Probability Of Hypertension Research Articles

Vegetarian diets: prevalence in the Russian population, regional accents and associations with cardiovascular risk factors. Results of the ESSE-RF, ESSE-RF2 and ESSE-RF3 epidemiological studies

At the present time, there is a growing trend of vegetarian diets, even in countries with a traditional Nordic diet.Aim. To study the prevalence and characteristics of vegetarian diets in the Russian population at the present stage.Material and methods. The analysis included data from representative samples of the adult population 25-74 years old, examined within three sections of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study in 20132014, 2017 and 2020-2022. A total of 57351 participants (24862 men and 32489 women) were analyzed. Nutrition assessment was carried out using the frequency method. Restrictive diets include semi-vegetarian, vegetarian and vegan diets. Data are presented as frequencies and odds ratios (OR) with 95% confidence intervals (CI).Results. The prevalence of restrictive diets in the Russian population according to three sections of the ESSE-RF study was 3,1%. There is an increase in the prevalence of these diets from 2,7% in 2013, to 3,6% in 2017 and 3,3% in 2020-2022. Men are less likely than women to exclude red meat from their diet (OR 0,55 [0,49-0,61], p<0,05), as are married individuals (0,58 [0,52-0,64], p<0,05). Persons with higher education more often follow a semi-vegetarian diet (OR 1,15 [1,04-1,27], p<0,05). With age, the refusal to consume red meat in the population increases (p<0,001). A semi-vegetarian diet is associated with a lower likelihood of general (OR 0,84 [0,71-0,99], p=0,037) and abdominal obesity (0,78 [0,52-0,64], p<0,001), hypertriglyceridemia (0,82 [0,73-0,92], p=0,001) and hyperglycemia (0,81 [0,67-0,97], p=0,021). The probability of hypertension is lower among people who limit the consumption of animal products (semi-vegetarians (OR 0,85 [0,76-0,95], p=0,004) and vegetarians (0,62 [0,42-0,92], p=0,018), as well as hypercholesterolemia: in semi-vegetarians (0,90 [0,81-0,99], p=0,041), in vegetarians (0,68 [0,47-0,97], p=0,035) and in vegans (0,37 [0,15-0,91], p=0,030).Conclusion. In the Russian population, individuals following vegetarian diets (3,1% of the population) have a healthier profile of nutritional risk factors.

Abstract 18615: Utilizing Deep Learning Network for Analyzing National Health and Nutrition Examination Survey Data: Investigating the Association Between Self-Reported Sleep Duration and Hypertension

Introduction: Epidemiological evidence consistently demonstrates significant links between self-reported sleep duration and hypertension (HTN). However, traditional logistic regression models may not capture the full complexity of these associations. Therefore, in this study, we employed a Deep Learning Network to model the intricate relationships between sleep duration and HTN. Methods: Data were extracted from participants (n=38,540) in the National Health and Nutrition Examination Survey (2006-2016), a nationally representative study of the US civilian non-institutionalized population. Self-reported demographic, medical history and sleep duration were determined from household interview questions. HTN was determined as SBP ≥ 130 mmHg and DBP ≥ 80mmHg. We used a deep neural network architecture with three hidden layers with two input features and one binary output to model associations of sleep duration with HTN. The input features are the hours of sleep (limited to between 4 and 10 hours) and its square; and the output variable HTN. Probability predictions were generated 100 times from resampled (with replacement) data and averaged. Results: Participants ranged from 18 to 85 years old; 51% Female, 41% white, 22% black, 26% Hispanic, 46% married, and 25% <high school. The model showed that sleeping 7 hours habitually was associated with the least observed HTN probabilities (P=0.023%). HTN probabilities increased as sleep duration decreased (6hrs=0.05%; 5hrs=0.110%; 4hrs=0.16%); HTN probabilities for long sleepers were: (8hrs=0.027; 9hrs=0.024; 10hrs=0.022). Whites showed sleeping 7hrs or 9hrs was associated with lowest HTN probabilities (0.008 vs. 0.005); blacks showed the lowest HTN probabilities associated with sleeping 8hrs (0.07), and Hispanics showed the lowest HTN probabilities sleeping 7hrs (0.04). Conclusions: We found that sleeping 7 hours habitually confers the least amount of risk for HTN. Probability of HTN varies as a function of individual’s sex and race/ethnicity. Likewise, the finding that blacks experience the lowest HTN probability when they sleep habitually 8 hours is of great public health importance. Support: R01HL142066, R01AG067523, R01AG075007

Association of household fuel use with hypertension and blood pressure among adult women in rural Bangladesh: A cross-sectional study.

