Systolic Prehypertension Research Articles

Prevalence and Determinants of Pre-hypertension among Undergraduate Nursing Students of Private Health Sciences College

Hypertension is a major public health concern worldwide; while most studies describe hypertension in older adults, there is scarce data on prehypertension in young. The aim of highlighting this new category of "prehypertension" is to raise public awareness about the cardiovascular risk associated with blood pressure in this range and the importance of taking preventive action. Also, it is to determine the frequency of prehypertension among undergraduate nursing students and the association between demographic factors and psychological factors with prehypertension. A cross-sectional study was conducted in 2018 among undergraduate nursing students of private health colleges. A convenience sample of 282 students participated in this study. The Arabic version of Depression, Anxiety, and Stress Scale-21 elicited depression, anxiety, and stress levels. Blood pressures were measured twice using a sphygmomanometer, and the averages were taken. Data analyses used descriptive and inferential statistics. Out of the total number of 282 participants included in this study, 7.5% (19.6% male; 5.1% female) have a systolic pressure of ≥130 mmHg, and 6.7% (10.9% male; 5.9% female) have a diastolic pressure of ≥85 mmHg. Significant gender differences were detected regarding employment status, smoking, study year, depression, stress, and systolic pressure (p<.05). Results showed significant anthropometric differences in systolic and diastolic pressure (p<.001), higher in elevated than normal. The level of depression was significantly associated with systolic prehypertension, while the level of stress was significantly different for diastolic prehypertension (p<.05). The prevalence rate of prehypertension and hypertension was quite high in the present study. Early identification of pre-hypertensive individuals and early intervention by implementing a healthier lifestyle have been discovered to slow the development of hypertension.

Community Empowerment towards Healthy Living through The Implementation of Healthy Living Community Movements (GERMAS)

Indonesia is currently facing a triple burden of disease where the incidence of non-communicable diseases is increasing. The condition is related to lifestyle include lack of physical activity, an unhealthy and unbalanced diet, and unhealthy lifestyle as smoking and alcohol consumption. To educate the community to implement healthy living, GERMAS is being promoted, emphasizing promotive and preventive efforts. The purpose of these activities was to educate and mobilize the community to implement healthy living by implementing GERMAS that focuses on physical activities, consuming vegetables and fruit, and checking health regularly. From the health status monitoring, 15.6% of participants were in the systolic prehypertension stage, and 34.4% were in the systolic hypertension stage, 19.0% with high cholesterol levels, 43.8% with high uric acid levels and 21.9% with high blood sugar levels. This activity was continued by giving education about balanced and healthy food, routine physical activities during three months and the use of their yards for planting vegetables and fruit and motivating the communities for consuming the healthy food daily. After three months, the health condition improved in which the number of participants with systolic hypertension and high blood sugar levels decreased to 30% and 12.5%, respectively. It was concluded that the implementation of healthy life society movement daily could reduce the biological risk factors leading to the reduction of non-communicable disease incidence.

Prevalence of Hypertension and Adiposity Indicators Among Children and Adolescents of Meghwal Community: A Cross-sectional Study from Udaipur, Rajasthan (India)

Background: Early-age cardiometabolic disorders have a profound impact on adult health status. Studies indicated elevated blood pressure and increased adiposity among children and adolescents to be significantly correlated with adult cardiovascular diseases (CVDs). Aim: The study aims to estimate the prevalence of hypertension and adiposity indicators and their association among children and adolescents of Meghwal community, Rajasthan. Methods: This cross-sectional study recruited 150 boys and girls of 10–18 years. Anthropometric and physiologic variables were collected and categorized into adiposity indicators and blood pressure traits. Results: Prevalence of adiposity indicators in terms of both body mass index (BMI) and waist to height ratio (WHtR) was 2.67%, while almost half of the study participants had underweight BMI (46%). The study observed 16% and 8.67% prevalence of systolic hypertension stages I and II, respectively. Prevalence of diastolic hypertension stages I and II were 26.67% and 6.67%, respectively. The study indicated a range from 22% to 27% of high blood pressure traits attributable to increase in BMI. Further, overweight/obese BMI posed increased risk for systolic hypertension and diastolic pre-hypertension, albeit with no statistical significance. Conclusion: Findings from the present study throw light on the need for routine blood pressure measurements among children and adolescents for early detection and to prevent the risk of CVDs in adults.

