multivariate logistic regression analysis and also employed propensity score matching to minimize the influence of confounding factors.ResultsIn total, 394 participants were included in the analysis, with 66 individuals diagnosed with aortic diseases and 328 in the control group. The participants were predominantly male (64.5%) and over the age of 50 (68.5%), with an average PAC of 19.95 ng/dL. After controlling for confounding factors, the results showed hypertension patients with aortic disease were more likely to have high PAC levels than those without aortic disease (OR = 1.138, 95% CI [1.062 to 1.238]). Subgroup analysis revealed consistent relationship between PAC and primary hypertensive patients with aortic disease across the different stratification variables. Additionally, hypertensive patients with aortic disease still have a risk of higher PAC levels than those without aortic disease, even after propensity score matching.ConclusionsThe results of this study suggest that primary hypertensive patients with aortic diseases have elevated levels of PAC, but the causal relationship between PAC and aortic disease requires further study.

Preliminary Consequences of Blood Pressure Management and Blood Homocysteine Levels with Perindopril in Newly Diagnosed Hypertensive Patients in the Vietnamese Population.

Perindopril is an ACE inhibitor that aids in both blood pressure regulation and homocysteine reduction. Our study aimed to evaluate the results of controlling blood pressure and blood homocysteine levels by perindopril in patients with primary hypertension. A cross-sectional descriptive study with a longitudinal follow-up was conducted on 105 primary hypertensive patients treated with perindopril. The results of our study showed that after 6 weeks of treatment with perindopril, the proportion of patients with the target blood pressure (BP) level accounted for 70.5%, the rate of grade 1 hypertension decreased from 61.0% to 25.7%, grade 2 blood pressure decreased from 17.1% to 3.8%, and there was no case of grade 3 hypertension. At the same time, we also found that the rate of BP control in the group of patients who controlled Hcy below a threshold of 15 μmol/L was significantly higher than in the other group (p < 0.05). Concerning the efficacy of decreasing homocysteine in blood, we discovered that after 6 weeks of treatment with perindopril, the proportion of patients with elevated homocysteine reduced considerably from 74.3% to 40% (p < 0.05). In addition, the homocysteine concentration was 4.33 mol/L lower after treatment than before treatment (95% CI: 3.69-4.97) (p < 0.05). Perindopril helps control blood pressure and reduces blood homocysteine levels in patients with primary hypertension.

Sodium accumulation in the skin is associated with higher density of skin lymphatic vessels in patients with arterial hypertension

PurposeRecent studies, conducted mainly on the rodent model, have demonstrated that regulatory pathway in the skin provided by glycosaminoglycans, nuclear factor of activated T cells 5 (NFAT5), vascular endothelial growth factor C (VEGF-C) and process of lymphangiogenesis may play an important role in extrarenal regulation of sodium (Na+) balance, body water volume, and blood pressure. We aimed to investigate the concentrations and relations among the main factors of this pathway in human skin to confirm that this regulatory axis also exists in humans. Patients and methodsSkin specimens from patients diagnosed with arterial hypertension and from control group were histologically and molecularly examined. ResultsThe primary hypertensive and control groups did not differ in Na+ ​concentrations in the skin. However, the patients with hypertension and higher skin Na+ concentration had significantly greater density of skin lymphatic vessels. Higher skin Na+concentration was associated with higher skin water content. In turn, skin water content correlated with factors associated with lymphangiogenesis, i.e. NFAT5, VEGF-C, and podoplanin (PDPN) mRNA expression in the skin. The strong mutual pairwise correlations of the expressions of NFAT5, VEGF-C, vascular endothelial growth factor D (VEGF-D) and PDPN mRNA were noted in the skin in all of the studied groups. ConclusionsOur study confirms that skin interstitium and the lymphatic system may be important players in the pathophysiology of arterial hypertension in humans. Based on the results of our study and existing literature in this field, we propose the hypothetical model which might explain the phenomenon of salt-sensitivity.

The effect of statins on mortality and cardiovascular disease in primary care hypertensive patients without other cardiovascular disease or diabetes.

