Stages Of Hypertension Research Articles

Association between Physical Activity Frequency and Hypertension Incidence among Indonesian Adults based on Indonesian Family Life Survey Wave 4 and 5

Introduction: Hypertension incidence among adults in Indonesia increase every year. Many factors affect blood pressure, such as lifestyle which include diet and physical activity. This research aimed to analyse the association between physical activity frequency and hypertension incidence in Indonesia.Methods : This study used secondary data from Indonesian Family Life Survey Wave 4 and 5 held in 2007 and 2014, respectively from 257 adults. The subjects in this study had completed data on blood pressure, socioeconomic, and physical activity in both waves. The hypertension incidence was assessed using health practitioners’ diagnosis. Data analysis was conducted in logistic regressions.Results: There were differences in age, education level, systolic blood pressure (SBP), diastolic blood pressure (DBP), hypertension stage, and physical activities frequencies between IFLS4 data (2007) and IFLS5 data (2014) of the same subjects, with the p-values of <0.001. All of the physical activity frequencies (walk, moderate and vigorous) has no correlation with systolic blood pressure. The vigorous physical activity was positively correlated with diastolic blood pressure in both unadjusted (p=0.029) and adjusted analysis (p=0.017). Conclusion: The frequency of physical activity (walk, moderate, and vigorous) was not correlated to systolic blood pressures, but vigorous physical activity was positively correlated to diastolic blood pressure. For hypertension prevention, vigorous physical activity need to be reduced into moderate activities.

Peripapillary and macular vascular densities in healthy, ocular hypertensive, and different stages of glaucomatous eyes.

To investigate vascular changes in different stages of glaucoma and to evaluate the role of optical coherence tomography angiography (OCTA) in the early diagnosis of glaucoma. Glaucoma patients and healthy controls (n=29 eyes) were investigated in this cross-sectional comparative study. Glaucoma patients were grouped as ocular hypertension (n=44 eyes), preperimetric glaucoma (PPG; n=32 eyes), early glaucoma (EG; n=35 eyes), moderate stage glaucoma (MG; n=36 eyes), and advanced glaucoma (AG; n=35 eyes). Peripapillary and macular vascular densities (VDs) of all participants were compared and correlations of VDs and retinal nerve fiber layer thickness (RNFLT), ganglion cell analysis (GCA), and visual field (VF) tests were evaluated. Area under the receiver operation characteristic curves (AUC) of the peripapillary and macular VD parameters were obtained. VD values decreased with the progression of glaucoma. Most peripapillary and macular VD parameters of PPG and EG groups were lower than healthy controls (P<0.001). There was no significant difference in RNFLT between the PPG and EG groups, but most peripapillary and macular VDs were found to be lower in EG group than in PPG group (P<0.05). In most disease group, VDs were significantly correlated with OCT parameters (P<0.001) and VF index (P<0.05). There were no significant correlations between VF and RNFLT indices in the AG group, but significant correlations were found between VF and VD values (P<0.05). AUC for discriminating between healthy and glaucomatous eyes were highest in whole image peripapillary VD (AUC: 0.865, 0.929, and 0.986, respectively in EG, MG, and AG groups). OCTA can be used in the early diagnosis of glaucoma and can be useful in follow-up of the advanced disease. In cases where limitations or suspicions in structural and functional tests are present, OCTA can be used as a supportive diagnostic test, both in EG and AG.

A model to determine factors influencing intraoperative complications in sleeve gastrectomy.

The study presents a logistic regression model describing the factors leading to intraoperative complications in laparoscopic sleeve gastrectomy (LSG) and a detailed description of the intraoperative complications that occurred in our operations. The study was designed as a retrospective and cohort study. It includes patients who underwent laparoscopic sleeve gastrectomy between January 2008 and December 2020. The study included 257 patients. The mean (SD) age of all patients included in the study was 40.28 (9.58) years. The body mass index of our patients ranged from 31.2 to 86.6 kg/m2. The Stepwise Backward model was used (Cox and Snell R2 = 0.051, Nagelkerke R2 = 0.072, Hosmer-Lemesxow χ2 = 1.968, df = 4, p = 0.742, overall model accuracy of 70.4%). The model shows that pre-operative diabetes mellitus or hypertension Stage 3 significantly increases the probability or risk of intraoperative complications. The study shows which intraoperative complications occur in LSG, how they can be remedied and which factors can lead to them and influence the outcome of the operation itself. The recognition and successful treatment of intraoperative complications are very important as they reduce the number of reoperations and treatment costs.

