High Blood Pressure Rate Research Articles

Status of elevated blood pressure among Chinese children and adolescents aged 7-17 from 2016 to 2017 according to 4 different references

To describe and analysis the detection rate of high normal blood pressure and high blood pressure among Chinese children and adolescents aged 7-17 years from 2016 to 2017 according to the clinical practice guideline for screening and management of high blood pressure in Children and Adolescents published by the American Academy of Pediatrics(the AAP reference), the international blood pressure references among Children and Adolescents aged 6 to 17 years(the international reference), health industry standard of the People's Republic of China "Reference of screening for elevated blood pressure among children and adolescents aged 7 to 18 years(WS/T 610-2018)"(the industry reference) and updating blood pressure references for Chinese children aged 3 to 17 years(the guideline reference). Data was from the China Nutrition and Health Surveillance of Children and Lactating Women(2016-2017), in which the multistage stratified whole group random sampling method was used to draw participants from 275 surveillance sites in 31 provinces(autonomous regions and municipalities). In total, 67 231 participants were included according to the inclusion and exclusion criteria. Blood pressure was measured three times by trained staff using a validated oscillometric blood pressure monitor at the same point. The average blood pressure was calculated for the three measurements for SBP and DBP. To match the sampling design methodology, all values were weighted to represent the total population of Chinese children and adolescents 7-17 years of age considering sampling weights for each stratification based on the sixth population census data provided by the National Bureau of Statistics. The detection rate varied greatly under different references. The detection rate of high normal blood pressure was ranked from high to low according to the AAP reference(20.15%) > the guideline reference(17.29%) > the industry reference(13.14%) > the international reference(12.66%); the detection rate of high blood pressure in descending order is the guideline reference(24.31%) > the international reference(21.34%) > the AAP reference(20.59%) > the industry reference(19.96%). Although the consistency between the AAP references and international references and our national two references were medium to high, the difference in detection rate obtained by analysis was large. Considering the differences of demographic characteristics in the reference population, caution should be taken when applying foreign references to judge the blood pressure status of children and adolescents in China.

Illness perceptions and blood pressure control among hypertensive Filipino Americans: A cross-sectional study.

Among Asian Americans, Filipino Americans (FAs)-who constitute the fourth largest US immigrant group and who fill in health care workforce shortages-experience high prevalence but low control rates of high blood pressure (HBP). Research reveals that patients' illness perceptions, their common-sense model (CSM) of the illness, influence treatment behaviors, and management outcomes. However, scarce information exists about FAs' perceptions about HBP. To address this gap, we conducted a cross-sectional study to (a) identify the illness perceptions of hypertensive FAs, (b) classify these perceptions into clusters, and (c) determine the association between illness perceptions and BP control. The responses of 248 FAs with HBP to the Brief Illness Perception Questionnaire were analyzed using JMP Pro version 17 to discover their CSMs or illness perceptions. We used iterative K means cluster analysis to classify variations in CSMs and analysis of means chart to determine the association of illness perceptions and BP control. Hypertensive FAs expressed threatening (negative) views of HBP through their emotional perceptions of the illness and its chronic time line, whereas their positive views centered on their cognitive beliefs about understanding HBP and its controllability. Based on the biomedical model of HBP, the overall illness perceptions or CSMs encompassed three clusters. Generally, threatening illness perceptions were associated with stage 2 HBP. The findings underscore the need for nurse practitioners to elicit, listen, discern, and understand the illness perceptions or CSMs of hypertensive FAs to improve BP treatment and control with scientifically and culturally tailored interventions.

Prospective Association Between Video and Computer Game Use During Adolescence and Incidence of Metabolic Health Risks: Secondary Data Analysis.