Studies in primary healthcare (PHC) assessing the effect of primary prevention with statins on mortality and cardiovascular disease (CVD) are scarce. This study aimed to estimate the effect of statins on all-cause mortality, cardiovascular mortality, myocardial infarction (MI), and stroke in individuals in PHC with hypertension without CVD or diabetes. Using the Swedish PHC quality assurance register QregPV, the study included 13 193 individuals with hypertension without CVD or diabetes, who had filled a first statin prescription between 2010 and 2016, and 13 193 matched controls without a filled statin prescription at the index date. Controls were matched on sex and propensity score using clinical data and data from national registers on comorbidities, prescriptions, and socioeconomic status. The effect of statins was estimated in Cox regression models. During a median of 4.2 years of follow-up, 395 individuals in the statin group vs. 475 in the control group died, 197 vs. 232 died of cardiovascular disease, 171 vs. 191 had an MI, and 161 vs. 181 had a stroke. The treatment effect of statins was significant for all-cause mortality [hazard ratio (HR) 0.83, 95% confidence interval (CI) 0.74-0.93] and cardiovascular mortality (HR 0.85, 95% CI 0.72-0.998). Overall, no significant treatment effect of statins was seen for MI (HR 0.89, 95% CI 0.74-1.07), but there was a significant interaction with sex (P = 0.008) with decreased risk of MI for women but not for men (HR 0.66, 95% CI 0.49-0.88 vs. HR 1.09, 95% CI 0.86-1.38). Primary prevention with statins in PHC was associated with reduced risk of all-cause mortality, cardiovascular mortality, and in women, lower risk of MI.

Slow stroke back massage (SSBM) therapy with lavender essential oil effectively lowers blood pressure

Hypertension is a global health problem that is a major factor causing cardiovascular disease and premature death. While pharmacological therapy is still the main choice, non-pharmacological therapies with minimal side effects, such as a combination of slow stroke back massage (SSBM) and aromatherapy, are expected to increase relaxation so as to increase the effectiveness of lowering blood pressure in hypertensive patients. This study aimed to test the effectiveness of SSBM therapy with lavender essential oil in lowering blood pressure in patients with primary hypertension. The research used a quasi-experiment method with a pretest-posttest design with a control group. In this study, the samples used were hospitalized patients with primary hypertension who met the inclusion and exclusion criteria, with as many as 40 respondents using purposive sampling techniques. Slow stroke back massage (SSBM) therapy with lavender essential oil significantly lowers blood pressure values in primary hypertensive patients compared to SSBM therapy with baby oil (P value 0.05). The mean difference in systolic and diastolic blood pressure in the intervention and control groups was 6.25 and 2.65, respectively. This therapy has been proven to be effective in lowering blood pressure in primary hypertensive patients. Therefore, hospital management may consider applying this nonpharmacological therapy to manage primary hypertension patients.

Effect of Yoga Nidra (Psychic Sleep) in patients with Alcoholic Hypertensives - A Randomized Controlled Trial

Background: Primary Hypertension in alcoholic individuals is one of the major health issues of the society. Yoga is found to have a wonderful tool to treat primary hypertension in alcoholic individuals. Yoga Nidra, is a cost effective tool to manage these symptoms. Objectives: The objectives of the study are to assess whether Yoga Nidra is having effect on blood pressure, heart rate variability &amp; respiratory rate in primary hypertensive alcohol dependent individuals. Materials and Methods: A total of sixty primary hypertensive alcoholic dependent individuals have been recruited after they meet the inclusion and exclusion criteria and the screening of the subjects by using Alcohol Use Disorders Identification Test (AUDIT) questionnaire and into two Groups, Subjects in the group one practiced Yoga Nidra for a period of 10 days and group two carried on its routine activities. Both the groups were assessed for blood pressure, heart rate variability &amp; respiratory rate at day one and day ten. Results: In the present study comparison between the group there was a significant results seen in the HR, RR, SBP with P value &lt; 0.0001, LF/HF ratio with P value &lt; 0.0500, DBP with P value&lt; 0.0257 respectively. Conclusion: Ten days of Yoga Nidra practice has shown to bring a positive influence in primary hypertensive alcoholic dependent individuals in improving HR, RR, Mean RR, RMSSD, NN50, PNN50, VLF, LF, HF, LF/HF ratio, SBP &amp; DBP.