Controlled hypoxia-hyperoxytherapy as a component of a targeted approach in the rehabilitation of patients with multimorbidity: a single-center, randomized, placebo-controlled, prospective study

BACKGROUND: Multimorbidity is one of the most important public health problems, leading not only to a deterioration in the functional abilities of an individual, but also to an increase in the disability of the population, which determines the need to use effective measures in the treatment and rehabilitation of patients with multimorbid pathology.&#x0D; AIM: The aim of this study was to evaluate the effect of a two-week medical rehabilitation program including the respiratory therapy method based on short-term intermittent exposure to hypoxia and hyperoxia on the dynamics of hypoxia-inducible factor-1 (HIF-1) and C-reactive protein in patients with multiple chronic diseases. The novelty of this study is due to the peculiarities of the study group — patients with multimorbid pathology.&#x0D; MATERIALS AND METHODS: A single-center, randomized, placebo-controlled, prospective study (NCT05053672, ClinicalTrials.gov) included 42 patients aged 43 to 68 years with multimorbid pathology: generalized osteoarthritis — 61.9%, knee OA — 21.4%, hip OA — 16.7%, controlled arterial hypertension stage I–II — 90.5%, post-Covid syndrome — 100%. Patients were randomized into 2 groups by the method of numbered identical containers. According to clinical and demographic characteristics of patients, concomitant pathology, C-reactive protein and HIF-1 levels, the studied groups were comparable. The main group (27 patients) received a course (8–10 sessions) of individually dosed hypoxy-hyperoxytherapy on the basis of biofeedback (reoxytherapy) against the background of the standard complex of medical rehabilitation. The comparison group (15 patients) received sham reoxy therapy (placebo treatment) along with standard rehabilitation.&#x0D; RESULTS: The data obtained as a result of the study in multimorbid patients using reoxy-therapy clearly demonstrated reduction of clinical symptoms, improvement of general well-being according to visual analogue scale and decrease of C-reactive protein as a classical marker of inflammation against the background of stabilization of HIF-1 dynamics.&#x0D; CONCLUSION: The use of biofeedback-based short-term intermittent exposure to hypoxia and hyperoxia (reoxy therapy) in patients with different initial characteristics in terms of clinical health status and multimorbid pathology is reasonable taking into account modern personalized approaches to medical rehabilitation.

Dynamics of lipid metabolism in hypertensive patients who have had COVID-19 when the L-arginine + dihydroquercetin complex is included in the combined antihypertensive pharmacotherapy

Purpose: To evaluate data on the dynamics of lipid metabolism in patients with arterial hypertension stage II who have had COVID-19, when the L-arginine complex + dihydroquercetin. Materials and methods: The article provides data on the dynamics of lipid metabolism in patients with arterial hypertension stage II who have had COVID-19, when the L-arginine complex (500 mg tablets 1 time per day) + dihydroquercetin (25 mg tablets 2 times) is included in combination antihypertensive therapy per day. Results: In patients who received combination antihypertensive therapy, which included statins (group 1), the target triglyceride value (&lt;1.7 mmol/l) was not achieved. The target value for calculated low-density lipoprotein cholesterol (&lt;3.7 mmol/L) was also not achieved. More significant changes in lipid metabolism were detected in patients (group 2) who took the L-arginine + dihydroquercetin complex as part of combined antihypertensive therapy, which included statins. Thus, in patients of group 2, total cholesterol and triglycerides decreased significantly (by 20-30%). There was also a significant decrease in this group of patients (by 30%) in the calculated indicator of low-density lipoprotein cholesterol and its target value was achieved (&lt;3.7 mmol/l), namely 3.13±0.19 mmol/l. Summary: the inclusion of the L-arginine complex (tablets 500 mg 1 time per day) + dihydroquercetin (tablets 25 mg 2 times per day) in the combined AHT + statins in patients with stage II hypertension who have had COVID-19 is more effective than the combination AHT + statins affect OB, which is manifested by an improvement in its key indicators (TC, TG, LDL-C and HDL-C), as well as the calculated indicator of non-HDL-C.

Machine learning approaches for cardiovascular hypertension stage estimation using photoplethysmography and clinical features.

Cardiovascular diseases (CVDs) are a leading cause of death worldwide, with hypertension emerging as a significant risk factor. Early detection and treatment of hypertension can significantly reduce the risk of developing CVDs and related complications. This work proposes a novel approach employing features extracted from the acceleration photoplethysmography (APG) waveform, alongside clinical parameters, to estimate different stages of hypertension. The current study used a publicly available dataset and a novel feature extraction algorithm to extract APG waveform features. Three distinct supervised machine learning algorithms were employed in the classification task, namely: Decision Tree (DT), Linear Discriminant Analysis (LDA), and Linear Support Vector Machine (LSVM). Results indicate that the DT model achieved exceptional training accuracy of 100% during cross-validation and maintained a high accuracy of 96.87% on the test dataset. The LDA model demonstrated competitive performance, yielding 85.02% accuracy during cross-validation and 84.37% on the test dataset. Meanwhile, the LSVM model exhibited robust accuracy, achieving 88.77% during cross-validation and 93.75% on the test dataset. These findings underscore the potential of APG analysis as a valuable tool for clinicians in estimating hypertension stages, supporting the need for early detection and intervention. This investigation not only advances hypertension risk assessment but also advocates for enhanced cardiovascular healthcare outcomes.