THE RELATIONSHIP BETWEEN WORKLOAD AND INCIDENT HYPERTENSION AMONG FARMER IN KECAMATAN PANTI KABUPATEN JEMBER

ABSTRACT
 Workload among farmers affected increasing blood plusure that accumulated incidence of hypertension. The purpose of this research was to analyze the relationship between workload and incidence of hypertension among farmers in publichers service of Panti Kabupaten Jember. cross sectional study was used among 248 farmers using Stratified Random. The data was taken by questionnaire of NASA-TLX and sphygmomanometer digital to measure workload and blood pressure. The data was analyzed using Chi Square (p<0,05). The result showed a little Workload of farmers (66,1%), systolic pre-hypertension (37,5%), and normal diastolic blood pressure (35,9%). There were a no relationship between workload and hypertension systolic (X2 = 0.881; p value = 0.830), and hypertension diastolic (X2 =0.650; p value =0.885 ) among farmers in public health services of Panti Kabupaten Jember. The conclusion this of study, frequency of little workload is no related with incidence of hypertension sistolic and diastolic. Therefore, monitoring of blood pressure and regulating of consumption food among farmers should be maintained regulary permonth through posyandu non-communicable disease.
 
 Keywords : Workload, Hypertension Accident, Farmer

Feeding habits, Overweight, Obesity and Hypertension and Associated Factors among Polytechnic Students in Ekiti State, Southwest Nigeria

Overweight and obesity is a risk factor to chronic non-communicable diseases. This study assessed level of overweight/obesity and blood pressure among students of a higher institution in Southwest Nigeria. This cross-section study involved 300 students of a public higher institution in Ado- Ekiti, Southwest, Nigeria. A validated self-administered questionnaire was used to collect data on personal characteristics, feeding pattern and lifestyle of the students. Body Mass Index (BMI) was categorized into normal weight (BMI<25) and overweight/obesity (BMI ≥ 25). Waist circumference and waist-hip-ratio (WHR) were classified as normal and at risk. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and diastolic blood pressure (DBP) ≥ 90 mmHg. Chi square test was used to establish relationship between variables at 5% level of significance. The mean age of the students was 22.25 years and 62.8% were above 20years. Monthly allowance less than ₦30000.00 was received by 64.4% of the students, 47.3% skipped breakfast meal, 96% consumed carbonated soft drinks and 37.1% did not engaged in physical exercise. Prevalence of general obesity was 17.1% (BMI≥25); 7% and 15.5% were at risk of abdominal and central obesity respectively. Students in systolic pre-hypertension and stage I hypertension were 33.3% and 3% respectively whereas 15.5% and 2.4% were in diastolic pre-hypertension and stage I hypertension respectively. Female gender, monthly allowance less than ₦30000.00 and adolescent stage were associated with obesity. Older age, male gender and monthly allowance less than ₦30000.00 were associated with BP. Nutrition education is recommended for this population group.

Early Detection of Renal Dysfunction in Adolescents Aged 10-13 Years Born with very Low Birth Weight

Objective: Very low birth weight (VLBW), defined as less than 1500 gr, is an established risk factor for kidney disease in adulthood. To assess that, we examined whether VLBW manifests signs of renal dysfunction at as early as age 10 years, as reflected by elevated blood pressure, proteinuria and reduced glomerular filtration rate (GFR). Methods: 103 children aged 10-13 years and born with VLBW underwent consecutive blood pressure measurements, spot urine analysis, and weight and height measurements. Prevalence rates of hypertension, pre-hypertension and proteinuria were calculated. Characteristics were compared between children with normal and abnormal renal function, to identify risk factors for renal dysfunction. Results: The prevalence of systolic hypertension was 15.8% (95% CI 8.69% - 22.91%) of systolic pre-hypertension 6.9% (95% CI1.96% - 11.84%), and of proteinuria 15.7% (95% CI 8.64% - 22.76%) of the study population. Hypertension was associated with a significantly diminished mean birth weight compared to the remainder of the cohort (939.3gr vs 1111gr, P=0.024). Proteinuria and microalbuminuria were associated with lower mean current body weights: 27.2kg vs 36.7kg P=0.015 and 31.3 kg vs 36.8kg; P=0.023; and with increased mean estimated GFR (126.1 vs 108.3 mL/min per 1.73 m2; P = 0.0059). Conclusions: In a cohort of children aged 10-13 years, who were born preterm with VLBW, disturbed kidney function presented in considerably higher proportions than in general populations of this age. The findings merit considering initiation of routine screening during early adolescence, for hypertension, proteinuria and GFR in this risk group.

