Risk Factor For Arterial Hypertension Research Articles

Stress-induced arterial hypertension in the ESH Guidelines for the Management of Hypertension 2023

New ESH data on risk factors for arterial hypertension are presented. The article examines the mechanisms of the relationship between stress and arterial hypertension, the relationship of stress with white coat hypertension and masked arterial hypertension, perioperative hypertension. A brief review of the results of clinical studies on the relationship between chronic stress and arterial hypertension, including stress at work and in everyday life, is presented. Modern approaches to the prevention and treatment of stress-induced hypertension are considered, which include recommendations for lifestyle changes, stress management methods, and drug therapy.

THE ARTERIAL STIFFNESS AS RISK FACTOR FOR THE OCCURRENCE OF ARTERIAL HYPERTENSION IN POSTOPERATIVE CRITICALLY ILL PATIENTS

Objective: The aim of the present study is to investigate the predictive value of arterial stiffness in the occurrence of arterial hypertension in critically ill patients. Also, the study investigates the risk factors of arterial hypertension in ICU patients. Design and method: This is a prospective observational study. The study included postoperative patients who were admitted to the ICU. We collected demographic characteristics of the patients, their clinical characteristics (i.e. hemodynamic status), clinical severity (APACHE II, SOFA score), lifestyle data (i.e. smoking, alcohol, drugs), and medical history (diabetes mellitus, cardiovascular diseases). Arterial stiffness assessment is performed by recording and analyzing the pulse wave in postoperative patients during the first 24 hours of admission to the ICU. The Sphygmocor software was used for pulse wave analysis and IBM SPSS v.27.0 software was used for statistical analysis. Results: The sample of the study consisted of 74 patients. Most of them were males (70.3%) aged 59.3±18.6 yrs and the rest were females (29.7%) aged 63.3±16.9 yrs. Totally, 54.1% of patients had emergency surgery, 60.8% survived and discharged from ICU, 52.7% had arterial hypertension, 70.3% had diabetes mellitus, 58.1% were smoking, and 63.5% had hypercholesterolemia. The APACHE II score of patients was found 21.2±7.2 and the SOFA score 7.5±2.8 The value of peripheral systolic blood pressure (PSBP) was 138.7±19.4 mmHg, peripheral diastolic blood pressure (PDBP) was 67.1±13.2 mmHg, mean peripheral blood pressure (MPBP) was 90.7±14.6 mmHg, pulse pressure (PP) was 53.1±15.3 mmHg and AIX@75 was 22.3±13.1%. Older patients (69.1±14.9 vs. 52.7±17.3, p=0.001), patients with diabetes mellitus (92.3% vs. 7.7%, p=0.001), patients with hypercholesterolemia (92.3% vs. 7.7%, p=0.001), patients with higher value of Albumin (2.9±0.5 vs. 2.5±0.6, p=0.025), and patients with a higher value of AIX@75 (26.8±10.5 vs. 18.3±14.1, p=0.004) had statistically significant higher percentages of arterial hypertension. Higher AIX values are associated with a greater likelihood of arterial hypertension (OR: 1.027; 95%CI: 1.004-1.049, p=0.018). Conclusions: The arterial stiffness is an independent risk factor for arterial hypertension in postoperative critically ill patients.