MANAJEMEN HIPERTENSI DENGAN TREATMENT NON-FARMAKOLOGI

Management of hypertension therapy must be carried out throughout life, both pharmacological and non-pharmacological therapy, to reduce the risk of complications and improve the quality of life of the elderly. This causes the need for assistance through providing education for elderly people who suffer from hypertension in order to achieve controlled blood pressure and reduce the symptoms of hypertension so that the risk of complications can be reduced. The design of this research is a systematic review. The search for articles discussed in this study used several databases, including Pubmed, Proquest, and ScienceDirect, with a time span of 2012 to 2022. The keywords used to search for these articles were hypertension management, hypertension treatment, non-pharmacological treatment. The type of article used is a research article. The articles collected were then re-selected using inclusion criteria, namely: 1) the aim of the article was to analyze the effectiveness of non-pharmacological treatment in hypertension management, 2) it was experimental research, as well as exclusion criteria, namely 1) it was not a full text article, 2) the article did not use English. Based on 23 selected articles, non-pharmacological interventions help reduce the daily dose of antihypertensive drugs and delay the progression from prehypertension to the hypertensive stage.

The relationship of asymmetric dimethylarginine levels with uncontrolled arterial hypertension and hypertension disease stage

Background: Patients with treatment-resistant hypertension have a worse cardiovascular prognosis compared to those who achieve their target levels of blood pressure (BP). One of biochemical and clinical markers of a decreased response to antihypertensive therapy can be asymmetric dimethylarginine (ADMA), a molecule that reduces formation of nitric oxide and promotes endothelial dysfunction and vasoconstriction.&#x0D; Aim: To assess the status of the nitrogen oxide synthesis system and clinical and laboratory profile in patients, depending on the hypertensive disease stage, who achieved or not achieved their target BP levels during hospitalization.&#x0D; Materials and methods: We performed аn observational retrospective uncontrolled study in a consecutive sample of 192 patients aged 45–65 years who were admitted to the City Clinical Hospital No. 25 (city of Novosibirsk) with a diagnosis of uncomplicated hypertensive crisis. On the day of discharge, the patients were retrospectively divided into 2 groups. Group 1 included patients who achieved their target BP during hospitalization (target BP group, n = 116). Group 2 included patients with uncontrolled hypertension, in whom the administration of three antihypertensive drugs including a diuretic in optimal or maximal tolerated doses did not result in the achievement of the target BP below 140 and/or 90 mm Hg during hospitalization (non-target BP group, n = 76).&#x0D; The following parameters were measured: ADMA, symmetrical dimethylarginine (SDMA), N-monomethyl-L-arginine (NMMA), and total nitric oxide.&#x0D; Results: Serum ADMA concentrations (Me [Q25%; Q75%] were increasing with the stage of hypertension: stage I, 0.75 µmol/L [0.66; 0.78], stage II, 1.14 µmol/L [0.87; 1.39], stage III, 1.38 µmol/L [1.22; 1.49] (p 0.0001, Kruskal-Wallis test). In the pairwise comparison, the difference between all these subgroups was significant at p 0.01. In the patients with uncontrolled arterial hypertension ADMA levels were increased compared to those in the target BP group: 1.2 µmol/L [0.99; 1.47] vs 1.07 [0.79; 1.34] µmol/L (p = 0.002). The proportion of patients with type 2 diabetes mellitus among those with uncontrolled arterial hypertension was 31.2% (24/76), while in the target BP group there were only 3.5% of such patients (4/116) (odds ratio 12.57, 95% confidence interval 4.15–38.05; p = 0.00001).&#x0D; Conclusion: ADMA measurement may help identify patients with a potential poor response to antihypertensive therapy. This should be taken into account when choosing a treatment regimen and BP monitoring. In addition, ADMA seems to be a promising target for the development of new drug classes.