Vascular phenotypes in early hypertension

The study characterises vascular phenotypes of hypertensive patients utilising machine learning approaches. Newly diagnosed and treatment-naïve primary hypertensive patients without co-morbidities (aged 18–55, n = 73), and matched normotensive controls (n = 79) were recruited (NCT04015635). Blood pressure (BP) and BP variability were determined using 24 h ambulatory monitoring. Vascular phenotyping included SphygmoCor® measurement of pulse wave velocity (PWV), pulse wave analysis-derived augmentation index (PWA-AIx), and central BP; EndoPAT™-2000® provided reactive hyperaemia index (LnRHI) and augmentation index adjusted to heart rate of 75bpm. Ultrasound was used to analyse flow mediated dilatation and carotid intima-media thickness (CIMT). In addition to standard statistical methods to compare normotensive and hypertensive groups, machine learning techniques including biclustering explored hypertensive phenotypic subgroups. We report that arterial stiffness (PWV, PWA-AIx, EndoPAT-2000-derived AI@75) and central pressures were greater in incident hypertension than normotension. Endothelial function, percent nocturnal dip, and CIMT did not differ between groups. The vascular phenotype of white-coat hypertension imitated sustained hypertension with elevated arterial stiffness and central pressure; masked hypertension demonstrating values similar to normotension. Machine learning revealed three distinct hypertension clusters, representing ‘arterially stiffened’, ‘vaso-protected’, and ‘non-dipper’ patients. Key clustering features were nocturnal- and central-BP, percent dipping, and arterial stiffness measures. We conclude that untreated patients with primary hypertension demonstrate early arterial stiffening rather than endothelial dysfunction or CIMT alterations. Phenotypic heterogeneity in nocturnal and central BP, percent dipping, and arterial stiffness observed early in the course of disease may have implications for risk stratification.

Effect of Visual Evoked Potentials in Patients with Primary Hypertension

Hypertension can cause vascular endothelial changes which can lead to hyalinization and demyelination. It also causes hypertensive retinopathy and retinal artery atrophy in chronic hypertensive patients. Retinal artery atrophy can lead to demyelination changes in the optic nerve. Visual evoked potentials (VEPs) can be used as a sensitive method for documenting the abnormalities in the visual pathways. VEPs are electrical potential differences recorded from the scalp to the visual stimuli. The demyelination changes of optic nerve in early stages of primary hypertension were not studied much. Hence, this study was aimed to assess the effect of VEP in primary hypertension. The main objective of this study was to correlate the latency and amplitude of VEPs in normal individuals and primary hypertensive patients. This is a comparative study which was done between two groups. Group A was a control group with 60 normal participants and group B was a study group that had 60 primary hypertensive patients. Pattern reversal VEP (Parameters – N75, P100 &amp; N145 latencies and amplitude of P100) was recorded in both groups. The variables were correlated between group A and group B. In the result of this study, the VEP latencies of N75 and P100 waves was increased (duration delayed) significantly in both right eye and left eye of participants in Group B than Group A. Amplitude of P100 wave was decreased in both eye, but it is not statistically significant in left eye. VEP parameters can be used for routine screening and diagnostic tests for visual impairment and hypertensive retinopathy even in earlier stages of hypertensive patients.