THE PREVALENCE AND RISK FACTORS FOR ARTERIAL HYPERTENSION IN CHILDREN WITH IDIOPATHIC NEPHROTIC SYNDROME

Objective: Arterial hypertension (AH) is claimed to be an uncommon finding in children with idiopathic nephrotic syndrome (INS). The study aimed to analyze blood pressure, prevalence, and risk factors of AH in children with INS. Design and method: In 153 children with INS (9.32±3.84 years, 100 boys), we evaluated systolic and diastolic blood pressure (mm Hg, Z-scores), age at onset of the disease, anthropometric data, response to steroids, results of kidney biopsy, number of INS relapses, and medications. Results: The mean age at disease onset was 4.39±2.38 years; 67 patients had steroid-sensitive nephrotic syndrome (SSNS), 12 frequently relapsing nephrotic syndrome (FRNS), 58 steroid-dependent nephrotic syndrome (SDNS), and 16 steroid-resistant nephrotic syndrome (SRNS). Kidney biopsy was performed in 26: 5 – minimal change disease, 11 – mesangial proliferation, 10 – focal and segmental glomerulosclerosis. AH at disease onset was found in 10 (6.5%) patients in the following 11 (7.2%) after corticosteroid initiation. The observation period was 4.93±3.80 years, and AH was found in 31 (20.3%) – in 3 (4.5%) patients with SSNS, 2 (16.7%) with FRNS, 20 (34.5%) with SDNS, and 6 (37.5%) with SRNS. Patients with AH had lower height Z-score (-0.46±1.20 vs. 0.18±1.15, p=0.006), higher BMI Z-score (1.15±1.10 vs. 0.41±1.09, p<0.001), number of INS relapses (8.32±6.78 vs. 4.41±3.82, p<0.001), and current prednisone dose (0.49±0.67 vs. 0.18±0.29 [mg/kg/24h], p<0.001). Systolic blood pressure Z-score at the end of observation correlated with age (r=-0.192, p=0.017), BMI Z-score (r=0.368, p<0.001), and present prednisone dose [mg/kg/24h] (r=0.186, p=0.021), diastolic blood pressure Z-score with BMI Z-score (r=0.231, p=0.004), and number of INS relapses (r=0.163, p=0.044). In Cox Proportional Hazard presence of SDNS and SRNS were the only predictors of AH (SDNS: HR=4.80, 95CI(1.30-17.75), SRNS: HR=4.77, 95CI(1.06-21.53)). Conclusions: 1. Approximately one-third of patients with SDNS and SRNS develop arterial hypertension in the course of the disease. 2. Steroid dependence and steroid resistance are the strongest predictors of AH in children with INS. Other determinants of blood pressure elevation in this group of patients are high BMI and a high number of relapses.

Prospective Study of Modifiable Risk Factors of Arterial Hypertension and Left Ventricular Hypertrophy in Pediatric Patients on Hemodialysis

IntroductionFluid and salt overload in dialysis patients result in high blood pressure (BP), left ventricular hypertrophy (LVH) and hemodynamic instability, resulting in cardiovascular morbidity and mortality. MethodsAnalysis of 910 pediatric patients on maintenance hemodialysis/hemodiafiltration (HD/HDF), prospectively followed with 2758 observations recorded every 6-months in the International Pediatric Hemodialysis Network. ResultsUncontrolled hypertension was present in 55% of observations, with 27% of patients exhibiting persistently elevated pre-dialysis BP. Systolic and diastolic, height- and age-standardized BP (BP-SDS) were independently associated with number of antihypertensive medications (OR=1.47 [1.39-1.56], 1.36 [1.23-1.36]) and interdialytic weight gain (IDWG; 1.19 [1.14-1.22], 1.09 [1.06-1.11]). IDWG was related to urine output (OR=0.27 [0.23-0.32]) and dialysate sodium (dNa; 1.06 [1.01-1.10]; all p<0.0001). In subjects with pre-dialysis and 24h-BP measurements, the prevalence of masked hypertension was 24%, and HD versus HDF use was an independent risk factor of elevated MAP-SDS (OR=2.28 [1.18-4.41], p=0.01).51% of 1135 echocardiograms demonstrated LVH. Modifiable risk factors included pre-dialysis systolic BP-SDS (OR=1.06 [1.04-1.09], p<0.0001), blood hemoglobin (0.97 [0.95-0.99], HD versus HDF modality (1.09 [1.02-1.18], p=0.01) and IDWG (1.02 [1.02-1.03], p=0.04). Additionally HD modality increased the risk of LVH progression (OR=1.23 [1.03-1.48]). Intradialytic hypotension (IDH) was prevalent in patients progressing to LVH and independently associated with pre-dialysis BP-SDS below 25th percentile, lower number of antihypertensives, HD versus HDF modality, ultrafiltration rate and urine output, but not with dNa. ConclusionsUncontrolled hypertension and LVH are common in pediatric hemodialysis, despite intense pharmacological therapy. Outcome may improve with use of HDF, and superior anemia and IDWG control; the latter via lowering dNa, without increasing the risk of IDH.