Health Screening Among a Rural, Hourly Workforce: North Carolina SERVIRE Project

This study demonstrates the feasibility of a novel, business-partnered, and worksite-based approach to healthcare access to facilitate chronic disease screening and diagnosis among rural hourly workers. The prevalence of undiagnosed and untreated diabetes and hypertension among screening participants was determined. From February 2021 to June 2023, investigators partnered with 29 businesses to screen 1,114 workers. Health screenings included a demographic questionnaire, A1c testing for prediabetes (A1c of 5.7-6.4) and diabetes (A1c≥6.5), hypertension (Stage 1: systolic blood pressure of 130-139 mmHg; Stage 2: systolic blood pressure ≥140 mmHg), kidney disease (estimated glomerular filtration rate <60; urine protein ≥1+), and questionnaire assessment of stroke (CHA2DS2-VASc) and sleep apnea (STOP-bang) risk. Of the 1,114 individuals screened (n=632, 56.7% male; n=497, 44.6% Black)), 388 (36%) screened positive for prediabetes or diabetes. Diabetes was previously undiagnosed in 273 (70.4%) of these participants. More than half of the participants (n=680, 62.4%) had an elevated blood pressure reading during the screening, and the majority of these participants (n=445, 65.4%) had not been previously diagnosed with hypertension. In addition, 241 (21.6%) participants were at an increased risk of stroke (CHA2DS2-VASc≥2), and 182 (23.7%) had a STOP-Bang score ≥4, indicating an increased risk of obstructive sleep apnea. By partnering with local businesses to deliver worksite-based health screenings, high rates of undiagnosed and uncontrolled diabetes and hypertension were identified among the rural, hourly workforce. This worksite-based approach to healthcare access could facilitate early detection of chronic disease, improve patient engagement in the healthcare system, and ultimately yield better long-term public health outcomes.

Outcomes of asymptomatic left ventricular dysfunction in the patient with or without type 2 diabetic Mellitus

Abstract Background Type 2 diabetes mellitus (T2DM) has been related to ventricular systolic and diastolic dysfunction and subsequent heart failure. [1] The study aimed to investigate the prevalence of asymptomatic left ventricular dysfunction (aLVD) in subjects with T2DM, and its predisposing factors. Method Subjects without existed cardiovascular disease were eligible for this study. Left ventricular ejection fraction (LVEF), mitral E/A ratio, peak mitral annulus tissue velocity (e’), left atrial dimension (LAD), peak tricuspid regurgitation velocity (TR Vmax) were obtained by a standard echocardiographic study. Asymptomatic left ventricular diastolic dysfunction (ALVSD) was defined as LVEF &amp;lt; 50% and the asymptomatic left ventricular diastolic dysfunction (ALVDD) was defined as having three or more of the four parameters: septal e' &amp;lt; 7, septal E/e’&amp;gt;15, LAD &amp;gt; 40mm, and TR Vmax &amp;gt; 2.8 m/s. [2] All-cause mortality up to 2 years was obtained by linking to the National Death Registry. Result A total of 27684 subjects (59.6±17.4 years, 46.2% men, 17.7% diabetes) were included in this study(Table 1). The ALVSD patients were older, male dominant, more prevalent with hypertension, diabetes mellitus and coronary artery disease, and had higher BMI, lower hemoglobin, and estimated glomerular filtration rate. ALVSD and ALVDD was more prevalent in patients with T2DM than those without (4.9% vs 8.2%, P&amp;lt;0.001)(15.4% v.s. 32.1%) (Figure 1). Age (odds ratio and 95% confidence interval: 1.04, 1.03–1.04), male gender(2.24, 1.99-2.52), T2DM (1.28, 1.11-1.46), coronary artery disease (1.38, 1.14-1.68), hemoglobin (0.95, 0.91-1.00), CKD stage 3(2.02, 1.63-2.50), and CKD stage 4-5(3.95, 3.06-5.09) were all independently correlated to ALVSD(Table 2a). On the other hand age (odds ratio and 95% confidence interval: 1.07, 1.07–1.08), BMI (1.12, 1.11-1.13), T2DM (1.34, 1.24-1.46), hypertension (1.31, 1.20-1.43), hemoglobin (0.88, 0.85-0.91), and CKD stage 4-5(3.11, 2.58-3.76) were independently correlated to ALVDD(Table 2b). During a mean follow-up of 5.3 ± 3.6 years, there were 2625 deaths (9.5%). The Kaplan–Meier curve analysis revealed diabetic subjects with were associated with the worst survival rate than those with either T2DM or ALVSD/ALVDD (Figure 2). The Cox regression analysis revealed the ALVDD and ALVSD was related to mortality, independent of age, gender, body mass index, hypertension, coronary artery disease, hemoglobulin, estimated glomerular filtration rate, and medication [hazard ratio and 95% confidence interval of mortality(ALVSD/ALVDD): 1.78 (1.40–2.25)/1.31(1.15-1.49)]. Conclusion ALVD has a high disease burden in patients without established cardiovascular disease, and its prevalence is higher in patients with T2DM, which was associated with an excessive mortality rate. Therefore, early screening and intervention should be considered in diabetic patients.