Analysis of Platelet Indices and Proteinuria in Primary Hypertensive Patients

Hypertension is a silent killer that causes premature death, an estimated 9.4 million people die each year due to hypertension and its complications. Primary hypertension promotes endothelial damage-causing platelet release reaction. Without treatment, it may cause renal damage, which leads to proteinuria. This study aimed to analyze the relationship of the platelet indices (PLT, PDW, PCT, MPV) in predicting proteinuria among patients with primary hypertension based on its stage. A retrospective study using medical records of patients diagnosed with primary hypertension by clinicians at Dr. Wahidin Sudirohusodo Hospital from January-December 2019. Complete Blood Count (CBC) using the flow cytometry and routine urine test with urine analyzer were performed. The statistical test used in this study were the independent T-test, Chi-Square test, and oneway ANOVA test. Receiver Operating Characteristics (ROC) were used to determine the cut-off. The sample consisted of 78 patients. Mean Platelet Volume (MPV) was significantly higher in proteinuria patients and stage two hypertension with p&lt;0.001. There was a significant relationship between stage two hypertension and proteinuria with p=0.018. ROC analysis showed MPV Area Under the Curve (AUC) of 0.774 with p&lt;0.001, which indicated that MPV can be used as a predictor of proteinuria with a cut-off point of 8.55. MPV increases on the platelet indices, proteinuria with stage 2 hypertension are caused by damage to glomerular endothelium, which leads to platelet activation characterized by degranulation, swelling, and increases in platelet mass and volume. There was a relationship between an increase of MPV and proteinuria in patients with stage 2 hypertension.

The Correlation of Self Management Behavior with Quality of Life in Patients with Primary Hypertension

Hypertension is a cardiovascular disease that is a major concern because of the high morbidity and mortality rates. Uncontrolled hypertension will cause various complications will interfere quality of life the patient with hypertension. Quality of life in hypertensive patients is influenced by the severity and severity of complications experienced by the patient. Self management behavior as a disease management to support patients with chronic diseases, behavior modification is very useful to reduce or delay the adverse effects of hypertension. The purpose of this study was to determine the correlation between self-management behavior and quality of life in patients with primary hypertension at UPTD Puskesmas Manggis I Karangasem. This research is a descriptive quantitative correlational research with a cross sectional approach. The sample of this study was 79 respondents who were selected through simple random sampling technique, data analysis used Spearman Rank test. The results showed that 31 respondents (39.2%) had good self-management behavior and 34 respondents (43.1%) had good quality of life. The results of the Rank Spearman test, p value = 0.000 (≤0.05) showed a significant correlation between self-management behavior and quality of life in patients with primary hypertensive. The correlation coefficient value (r) 0.835 means a very strong correlation between self-management behavior and quality of life. Nurses are expected to be able to provide education about self-management behavior that they can improve the quality of life patients with hypertension.

Role of Serum Retinol Binding Protein 4 (RBP4) Concentration in Patients with Primary Hypertension: A Case-control Study

Introduction: Serum Retinol Binding Protein 4 (RBP4), an adipokine that transports vitamin A from the liver to other tissues, is reported to be elevated in hypertensive subjects. Positive correlation between RBP4 and cardiovascular risk factors has been noted in a few studies. Aim: To evaluate serum RBP4 levels in newly diagnosed primary hypertensive cases and non hypertensive controls and to correlate serum RBP4 levels with lipid profile. Materials and Methods:This case-control study was conducted at the Department of Biochemistry in collaboration with the Department of Medicine, from August 2019 to June 2020 in MKCG Medical College and Hospital, Berhampur, Odisha, India. A total of 51 newly diagnosed primary hypertensive patients and 51 healthy age and sex-matched individuals between the ages of 18 to 50 years were enrolled in the study. Systolic and Diastolic Blood Pressure (SBP and DBP) were measured in both cases and controls.Serum RBP4 was measured by Enzyme-Linked Immunosorbent Assay (ELISA) and other biochemical parameters were measured by TBA120FR autoanalyser. Result: The mean age for controls was 36.98±8.7 years and that in cases was 39.00±8.4 years. Proportion of males was higher (56.8%) than females (43.2%). The mean systolic blood pressure in the case group was significantly higher as compared to the control group. The cases had a higher level of serum RBP4 (31.82 mg/L) compared to the control groups (15.5 mg/L) RBP4 (p&lt;0.001). The cases had a higher level of mean serum triglyceride (196.20±67.81 mg/dL) and lower level of mean serum High-Density Lipoprotein cholesterol (HDLc) (37.53±11.90 mg/dL) as compared to the control groups which had a mean triglyceride of 104.25±39.89 mg/dL and HDLc of 57.18±10.73 mg/dL (p&lt;0.001). The serum RBP4 level positively correlated with SBP (r=0.644, p&lt;0.001), DBP (r=0.444, p&lt;0.001), serum triglycerides (r=0.649, p&lt;0.001), and negatively correlated with HDLc (r=-0.313, p=0.025). Conclusion: A high serum RBP4 level was found in the newly diagnosed hypertensive cases as compared to normotensive controls. A significant positive correlation was observed between RBP4 with systolic and diastolic blood pressure along with triglyceride levels. A significant negative correlation was observed between RBP4 with HDLc.