Preclinical Orthostatic Abnormalities May Predict Early Increase in Vascular Stiffness in Different Age Groups: A Pilot Study.

Clinical orthostatic hypotension (OH) and hypertension (OHT) are risk factors for arterial hypertension (AH) and cardiovascular diseases (CVD) and are associated with increased vascular stiffness. Preclinical OH and OHT are poorly understood. The main objective was to investigate preclinical orthostatic abnormalities and their association with increased vascular stiffness in different age groups of adults. A specially designed head-up tilt test standardized for hydrostatic column height was used to detect them. Three age groups of clinically healthy subjects were examined. In the group of young adults up to 30 years old, a significant predominance of orthostatic normotension (ONT) and an insignificant number of subjects with preclinical OH and OHT were found. In the age group over 45 years, compared to the group under 30 years, there was a twofold decrease in the proportion of individuals with ONT and a significant increase with preclinical OH and OHT. In all age groups, there was a significant orthostatic increase in vascular stiffness (as measured by the brachial-ankle pulse wave velocity (baPWV), which was recovered to the baseline level when returning to the supine position. Overall, subjects with preclinical OH and OHT had significantly higher baPWV values compared to those with ONT (p = 0.001 and p = 0.002, respectively), with all subjects having vascular stiffness values within normal age-related values.

РОЛЬ КУРЕНИЯ В РАЗВИТИИ АРТЕРИАЛЬНОЙ ГИПЕРТОНИИ У БЕРЕМЕННЫХ

Introduction. It is well known about the risk factors (RF) for arterial hypertension in the general population, however, their significance in hypertension is well known, however, their significance in pregnant women has been little studied. The purpose of the study was to evaluate the effect of the most common risk factors on the development of hypertension in pregnant women. Materials and methods. The study group consisted of 312 pregnant women suffering from hypertension, the control group - 358 pregnant women with normal blood pressure. The relative odds (OR) were calculated using the logistic regression method for the following risk factors: age, smoking, family history, and overweight. Results. With overweight (25≤ BMI ≥29.9 kg/m2), the OR for the development of hypertension was 3.1 (1.7-5.8), while with obesity (compared with normal and overweight) it increased to 12 ( 7.6-19.1). With aggravated heredity, the OR was 6.9 (4.7-10.3). OR in pregnant women with aggravated heredity on the paternal side was 5.2 (2.7-10.2), on the maternal side - 7.4 (4.6-11.8), on both parents - 9.3 (3.6 -24.9). In our study, 20% of women in the group with hypertension smoked, which is significantly more than in the group without hypertension - 13%, p=0.01. At the same time, IPI in the group of pregnant women with AH was 7.5 (2.5-15), which was significantly higher than in the control group 1.9 (1-7.5), p&lt;0.001. It was found that smoking increased the OR of developing hypertension in pregnant women by 4.6 times (2.43-9.4). At the same time, with a pack/year index (PLI) of more than 10 (compared with non-smokers), the OR was 13.1 (5.5–29.9), which was statistically significantly higher than with smoking with a PLI ≤10 (compared with non-smokers) OR was only 2.6 (1.6-3.9), p=0.006. When comparing two groups by age, it was found that pregnant women with hypertension were older than those with normal blood pressure (32 (28-36) and 28 (24-32) years, respectively, p=0.002). ROC analysis with a probability of more than 80% determined that age over 33 years is a risk factor for the presence of hypertension in pregnant women. Thus, the risk of developing hypertension in the group of pregnant women over the age of 33 is 1.8 times higher than in the younger age group. When analyzing combinations of several FGs for the development of AH, a multiple increase in the risk in pregnant women was found. Thus, in the group of smoking women under 33 years of age, the OR for the development of AH was 2.2 (1.3-3.8), and in smoking pregnant women over 33 years of age it was 14.1 (5.9-33.5). With a combination of smoking and heredity, the OR increased to 27 (11.5-56), and with a combination of smoking and obesity - 33 (7.3-62). It is noteworthy that with a combination of obesity and hereditary burden, the risk of developing hypertension during pregnancy increased by 54 (6.2-429) times. Conclusion. Smoking ranks third among other risk factors for arterial hypertension in pregnant women, increasing the OR of developing hypertension by 13 times compared to non-smokers. The combination of smoking with other risk factors significantly increased the chance of developing hypertension in pregnant women.