Target blood pressure level in patients in the pre- and post-stroke period: features of antihypertensive therapy depending on the stage of hypertension (literature review)

Today, the problem of managing patients in the pre- and post-stroke period is associated with the target level of blood pressure. However, it is difficult to determine, because patients differ in age, duration and stage of hypertension, and comorbidities. Instrumental studies of the brain reveal its various lesions, as well as damage to the heart, impaired autoregulation of cerebral circulation, atherosclerosis of the major vessels of the head and neck. All these factors are certainly crucial for planning the long-term antihypertensive therapy.

Abstract 14690: ProduceRX Clinical Trial

Background: Nutrition related cardiometabolic diseases are leading causes of morbidity, health disparities and health care spending. Produce prescriptions are highly promising to address these issues but impacts on health outcomes have not been tested in a randomized controlled trial. Hypothesis: A pre-randomized controlled trial that provides 6 months of free weekly produce deliveries to the intervention group reduces hemoglobin A1c (HbA1c), body mass index (BMI), and blood pressure (BP), among Medicaid patients with type 2 diabetes (T2DM) and persistently elevated HbA1c when compared to the control group. Methods: A total of 450 eligible Kaiser Permanente Southern California patients were enrolled 1:1:1 into control, high- and low-dose intervention groups. Eligibility criteria included: being enrolled through Medicaid (MediCal), age 18+ years, having T2DM with at least two HbA1c values &gt; 7.5% in the past 12 months. Produce amounts were scaled to household size and ranged from $90-270 and $90-180 for high and low-dose households, respectively. The primary endpoint was change in HbA1c at 6 months (measured up to 90 days post-intervention). Secondary outcomes were changes in BMI and BP. Primary analysis assessed both intervention groups compared to control; exploratory analyses considered dose-response. Analysis was conducted using random effects models. Results: Participants were predominantly Hispanic (85%), female (65%), and in average 59.4(SD=13.2) years old. At baseline, HbA1c was 9.40% (1.52); BMI 34.1kg/m2 (7.95); 74% had elevated BP or hypertension (stage 1 or 2), 58.3% were food insecure. Baseline characteristics were similar between control and intervention groups, 87% of participants had a 6-month HbA1c measure. In intention-to-treat analysis, compared to control, HbA1c at 6 months was significantly reduced in the intervention group: -0.37 [95%CI:-0.71;-0.04],p=0.028. Reduction in HbA1c was not significantly different between the high- and low-dose intervention. Results for BMI and BP are forthcoming. Conclusion: In the first randomized controlled trial of its kind, a produce prescription program significantly improved HbA1c among low-income patients on Medicaid with poor glycemic control at baseline.

Abstract 12736: Prevalence, Characteristics, and Outcomes of Infective Endocarditis in Patients With Liver Disease in the United States

Introduction: Infective endocarditis (IE) is common in patients with liver disease. Data regarding IE in liver disease are limited. Hypothesis: We analyzed IE admissions to determine inpatient outcomes among patients with liver disease in the United States. Methods: We used the 2017 National Readmission Database to identify index admission of adults with IE, based on the International Classification of Disease, 10th revision codes. The primary outcome was 30-day readmission. Secondary outcomes were mortality and predictors of hospitalization readmission. Results: We identified 40,413 IE admissions. Figure 1 presents prevalence of variables associated with liver disease in this cohort. Patients who were readmitted were more likely to have a history of hepatitis C virus (19.4% vs 12.3%, p &lt; 0.001), hyponatremia (25% vs 21%, p &lt; 0.001), and thrombocytopenia (20.3% vs 16.3%, p &lt;0.001). After adjusting for age, hypertension, heart failure, diabetes mellitus, and end stage renal disease, hyponatremia (odds ratio (OR): 1.25; 95% confidence intervals [CI]: 1.17 to 1.35; p &lt; 0.001) and thrombocytopenia (OR: 1.16; 95% CI: 1.08 to 1.24; p &lt; 0.001) correlated with higher odds of 30-day readmission. Mortality was higher among patients with hyponatremia (29% vs 22%, p &lt; 0.001), thrombocytopenia (29% vs 17%, p &lt; 0.001), coagulopathy (12% vs 5%, p &lt; 0.001), cirrhosis (6% vs 4%, p &lt; 0.001), ascites (7% vs 3%, p &lt;0.001), liver failure (18% vs 3%, p &lt; 0.001), and portal hypertension (3% vs 1.5%, p &lt; 0.001) (Figure 2). Conclusions: Important liver disease related variables correlate with higher risks of hospital readmission and mortality in patients with IE. Targeting such variables may improve outcomes in this patient population.