Video and computer games are popular activities, with 72% of adolescents aged 13 to 17 years reporting video game use on either a computer, game console, or portable device. Despite high levels of video and computer game use in adolescence, relatively little scientific literature exists examining the association and effects of video and computer games on adolescents. The objective of this study was to examine the prevalence of video and computer game use among US adolescents and rates of positive screens for obesity, diabetes, high blood pressure (BP), and high cholesterol. A secondary data analysis was conducted using the National Longitudinal Study of Adolescent to Adult Health (Add Health) data, including adolescents aged 12 to 19 years between 1994 and 2018. Respondents (n=4190) who played the most video and computer games had a significantly (P=.02) higher BMI and were more likely to self-report having at least one of the evaluated metabolic disorders: obesity (BMI >30 kg/m2), diabetes, high BP (BP >140/90), and high cholesterol (>240). With increased video or computer game use, there was a statistically significant increase in high BP rates in each quartile, with those with more frequent use also having higher rates of high BP. A similar trend was observed for diabetes, though the association did not reach statistical significance. No significant association was observed between video or computer game use and diagnoses of dyslipidemia, eating disorders, or depression. Frequency of video and computer game use is associated with obesity, diabetes, high BP, and high cholesterol in adolescents aged 12 to 19 years. Adolescents who play the most video and computer games have a significantly higher BMI. They are more likely to have at least one of the evaluated metabolic disorders: diabetes, high BP, or high cholesterol. Public health interventions designed to target modifiable disease states through health promotion and self-management may support the health of adolescents aged 12 to 19 years. Video and computer games can integrate health promotion interventions in gameplay. This is an important area for future research as video and computer games are integrated into the lives of adolescents.

Cutoff values of body mass index for severe obesity in Korean children and adolescents: the 99th percentile versus 120% of the 95th percentile.

Several definitions for severe obesity have been used, primarily the 99th percentile of the body mass index (BMI) and 120% of the 95th BMI percentile. This study aimed to establish a standardized definition for severe obesity in children and adolescents in Korea. The 99th BMI percentile line and 120% of the 95th BMI percentile line were constructed using 2017 Korean National Growth Charts. To compare these 2 cutoff points for severe obesity, we included 9,984 individuals (5,289 males and 4,695 females) aged 10-18 years with anthropometric data available from the Korean National Health and Nutrition Examination Survey 2007-2018. Although 120% of the 95th percentile of BMI is widely used as a definition of severe obesity, the 99th percentile is almost identical to 110% of the 95th percentile in Korea, according to the latest national BMI growth chart for children and adolescents. The prevalence rates of high blood pressure, high triglycerides, low high-density lipoprotein cholesterol, and high alanine aminotransferase in the participants whose BMI was ≥120% of the 95th percentile were higher than in those whose BMI was ≥99th percentile (P<0.001). A cutoff value for severe obesity of ≥120% of the 95th percentile is appropriate in children and adolescents in Korea. To provide follow-up care for severely obese children and adolescents, it is necessary to add a new line at 120% of the 95th percentile to the national BMI growth chart.

Impact of the 2017 AAP clinical guideline on the prevalence of high blood pressure among adolescents in Lagos, Nigeria.

Adolescent high blood pressure (HBP) can lead to several end-organ complications if it continues into adulthood. The 2017 AAP Guideline has lower blood pressure cut-off points and consequently leads to the identification of more people with high blood pressure. This study evaluated the impact of the 2017 American Academy of Pediatrics (AAP) Clinical Guideline on the prevalence of high blood pressure among adolescents when compared to the 2004 Fourth Report. A descriptive cross-sectional study was conducted from August 2020 to December 2020. The selection of 1,490 students, 10-19 years old, was by a two-stage sampling technique. Socio-demographic information and relevant clinical data were obtained using a structured questionnaire. Blood pressure was measured according to standard protocol. Categorical and numerical variables were summarized using frequency, percentages, mean, and standard deviation. The McNemar-Bowker test of symmetry was used to compare the blood pressure values in the 2004 Fourth Report and the 2017 AAP Clinical Guideline. The Kappa statistic was used to test for the degree of agreement between the 2004 Fourth Report and the 2017 AAP Clinical Guideline. The prevalence rates of high blood pressure, elevated blood pressure, and hypertension among adolescents were 26.7%, 13.8%, and 12.9%, respectively, using the 2017 AAP Clinical Guideline, and 14.5%, 6.1%, and 8.4%, respectively, using the 2004 Fourth Report. The degree of agreement between the 2004 and 2017 guidelines with respect to the classification of blood pressure was 84.8%. The Kappa statistic was 0.71 (CI: 0.67-0.75). The impact of this was a 12.2%, 7.7%, and 4.5% increase in the prevalence of high blood pressure, elevated blood pressure, and hypertension, respectively, using the 2017 AAP Clinical Guideline. The 2017 AAP Clinical Guideline detects a greater proportion of high blood pressure among adolescents. The adoption of this new guideline in clinical practice and its use in the routine screening of high blood pressure among adolescents is recommended.