This study aimed to determine the association of household fuel use with hypertension, systolic blood pressure (SBP), and diastolic blood pressure (DBP) among adult women. A cross-sectional survey through face-to-face interviews and blood pressure (BP) measurement were conducted among 2182 randomly selected women (1236 solid fuel users and 946 clean fuel users) in rural areas of Bangladesh. Overall, 21% of women were hypertensive. Mean SBP and DBP for the study population were 121.27 mmHg (SD ± 15.43) and 76.18 mmHg (SD ± 12.00), respectively. Hypertension was found significantly (p=.006) higher among solid fuel users (23%) compared to clean fuel users (18%). Women using solid fuels have a 35% higher chance (AOR: 1.35, CI: 1.10-1.80) of having hypertension and have more than twice the risk of developing elevated SBP (AOR: 2.01, CI: 1.55-2.95) relative to women using clean fuels for their daily cooking. The probability of hypertension (AOR: 1.39, CI: 1.17-1.60) and elevated SBP (AOR: 1.35, CI: 1.10-1.61) increased significantly for every hour of fuel use. Using clean fuel, reducing the duration of daily cooking time, and improved cooking facilities may help minimizing hypertension and ultimately cardiovascular disease risk among women.

Indicadores de desempenho funcional associados à hipertensão em pessoas idosas

Abstract Introduction During aging, changes occur in the human body that increase the probability of arterial hypertension which can potentiate deleterious effects on functional performance. Objective To analyze the association of functional performance indicators with hypertension in older people. Methods An epidemiological, population-based, cross-sectional survey was conducted with 209 older adults (58.40% women). Functional performance was assessed by the following tests: handgrip strength; chair stand test; arm curl test; timed up and go (TUG); sit and reach test; and step in place test (SPT). Diagnosis of arterial hypertension was self-reported. Results The prevalence of hypertension was found to be 58.90% (males: 51.70%; females: 63.90%). It was also observed that the hypertensive individuals of both sexes had worse performance in SPT and TUG (p < 0.05). Furthermore, it was found that each additional second for TUG increased by 11% the probability of hypertension in men (PR:1.11; 95%CI: 1.03-1.20) and by 7% in women (PR: 1.07; 95%CI: 1.04-1.12), while each step performed in the SPT decreased the probability for the outcome by 2% (men and women = PR: 0.98; 95%CI: 0.97-0.99). Conclusion TUG was found to be positively associated with hypertension, while SPT was inversely associated with hypertension.

Hypertension Risk Factors in Batu Ampar Public Health Center West Borneo

Many people do not know that they have been diagnosed with hypertension until complications arise. Hypertension is a non-communicable disease caused by many factors. The risk factors that influence the incidence of hypertension are divided into two: modifiable and non-modifiable risk factors. Thus far, there is no data on risk factors for hypertension in the Batu Ampar Public Health Center work area. The objective of research is knowing the risk factors for hypertension in the working area of Batu Ampar Public Health Center. An observational study with a cross sectional design conducted at the Batu Ampar Public Health Center from April to June 2022. The variable data collected were age, gender, education level, occupation, obesity, smoking habits, exercise habits, alcohol consumption, salt consumption and fruit consumption. and vegetables. Of the 150 respondents (75 with hypertension and 75 without hypertension) it was found that age, occupation, alcohol consumption and salt consumption were risk factors. The probability of hypertension having these four risk factors is 97%. Risk factors for hypertension in the working area of Batu Ampar Public Health Center are age, occupation, alcohol consumption and salt consumption.

Abstract 10261: Adverse Childhood Experiences Are Linked to High Blood Pressure During the First Trimester and Hypertensive Complications During Pregnancy

Introduction: Adverse Childhood Experiences (ACEs) are associated with impaired vascular function in young adult women, and increased blood pressure and CVD risk later in life. Hypotheses: We hypothesized that exposure to ACEs would be associated with an increased risk of first trimester hypertension and subsequently with hypertensive complications during pregnancy. Methods: Exposure to ACEs, self-reported incidence of first trimester hypertension (HT) and hypertensive complications in pregnancy (HTCs), as well as age, education, chronic health conditions, gravidity and BMI were obtained from women enrolled in a clinic-based longitudinal study of women ages 16-38 who were enrolled in their first prenatal visit. To avoid potential confounding of severe obesity, we restricted analyses to only those women with a BMI <40 kg/m 2 . Consequently, 135 pregnant women (age = 26 ± 6; BMI = 27 ± 6; gravidity = 2.7 ± 1.5) were included in this analysis; however, data from 20 women was missing for HTC incidence (n =115). The sample was diverse (49% Non-White) and had a high prevalence of ACEs (41% with ≥4 ACEs). Logistic regression models were used to examine the association of ACE exposure with the probability of HT and HTCs. Models included: (1) ACEs alone, and (2) ACEs following adjustment for age, BMI, gravidity, Race, and chronic health conditions. Results: Exposure to ACEs predicted HT (OR [95% CI] = 1.32 [1.10 - 1.59]) and HTC (1.26 [1.03 - 1.52]) incidence. Following full adjustment, the odds of HT increased 51% for each additional ACE (1.51 [1.03 - 2.22]). Following full adjustment, the odds of HTC increased 40% for each additional ACE (1.40 [1.06 - 1.83]). In each of the fully adjusted models, only chronic health conditions were also a significant predictor. Conclusions: ACE exposure is an important risk factor for HT and HTC, especially when considered alongside existing chronic health conditions. Screening for ACEs may be a worthwhile public health strategy to identify women at risk for hypertension and hypertensive complications in pregnancy. However, larger scale, longitudinal cohort studies are needed to confirm and to further understand these associations.