The association between arterial hypertension and menarcheal age.

Menarche, as a milestone of puberty, may have a long-term effect on health. The present study investigated the association of age at menarche with the incidence of arterial hypertension. A total of 4747 post-menarcheal participants of the Tehran Lipid and Glucose Study who met the eligibility criteria were selected. Demographic, lifestyle, reproductive, and anthropometric data, as well as risk factors for cardiovascular diseases, were collected. Participants were classified according to their age at menarche: group I: ≤11years, group II: 12-15years, and group III: ≥16years. A Cox proportional hazards regression model was used to estimate the associations between age at menarche and arterial hypertension outcomes. The generalized estimating equation models were used to compare the trend of changes in systolic and diastolic blood pressure between the three groups. The mean age of participants at baseline was 33.9 (13.0). At the end of the study, 1261 (26.6%) participants had arterial hypertension. Women in group III had a 2.04-fold higher risk of arterial hypertension than those in group II. The mean changes in systolic and diastolic blood pressure were 29% (95% CI: 0.02-0.57) and 16% (95% CI: 0.00-0.38) higher for women in group III compared with group II. Late menarche could be a risk factor for arterial hypertension, so it is necessary to pay more attention to age at menarche in cardiovascular risk assessment programs.

Risk factors for arterial hypertension in women with abdominal obesity and hypertensive disorders of pregnancy in the history

The article provides data from epidemiological studies on the correlation between hypertensive disorders in pregnant women and the risk of cardiovascular diseases in later life, describes possible pathophysiological determinants for the occurrence of arterial hypertension after complicated pregnancy. The most informative predictors of the development of arterial hypertension in women with abdominal obesity are described, which were indicators of waist circumference, uterine artery resistance index, N-terminal fragment of the brain natriuretic peptide and highly sensitive C-reactive protein; a mathematical model was calculated to predict the probability of developing arterial hypertension in women with abdominal obesity and hypertensive disorders of pregnancy one year after delivery.

The problem of cross risk of arterial hypertension progression, obstructive sleep apnea syndrome and COVID-19

This review considers the risk factors for arterial hypertension (AH) progression, obstructive sleep apnea syndrome (OSAS) and novel coronavirus infection (COVID-19) as potential variables for the prognostic models of estimating the probability of destabilization of the mentioned conditions. The most published studies consider AH and OSAS as the risk factors influencing the course of COVID-19, while moderate and mild COVID-19 can be destabilizing factor regarding to AH and OSAS. In addition, COVID-19, AH and OSAS are interrelated with sleep quality. The worsening of sleep quality often can be both a consequence of these diseases and a factor aggravating their course, and also can cause the increased vulnerability to acute diseases. An increased body mass index is a universal risk factor for many diseases and clinical conditions, and the monitoring of body mass increases the degree of the control of the diseases associated with obesity. In addition, the worsening of sleep quality can be both a consequence of any of above-mentioned conditions and a factor aggravating their course. Also, a promising direction for improving prognostic models is the analysis of autonomic dysfunction in patients.

Knowledge of Primary Care Patients Living in the Urban Areas about Risk Factors of Arterial Hypertension.

Arterial hypertension (AH), one of the most common diseases of civilization, is an independent risk factor for cardiovascular morbidity and mortality. This disease is the second, after lipid disorders, the most common cardiovascular risk factor and a significant cause of premature death. In Poland, one in three adults (approximately 11 million people) suffers from it. The aim of our survey was to determine patients’ knowledge of the factors (e.g., age, smoking cigarettes, drinking coffee, shift work) that may influence the development of hypertension. The survey was conducted among 205 adult primary care patients living in urban areas. There was a high correlation between patients’ education and risk factors of AH, such: as excess salt in the diet (p = 0.038), smoking electronic cigarettes (p = 0.005), moderate alcohol consumption (p = 0.028), moderate daily physical activity (p = 0.011), female and male sex (p = 0.032 and p = 0.012), air pollution (p < 0.001) and others. In addition, a statistically significant factor shaping patients’ attitudes toward hypertension prevention was the correlation between the respondents’ education and their parents’ prevalence of hypertension (p = 0.40). This study increases the knowledge of patients’ awareness of hypertension. It may serve as guidance for primary care providers to pay special attention to environmental interviews with patients and the patient’s family history for the prevention of hypertension incidence.