The mechanism of chronic unpredictable mild stress induced high blood pressure in rats: a proteomic and targeted metabolomic analysis.

Chronic stress, a leading factor for high blood pressure (BP) and even hypertension, affects health quality seriously. However, the management is rather difficult in our rapidly developing modern society, and the underlying mechanism that caused hypertension remains incompletely understood. In this study, we established a rat model of high BP induced by chronic unpredictable mild stress (CUMS). The results showed that CUMS increased the BP and heart rate, as well as the concentrations of CORT, NA, and ACTH. Based on tandem mass tag (TMT)-labeled proteomics, 13 proteins changed in RVLM. Then, targeted metabolomics together with real-time qPCR were applied to validate the levels of the biomolecules quantitatively. The related molecules were confirmed to reveal that CUMS has a great role in the upregulation of muscle contraction, synthesis of cAMP and transport of metals, while down-regulating ralaxin signaling. This finding facilitates a better understanding of the mechanism of hypertension induced by chronic stress and could provide an insight into the prevention and treatment of hypertension.

Perirenal adipose afferent nerves sustain pathological high blood pressure in rats

Hypertension is a pathological condition of persistent high blood pressure (BP) of which the underlying neural mechanisms remain obscure. Here, we show that the afferent nerves in perirenal adipose tissue (PRAT) contribute to maintain pathological high BP, without affecting physiological BP. Bilateral PRAT ablation or denervation leads to a long-term reduction of high BP in spontaneous hypertensive rats (SHR), but has no effect on normal BP in control rats. Further, gain- and loss-of-function and neuron transcriptomics studies show that augmented activities and remodeling of L1-L2 dorsal root ganglia neurons are responsible for hypertension in SHR. Moreover, we went on to show that calcitonin gene-related peptide (CGRP) is a key endogenous suppressor of hypertension that is sequestered by pro-hypertensive PRAT in SHRs. Taken together, we identify PRAT afferent nerves as a pro-hypertensive node that sustains high BP via suppressing CGRP, thereby providing a therapeutic target to tackle primary hypertension.

New-Onset Diabetes after Transplantation (NODAT) in Renal Transplant Recipients, A Retrospective Single Centre Study

Objective: New onset diabetes after transplant (NODAT) is a known post-transplant complication contributing to morbidity and mortality. This study was aimed to find out the frequency of NODAT in kidney disease patients after one year. Methods and subjects: The study was conducted retrospectively on 275 Asian patients who underwent kidney transplant. The demographic and clinical data was evaluated at the time, as well as 3, 6, and 12 months after kidney transplant. The etiology of end-stage renal disease (ESRD) or comorbidities was also documented. Every patient received a combination of Tacrolimus (Tac), Mycophenolate Mofetil (MMF), and Prednisone (Pred) as post-transplant immunosuppression. Patients who developed NODAT were compared with those who did not. RESULTS: One year after the transplantation, the incidence of NODAT was 4.3 percent. Patients diagnosed with NODAT were older (p = 0.001) and had renal failure owing to Chronic glomerulonephritis with hypertension (p = 0.001), according to the results of the univariate analysis. The NODAT group had significantly greater rates of high blood pressure after transplantation (p = 0.01), heart failure (p = 0.02), and dyslipidemia (p = 0.001) than the other groups. Through the use of logistic regression, it was shown that high blood pressure after transplant, and dyslipidemia are all independently linked with NODAT. Conclusion: Asian patients who had high blood pressure and dyslipidemia had a higher incidence of NODAT compared to those who did not have. Keywords: kidney transplantation, prevalence, new-onset diabetes after trasplant

