Risk Factors In Hypertensive Patients Research Articles

Prevalence, Clustering, and Current Management of Cardiovascular Risk Factors Upon First Referral to Hypertension Specialists: the APPROACH Study.

Several observational studies have been conducted to assess the prevalence of cardiovascular risk factors in hypertensive patients; however, none has yet investigated prevalence, clustering, and current management of cardiovascular risk factors upon first referral to hypertension specialists, which is the aim of the present study. Consecutive adult outpatients with essential/secondary hypertension were included at the time of their first referral to hypertension specialists at 13 Italian centers in the period April 2022-2023 if they had at least one additional major cardiovascular risk factor among LDL-hypercholesterolemia, type 2 diabetes, and cigarette smoking. Prevalence, degree of control, and current management strategies of cardiovascular risk factors were assessed. A total of 255 individuals were included, 40.2% women and 98.4% Caucasian. Mean age was 60.3±13.3years and mean blood pressure [BP] was 140.3±17.9/84.8±12.3mmHg). Most participants were smokers (55.3%), had a sedentary lifestyle (75.7%), suffered from overweight/obesity (51%) or high LDL-cholesterol (41.6%), had never adopted strategies to lose weight (55.7%), and were not on a low-salt diet (57.4%). Only a minority of patients reported receiving specialist counseling, and 27.9% had never received recommendations to correct unhealthy lifestyle habits. Nearly 90% of individuals with an estimated high/very high cardiovascular risk profile did not achieve recommended LDL-cholesterol targets. In patients with hypertension, both pharmacological and lifestyle therapeutic advice are yet to improve before referral to hypertension specialists. This should be considered in the primary care setting in order to optimize cardiovascular risk management strategies.

Community intervention in patients with arterial hypertension

Healthy eating habits and lifestyle modifications play a vital role in the treatment and control of high blood pressure. Objective: evaluate community intervention to modify the knowledge of bad eating habits in the hypertensive population of office 149 of the Hermanos Cruz Polyclinic in the period 2021-2023. Material and method: an action research was carried out with the purpose of modifying the knowledge of the bad eating habits of the hypertensive population in office 149 of the Hermanos Cruz Polyclinic, from September 2021 to June 2023. The universe was made up of 128 hypertensive patients, adults, from the medical office under study. The sample was made up of 125 patients. Results: the age group of 40-49 years predominated with 32 %. Regarding nutritional status, a predominance of overweight and normal weight patients was demonstrated. Inadequate sodium intake also played a leading role. A community intervention was applied that decreased patients with inadequate sodium intake, increased normal weight, and increased the level of knowledge about high blood pressure. Conclusions: community intervention decreased risk factors in hypertensive patients.

Connection between uric acid and cardiovascular risk factors in hypertensive patients

The aim of the research is to analyze correlations between uric acid and cardiovascular risk factors (age, body mass index, waist circumference, total cholesterol and low-density lipoprotein cholesterol levels, glucose) and glomerular filtration Rate in outpatient care hypertensive patients. The research was based on the data of 1285 ambulatory patients from the national register of hypertension. Hyperuricemia was detected in 28,4% of cases. A positive correlation was established between uric acid and waist circumference, body mass index; negative – between uric acid and kidney function deterioration (based on glomerular filtration rate). It was stated that diuretic therapy and smoking are associated with the increase in uric acid serum levels. The study of cardiovascular risk factors frequency in patients with hypertension and hyperuricemia concluded that 80% had more than 1 additional risk factor; combination of ≥3 risk factors occurred in males significantly more often than in females.Acquired data proves that uric acid is closely related to disturbance in metabolic factors, kidney function and diuretic therapy admission, which makes it essential to control its levels in hypertensive patients, as well as to use measures approved by the modern guidelines to decrease uric acid in patients with hyperuricemia.