Социальные и метаболические факторы риска артериальной гипертензии у подростков

Aim: to study the features of social and metabolic indicators in adolescents with arterial hypertension (AH), to assess their informative significance and the magnitude of their contribution to the risk of developing this pathology. Design: a comparative clinical study of patients. Materials and Methods: The object of the study was adolescents aged 12–17 years (boys and girls) with and without AH. The 1st stage included the analysis of biomedical, social and metabolic indicators, the 2nd stage included an assessment of the informative significance and degree of participation of indicators as risk factors for AH. Methods: questioning, laboratory, clinical and functional, statistical. Examination program: verification of AH and its severity; association of AH with functional somatic disorders; features of biomedical, social and metabolic indicators; assessment of the significance and contribution of indicators as risk factors for AH. Results. Of the 504 examined, AH was diagnosed in 86 (17.06%) adolescents, of which 47.7% (41 people) had grade 1 AH and 52.3% (45 people) had grade 2 AH. Social risk factors for hypertension associated with family characteristics: the degree of marriage of parents — temporary cohabitation (OR = 3.36), father's profession — worker (OR = 3.14), father's education — secondary special (OR = 2.25), deviant family (OR = 2.78), family at medical and social risk (OR = 1.87). Metabolic predictors of the risk of AH: the presence of DLP (OR = 1.95), HChS (OR = 2.62), HTG (OR = 2.21), Hyper-β-CHS (OR = 1.87) and Hyper-pre-β-ChS (OR = 2.14). Conclusion. Along with traditional ones, it is necessary to identify and correct socially determined and metabolic risk factors for AH in order to optimize the diagnosis and prevention of this pathology in adolescents. Keywords: adolescents, arterial hypertension, risk factors, social factors, lipid spectrum

Lifestyle and cardiometabolic risk factors in the ethnic and non-ethnic population > 15 years of age: results from the National Chilean Health Survey 2016-2017.

Background: lifestyle and cardiometabolic risk factors information is scarce regarding youth and adults of Latin-American ethnics. Objective: the primary aim was to describe the lifestyle and cardiometabolic risk factors for arterial hypertension (HTN) and diabetes in ethnic Latin-American groups (Mapuche and Aymara) and other non-ethnics > 15 years of age in the Chilean population. A secondary aim was to determine the association between physical activity 'intensity' with HTN and diabetes markers. Material and methods: a representative sample from the National Chilean Health Survey 2016-2017, included Mapuche (EG-Map; women n = 166, men n = 300; total n = 466), Aymara (EG-Aym; women n = 96, men n = 55; total n = 151), and a non-ethnic population group (No-EG; women n = 2057, men n = 3445; total n = 5502). The main outcomes were; systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (GL), and secondary outcomes were other anthropometric, lipid profile, and lifestyle parameters. Results: GL was significantly associated with nutrition (0.9 %, p < 0.0001), tobacco and alcohol habits (0.6 %, p < 0.0001). SBP was significantly associated with nutrition (whole-grains 0.04, p = 0.001; water consumption 0.07, p < 0.0001), sleep hygiene (week 0.04, p = 0.030; on weekends -0.04, p = 0.026), and alcohol consumption (-0.06, p < 0.0001). Conclusion: in conclusion, lifestyle differences among Mapuche and Aymara ethnic groups in comparison with non-ethnic Chilean peers > 15 years are significantly associated with blood pressure and glycemia.