A CLOSE POSITIVE ASSOCIATION BETWEEN OBESITY AND BLOOD PRESSURE IN RATS

The purpose of this study was to analyze how the effect of each increase in Body Mass Index (BMI) on the increase in blood pressure (BP). The research design was a laboratory experiment with 52 non-obese and obese rats as subjects (non-obese, n=14 and obese, n=38). Rats were induced obesity using a high-fat diet for four weeks. BMI used is based on the Lee Index with obesity indicators if 300 g/cm. Data analysis using independent sample t-test, simple linear regression test, and Pearson correlation test; (p0.05). The results: BP in non-obese rats was lower than obese rats (89.00±7.38 vs 190.11±4.42; p=0.001*), BMI was positively associated with BP (p=0.001*); an increase in BMI will increase BP (p=0.001*), there is a strong correlation between BMI and BP (r=0.977; p=0.001*). The regression equation (Y = 707.42 + 2.75 X) indicates that every 1 g/cm increase in BMI will be followed by an increase in BP of 2.75 mmHg. The analysis of R-square = 0.942 shows that the accuracy of the linear equation model is 94.2%. In conclusion, BMI has a strong positive correlation with BP, an increase in BMI will increase BP; obesity induces high blood pressure in rats.

Preventive Potential of the Aqueous Extract of the Mixture of Bidens pilosa (Asteraceae) and Cymbopogon citratus (Poaceae) Aerial Parts on Hypertension Induced by a Chronic Salt and Alcohol Consumption on the Rats.

High blood pressure (HBP) is currently one of the main risk factors for cardiovascular and kidney diseases. Nowadays, populations make extensive use of alternative medicine for their health problems. Bidens pilosa (B. pilosa) and Cymbopogon citratus (C. citratus) are used individually in the traditional treatment of cardiovascular disorders. This study assessed the effects of the mixture of these two plants aqueous extract on HBP in rats. Male rats (42) were divided into 7 groups of 6 rats each. Normotensive rats received only distilled water and formed group 1. The other animals received ethanol + salt preceded by distilled water (10 mL/kg; group 2) and spironolactone (10 mg/kg; group 3); the aqueous extracts of the mixture (100 and 200 mg/kg; groups 4 and 5) isolated plants B. pilosa (200 mg/kg; group 6) and C. citratus (200 mg/kg; group 7). Animals were treated for 7 weeks during which water consumption and urine volume were assessed; then, hemodynamic parameters were recorded, and rats were sacrificed. Serum and some organs (liver, kidney, heart, and aorta) were used to evaluate biochemical parameters. Ingestion of ethanol + salt leads to a significant increase in urinary volume and water intake that were significantly prevented by the extracts from the mixture and isolated plants. Ethanol + salt solution significantly increased the blood pressure, heart rate, triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-chol), very-low-density lipoprotein cholesterol (VLDL-chol), atherogenic indices, liver and kidney function parameters, and malondialdehyde (MDA) levels. However, the levels of high-density lipoprotein cholesterol (HDL-chol), albumin, reduced glutathione (GSH), catalase, and superoxide dismutase (SOD) activity were significantly reduced. The extracts of the mixture and isolated plants significantly prevented all these variations with a more pronounced action for the lowest dose of the mixture on the lipid profile, oxidative stress, and kidney function. These observations confirm the beneficial effects of B. pilosa and C. citratus to manage hypertension.