Retracted: Observation of the Clinical Correlation between Carotid Artery Intima-Media Thickness and Cardiovascular Risk Factors in Hypertensive Patients under Microscope Images

Retracted: Observation of the Clinical Correlation between Carotid Artery Intima-Media Thickness and Cardiovascular Risk Factors in Hypertensive Patients under Microscope Images

Inflammatory Markers and Risk Factors in Hypertensive Patients: A Cross-Sectional Study

Objective: To observe risk factors that hypertensive patients present in the outpatient segment from the nursing perspective care. Method: Cross-sectional study where essential hypertensives of legal age belonging to the hypertension program of a municipality in Bahia were included. Those with cancer, hepatitis, HIV, lupus, arthritis, pregnant women, and chronic corticosteroid users were excluded. Collected patient demographic information and cardiovascular risk factors. Results: Included 61 patients with a mean age of 58±11, 56% women. A relationship was established between age/glucose; IL6/LDL; vitamin D/ferritin; waist circumference/BMI; BMI/CRP; smoking, age, blood pressure, LDL, and neutrophil/lymphocyte ratio. The statistical analysis evaluated predictive variables for developing hypertension and high cardiovascular risk. In the cardiovascular risk stratification, 09 patients had low chance; one was intermediate, 37 high risk, and 02 very high risk.

The Role of Heart Rate Variability (HRV) in Different Hypertensive Syndromes

Cardiac innervation by the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS) modulates the heart rate (HR) (chronotropic activity) and the contraction of the cardiac muscle (inotropic activity). The peripheral vasculature is controlled only by the SNS, which is responsible for peripheral vascular resistance. This also mediates the baroreceptor reflex (BR), which in turn mediates blood pressure (BP). Hypertension (HTN) and the autonomic nervous system (ANS) are closely related, such that derangements can lead to vasomotor impairments and several comorbidities, including obesity, hypertension, resistant hypertension, and chronic kidney disease. Autonomic dysfunction is also associated with functional and structural changes in target organs (heart, brain, kidneys, and blood vessels), increasing cardiovascular risk. Heart rate variability (HRV) is a method of assessing cardiac autonomic modulation. This tool has been used for clinical evaluation and to address the effect of therapeutic interventions. The present review aims (a) to approach the heart rate (HR) as a CV risk factor in hypertensive patients; (b) to analyze the heart rate variability (HRV) as a "tool" to estimate the individual risk stratum for Pre-HTN (P-HTN), Controlled-HTN (C-HTN), Resistant and Refractory HTN (R-HTN and Rf-HTN, respectively), and hypertensive patients with chronic renal disease (HTN+CKD).

Hyperhomocysteinemia in Patients with Newly Diagnosed Primary Hypertension in Can Tho City, Vietnam.

Elevated levels of blood total homocysteine is one of the cardiovascular risk factors in hypertensive patients. Determine the prevalence of hyperhomocysteinemia and its associated factors in newly diagnosed primary hypertension patients. A cross-sectional descriptive study on 105 patients with newly diagnosed primary hypertension at Can Tho University of Medicine and Pharmacy Hospital from May 2017 to May 2018. Total homocysteine levels and related factors were collected at the study time. The mean plasma total homocysteine level was 16.24 ± 4.49 µmol/L. There were 78 patients with elevated plasma total homocysteine levels ≥15 µmol/L, accounting for 74.3% of all patients. Being elderly, gender, hypertension stage, and diabetes were factors associated with hyperhomocysteinemia (p < 0.05). Total homocysteine levels were positively correlated with SBP, DBP, and age with r(SBP) = 0.696, r(DBP) = 0.585, and r(age) = 0.286. Research on the subpopulation of Vietnamese people shows that hyperhomocysteinemia is common in patients with newly diagnosed primary hypertension, and high blood total homocysteine levels are often related to age, sex, hypertension stage, and diabetes.

Associations of Parameters of the Tryptophan-Kynurenine Pathway with Cardiovascular Risk Factors in Hypertensive Patients.