Hyperuricemia as a risk factor for arterial hypertension among the population of the Fergana region of the Republic of Uzbekistan

Today, a lot of data has been accumulated on the role of purine metabolism disorders in the development of a number of diseases, including cardiovascular diseases. However, the results of a large number of epidemiological and clinical studies aimed at detecting the pathogenetic relationship between hyperuricemia (HU) and arterial hypertension (AH) are contradictory. According to the purpose of the study - to study the epidemiological conditions in relation to hypertension in connection with HU and other risk factors in order to be ¬able to plan multifactorial prevention on this basis, we carried out epidemiological study ¬of hypertension due to a combination of risk factors such as HU, impaired carbohydrate tolerance (IHT), pesticideemia, dyslipoproteinemia (DLP), overweight and smoking among rural men ¬and women of working age. We chose a continuous method of epidemiological examination with the measurement of blood pressure, ECG, anthropometric and biochemical studies. To determine the groups for primary, secondary and tertiary prevention, we have established the level of individual risk of developing hypertension. On this basis, a percentile distribution was built and the entire population of men and women was divided into 3 groups: 1-group of moderate risk (84.6%); 2-high-risk group (10.3%) and 3-group of patients (5.1%).

Hypertension in female prisoners in Brazil: far beyond the biological aspects

The scope was to estimate the prevalence of arterial hypertension (AHT) and associated risk factors among female prisoners. Data from the National Health Survey of the Female Prison Population and Prison Guards were used, investigating sociodemographic variables, prison characteristics, health behaviors and conditions. Information was collected through a self-administered questionnaire, and the magnitude of the association was estimated by the odds ratio and 95% confidence interval. Of the 1,327 prisoner participants, 24.4% were hypertensive, the majority were 31 years of age or older (54.6%), and 51.5% self-reported mixed race. After adjustment for associated risk factors in the bivariate analysis, a direct relationship between age and AHT was observed, in which age equal to/over 41 years was independently associated with a 7-fold greater chance of having AHT, compared to those under 25 years of age. Those who self-reported mixed race, had high cholesterol, were obese and were also independently associated with a higher prevalence of AHT. The greater the number of people with whom the inmate shares a cell was associated with a higher prevalence of AHT, but without a dose-response relationship. The conclusion drawn is that age, race, obesity, physical inactivity and stress are risk factors for AHT in female prisoners.

Adropin and risk factors of arterial hypertension in patients with excess body weight and obesity

Introduction. Adropin is a hormone that is involved in the pathogenesis of arterial hypertension (AH) and diseases of the cardiovascular system and energy homeostasis, in particular, it reduces insulin resistance by controlling glucose synthesis in the liver. Aim. To investigate the level of adropin and its interaction with risk factors for AH in overweight and obese patients. Materials and methods. 70 patients with AH and overweight or obesity aged 62.4 ± 10.4 years were examined. 10 practically healthy people were selected for the control group. The level of adropin was determined by enzyme immunoassay (Finetest Elisa Kit) in blood serum. The inclusion criteria for participation in the study were: age of patients 40–75 years; arterial hypertension; BMI &gt; 25 kg/m2. Results. It was established that the average level of adropin in patients with AH and comorbid obesity or excess body weight (n = 70) was 775.5 ± 311.7 pg/ml, which is significantly lower than the content of this peptide in practically healthy individuals (n = 10), which was 1084.6 ± 110.2 pg/ml (p &lt; 0.01). A tendency towards a decrease in the level of the hormone in men was noted. It is probably associated with a much higher prevalence of smoking among this category of people, since when assessing the factors contributing to the development of AH and worsening its prognosis, a significant decrease in adropin was found in persons with a history of smoking (p &lt; 0.01). In obese patients (BMI &gt; 30 kg/m2), the level of adropin was significantly lower (p &lt; 0.05), as well as in individuals with blood pressure &gt; 150/90 mm Hg (p &gt; 0.05). Conclusions. The level of serum adropin is significantly reduced in persons with AH and overweight and obesity compared to practically healthy persons. Factors contributing to a decrease in peptide concentration include smoking, obesity, and elevated blood glucose levels. Blood pressure indicators are not critical for changes in blood hormone concentration, which is probably due to medications used to treat AH.