Serum apolipoprotein A1 rather than apolipoprotein B is associated with hypertension prevalence in Chinese people with coronary artery disease.

Studies on the association of apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) with hypertension (HTN) prevalence in patients with coronary artery disease (CAD) are limited. This cross-sectional study aimed to investigate this association in Chinese people in Wuhan, China. Serum ApoA1 and ApoB levels were measured by immunoturbidimetry assay. Logistic regression analysis was used to estimate the associations of ApoA1 and ApoB level and ApoB/A1 ratio with HTN prevalence. We included 5192 individuals (3060 men, mean age 61 years; 4412 HTN cases) in this study. After adjusting for covariates, serum ApoA1 but not ApoB level or ApoB/A1 ratio was inversely associated with HTN prevalence. HTN prevalence was reduced with the fifth versus first quintile of ApoA1 level [odds ratio = 0.78 (95% confidence interval 0.62-0.98)]. In stratified analyses based on sex, the probability of HTN with the fifth versus first ApoA1 level was 0.71 (0.53-0.96) for men. The probability of HTN with the fifth versus first quintile of ApoB/A1 ratio was 1.54 (1.11-2.13) after adjustment. With quintiles 2-5 versus of ApoB level, the probability of HTN did not differ in both men and women. On path analyses, the association of ApoA1 level and ApoB/A1 ratio with HTN was mediated by BMI (β coefficients: -0.179 to 0.133). In general, high serum ApoA1 level may be associated with a reduced probability of HTN prevalence in patients with CAD in China, and this association may be mediated by BMI.

Urban-rural differential in diabetes and hypertension among elderly in India: A study of prevalence, factors, and treatment-seeking

AimsThis study estimates the prevalence of hypertension and diabetes among older adults and brings forth the urban-rural differentials in the said morbidities. The treatment-seeking approach of older adults is also looked at with regard to hypertension and diabetes. MethodsStudy utilized Longitudinal Ageing Study in India (LASI) data. Logistic regression was used to check the likelihood of hypertension and diabetes with socioeconomic and demographic variables. Fairlie's decomposition technique was applied to check the difference in the probability of hypertension and diabetes between rural and urban areas by estimating contributions of a group (rural-urban) differences. ResultsStudy noted a higher prevalence of hypertension and diabetes among elderly residing in urban areas than their rural counterparts. Prevalence of hypertension and diabetes was higher among those aged 70+, elderly females, less educated, and non-poor. Education status alone accounts for more than four-fifths (88.62%) and more than half (52.02%) of the inequality in the prevalence of urban-rural hypertension and diabetes, respectively. ConclusionsSince treatment-seeking is relatively low among elderly in poor households, practices must be identified for a poverty-stricken elderly population to overcome the financial barriers that may prevent the elderly from seeking and complying with treatment.

Pre-Pregnancy Obesity vs. Other Risk Factors in Probability Models of Preeclampsia and Gestational Hypertension.

In the face of the obesity epidemic around the world, attention should be focused on the role of maternal obesity in the development of pregnancy. The purpose of this analysis was to evaluate the prediction of preeclampsia (PE) and isolated gestational hypertension (GH) for a number of maternal factors, in order to investigate the importance of pre-pregnancy obesity (body mass index, BMI ≥ 30 kg/m2), compared to other risk factors (e.g., prior PE, pregnancy weight gain (GWG), infertility treatment, interpregnancy interval, family history, the lack of vitamin supplementation, urogenital infection, and socioeconomic factors). In total, 912 women without chronic diseases were examined in a Polish prospective cohort of women with a singleton pregnancy (recruited in 2015–2016). Separate analyses were performed for the women who developed GH (n = 113) vs. 775 women who remained normotensive, as well as for those who developed PE (n = 24) vs. 775 controls. The probability of each disease was assessed for the base prediction model (age + primiparity) and for the model extended by one (test) variable, using logistic regression. Three measures were used to assess the prediction: area under curve (AUC) of the base and extended model, integrated discrimination improvement (IDI) (the index shows the difference between the value of the mean change in the predicted probability between the group of sick and healthy women when a new factor is added to the model), and net reclassification improvement (NRI) (the index focuses on the reclassification table describing the number of women in whom an upward or downward shift in the disease probability value occurred after a new factor had been added, including results for healthy and sick women). In the GH prediction, AUC increased most strongly when we added BMI (kg/m2) as a continuous variable (AUC = 0.716, p < 0.001) to the base model. The highest IDI index was obtained for prior GH/PE (IDI = 0.068, p < 0.001). The addition of BMI as a continuous variable or BMI ≥ 25 kg/m2 improved the classification for healthy and sick women the most (NRI = 0.571, p < 0.001). In the PE prediction, AUC increased most strongly when we added BMI categories (AUC = 0.726, p < 0.001) to the base model. The highest IDI index was obtained for prior GH/PE (IDI = 0.050, p = 0.080). The addition of BMI categories improved the classification for healthy and sick women the most (NRI = 0.688; p = 0.001). After summing up the results of three indexes, the probability of hypertension in pregnancy was most strongly improved by BMI, including BMI ≥ 25 kg/m2 for the GH prediction, and BMI ≥ 30 kg/m2 for the PE prediction. Main conclusions: Pre-pregnancy BMI was the most likely factor to increase the probability of developing hypertension in pregnancy, compared to other risk factors. Hierarchies of PE and GH risk factors may suggest different (or common) mechanisms of their development.