Accumulating evidence suggests an association of the tryptophan-kynurenine (TRP-KYN) pathway with atherosclerosis and cardiovascular risk factors. In this cross-sectional analysis we investigated whether TRP-KYN pathway parameters are associated with 24 h blood pressure (BP) and other risk factors in patients with arterial hypertension from a tertiary care centre. In 490 participants, we found no significant and independent association of 24 h systolic and diastolic BP with parameters of the TRP-KYN pathway. However, linear regression analyses of HDL as dependent and TRP, KYN and quinolinic acid (QUIN) as explanatory variables adjusted for BMI and sex showed significant associations. These were found for KYN, BMI and sex (unstandardised beta coefficient -0.182, standard error 0.052, p < 0.001; -0.313 (0.078), p < 0.001; -0.180 (0.024), p < 0.001, respectively) as well as for QUIN, BMI and sex (-0.157 (0.038), p < 0.001; -0.321 (0.079), p < 0.001; -0.193 (0.024), p < 0.001, respectively). Smokers had significantly lower levels of KYN (2.36 µmol/L, IQR 2.01-2.98, versus 2.71 µmol/L, IQR 2.31-3.27, p < 0.001), QUIN (384 nmol/L, IQR 303-448, versus 451 nmol/L, IQR 369-575, p < 0.001) and KYN/TRP ratio (38.2, IQR 33.7-43.2, versus 43.1, IQR 37.5-50.9, p < 0.001) compared to non-smokers. We demonstrated that TRP/KYN pathway metabolites are associated with some cardiovascular risk factors, warranting further studies to elucidate the diagnostic and therapeutic potential of the TRP-KYN pathway for cardiovascular diseases.

Training, detraining and retraining effects of moderate vs. high intensity exercise training programme on cardiovascular risk factors.

The aim of the present study was to analyse the effect of 12 weeks of training, 7 weeks of detraining and 16 weeks of retraining using a moderate or high intensity training programme on cardiovascular risk factors in hypertensive patients. Thirty-four patients took part in the study. The intensity training was 80-90% of maximum heart rate for the high-intensity training (HIT) group ( n = 15) and at 50-70% of maximum heart rate for the moderate training (MT) group ( n = 19). Blood pressure, body composition, lipid profile, fasting glucose, strength and cardiovascular fitness were analysed. The first training period did not decrease blood pressure, but the second training period saw significant decreases in blood pressures in HIT group. Moreover, 12 weeks of MT or HIT did not decrease body mass, body mass index or fat mass. However, after 7 weeks of detraining, the inclusion of a second training period using HIT saw decreases in these body composition variables. Both training periods and intensities improved high-density lipoprotein and low-density lipoprotein, but only HIT decreased total cholesterol. In addition, after 7 weeks of detraining, the lipid profile variables returned to baseline values. Additionally, 16 weeks of retraining with HIT or MT decreased blood glucose significantly. Moreover, MT and HIT training programmes in both periods improved cardiorespiratory fitness, but with 7 weeks of detraining, it returned to baseline values. Our data demonstrated the effectiveness of the inclusion of a MT or HIT programme as adjuvant therapy in hypertensive patients.

Evaluation of MMP-9 with atherogenic index and electrocardiogram as a predictor of cardiovascular risk factors in hypertensive patients

Hypertension is the strongest or one of the strongest risk factors for almost all different cardiovascular diseases acquired during life, including coronary disease, left ventricular hypertrophy, and valvular heart diseases. So, the aim of this study was to evaluate the plasma concentration of MMP-9 and AIP in mild to moderate hypertensive patients. : A total of 162 patients with hypertensive case were recruited and compared with the 100 normotensive controls from the Rohilkhand Medical College and Hospital Bareilly. Parameters include waist circumference (WC), Fasting Blood Sugar (FBS), Lipid profile with Atherogenic Index, and Matrix metalloproteinase-2 were estimated in the plasma of all the test groups. Electrocardiography (ECG) was also performed as a cardiovascular tool.There was a significantly increased concentration of WC, FBS, and Lipid parameters except for HDL which is slightly lower in the case group when compared to the control group. The concentration of MMP-9 was also increased, which is positively significant. The mean value of the P-R interval, QRS complex, and QT interval was also increased in hypertensive as compared to the controls.Atherogenic index and MMP-9 are significantly higher in hypertensive patients. So, it could be a biomarker of cardiovascular disease.