Prevalence and correlation of vitamin D deficiency and high blood pressure in primary and middle school students in Chongqing

Objective To understand the status of vitamin D deficiency and high blood pressure in primary and middle school students aged 7 to 17 years old in Chongqing, and to explore the correlation between vitamin D deficiency and high blood pressure in children and adolescents. Methods From 2016 to 2017, a total of 1 360 primary and middle school students, aged 7 to 17 years old, were selected from three rural and three urban sites in Chongqing using multi-stage stratified random sampling. This study carried out a questionnaire survey, and participants underwent a physical examination which included blood pressure and serum vitamin D assessments. Results The deficiency and insufficiency rates of vitamin D were 9.71%, and 62.57%, respectively. The high blood pressure rate was 25.88%. Multivariate Logistic regression analysis showed that after adjusting for age, economic status, waist circumference, BMI classification, and family history of hypertension, the risk of hypertension was 1.42 times that of the normal group ( P<0.05), and the risk of high systolic blood pressure was 1.59 times that of the normal group ( P<0.05). Conclusion The deficiency and insufficiency rate of vitamin D among children and adolescents aged 7 to 17 years old in Chongqing was high, and the phenomenon of high blood pressure was prominent. Students with vitamin D deficiency and insufficiency were more likely to have high blood pressure. 【摘要】 目的 了解重庆市中小学生维生素 D 缺乏和血压偏高现况及其相关性, 为有针对性防治儿童高血压的发生发展 提供参考依据。 方法 2016 年 10 月至 2017 年 1 月, 通过多阶段分层随机抽样在重庆市选择 3 个农村点和 3 个城市点共 1 360 名 7~17 岁中小学生, 开展问卷调查、体格测量、血压测量和血清维生素 D 检测。 结果 中小学生维生素D缺乏率为 9.71%, 不足率为 62.57%; 血压偏高率为 25.88%。多因素 Logistic 回归分析结果显示, 调整了年龄、经济状况、腰围和体质 量指数 (BMI) 分类、高血压家族史等因素后, 维生素 D 缺乏和不足组发生高血压的风险是正常组的 1.42倍, 收缩压偏高的 风险是正常组的 1.59倍 ( P 值均<0.05)。 结论 重庆市中小学生维生素 D 缺乏和不足、血压偏高现象较突出, 需引起关 注。维生素 D 不足和缺乏者较容易出现血压偏高。

Frequency of Detection of the Main Risk Factors for Cardiovascular Events Among Servicemen

Frequency of Detection of the Main Risk Factors for Cardiovascular Events Among Servicemen

Butterfly Pea Flower (Clitoria ternatea Linn.) Extract Ameliorates Cardiovascular Dysfunction and Oxidative Stress in Nitric Oxide-Deficient Hypertensive Rats.

In this study, we examine whether Clitoria ternatea Linn. (CT) can prevent Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME)-induced cardiac and vascular dysfunction in rats. Male Sprague Dawley rats were given L-NAME (40 mg/kg, drinking water) and orally administered with CT extract (300 mg/kg/day) or lisinopril (2.5 mg/kg/day) for 5 weeks. The main phytochemical components of the CT extract were found to be flavonoids. The CT extract alleviated the high blood pressure in rats receiving L-NAME. Decreased vasorelaxation responses to acetylcholine and enhanced contractile responses to sympathetic nerve stimulation in aortic rings and mesenteric vascular beds of L-NAME treated rats were ameliorated by CT extract supplementation. Left ventricular hypertrophy and dysfunction were developed in L-NAME rats, which were partially prevented by CT extract treatment. The CT extract alleviated upregulated endothelial nitric oxide synthase expression, decreased plasma nitrate/nitrite levels, and increased oxidative stress in L-NAME rats. It suppressed high levels of serum angiotensin-converting enzyme activity, plasma angiotensin II, and cardiac angiotensin II type 1 receptor, NADPH oxidases 2, nuclear factor-kappa B, and tumor necrosis factor-alpha expression. The CT extract, therefore, partially prevented L-NAME-induced hypertension and cardiovascular alterations in rats. These effects might be related to a reduction in the oxidative stress and renin–angiotensin system activation due to L-NAME in rats.

Red ginger-extract nanoemulsion modulates high blood pressure in rats by regulating angiotensin-converting enzyme production.