Risk Factors for Arterial Hypertension in Women Seen in a Medical Office at the Orlando Matos Mosqueda Polyclinic-2022

Introduction: Hypertension is one of the most frequent chronic diseases in Cuba. In our country the prevalence is 70% and is proportional to the years of life. More than 30% of the adult population suffers from it, causing high morbidity and mortality. Objective: To describe the main risk factors in women with arterial hypertension of the doctor’s office 2 of the Párraga health area in the year 2021. Methods: An epidemiological, observational, descriptive and cross-sectional study was carried out in a universe of 153 female patients with arterial hypertension. Sociodemographic and epidemiological variables were studied. Results: 39.8% corresponded to patients between 41 and 50 years old, with a weight above the normal value in 40.5% d. 62 women did not finish high school and the most frequent toxic habit was coffee consumption in 69.3 %. More than 70% are heavy consumers of and salt. 58 patients had a history of medication intake, prevailing the intake of non-steroidal anti-inflammatory drugs in 18.3%. Conclusions: The age group of 41 to 50 years prevailed, with unfinished secondary school level and housewives, a high percentage of them is above the ideal weight and coffee intake, smoking, salt consumption and the previous intake of medications continue to behave as the main risk factors in the disease.

Family history of arterial hypertension and central adiposity: impact on blood pressure in schoolchildren

BackgroundA family history of arterial hypertension is an important risk factor for arterial hypertension. This study aimed to verify the mediating role of high central adiposity in the relationship between family history of arterial hypertension and blood pressure in schoolchildren. MethodsCross-sectional study with 118 schoolchildren of both sexes aged between 11 and 17 years. Weight, height, waist circumference and body mass index z score were verified. Somatic maturation was predicted by age for peak growth velocity. The family history of arterial hypertension was verified and defined as hypertensive schoolchildren with systolic blood pressure or diastolic blood pressure. Mediation analysis was used with linear regression models applied by PROCESS macro for SPSS (version 22.0), with significance p < 0.05.ResultsIt was observed that 34.7% of the students have family history of arterial hypertension, 36% of the girls and 44.2% of the boys have arterial hypertension. In girls, the relationship between waist circumference and systolic blood pressure was direct (β = 0.535 p = 0.005), and those with a family history of arterial hypertension and who had a waist circumference greater than those without a family history of arterial hypertension was significant (β = -5,437 p = 0.009). Likewise, the relationship between family history of arterial hypertension and systolic blood pressure was attenuated when waist circumference was included in the model (β = -5.544; p = 0.103), indicating waist circumference as a mediator with an influence percentage of 19%. For boys, waist circumference is not a mediator of the relationship between family history of arterial hypertension and blood pressure.ConclusionsElevated central adiposity was a mediator of the relationship between family history of arterial hypertension and high blood pressure in girls, indicating the importance of family health strategies in the prevention and management of arterial hypertension in children and adolescents.

Frequency of occurrence of cardiovascular risk factors in patients with anthracosilicosis in combination with arterial hypertension and coronary heart disease

Introduction. Clinical and experimental studies show the adverse effect of coal-rock dust not only on the bronchopulmonary, but also on the cardiovascular system. Coal mine workers have a high incidence of arterial hypertension and coronary heart disease. The key point in the prevention of the diseases of the circulatory system is the timely detection and correction of not only the main (non-occupational), but also occupational factors of cardiovascular risk. In this regard, the study of risk factors for arterial hypertension and coronary heart disease in coal mining workers is an urgent task. The study aims to explore the frequency and reveal the most significant non-occupational and occupational factors of cardiovascular risk in patients with anthracosilicosis in combination with arterial hypertension and coronary heart disease. Materials and methods. The study involved 269 coal mine workers: 139 miners with previously diagnosed anthracosilicosis and 130 miners in the control group without lung pathology. All of them underwent a comprehensive clinical, instrumental and laboratory examination to identify arterial hypertension, coronary artery disease and risk factors for the development of the diseases of the circulatory system. Results. According to the findings of the study, a significantly higher incidence of arterial hypertension and coronary heart disease was identified in the patients with anthracosilicosis compared with the miners who worked for a long time in harmful labour conditions but did not have occupational pulmonary pathology. The most significant non-occupational risk factors for arterial hypertension in the patients with anthracosilicosis were determined: age 50 years and older, the presence of fasting hyperglycemia, hyperhomocysteinemia, abdominal type of obesity, hypersthenic constitutional-morphological type according to the Rees-Eysenck index, blood group AB (IV). Occupational risk factors for the development of arterial hypertension in the patients with anthracosilicosis were also identified: work experience in hazardous working conditions of 25 years and more, the dust level in the working area exceeding the maximum permissible concentration by 10 times and more. In the patients with anthracosilicosis, the most significant risk factors for the development of coronary heart disease were: age 45 years and older, the presence of arterial hypertension, metabolic syndrome, andromorphic constitutional-morphological type according to the Tanner index, hyperhomocysteinemia, hyperfibrinogenemia, increased levels of soluble fibrin-monomer complexes and C-reactive protein. Occupational risk factors for the development of coronary heart disease in the patients with anthracosilicosis were also identified: work experience in hazardous working conditions of 20 years and more, the presence of respiratory failure (as a complication of an occupational disease). Limitations. This study is limited to a sample of workers in the main occupations of coal mines who are examined at the Research Institute for Complex Problems of Hygiene and Occupational Diseases. The age group of workers from 40 to 54 years old, with a long work experience in underground dusty conditions (more than 15 years) was studied. The study did not include persons with proven occupational diseases other than anthracosilicosis. Conclusions. The identified significant markers of cardiovascular risk can be applied to elaborate prognostic methods. Timely detection and elimination of cardiovascular risk factors as primary preventive measures should be used to reduce the level of cardiovascular incidence rate among individuals working in hazardous labour conditions. Ethics. This medical research involving a human was carried out in accordance with the ethical principles presented in the latest version of the Declaration of Helsinki by the World Medical Association.