Probability of Hypertension in Advancing Ages of Women

Hypertension is a problem in Indonesia, with 34.1% prevalence. The number reflected the number of hypertensive patients in the 2016 clinic report of Pasirjambu Public Health Center as the most prominent non-communicable disease. This research aimed to discover the specific age of onset and risk factors of hypertension in the village where the health center located. A rapid survey collected the data in May 2017, where 210 women (representing their household) were chosen by randomization inside their respective clusters. Risk factors were analyzed by a robust and parsimonious logistic regression model along with probability count on age as the final prediction. The prevalence of hypertension was 59.5% (95%CI: 52.9, 66.2%). Risk factors for hypertension were age (OR=1.06, p=0.00), stress (OR=1.74, p=0.09) and family history (OR=1.99, p=0.03) but the protective factor was consumption frequency of salty food (OR=0.64, p=0.10). In conclusion, a woman would have a 42.9% chance (95%CI: 33.7, 52.1%) for having hypertension at 40 years old of age after adjusted by other risk factors. Despite only two modifiable risk factors that can be intervened with, it would be worth trying to decrease the pace of onset in hypertension and the prevalence. KEMUNGKINAN HIPERTENSI BERDASAR ATAS USIA PADA WANITAHipertensi merupakan sebuah masalah di Indonesia dengan prevalensi sebesar 34,1%, angka tersebut terlihat dalam laporan tahunan Puskesmas Pasirjambu sebagai penyakit tidak menular terbanyak di wilayah kerjanya. Tujuan penelitian ini adalah mengetahui usia munculnya hipertensi dan faktor risikonya. Pengumpulan data dilakukan melalui survei cepat di bulan Mei 2017, melibatkan 210 wanita yang mewakili rumah tangganya dipilih secara random. Faktor risiko dianalisis menggunakan regresi logistik dengan hasil akhir berupa prediksi kemungkinan. Hasil penelitian menunjukkan prevalensi hipertensi sebesar 59,5% (IK95%: 52,9; 66,2%). Usia (OR=1,06; p=0,00), stress (OR=1,74; p=0,09) dan riwayat hipertensi dalam keluarga (OR=1,99; p=0,03) menjadi faktor risiko, sedangkan frekuensi konsumsi makanan asin (OR=0,64; p=0,10) menjadi faktor protektif. Setelah adjusted terhadap variabel lain, kemungkinan untuk hipertensi seorang wanita usia 40 tahun sebesar 42,9% (IK95%: 33,7; 52,1%). Pencegahan untuk menurunkan prevalensi dan laju insidensi dapat dilakukan dalam usia tersebut walaupun hanya ada dua faktor risiko yang dapat dimodifikasi.

Prevalence of hypertension, levels of lipids and blood glucose in patients with acute pancreatitis, chronic pancreatitis and pancreatic cancer