Background and Aim:Red ginger (RG) has reportedly been used in folk medicine for the management and prevention of hypertension. One of the hypertension study models in experimental animals is the unilateral ureteral obstruction (UUO). This study aimed at evaluating the effect of RG-extract (RGE) nanoemulsion on UUO-induced hypertension and angiotensin-converting enzyme (ACE) production in rats.Materials and Methods:RG was extracted using ethanol, combined with virgin coconut oil, polysorbate 80, and polyethylene glycol 400 to form the oil phase. The particle sizes of RGE nanoemulsions were analyzed using a particle size analyzer. The UUO method was used to induce chronic kidney disease in rats (504 mg/200 g and 360 mg/200 g b/w per oral for 7 days). The systolic and diastolic blood pressure was determined non-invasively in conscious state by tail plethysmography using an automated blood pressure monitor. ACE in serum was measured using enzyme-linked immunosorbent assay.Results:The RGE nanoemulsions exhibited a particle size of32.8 nm and a polydispersity index (PI) of 0.268, indicating a homogenous nanoemulsion. UUO rats treated with RGE nanoemulsion (360 mg/200 g b/w) experienced a significant decrease in both their systolic blood pressure (p<0.05) from 142±1 mmHg to 107±6 mmHg and their diastolic blood pressure from 106±1 mmHg to 84±4 mmHg. Furthermore, treatment with RGE resulted in a 10.80% decrease in the level of ACE.Conclusion:The size and the PI of the RGE used in this study suggest a stable and effective distribution of the particle size in the emulsions. RGE nanoemulsions at the dose of 360 mg/200 g bw can be used as potential ACE inhibitors because they were found to decrease the blood pressure of hypertensive UUO rats.

The Demographic Representativeness and Health Outcomes of Digital Health Station Users: Longitudinal Study.

BackgroundDigital health stations offer an affordable and accessible platform for people to monitor their health; however, there is limited information regarding the demographic profile of users and the health benefits of this technology.ObjectiveThis study aimed to assess the demographic representativeness of health station users, identify the factors associated with repeat utilization of stations, and determine if the health status of repeat users changed between baseline and final health check.MethodsData from 180,442 health station users in Australia, including 8441 repeat users, were compared with 2014-2015 Australian National Health Survey (NHS) participants on key demographic and health characteristics. Binary logistic regression analyses were used to compare demographic and health characteristics of repeat and one-time users. Baseline and final health checks of repeat users were compared using McNemar tests and Wilcoxon signed rank tests. The relationship between the number of checks and final health scores was investigated using generalized linear models.ResultsThe demographic profile of SiSU health station users differs from that of the general population. A larger proportion of SiSU users were female (100,814/180,442, 55.87% vs 7807/15,393, 50.72%), younger (86,387/180,442, 47.88% vs 5309/15,393, 34.49% aged less than 35 years), and socioeconomically advantaged (64,388/180,442, 35.68% vs 3117/15,393, 20.25%). Compared with NHS participants, a smaller proportion of SiSU health station users were overweight or obese, were smokers, had high blood pressure (BP), or had diabetes. When data were weighted for demographic differences, only rates of high BP were found to be lower for SiSU users compared with the NHS participants (odds ratio [OR] 1.26; P<.001). Repeat users were more likely to be female (OR 1.37; P<.001), younger (OR 0.99; P<.001), and from high socioeconomic status areas—those residing in socioeconomic index for areas quintiles 4 and 5 were significantly more likely to be repeat users compared with those residing in quintile 1 (OR 1.243; P<.001 and OR 1.151; P<.001, respectively). Repeat users were more likely to have a higher BMI (OR 1.02; P<.001), high BP (OR 1.15; P<.001), and less likely to be smokers (OR 0.77; P<.001). Significant improvements in health status were observed for repeat users. Mean BMI decreased by 0.97 kg/m2 from baseline to final check (z=−14.24; P<.001), whereas the proportion of people with high BP decreased from 15.77% (1080/6848) to 12.90% (885/6860; χ21=38.2; P<.001). The proportion of smokers decreased from 11.91% (1005/8438) to 10.13% (853/8421; χ21=48.4; P<.001). Number of repeat health checks was significantly associated with smoking status (OR 0.96; P<.048) but not with higher BP (P=.14) or BMI (P=.23).ConclusionsThese findings provide valuable insight into the benefits of health stations for self-monitoring and partially support previous research regarding the effect of demographics and health status on self-management of health.