Comprehensive diagnosis of arterial hypertension in athletes specializing in various sports

While for adult athletes, increasing blood pressure is one of the main reasons for withdrawing from sports for medical reasons, for children this issue is only being studied. Prevalence, risk factors for arterial hypertension and target organ involvement in young (under 18 years old) athletes’ population of different sports specialization and skill levels have not yet been determined.The purpose of this work was an attempt to determine the arterial hypertension prevalence depending on sports affiliation among highly trained young athletes. It was determined that in athletes the blood pressure’s level, as well as some markers of hidden hypertension, vary significantly (0–23%) depending on diagnostics method, sports specialization, and professional experience.

Oil-producing enterprise

Arterial hypertension is an urgent health problem worldwide causing an increase in temporary and permanent disability, invalidity and mortality due to cardiovascular diseases. Researchers recognize the multifactorial nature of arterial hypertension, but environmental factors are of particular potential importance. The working conditions at oil production enterprises are characterized by a more pronounced influence of these factors which may predispose for early development of disadaptation disorders, functional changes in immune and humoral regulation, and, finally, for increased risk of cardiovascular diseases in people engaged in oil production. The aim of the present work was to study the features of immunity and humoral risk factors of arterial hypertension in hypertensive employees at an oil-producing enterprise. To this purpose, a comparative analysis of lymphocyte subpopulations (CD3+CD4+, CD3+CD25+), markers of apoptosis (CD3+CD95+, TNFR, p53, Bax, Annexin V-FITC+7AAD), phagocytic activity of leukocytes (absolute phagocytosis index), and the levels of vascular humoral factors (nitric oxide and homocysteine) was performed in employees of an oil production enterprise exposed to adverse production factors. The observational group consisted of employees with established episodes of increased blood pressure. A comparison group consisted of individuals without clinical manifestations of cardiovascular disease. As a result of the clinical and laboratory examination of employees at the oil-producing enterprise with arterial hypertension, some functional changes in immune regulation were revealed. This group was characterized by a significantly (p 0.05) decreased CD3+CD4+, and CD3+CD25+ lymphocyte contents, along with increased levels of regulatory CD127 lymphocytes against the comparison group (p 0.05). The workers at an oil production enterprise with arterial hypertension are characterized by decreased (p 0.05) phagocytic activity of peripheral blood leukocytes using the criteria of absolute phagocytosis. We found some signs of inhibited lymphocyte apoptosis (p 0.05), i.e., a decrease in CD95+, TNFR, and p53 over the background values, as well as increased Bax levels over the comparison group (p 0.05). However, the content of TNFR and p53 significantly (p 0.05) exceeded the reference level, regardless of previous arterial hypertension episodes. Development of the high blood pressure episodes among the employees at oi-producing plant showed a significant association (p 0.05) with elevated levels of homocysteine and nitric oxide concentrations which are known to induce endothelial dysfunction, atherogenesis and, hence, a persistent increase in blood pressure.