Aim. To determine the prevalence of hypertension (HTN) in patients with acute pancreatitis (AP), chronic pancreatitis (CP), pancreatic cancer (PC) and establish associations of HTN with other risk factors (obesity, dyslipidemia (DLP), plasma glucose ≥7,0 mmol/l, smoking, alcohol consumption).Material and methods. This observational multicenter clinical cross-sectional uncontrolled study included 44 patients with AP, 97 patients with CP and 45 patients with PC. The groups were comparable by sex and age. The HTN was diagnosed according to the criteria of Russian Society of Cardiology (2020).Results. HTN was much more common in patients with PC (55,6%) than in patients with AP (25,0%) (χ 2 =8,6, p=0,003). In patients with CP, the prevalence of HTN (39,2%) did not differ from those with AP or PC. Among patients with AP and HTN, higher levels of triglycerides (TG) (U=88,0, p=0,010) and glucose (U=89,5, p=0,011) than in non-HTN patients with AP were determined. In HTN patients with CP, glucose ≥7,0 mmol/l was recorded 3 times more often than in non-HTN patients with CP (χ 2 =16,2, p=0,000). In patients with PC and HTN, a higher mean body mass index (BMI) (F=7,8, p=0,008) and less common normal body weight than in non-HTN patients with PC (28,0 and 65,0%, χ 2 =6,2, p=0,013) was revealed. In patients with CP, increased glucose levels by 1 mmol/l (Exp (B)=1,933, 95% confidence interval (CI) 1,350-2,767, p=0,000) or BMI by 1 kg/m2 (Exp (B)=1,224, 95% CI 1,085-1,380, p=0,001) raised the probability of HTN; in patients with PC, increased BMI by 1 kg/ m2 (Exp (B)=1,394, 95% CI 1,057-1,840, p=0,019) or age by 1 year (Exp (B)=1,251, 95% CI 1,052-1,489, p=0,011) raised the probability of HTN.Conclusion. HTN was more often observed in patients with PC than in those with AP. In patients with CP, the prevalence of HTN did not differ from those with AP or PC. HTN was a cofactor to other metabolic risk factors (glucose ≥7,0 mmol/l, obesity) in patients with AP or CP; behavioral risk factors, on the contrary, were less common in HTN patients with AP or CP. In patients with CP, there was a direct association of HTN with glucose levels or BMI, and in patients with PC — HTN with BMI or age.

1058 Modeling Self-reported Sleep Duration And Hypertension Using Deep Learning Network: Analysis Of The National Health And Nutrition Examination Survey Data

Abstract Introduction Epidemiologic data show strong associations between self-reported sleep duration and hypertension (HTN). Modeling these associations is suboptimal when utilizing traditional logistic regressions. In this study, we modeled the associations of sleep duration and HTN using Deep Learning Network. Methods Data were extracted from participants (n=38,540) in the National Health and Nutrition Examination Survey (2006-2016), a nationally representative study of the US civilian non-institutionalized population. Self-reported demographic, medical history and sleep duration were determined from household interview questions. HTN was determined as SBP ≥ 130 mmHg and DBP ≥ 80 mmHg. We used a deep neural network architecture with three hidden layers with two input features and one binary output to model associations of sleep duration with HTN. The input features are the hours of sleep (limited to between 4 and 10 hours) and its square; and the output variable HTN. Probability predictions were generated 100 times from resampled (with replacement) data and averaged. Results Participants ranged from 18 to 85 years old; 51% Female, 41% white, 22% black, 26% Hispanic, 46% married, and 25% &amp;lt; high school. The model showed that sleeping 7 hours habitually was associated with the least observed HTN probabilities (P=0.023%). HTN probabilities increased as sleep duration decreased (6hrs=0.05%; 5hrs=0.110%; 4hrs=0.16%); HTN probabilities for long sleepers were: (8hrs=0.027; 9hrs=0.024; 10hrs=0.022). Whites showed sleeping 7hrs or 9hrs was associated with lowest HTN probabilities (0.008 vs. 0.005); blacks showed the lowest HTN probabilities associated with sleeping 8hrs (0.07), and Hispanics showed the lowest HTN probabilities sleeping 7hrs (0.04). Conclusion We found that sleeping 7 hours habitually confers the least amount of risk for HTN. Probability of HTN varies as a function of individual’s sex and race/ethnicity. Likewise, the finding that blacks experience the lowest HTN probability when they sleep habitually 8 hours is of great public health importance. Support This study was supported by funding from the NIH: R01MD007716, R01HL142066, R01AG056531, T32HL129953, K01HL135452, and K07AG052685.

Correlation of Serum Urea and Serum Creatinine in Diabetics patients and normal individuals

Diabetic Nephropathy in the long run leads to end Stage Renal Disease (ESRD). Serum Creatinine and Serum Urea are recognised as ideal markers to co-relate the progression of diabetic nephropathy. Diabetic Nephropathy is clinically diagnosed with decrease in Glomerular function rate (GFR), probability of hypertension, cardiovascular diseases and morbidity or mortality caused due to it. The early detection of an imbalance in the level of Urea and Creatinine levels can assist in the diagnosis and prevention of Diabetic Renal diseases and its progression. In this study, the period of the commencement of Diabetes and its severity is intensely correlated with an abnormal level of Urea but not so with that of Creatinine. While Creatinine is regarded as greater sensitive index of kidney function than Urea and hence this justifies as the requirement for a perfect filtration marker.