COMBINATION OF FOOT HYDROTHERAPY AND SLOW DEEP BREATHING ON BLOOD PRESSURE IN HYPERTENSIVE PATIENTS

Introduction. Hypertension becomes very dangerous when the patient cannot control blood pressure, because it will cause complications. One of the nonpharmacological therapies that can be done is foot hydrotherapy using warm red ginger decoction and slow deep breathing. The purpose of this study was to determine the effect of the combination of red ginger foot hydrotherapy and slow deep breathing on blood pressure in patients with hypertension. Method. Pre-experimental research design with one group pre-test post-test design approach with a sample of 20 people. Total sampling technique. Observation sheet measuring instrument and sphygmomanometer with Wilcoxon statistical test. Result &amp; Analysis. The results of the study obtained blood pressure values before the intervention and found that all respondents had blood pressure in the category of hypertension stage 2 (100%) and after the intervention found 55% in the elevated category and stage 1 hypertension as much as 45%. The results of the static test p-value = 0.000, which shows the effect of the Red Ginger Foot Hydrotherapy combination of Slow Deep Breathing on the blood pressure of hypertensive patients. Discussion. Doing red ginger foot hydrotherapy in combination with slow deep breathing can control blood pressure, but must be supported to consume drugs regularly, exercise, carrying out a diet, and avoiding stress.

Relationship between hypertension/blood pressure and hearing sensitivity among drivers: A correlation analysis.

One of the most common chronic diseases is hypertension. The majority of research has linked hearing loss to hypertension. However, the relationship between hypertension and hearing is still unknown. The primary goal of the study is to investigate the effect of hypertension on hearing and to find out the association between blood pressure levels and auditory health in auto-rickshaw drivers. The study utilized 121 healthy professional auto-drivers between the age range of 25 and 55 years. Pure-tone audiometry (PTA) and extended high-frequency audiometry (EHFA) were used to determine the participants' hearing thresholds from 0.25 to 16 kHz. The cochlear hair cell functioning was evaluated using distortion-product otoacoustic emission (DPOAE) testing. Blood pressure (mmHg) measurements were categorized under hypertension stage (normal (120; <80); elevated (120-129; <80); hypertension - stage 1 (130-139; 80-89); hypertension - stage 2 (≥140; ≥90)). The mean age of the study participants was 42.17 ± 9.03 years. The mean systolic and diastolic BP of all the study participants were 138.24 ± 19.73 (105-216) mmHg and 87.69 ± 12.14 (60-134) mmHg, respectively. BP levels were normal for 17.4% (N = 21) of the study participants, 21.5% (N = 26) had elevated blood pressure, 21.5% (N = 26) of the population falls under stage 1 hypertension, and 39.7% (N = 48) had stage 2 hypertension. Our study discovered a significant difference between main group effects and no significant difference between group interaction effects. Hearing thresholds were significantly higher in hypertensive participants compared to non-hypertensive participants. However, there was no statistically significant relationship between the two variables hypertension and hearing loss. Implementing health promotion initiatives and raising awareness about hearing health could improve the quality of life for a high-risk occupational group of drivers.

HUBUNGAN DRUG RELATED PROBLEMS (DRPs) KATEGORI DOSIS OBAT AMLODIPIN DAN KAPTOPRIL TERHADAP KONDISI TEKANAN DARAH PADA PASIEN HIPERTENSI

The incidence of drug-related problems (DRPs) in the dose category on the use of antihypertensive drugs has been associated with the failure of the patient's optimal blood pressure target. The study aims to analyze the relationship between drug-related problems (DRPs) on administering amlodipine and captopril drugs to the blood pressure conditions of elderly hypertensive patients in Puskesmas. This research is observational research with a cross-sectional design of analytical nature—purposive sampling techniques. The total number of samples meeting the inclusion and exclusion criteria was 435 patients. Analysis of DRPs dose category relationship data on administration of amlodipine and captopril against blood pressure conditions using a chi-square test. The results of the study showed that the characteristics of patients visited tended to be aged 65-69 years (53.33%), female (68,51%), stage II hypertensive (62.1%), amlodipine (80.92%). The incidence of the DRP dose category in stage II hypertensive (7.6%). Statistically known DRPs of amlodipine and captopril dosing categories showed different significance in each patient's condition of prehypertension (p=0.260), hypertension stage I (p = &lt;0,001), hypertensive stage II (p&lt;0,001). This study concludes, there is a relationship between the incidence of DRPs in the dose category in patients with stage I and stage II hypertension.