Dietary diversity score is associated with cardiometabolic risk factors in patients with hypertension (Hoveyzeh cohort study)

BACKGROUND: Dietary diversity score (DDS) is recognized as an essential factor of a high-quality diet. OBJECTIVE: To evaluate the relationship between DDS and cardiometabolic risk factors in hypertensive patients. METHODS: In this cross-sectional study, 972 hypertensive patients (322 males and 650 females) aged 35–70y participated were recruited. Dietary intake was evaluated using a semi-quantitative food frequency questionnaire and DDS was calculated. Metabolic syndrome was defined according to the IDF/AHA criteria. The anthropometric parameters, fasting blood sugar, lipid profile, and liver enzymes were measured. RESULTS: Male subjects who assigned to the top DDS tertile had 51% lower risk of having low serum HDL-C (OR: 0.49; 95% CI: 0.24–0.96) in the crude model. A similar association was observed for men in the second tertile of DDS after adjusting for covariates (OR: 0.47; 95% CI: 0.23–0.97). A significant inverse association was found between vegetable diversity score and odds of hyperglycemia in the male group in the adjusted model (OR: 0.44; 95% CI: 0.22–0.91). The vegetable diversity score was inversely associated with 67% decreased metabolic syndrome risk in the adjusted model (OR: 0.33; 95% CI: 0.15–0.70). CONCLUSION: These findings clarify the possible preventive role of higher DDS against metabolic syndrome.

Cardiovascular Disease Risk Factors in Hypertensive Patients: A Case Study of Jimma University Medical Center.

BackgroundCardiovascular diseases are a group of disorders of the heart and blood vessels. Globally an estimated 17.9 million people died from cardiovascular diseases, which covers 31% of all global deaths, and the three quarters taking place in developing countries. Hypertension is the major cause of cardiovascular diseases. Its influence is high with other risk factors. This study aimed to determine the major risk factors of cardiovascular disease among hypertensive patients at Jimma University Medical Center.MethodsUsing December to January 2017 hypertension-related report of Jimma University Medical Center (JUMC), a retrospective cohort study type was conducted on purposively selected 343 patients. Three nurses from JUMC participated in the data collection, and the data were fitted using the Cox-Proportional Hazard (Cox-PH) model.ResultsAbout 138 (40.23%) patients were experienced cardiovascular disease at 28 months median time. From the Cox-PH model, the hazard ratio and 95% CI of age (HR = 1.0495, 95% CI: 1.0250-1.0747), urban (HR = 2.1225, 95% CI: 1.3813-3.2613), diabetes mellitus (HR = 1.702, 95% CI: 1.0082-2.8731), proteinuria (HR = 1.8749, 95% CI: 1.2675-2.7734), two drug users (HR = 0.2533, 95% CI: 0.1376-0.4662), systolic blood pressure (HR = 1.0343, 95% CI: 1.0147-1.0542) and pulse rate (HR = 1.0111, 95% CI: 0.9933-1.0293).ConclusionThe presence of proteinuria, diabetes mellitus, and being an urban resident had a great impact on the cardiovascular diseases of hypertensive patients.

Relationship between obesity and psychosocial risk factors in hypertensive patients

Abstract Introduction: Unhealthy lifestyle habits, including sedentary behaviour and improper diet are major risk factors for obesity. Overweight is very frequent in hypertensive and type 2 diabetic patients. Psychosocial factors are associated with multiple health behaviors related to overweight/obesity. The aim of the study was to evaluate the relationship between obesity and psychosocial risk factors in hypertensive patients having different levels of education. Material and methods: 623 hypertensive patients, admitted to the Cardiovascular Rehabilitation Clinic in Tîrgu Mureș were evaluated by weight, height, waist circumference, laboratory analyses and psychosocial risk based on a validated questionnaire on nine topics. Non-paired Student t test was used for statistical evaluation of the obtained data. Results: Obesity or overweight affected 86.9% of the studied hypertensive patients. Obesity was more frequent in subjects having type 2 diabetes as comorbidity. Mean BMI was significantly higher in the lower education group (p=0.007) compared to those with higher level of education. Average triglyceride and uric acid levels were significantly higher in obese subjects compared to those having lower BMI (p<0.0001). Patients living alone had significantly lower mean BMI (p=0.006) and waist circumference values (p=0.001) compared to those living with their spouse. Conclusions: Weight excess in very frequent in the studied hypertensive patients, especially in those with type 2 diabetes as comorbidity and having lower educational level. Hypertriglyceridemia and hyperuricemia occurred more frequently in obese subjects compared to non-obese ones. Overweight is less frequent in patients living alone.