Evaluation of serum uric acid among new-onset primary hypertension patients – A cross-sectional study

Background: Hypertension is associated with a myriad of confounding factors, out of which elevated serum uric acid (SUA) profile is of interest as a biomarker. Despite a handful of studies alluding to the seminal relationship between the two, its prevalence and correlation in the Indian context have not been adequately investigated. Hence, the present study was aimed to evaluate the relationship between SUA levels and primary hypertension (HTN). Materials and Methods: This 1-year hospital-based cross-sectional study comprised 100 patients who were recently diagnosed with primary HTN and had not received antihypertensive medications, SUA levels and severity of HTN among patients were assessed along with their age, sex, body mass index, total cholesterol, and lipid profile. Results were statistically analyzed by Chi-square test, logistics regression, t-test/Welch t-test/Mann–Whitney U-test, and Pearson–Spearman rank correlation. Results: A strong correlation between SUA level with systolic blood pressure (SBP) in patients with primary HTN (r = 0.5046; P < 0.0001) was observed. The mean SBP (163.89 ± 9.99 mmHg) was significantly high (P < 0.001) in hyperuricemic patients, and raised SUA was noted in 38% of the cohort. Stage II hypertensive subjects of the 58–66 years age group were found to be a particularly vulnerable group (odds ratio of 32). History of diabetes mellitus, tobacco, and alcohol consumption showed a significant association with elevated SUA levels in males (P < 0.05). Conclusion: One in every three primary hypertensive patients is likely to present with hyperuricemia, and there exists a pertinent association between elevated SUA levels with SBP.

Effect of Different Types of Aerobic Exercise on Individuals With and Without Hypertension: An Updated Systematic Review

High blood pressure (BP) is one of the main modifiable risk factors for cardiovascular disease (CVD) and preventing it greatly reduces the vascular consequences of aging and, along with intensive treatment of hypertension, eliminates a large portion of the burden of CVD-related mortality. Many meta-analyses and studies proved that regular aerobic exercise (AE) reduces BP but most of these studies consider only hypertensive populations or only AE but not resistant exercise or their combination. In this review, we aimed to study the effect of different types of physical activity (PA)/AE on various populations including normotensive, prehypertensive, primary hypertensive, and resistant hypertensive with different comorbidities. We searched PubMed, Web of Science, and Google Scholar for English articles with keywords for physical activity, aerobic exercise, and blood pressure from January 2010 until September 2021. Finally, 24 studies were included. Results showed that chronic or acute AE (long-term or short-term), either alone or as combined with different sessions and programs can reduce systolic and diastolic BP in every group including normotensive, prehypertensive, primary hypertensive, resistant hypertensive individuals and diabetic patients and those with kidney problems but not in people with chronic heart failure. Isometric exercise training showed to be useful in reducing BP in all groups either as low intensity or as high intensity but the rate of reduction was different in terms of gender. AE showed to be effective in terms of BP reduction in a different age range. It can be seen that different types and duration of AE independent of the modality and programs and independent of the BP medical situation of individuals have been successful in terms of BP reduction. For those with chronic heart failure, more concern and help might be needed to decrease BP via exercise.