Associations of serum uric acid with hypertension status, stages, phenotypes and progressions among Chinese middle-aged and elderly

Background and aimsNo consensus has been reached on the association between serum uric acid (SUA) and hypertension. This study aimed to investigate the associations between SUA and hypertension, including its status, stages, phenotypes and progressions, among middle-aged and older Chinese. Methods and resultsData were obtained from the China Health and Retirement Longitudinal Study 2011–2015. Binary logistic regression was used to evaluate the association between SUA and hypertension status. Multinomial logistic regression was used to explore the associations of SUA with hypertension stages, phenotypes and hypertension status progressions. Models were adjusted for potential confounders and stratified by sex. A total of 7931 individuals aged ≥45 years were included, with 39.16 % of hypertension. Significant associations were found of SUA with stage2 and above hypertension (quartile 4 [Q4] vs quartile 1 [Q1]: odds ratio 1.78, 95 % confidence interval 1.31–2.42, P < 0.001), and systolic diastolic hypertension (SDH) (Q4 vs Q1: 1.53, 1.14–2.06, P = 0.005). In sex stratification, significant associations were found between SUA and stage2 and above hypertension and SDH only for men. Moreover, higher quartiles of baseline SUA showed increased risks of maintained hypertension from 2011 to 2015 (Q3 vs Q1: 1.23, 1.03–1.48, P = 0.024; Q4 vs Q1: 1.73, 1.43–2.10, P < 0.001). ConclusionHigher SUA was associated with hypertension and maintained hypertension among Chinese middle-aged and elderly. Sex-specific associations of SUA with hypertension stages and phenotypes were observed. Regular measurement of SUA in clinical practice may indicate hypertension and its progression, particularly among men.

Cutaneous manifestations, viral load, and prognosis among hospitalised patients with COVID-19: a cohort study.

Various cutaneous manifestations have been reported as symptoms of coronavirus disease 2019 (COVID-19), which may facilitate early clinical diagnosis and management. This study explored the incidence of cutaneous manifestations among hospitalised patients with COVID-19 and investigated its relationships with viral load, co-morbidities, and outcomes. This retrospective study included adult patients admitted to a tertiary hospital for COVID-19 from July to September 2020. Clinical information, co-morbidities, viral load (cycle threshold [Ct] value), and outcomes were analysed. In total, 219 patients with confirmed COVID-19 were included. Twenty patients presented with new onset of rash. The incidence of new rash was 9.1% (95% confidence interval=6.25%-14.4%). The most common manifestations were maculopapular exanthem (n=6, 42.9%, median Ct value: 24.8), followed by livedo reticularis (n=4, 28.6%, median Ct value: 21.3), varicella-like lesions (n=2, 14.3%, median Ct value: 19.3), urticaria (n=1, 7.1%, median Ct value: 14.4), and acral chilblain and petechiae (n=1, 7.1%, median Ct value: 33.1). The median Ct values for patients with and without rash were 22.9 and 24.1, respectively (P=0.58). There were no significant differences in mortality or hospital stay between patients with and without rash. Patients with rash were more likely to display fever on admission (P<0.01). Regardless of cutaneous manifestations, patients with older age, hypertension, and chronic kidney disease stage ≥3 had significantly higher viral load and mortality (P<0.05). This study revealed no associations between cutaneous manifestation and viral load or clinical outcomes. Older patients with multiple co-morbidities have risks of high viral load and mortality; they should be closely monitored.

Characteristics of arterial hypertension in patients after being in a combat zone in the Kharkiv region of Ukraine