Observation of the Clinical Correlation between Carotid Artery Intima-Media Thickness and Cardiovascular Risk Factors in Hypertensive Patients under Microscope Images

With the development of social science and technology and people’s demand for exploring the micro world, digital microscope technology came into being. Microscope image processing technology has been widely used in industrial micromanipulation, biomedicine, and cultural relic identification and preservation. In order to in-depth study the use of microscope image technology to observe the thickness of the carotid artery intima-media in hypertensive patients to find out whether it is feasible to explore many risk factors for cardiovascular development, this article uses data analysis, concept analysis, and graphic construction methods to collect samples, analyzed the image, streamlined the algorithm, and created a microscope image that can study its risk factors. The severity of hypertension, diabetes, and other factors affects the thickness of carotid arteries and cardiovascular diseases. The results show that the longer the duration of hypertension, the higher the central and peripheral blood pressure, the higher the height, and the higher the central blood pressure, which is relatively low. The detection rate of elevated central blood pressure is higher (76.8%). The second group (53.6%) and the third group (49.2%) ( P < 0.008 ); older age, the central blood pressure is relatively high, and the detection rate of central blood pressure increases (75.5%). It is higher than normal blood pressure (24.5%), so it can be concluded that hypertension not only affects central blood pressure but also peripheral blood; height and age are independent factors that affect central blood pressure. It is basically realized that starting from the microscope image, many risk factors of cardiovascular disease have been successfully analyzed.

A prospective, multicenter, epidemiological study of the prevalence of cardiovascular risk factors in hypertensive patients in Greece, the WIN-HAZARD study

Abstract Background/Introduction Arterial hypertension (AH) is a major, common, modifiable, risk factor for cardiovascular disease. It is strongly associated with cardiovascular disease (CVD), the leading cause of death globally, according to World Health Organization. In addition to elevated blood pressure (BP), many hypertensive patients have other risk factors that increase the overall cardiovascular risk. The calculation of the total cardiovascular (CV) risk is necessary for selecting the proper treatment strategy and guide timely treatment decisions and interventions. Purpose This prospective, multicenter, epidemiological, non-interventional, nationwide study aimed to evaluate the type and number of total CVD risk factors in hypertensive patients in Greece, according to the 2013 guidelines of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC), applicable at the time of the study conduct. Methods Overall, 3 Cardiology Hospital sites and 167 private Cardiologists, Internists, Endocrinologists and General Practitioners nationwide participated in the study, enrolling consecutive adult patients with hypertension under treatment. Total CV risk was assessed by 2013 ESH/ESC criteria, and the European Systematic Coronary Risk Evaluation (SCORE) algorithm. It involved a single visit, with no screening period for the patients. The study has been conducted in compliance with ICH/GCP standards, from March 2017 to April 2019. Results In total 1309 patients with AH under treatment were enrolled (59% male, mean age 60.6 years, mean BMI 28.2). The median time from AH diagnosis was 3.7 years. The most common CV risk factors were dyslipidaemia (76.4%), male gender (59%), advanced age (58.1%) and abdominal obesity (46.1%). The incidence of the remaining total CV risk factors per category was asymptomatic target organ damage (20.8%), diabetes (11.3%) and established CV or renal disease (5.8%). The majority of the study patients (71.6%) had concomitantly ≥3 total CV risk factors (table 1 and table 2). The mean (±SD) systolic arterial pressure was 143.5±14.7 mmHg and the mean (±SD) diastolic 85.5±8.6 mmHg. More than half of the patients (51.8%) received one antihypertensive drug, with angiotensin II receptor blockers (ARBs) being the most commonly reported drug class (23.9%), followed by calcium channel blockers (15.8%). Conclusion This real-world study with its broad geographical coverage and phycisians' specialty range, contributed significant epidemiological data pertaining to prevalence of cardiovascular risk factors in adult hypertensive patients and their current treatment status in Greece. The value of this observational study lies in supporting the proper deployment of current guidelines, as well as, the implementation of future preventive healthcare programmes. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): WIN MEDICA S.A. Table 1Table 2

The Progetto Ipertensione Umbria Monitoraggio Ambulatoriale (PIUMA) Study.