ДИАГНОСТИЧЕСКАЯ МОДЕЛЬ ВЫЯВЛЕНИЯ ВЫСОКОЙ ВЕРОЯТНОСТИ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ I СТЕПЕНИ У МУЖЧИН В ВОЗРАСТЕ 18-29 ЛЕТ

Aim: to develop a model for differential diagnosis of hypertension (HT) in men aged 18-29 years based on anamnestic data and instrumental indicators. Material and methods: Ambulatory blood pressure (BP) monitoring, heart rate variability analysis, exercise testing, echocardiography and detecting of pulse wave velocity were performed in 91 patients with high normal BP and 67 patients with HT. Results: Significant indicators of HT in men aged 18-29 years were: the type of hemodynamic response to exercise of diastolic BP (DBP) to exercise (OR 1.17 [1.05-1.30], p=0.004); indicators of autonomic support (AS) (OR 0.82 [0.70-0.96], p=0.016); relative left ventricle wall thickness (OR 1.04 [1.01-3.52], p=0.004); office systolic BP (SBP) (OR 1.1 [1.03-1.18], p=0.004). Conclusion: A diagnostic model for identifying patients aged 18-29 with a high probability of HT is proposed.

Association of hypertriglyceridemic waist-to-height ratio and its dynamic status with incident hypertension: the Rural Chinese Cohort Study.

We aimed to evaluate whether hypertriglyceridemic waist-to-height ratio (HWHtR) and its dynamic status was associated with hypertension (HTN). We examined data for 10 312 nonhypertensive participants aged at least 18 years from the Rural Chinese Cohort Study at the baseline examination who were followed until 2014 with a median follow-up of 6 years. HWHtR was defined by combined triglyceride level and waist-to-height ratio (WHtR). Multiple logistic regression models were used to examine the probability of incident HTN according to HWHtR and its transformation, estimating odds ratios (ORs) and 95% confidence intervals (CIs). A total of 127 men and 225 women with high triglyceride level and high WHtR (HTHWH) had incident HTN during follow-up. After adjusting for potential confounders, the probability of HTN was increased with HTHWH for men [OR 1.49 (95% CI 1.01-2.20)] but this association was not significant for women [1.21 (0.88-1.66)]. The results of the sensitivity analyses were robust for men and women. The ORs were generally consistent on subgroup analysis by age,BMI, SBP and DBP for men. As compared with persistent normal triglyceride level and normal WHtR (NTNWH), the transformation from baseline NTNWH to follow-up HTHWH was associated with increased probability of HTN for men [OR 4.16 (95% CI 2.21-7.84)]. However, for women, the association of changed HWHtR from baseline to follow-up with probability of HTN was not significant for almost all transformation groups. HWHtR and its dynamic status was associated with incident HTN for rural Chinese men. From this cohort study, HWHtR may be an indicator for interventions aiming to reduce HTN among these men.

P3560Prospects for the use of integrated assessment of gene-candidates polymorphisms in the management of arterial hypertension: let's start

Abstract Nowadays a large amount of data about the frequency of gene-candidates polymorphisms occurrence in patients with arterial hypertension (AH) have been accumulated. The using of single polymorphisms for diagnostic and prognostic purposes appeared to be not perspective. However multiple accumulation of gene-candidates polymorphisms in person is realized mostly in formation of AH. The purpose of the research was to compare the proportion of modified gene-candidates in a group of hypertensive patients with a similar group of non-hypertensive patients using the gene modification index (GMI) calculation for possible using in diagnostic and prevention of AH. Methods 180 patients with AH (age 54,2 [43–75], male/female 86/94) and 82 non-hypertensive patients (age 52,6 [42–71], male/female 38/44) were examined (ESC/ISH 2018). For comparative significance in the conducted research the patients under 40 years old were not included. Patients of both groups were perfomed the analysis of polymorphisms of the following candidate genes by PCR: ADD1:1378, AGT: 704, AGT: 521, AGTR1:1166, AGTR2: 1675, CYP11B2:-344, GNB3:825, NOS3:-786, NOS3:894. Then the GMI was formed where the proportion of “pathological” homozygous polymorphism of one gene was 1.5 points, the heterozygous polymorphism – 1 point, “normal” genotype – 0 points. Then points were summed up and formed the GMI as proportion of the “pathological” genotypes, expressed as a percentage. GMI is calculated by the formula: GMI = (N/13,5) × 100, where N is the sum of points of present genetic polymorphisms; N = n1 + n2 + n3 + n4 + n5 + n6 + n7 + n8 + n9; 13,5 – the maximum number of points of present genetic polymorphisms. The GMI from 0 to 20% was considered as low genetic risk, from 21 to 40% – moderate risk, from 41 to 70% – high risk, from 71 to 100% – very high risk. Results In hypertensive patients the low genetic risk was in 5% of cases, in the group of non-hypertensive patients - in 85.4% (p=0.0001); moderate genetic risk was observed in 22.2% of patients with AH and in 13.4% patients without AH (p=0.14); 52.2% of hypertensive patients and 1.2% of non-hypertensive patients had a high genetic risk (p=0.0001); a very high risk was in 20.6% of patients with AH and was absent in patients without AH (p=0.0001). The average mean of GMI in the group with AH was 64.2% [CI 95%, 30–78], in the group of non-hypertensive patients - 22% [CI 95%, 5–30], (p=0.0001). At the same time in GMI less than 25% there was no case of the presence of AH. Conclusions In the conducted research the representative data was obtained: the proportion of the modified gene-candidates significantly exceeded the proportion of the modified genes in non-hypertensive patients. It demonstratively shows the perspectivity of GMI using in the diagnostic and preventive management of patients with AH. GMI up to 25% mostly is not phenotypically realized and the probability of hypertension developing in these patients is extremely low.