Objective — to study the characteristics of arterial hypertension (AH) in patients (representatives of the civilian population) after their stay in the combat zone in the Kharkiv region of Ukraine.&#x0D; Materials and methods. The study involved 62 patients with 2—3 degree AH (29 men and 33 women), who were examined in the Department of Arterial Hypertension and Kidney Disease at L. T. Mala NIT NAMSU before the war and 4—5 months after its start. The interval between the baseline and re‑examination was 8—9 months. All examined patients during the war were in the combat zone in Kharkiv region of Ukraine. The mean patients’ age was 52.4±4.3 years. All patients underwent general clinical, laboratory and instrumental examinations. The degree, stage of hypertension and the presence of risk factors for cardiovascular disease (CVD), established CVD and kidney disease were assessed in accordance with recent recommendations. At baseline, before the war start, all patients were administered two‑ or three‑component antihypertensive and (in the presence of elevated levels of low‑density lipoprotein cholesterol (LDL‑C) lipid‑lowering therapy in accordance with the latest guidelines. All 62 patients (100%) during their dynamic observation before the war, reached target levels of «office» blood pressure (BP). The frequency of achieving target levels of LDL‑C was significantly lower and amounted to 57%.&#x0D; Results. In patients with hypertension (representatives of the civilian population), who were in the combat zone in the Kharkiv region of Ukraine and experienced chronic wartime stress, a significant increase in the frequency of severe and uncontrolled hypertension, its crisis course and resistant form was found. Prognostically unfavorable consequences of staying in the combat zone in patients with hypertension is a significant increase in the incidence of such risk factors for CVD as increased LDL‑C blood levels, prediabetes and insulin resistance, smoking and regular alcohol consumption. Staying in the combat zone leads to a significant increase in the incidence of coronary heart disease, heart rhythm disturbances and heart failure in patients with hypertension and contributes to the accelerated development of type 2 diabetes mellitus, as well as such severe cardiovascular and cerebrovascular complications as atrial fibrillation, acute myocardial infarction, transient ischemic attack and ischemic stroke&#x0D; Conclusions. The stay of patients with hypertension in the combat zone and the related chronic stress of wartime leads to a significant worsening of hypertension course and to the development of adverse metabolic disorders and cardiovascular and cerebrovascular complications. This justifies the need to establish dynamic monitoring for this category of patients and conduct long‑term combined therapy, taking into account the characteristics of the clinical course and the presence and severity of the disease complications.&#x0D;

SAT617 Third Nerve Palsy As The Initial Presentation Of Pituitary Apoplexy, A Case Report

Abstract Disclosure: U. Siddiqui: None. M. Ahmad: None. K. Abiko: None. P. Ucciferro: None. Pituitary apoplexy is characterized by hemorrhage or infarction of the pituitary gland occurring after growth of a pre-existing adenoma. These adenomas are often asymptomatic, however, hemorrhage can compress surrounding cranial nerves and cause symptoms. We report a case of a 48-year-old male who presented with headache and third nerve palsy, found to have pituitary apoplexy despite negative initial CT imaging. Hospital Course: A 48-year-old man with a past medical history of asthma, cirrhosis, type 2 diabetes mellitus, hypertension and end stage renal disease presented to the emergency room for bitemporal headache. The headache was associated with right-sided blurry vision and ptosis. He was hypertensive to 166/79 mmHg, bradycardic to 58 beats per minute, afebrile with a temperature of 36.8 C with a respiratory rate of 18 breaths per minute. He was noted to have ptosis and inferolateral deviation of his right eye. Initial labs demonstrated the following: sodium 139 mmol/L, potassium 5.2 mmol/L, creatinine 8.44 mg/dL (baseline 6.5 mg/dL), bicarbonate 20 mmol/L, and hemoglobin 8.2 g/dL (baseline of 8-9 g/dL). The patient’s CT head without contrast and CT angiogram head and neck which were negative for acute infarct or hemorrhage, however, the patient’s MRI demonstrated a 2.1 x 2.1 x 1.4 cm macroadenoma with suprasellar extension and mild elevation of the optic chiasm. Further testing demonstrated a normal thyroid stimulating hormone level of 0.74 uIU/ml (normal 0.3-5.0 uIU/ml), low normal free t4 of 0.7 ng/dL (0.7-1.7 ng/dL), ACTH of &amp;lt;9 pg/ml (normal 9-46 pg/ml), morning cortisol of 1.3 mcg/dL (normal of &amp;gt;18 mcd/dL), total testosterone &amp;lt;10 ng/dL (normal 270-1070 ng/dL), follicular stimulating hormone of 2.2 mIU/ml (normal 1.5-12.4 mIU/mL) and a prolactin of 49 ng/ml (normal 0-19 mg/ml). Due to the patient’s symptoms and imaging findings he underwent transsphenoidal resection of tumor. Prior to the procedure he was placed on stress dosed steroids with IV hydrocortisone. After the procedure, the patient was weaned off IV hydrocortisone and continued on oral 15 mg of hydrocortisone in the morning and 5 mg in the evening. A repeat free T4 after the procedure was 0.9 ng/dl and the patient was not discharged on levothyroxine supplementation. He follows up with endocrinology as an outpatient and has had resolution of his right sided ptosis and vision changes. Discussion: Pituitary apoplexy presents in a variety of different ways including headache, nausea, altered mental status, and hormonal dysfunction. Third nerve palsy is a potential presentation of this uncommon condition and should be considered even with negative initial CT imaging. Through our case we hope to highlight this manifestation of pituitary apoplexy as, if the etiology of third nerve palsy remains elusive, pituitary apoplexy should be considered as a differential and further imaging should be obtained. Presentation: Saturday, June 17, 2023