Minimal Setting Stroke Unit in a Sub-Saharan African Public Hospital

Introduction: Sub-Saharan Africa (SSA) has the highest stroke prevalence along with a case fatality that amounts to 40%. We aimed to assess the effect of a minimal setting stroke unit in SSA Public hospital on stroke mortality and main medical complications.Materials and Methods: The study was set in Conakry, Guinea, Ignace Deen public referral hospital. Clinical characteristics, hospital mortality and main medical stroke complications rates (pneumonia, urinary tract infections, sores and venous thromboembolism) of admitted stroke patients after the installation of a minimal stroke unit equipped with heart rate, blood pressure and blood oxygen saturation monitoring and portable oxygen concentrator (POST) were compared to a similar number of stroke patients admitted before the stroke unit creation (PRE).Results: PRE (n = 318) and POST (n = 361) stroke, patients were comparable in term of age (61 ± 14 vs. 60 ± 14.8 years, p = 0.24), sex (56 vs. 50% males, p = 0.09), High blood pressure rate (76.7 vs. 79%, p = 0.44), stroke subtype (ischemic in 72 vs. 78% of cases, p = 0.05) and NIHSS (11 ± 4 vs. 11 ± 4, p = 0.85). Diabetes was more frequent in the PRE group (19 vs. 9%, p < 0.001). Mortality was significantly lower in the POST group (7.2 vs. 22.3%, p < 0.0001) as well as medical complications (4.1 vs. 27.7%, p < 0.001) and lower pneumonia rate (3.3 vs. 14.5%, p < 0.001).Conclusions: Minimally equipped stroke units significantly reduce stroke mortality and main medical complications in SSA.

China's Health Expenditure Projections To 2035: Future Trajectory And The Estimated Impact Of Reforms.

To understand the future trajectory of health expenditure in China if current trends continue and the estimated impact of reforms, this study projected health expenditure by disease and function from 2015 to 2035. Current health expenditure in China is projected to grow 8.4percent annually, on average, in that period. The growth will mainly be driven by rapid increases in services per case of disease and unit cost, which respectively contribute 4.3 and 2.4 percentage points. Circulatory disease expenditure is projected to increase to 23.4percent of health expenditure by 2035. The biggest challenge facing the Chinese health system is the projected rapid growth in inpatient services. Three percent of gross domestic product could be saved by 2035 by slowing the growth of inpatient service use from 8.2percent per year in 2016 to 3.5percent per year in 2035. Health expenditure in 2035 could be reduced by 3.5percent if the smoking rate were cut in half and by 3.4percent if the high blood pressure rate were cut by 25percent. Future action in controlling health expenditure growth in China should focus on the high growth in inpatient services expenditure and interventions to reduce risk factors.

A randomized controlled trial of 24weeks of varenicline for tobacco use among cancer patients: Efficacy, safety, and adherence.

Continuing to smoke after a cancer diagnosis undermines prognosis. Yet few trials have tested Food and Drug Administration (FDA)-approved tobacco use medications in this population. Extended use varenicline may represent an effective treatment for cancer patients who smoke given barriers to cessation including a prolonged time line for relapse. A placebo-controlled randomized trial tested 12weeks of varenicline plus 12weeks of placebo (standard [ST]) vs 24weeks of varenicline (extended [ET]) with seven counseling sessions for treatment-seeking cancer patients who smoke (N=207). Primary outcomes were 7-day biochemically confirmed abstinence at weeks 24 and 52. Treatment adherence and side effects, adverse and serious adverse events, and blood pressure were assessed. Point prevalence and continuous abstinence quit rates at weeks 24 and 52 were not significantly different across treatment arms (P's>0.05). Adherence (43% of sample) significantly interacted with treatment arm for week 24 point prevalence (odds ratio [OR]=2.31; 95% confidence interval [CI], 1.15-4.63; P=0.02) and continuous (OR=5.82; 95% CI, 2.66-12.71; P<0.001) abstinence. For both outcomes, adherent participants who received ET reported higher abstinence (60.5% and 44.2%) vs ST (44.7% and 27.7%), but differences in quit rates between arms were not significant for nonadherent participants (ET: 9.7% and 4.8%; ST: 12.7% and 10.9%). There were no significant differences between treatment arms on side effects, adverse and serious adverse events, and rates of high blood pressure (P's>0.05). Compared with ST, ET varenicline does not increase patient risk and increases smoking cessation rates among patients who adhere to treatment. Studies are needed to identify effective methods to increase medication adherence to treat patient tobacco use effectively.