Interaction between neighborhood walkability and traffic-related air pollution on hypertension and diabetes: The CANHEART cohort

BackgroundLiving in unwalkable neighborhoods has been associated with heightened risk for diabetes and hypertension. However, highly walkable environments may have higher concentrations of traffic-related air pollution, which may contribute to increased cardiovascular disease risk. We therefore aimed to assess how walkability and traffic-related air pollution jointly affect risk for hypertension and diabetes. MethodsWe used a cross-sectional, population-based sample of individuals aged 40–74 years residing in selected large urban centres in Ontario, Canada on January 1, 2008, assembled from administrative databases. Walkability and traffic-related air pollution (NO2) were assessed using validated tools and linked to individuals based on neighborhood of residence. Logistic regression was used to estimate adjusted associations between exposures and diagnoses of hypertension or diabetes accounting for potential confounders. ResultsOverall, 2,496,458 individuals were included in our analyses. Low walkability was associated with higher odds of hypertension (lowest vs. highest quintile OR = 1.34, 95% CI: 1.32, 1.37) and diabetes (lowest vs. highest quintile OR = 1.25, 95% CI: 1.22, 1.29), while NO2 exhibited similar trends (hypertension: OR = 1.09 per 10 p.p.b., 95% CI: 1.08, 1.10; diabetes: OR = 1.16, 95% CI: 1.14, 1.17). Significant interactions were identified between walkability and NO2 on risk for hypertension (p < 0.0001 and diabetes (p < 0.0001). At higher levels of pollution (40 p.p.b.), differences in the probability of hypertension (lowest vs. highest walkability quintile: 0.26 vs. 0.25) or diabetes (lowest vs. highest walkability quintile: 0.15 vs. 0.15) between highly walkable and unwalkable neighborhoods were diminished, compared to differences observed at lower levels of pollution (5 p.p.b.) (hypertension, lowest vs. highest walkability quintile: 0.21 vs. 0.13; diabetes, lowest vs. highest walkability quintile: 0.09 vs. 0.06). ConclusionsWalkability and traffic-related air pollution interact to jointly predict risk for hypertension and diabetes. Although walkable neighborhoods appear to have beneficial effects, they may accentuate the harmful effects of air pollution on cardiovascular risk factors.

PKD2-Related Autosomal Dominant Polycystic Kidney Disease: Prevalence, Clinical Presentation, Mutation Spectrum, and Prognosis

PKD2-related autosomal dominant polycystic kidney disease (ADPKD) is widely acknowledged to be of milder severity than PKD1-related disease, but population-based studies depicting the exact burden of the disease are lacking. We aimed to revisit PKD2 prevalence, clinical presentation, mutation spectrum, and prognosis through the Genkyst cohort. Case series, January 2010 to March2016. Genkyst study participants are individuals older than 18 years from 22 nephrology centers from western France with a diagnosis of ADPKD based on Pei criteria or at least 10 bilateral kidney cysts in the absence of a familial history. Publicly available whole-exome sequencing data from the ExAC database were used to provide an estimate of the genetic prevalence of the disease. Molecular analysis of PKD1 and PKD2 genes. Renal survival, age- and sex-adjusted estimated glomerular filtration rate. The Genkyst cohort included 293 patients with PKD2 mutations (203 pedigrees). PKD2 patients with a nephrology follow-up corresponded to 0.63 (95% CI, 0.54-0.72)/10,000 in Brittany, while PKD2 genetic prevalence was calculated at 1.64 (95% CI, 1.10-3.51)/10,000 inhabitants in the European population. Median age at diagnosis was 42 years. Flank pain was reported in 38.9%; macroscopic hematuria, in 31.1%; and cyst infections, in 15.3% of patients. At age 60 years, the cumulative probability of end-stage renal disease (ESRD) was 9.8% (95% CI, 5.2%-14.4%), whereas the probability of hypertension was 75.2% (95% CI, 68.5%-81.9%). Although there was no sex influence on renal survival, men had lower kidney function than women. Nontruncating mutations (n=36) were associated with higher age-adjusted estimated glomerular filtration rates. Among the 18 patients with more severe outcomes (ESRD before age 60), 44% had associated conditions or nephropathies likely to account for the early progression to ESRD. Younger patients and patients presenting with milder forms of PKD2-related disease may not be diagnosed or referred to nephrology centers. Patients with PKD2-related ADPKD typically present with mild disease. In case of accelerated degradation of kidney function, a concomitant nephropathy should be ruled out.