The Progetto Ipertensione Umbria Monitoraggio Ambulatoriale (PIUMA) Study is a prospective registry of morbidity and mortality in initially untreated patients with essential hypertension whose initial diagnostic evaluation included 24-hour ambulatory blood pressure (ABP) monitoring according to a standardized protocol. The present article summarizes the main results of the PIUMA Study. The PIUMA Study is conducted in three hospitals in Umbria, Italy. After their initial assessment at entry, patients are followed in the outpatient clinic of the referring hospital and in collaboration with their family doctors. Telephone interviews with patients and meetings with family doctors are periodically conducted to ascertain the incidence of major complications of hypertension. The PIUMA Study gave us a tremendous opportunity to investigate several aspects related to hypertension: 1) cross-sectional studies focused on the association between clinic and 24-hour ABP and organ damage; 2) longitudinal studies focused on the association between 24-hour ABP and hypertensive organ damage at cardiac level and other levels with the subsequent incidence of major cardiovascular events and mortality; 3) longitudinal studies exploring the prognostic impact of other risk factors in hypertensive patients (i.e. diabetes, dyslipidemia, atrial fibrillation, left ventricular dysfunction, etc.). The PIUMA Study provided the first ever evidence of the prognostic value of: 1) 24-hour ambulatory blood pressure monitoring; and 2) regression of echocardiographic left ventricular hypertrophy in hypertensive patients. The PIUMA Registry gave us an enormous opportunity for investigating several pathophysiologic, diagnostic and therapeutic aspects related to management of hypertensive patients. Some of our studies have been mentioned in several hypertension guidelines to support some specific statements.

RELATIONSHIP BETWEEN PCSK9 PLASMA LEVELS AND CAROTID ATEROSCLEROSIS IN HYPERTENSIVE PATIENTS

Objective: The objective of our study is to assess whether serum PSCK9 levels are associated with AT by measuring the CIMT, which allows the identification of an analytically independent risk factor in hypertensive patients, with the aim of improving early cardiovascular risk detection in these patients. Design and method: In a population of 166 patients with high blood pressure (HBP), the CIMT was evaluated and correlated with the analytical values of PCSK9. The age of the participants ranges between 30 and 86 years, with an average age of 59.5 years and a standard deviation of 11.4 years (CV-19.2%). 55.4% were men. Ultrasound variables related to the carotid arteries, specifically the CIMT and the presence of unstable plaques, were analysed. Results: We analyse the possible relationship between the plasma value of PCSK9 and the CIMT considering two situations: that the CIMT is normal or altered. The average PCSK9 levels for both situations are high, observing that the average value for people with altered CIMT is significantly higher (p = 0.001). If we calculate the mean values of CIMT for individuals with normal and altered PCSK9, it is observed that it is significantly higher in individuals with altered PCSK9 (p = 0.000). We also relate the percentage of individuals with altered CIMT with the presence of normal / altered PCSK9 values. The relationship between the variables is statistically significant (p = 0.000), indicating that the proportion of subjects with alteration of the PCSK9 is clearly higher in the group with altered CIMT (75.5% versus 39.3%). With respect to the relationship between PCSK9 values and the presence or absence of unstable carotid plaques, in individuals with this type of plaque, the average level of PCSK9 is clearly higher. However, since the group with this situation is very small, the difference cannot be considered significant (p = 0.170). Conclusions: The serum levels of PSCK9 are positively correlated with an early CV risk factor (CIMT). Therefore, we can conclude that PSCK9 can become an independent risk factor for AT in hypertensive patients. More studies are needed to confirm our preliminary results