PREVALENCE OF HYPERTENSION AND ITS ASSOCIATION WITH VITAL STATICS OF ADULTS AMONG URBAN, SEMIURBAN, RURAL AREAS OF UTTARAKHAND

Objective: India is in the affirmed phase of evolution and transition, demographic, economic, epidemiological, and nutrition transition. Moreover, all these transitions are leading non-communicable diseases such as obesity, hypertension, and insulin resistance. The study was aimed to estimate the prevalence of hypertension and its association with vital statics of adults among urban, semiurban, rural areas of Sub-Himalayan Region.Methods: A cross sectional community based study was done, using WHO step questionnaire. A survey was conducted in urban, semi urban, Rural areas of Uttrakhand, to make a sample size of 300 adults (18-45yr), 100 from each zone. Blood pressure and body mass index (BMI) of the participants was calculated. p&lt;0.05 was considered statistically significant.Results: In the sample population based on systolic BP, 61.3% were non-hypertensives, 29.7% were pre-hypertensives, and 9% were hypertensives. Based on diastolic BP, 43.3% were non-hypertensives, 32.7% were pre-hypertensives, and 24% were hypertensives. Participants with hypertension and pre-hypertension have higher BMI and waist circumference.Conclusion: A high prevalence rate of pre-hypertension and hypertension was depicted in urban, semiurban, and rural areas of the sub-Himalayan region. 4.8% of the female participants had systolic high blood pressure compared to the 11.9% of the male participants. On the other hand, 21.8% of the female participants had diastolic high blood pressure compared to the over 25% of the male participants. Dehradun has the highest rates of high blood pressure while Rudraprayag has the lowest. BMI was significantly correlated with systolic BP in Dehradun adults (p&lt;0.05). Diastolic BP was significantly positively correlated with age and BMI in Dehradun adults (p&lt;0.05). Age was positively significantly correlated with pulse rate in Dehradun and Uttarkashi adults (p&lt;0.05). In Rudraprayag adults, weight was significantly positively correlated with both systolic and diastolic BP (p&lt;0.05). No other correlations were seen in anthropometry and vital statistics of Rudraprayag or Uttarkashi adults (p&gt;0.05).

Prevalence of high blood pressure among schoolchildren from Córdoba, Argentina, and its relation to socioeconomic status.

Prior studies conducted in Argentina found variable prevalence rates of high blood pressure (HBP) among children using different measurement methods. The objective of this study was to know the prevalence of HBP among schoolchildren from the city of Córdoba and its relation to sex, nutritional status, socioeconomic status (SES), and level of maternal education. Blood pressure measurements and information on SES, level of maternal education, and body mass index of schoolchildren from the city of Córdoba, Argentina, were obtained. HBP was defined as systolic or diastolic blood pressure levels that are greater than or equal to the 95th percentile for a given age, sex, and height percentile at three consecutive measurements on separate days. A total of 1531 boys and girls participated; their average age was 10.6 years. Fifty-five children had HBP. Systolic and diastolic blood pressure levels showed a significant association with obesity (p= 0.001), but not with age (p= 0.87), sex (systolic: p= 0.48; diastolic: p= 0.71) or SES (systolic: p= 0.07; diastolic: p= 0.09). The prevalence of HBP in a sample of schoolchildren from Argentina was 3.7%. It showed a significant association with obesity, but not with SES.