Microalbuminuria in essential hypertension: A single centre study

To evaluate the prevalence of microalbuminuria in patients with essential hypertension and its relationship to severity of hypertension, to renal function and its association with coronary artery disease and target organ damage, present study was conducted. Total 100 primary hypertensive, non diabetic patients and 25 healthy normotensive, non diabetic patients (controls) admitted in S.S.G.H (Sir Sayajirao General Hospital) from June 2009 to November 2011. Patient's complete history, routine investigation along with microalbuminuria was measured by ACR by immunoturbidimetric method. In present study patient’s mean age was 52.7 years. Total 70% of patients selected for study were males and 30% were females. Total 50% to 75% of patients in the 61 -80 year age group were positive for microalbuminuria. Total 42.85% of males were positive for microalbuminuria as compared to 33.33% of females. Total 75% of patients having hypertension for more than 8 years had microalbuminuria. Total 67.5% of patients positive for microalbuminuria had associated target organ damage. Total 45% of patients positive for microalbuminuria had left ventricular hypertrophy and 40% of patients had hypertensive retinopathy. Microalbuminuria helps to identify incipient nephropathy and vascular changes. Its detection can thus help to prevent the development of complications by aggressive treatment to get down targeting blood pressure.

Gym and home-based combined training in men with primary hypertension: are they equally effective on functional fitness profile, body composition components, and biochemical parameters of hypertension?

ABSTRACT Objective This study aimed to compare the effects of 10 weeks of gym versus home-based combined training on the functional fitness, body composition, and biochemical parameters of hypertension in primary hypertensive men. Methods Forty-six patients (age 48 ± 9 years, BMI 30 ± 4 kg/m2) assigned into three groups: a gym-based combined training (GBCTr: n = 16; resistance at 60–80% of 1RM, using pin-loaded resistance equipment, aerobic at 40–60% HRR, and stretching), home-based combined training (HBCTr: n = 15; resistance at 12–15 RPE, using an elastic exercise band, aerobic at 40–60% HRR, and stretching), and control (CTR, n = 15). Results Following GBCTr and HBCTr, the functional aerobic capacity (P = .005 and P = .004, respectively), flexibility (P = .01 and P = .004, respectively), and lower limb muscle strength (P = .01 and P = .02, respectively) was increased significantly compared with the CTR group. The body weight (P = .02), body mass index (P = .008), hip circumference (P = .02), and nitric oxide level in GBCTr and HBCTr group (P = .002 and P = .02, respectively) was decreased significantly compared with the CTR group. No significant changes found in the plasma levels of NADPH oxidase 5, thioredoxin-2, thioredoxin reductase-2, and resting blood pressure after GBCTr and HBCTr compared with the CTR group. Conclusion These results suggest that in hypertensive men, HBCTr equally to GBCTr improved functional fitness and body composition remarkably without necessarily reducing resting blood pressure. Therefore, they can be advisable substitutes for gaining health benefits.

Adherence To Antihypertensive Medications Among Primary Care Centre Attendees in Trinidad: A Cross-Sectional Study

Objective: To determine the adherence levels to antihypertensive medications and its associated factors among primary care attendees in Trinidad. Methods: A cross-sectional study was carried out whereby an interviewer-administered questionnaire was administered to public primary care attendees throughout Trinidad. Non-pregnant hypertensive adults, attending chronic disease clinic on anti-hypertensive medications for at least 1 year were eligible. Results: Of 225 participants (92% response rate), 58% displayed a low level of adherence to anti-hypertensive medications and 73.3% had uncontrolled hypertension, both independent of age, gender, and ethnicity. Experiencing adverse effects to prescribed medications (P=0.003) and self-reported use of herbal/alternative treatment (P=0.024) for hypertension were significantly associated with higher rates of low adherence. Having too many pills to take and fear about the potential effects of these medications on the body were both correlated with low adherence (P&lt; 0.001) Obtaining antihypertensive medications from a national chronic disease assistance program was inversely correlated with low adherence (P= 0.03). There were no statistically significant associations between adherence and average systolic blood pressure (P= 0.20), home self-monitoring (P= 0.75), daily dosing frequency (P= 0.53), or daily number of pills (P= 0.68) Conclusion: Most primary care hypertensive patients who attended chronic disease clinics at primary care health centers around Trinidad were found to have uncontrolled hypertension along with low adherence to antihypertensive medications. Education, screening for herbal use, and improvements to the existing national medication program, are discussed as interventions to improve adherence in this setting. Keywords: Hypertension, Adherence, Antihypertensive medications, Primary Care