Incidence and risk of hypertension associated with vascular endothelial growth factor receptor tyrosine kinase inhibitors in cancer patients: a comprehensive network meta-analysis of 72 randomized controlled trials involving 30013 patients.

BackgroundTyrosine kinase inhibitors (TKIs) have been developed during the last decade that target the vascular endothelial growth factor receptor (VEGFR) are currently being evaluated as treatments for malignant tumors. The increased application of VEGFR-TKIs means that the probability of hypertension is a serious concern. However, the reported incidence varies markedly between clinical trials. Here, we undertook an up-to-date, comprehensive meta-analysis on clinical works to build the incidence of hypertension along with VEGFR-TKIs. The goal was to understand better of the overall venture of cancer patients’ hypertension treated with these drugs.MethodsDatabases (EMBASE, PubMed, and Cochrane library) and the abstracts of the American Society of Clinical Oncology annual meeting and European Society of Medical Oncology were searched to identify related studies. 95% confidence intervals (CIs), summary incidences, and relative risk (RR) were calculated utilizing either fixed-effects models on the basis of the heterogeneity of the included studies or random-effects.ResultsSeventy-two randomized controlled trials (including 30013 patients) were involved. The total incidence of high-grade and all-grade hypertensive events along with VEGFR-TKIs was 23.0% (95% CI, 20.1–26.0%) and 4.4% (95% CI, 3.7–5.0%), respectively. The use of VEGFR-TKIs remarkably enhanced the venture of developing high-grade (RR, 4.60; 95% CI, 3.92–5.40; P < 0.001) and all-grade (RR, 3.85; 95% CI, 3.37–4.40; P < 0.001) hypertensive events. Subgroup analyses revealed that the risk of a hypertensive event varied significantly in accordance with tumor type, VEGFR-TKI, trial phase, VEGFR-TKIs-based regimen, control therapy, and chemotherapy regimen.ConclusionsPatients with cancer that receive VEGFR-TKIs are at a remarkable venture of developing hypertension. Therefore, suitable treatment and monitoring should be introduced to avoid cardiovascular complications.

Calcium intake and hypertension among obese adults in United States: associations and implications explored.

The relationship between calcium intake and hypertension is receiving increased research attention. The prevalence of hypertension is high among the obese populations. Calcium is a mineral that influences blood pressure. The aim of the study was to examine the association between calcium intake and hypertension in a large nationally representative sample of obese American adults. A total of 14,408 obese adults aged 20 years or older were obtained from the 1999-2010 National Health and Nutrition Examination Survey. Analysis of variance and linear regression models were used to examine relationships between calcium intake and systolic blood pressure (SBP) as well as diastolic blood pressure (DBP). Multiple logistic regression models were used to examine the association between calcium intake and hypertension after adjusting for potential confounders and interactions, including: age, race, education level, alcohol use, smoking, diabetes status, sodium intake and potassium intake. Calcium intake was significantly lower for the hypertensive group compared with the normotensive group (P<0.0001), especially among those obese female young adults aged 20-44 years and among non-diabetic obese adults. Based on ordinary linear regression analysis, a significant inverse relationship was detected, SBP and DBP decreased if calcium intake increased (SBP: regression coefficient estimate=-0.015, P<0.0001; DBP: regression coefficient estimate=-0.028, P<0.0001). Multiple logistic regression showed that calcium intake was negatively associated with the probability of hypertension (odds ratio (OR)=0.81, 95% confidence interval (CI): 0.74-0.87, P<0.0001). In stratified analysis, calcium intake in youngest adults (age 20-44 years) had the lowest likelihood of hypertension (OR=0.77, 95% CI: 0.64-0.93, P<0.0001), the inverse relationship between calcium intake and probability of hypertension was stronger among females (OR: 0.68, 95% CI: 0.55-0.84, P<0.0001), when compared with the whole sample including all of 14,408 obese adults. The protective effect of calcium intake and hypertension was found significantly in obese non-diabetic adults (OR: OR=0.77, 95% CI: 0.67-0.89, P<0.0001) not in obese diabetic adults. SBP, DBP and calcium intake were log transformed for both ordinary linear regression analysis and logistic regression analysis. Our study findings underscore the need to explore the physiological mechanism between calcium intake and hypertension. In this study, increased calcium intake was associated with the lowest risk of hypertension. Future studies utilizing longitudinal research designs are needed to quantify therapeutic levels of calcium for control of hypertension among obese adults. Increasing calcium intake among American adults may offer promise as a cost-effective strategy to improve hypertension among obese adults; however, further scientific exploration is warranted.