ASSOCIATION RELATIVE TELOMERE LENGTH AND TELOMERASE ACTIVITY WITH LIFESTYLE RISK FACTORS IN HYPERTENSIVE PATIENTS

Objective: To determine association relative telomere length (RTL) and telomerase activity with lifestyle risk factors in hypertensive patients (pts) and normotensive individuals. Design and method: 80 people (34 hypertensive patients and 46 normotensive individuals) were examined. Mean age of hypertensive pts was 55.5 ± 8.7 and of normotensives was 49.7 ± 9.9 years. Smoking status, alcohol abuse, level of physical activity, body mass index, waist circumference, presence of obesity, dietary habits, blood pressure (BP), glucose and cholesterol levels, depressive episodes and psychological stress were evaluated. Arterial stiffness performed by volume sphygmography with assessing cardio-ankle-vascular index (CAVI) and ankle-brachial index. The RTL of peripheral blood leukocytes performed by previously validated real-time PCR. Telomerase activity was determined by enzyme immunoassay. Results: The association was found between RTL and CAVI (r = −0.414; p = 0.021) in the group of hypertensive pts. However, there were no association with age, levels of glucose and cholesterol, BP, obesity, diet and psychological risk factors. Sedentary work was related with shortening RTL in hypertensive patients (p = 0.043) and in normotensives (p = 0.003). Telomerase activity was related with fruit consumption (r = 0.520; p = 0.004) in hypertensive patients. Among normotensives telomerase activity was associated with consumption of fish (r = 0.344; p = 0.024) and vegetables (r = 0.302; p = 0.004). In hypertensive patients and in normotensives also was found trend toward relation between telomerase activity with dietary salt (r = −0.312; p = 0.08 and r = −0.270; p = 0.07, accordingly). Conclusions: The data suggests that lifestyle risk factors such as sedentary work and rare fruit consumption can influence on RTL and telomerase activity in hypertensive pts as well as sedentary work, low intake of fish and vegetables in normotensive people.

Resting Heart Rate as a Cardiovascular Risk Factor in Hypertensive Patients: An Update.

A large body of evidence has shown that resting heart rate (RHR) holds important prognostic information in several clinical conditions. In the majority of the general population studies, a graded association between RHR and mortality from all causes, cardiovascular (CV) disease, ischemic heart disease, and stroke has been observed. These associations appeared even stronger and more consistent in hypertensive patients. Studies performed with 24-hour ambulatory recording have shown that an elevated nighttime heart rate may confer an additional risk on top of office RHR. The mechanisms by which tachycardia alone or in association with sympathetic overactivity induces CV damage are well understood. Fast RHR is a strong predictor of future hypertension, metabolic disturbances, obesity, and diabetes. Several experimental lines of research point to high RHR as a main risk factor for the development of atherosclerosis, large artery stiffness, and CV disease. Elevated RHR is a common feature in patients with hypertension. Thus, there is a large segment of the hypertensive population that would benefit from a treatment able to decrease RHR. Improvement of unhealthy lifestyle should be the first goal in the management of the hypertensive patient with elevated RHR. Most clinical guidelines now recommend the use of combination therapies even in the initial treatment of hypertension. Although no results of clinical trials specifically designed to investigate the effect of RHR lowering in human beings without CV diseases are available, in hypertensive patients with high RHR a combination therapy including a cardiac slowing drug at optimized dose seems a sensible strategy. Tachycardia can be considered both as a marker of sympathetic overactivity and as a risk factor for cardiovascular events. In this sketch, the main cardiovascular and metabolic effects of increased sympathetic tone underlying high heart rate are shown. The link between tachycardia and cardiovascular events can be explained also by the direct hemodynamic action of heart rate on the arteries and the left ventricular (LV) wall.

Blood Pressure and Control Factor in Hypertensives Monitored at the Referral Hopsital in Boma. Democratic Repubic of the Congo

Uncontrolled hypertension remains a significant problem in daily clinical practice worldwide. Few data are available on blood pressure control in hospitals. The aim of this study was the frequency of uncontrolled hypertension and associated risk factors in hypertensive patients followed at the general referral hospital of Boma in the province of Kongo Central in the Democratic Republic of Congo From January 1 to May 31, 2019; we conducted a cross-sectional and descriptive study at the Boma reference hospital located in the southeast and 440 Km from Kinshasa, the capital of DR Congo. Included was any hypertensive patient aver 18 years and informed consent. Information on demographic parameters, behavioral lifestyles, anthropometric and biological (blood sugar, creatinine, urine strip and lipid profile ) and blood pressure (BP) measurements was obtained. Hypertension was defined as an average of two BP ≥ 140/90 mmHg. Independent factors associated with control hypertension were identified using logistic regression analysis. P<0.05 defined the level of statistical significance. The prevalence of uncontrolled hypertension was 62 % BP control was observed in 150 (38.0%) of 395 treated hypertensive participants mainly in men than women (68.3 vs 53.3 %; p=0.001). Age <60 years (p=0.005), no smoking ( p=0.047), no Central obesity (p=0.008), CKD ( stade 1 vs 2 ) (p=0.065) , and no hypercholesterolemia ( p= 0.014) emerged as associated with control hypertension. Uncontrolled hypertension was common in our hospitals.Therapeutic lifestyle changes and pharmacological treatment are necessary for hypertensive participants.