Prevalence of the risk factors for cardiometabolic disease among firefighters in the Western Cape province of South Africa.

Cardiometabolic disease (CMD) risk factors have reached epidemic proportions, with many people at risk of premature disability and death. There is insufficient data regarding the prevalence of CMD risk factors among firefighters in the Western Cape Province of South Africa. The purpose of this study was to examine the prevalence of CMD risk factors among South African firefighters in the Western Cape Province. Additional outcomes were to determine the relationship between BMI and CMD risk factors among firefighters. A total of 219 healthy male firefighters with mean age 37.8±9.80 years volunteered to participate in the study. Anthropometric (ISAK protocol compliant) and physiological variables (ACSM protocol compliant) were assessed. Descriptive statistics, such as mean, standard deviation and percentages were used to examine the CMD risk factors prevalence among the participants. Based on the BMI categorization, majority (42.5%) of the participants were obese, 17.4% were overweight, 39.7% had a normal BMI, while 0.5% were underweight. The participants with systolic prehypertension were 45.7%, while 14.2% were hypertensive. Furthermore, 39.3% were prediabetic, 18.3% were diabetic, while 1.4% had blood sugar below normal level (hypoglycemic). In terms of total blood cholesterol levels, 45.7% were normal, 38.8% were borderline high, while 15.5% were high in hypercholesterolemia. The majority (51.1%) of the participants reported non-participation in regular physical activity. Between BMI and the typical risk factors, there is a significant correlation with abdominal obesity (r=0.71; P<0.001), systolic blood pressure (r=0.33; P<0.001), diastolic blood pressure (r=0.31; P<0.001), fasting blood glucose (r=0.22; P<0.01) and total cholesterol (r=0.15; P<0.05). There was a high prevalence of cardiometabolic disease risk factors among firefighters. Furthermore, urgent intervention focusing on the lifestyle modification and weight management is a necessity.

Prenatal Alcohol Exposure and the Associated Risk of Elevated Blood Pressure: A Cross-sectional Analysis of 3- to 17-Year-Olds in Germany.

As the prevalence of obesity and high blood pressure increases among the population, early action is needed to reduce blood pressure. Certain lifestyles during pregnancy have negative effects resulting in high blood pressure for children and adolescents. Using data from the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS), this study analyzed: (i) the association between low-to-moderate prenatal alcohol exposure (PAE) and the risk of increased systolic and diastolic blood pressure and (ii) whether associations were modified by socioeconomic status (SES), prenatal smoke exposure (PSE), and body mass index (BMI) of the children and adolescents. We applied multivariate logistic regression analyses and stratified analyses by SES, PSE, and BMI with cross-sectional data from the KiGGS study (N = 14,253) to examine the association between PAE and prehypertension or hypertension in 3- to 17-year-olds. Of the surveyed children and adolescents, 13.7% had a systolic prehypertension and 11.5% had a diastolic prehypertension. A further 7.5% were identified as having systolic hypertension and 6.0% diastolic hypertension. In the regression analyses, PAE resulted in a decreased risk of systolic prehypertension (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.70, 0.99) and diastolic prehypertension (OR: 0.82, 95% CI: 0.68, 0.98). Risk reductions were not significant in surveyed children and adolescents with hypertension. Interactions between PAE and SES, PSE, and offspring BMI were not significant. Contrary to our initial hypothesis, PAE reduces the risk of prehypertension. Animal studies suggest that vasodilation is induced by nitric oxide in small quantities of PAE.

THE TRADITIONAL CARDIOVASCULAR RISK FACTORS ASSOCIATED WITH INCIDENT LATENT HEART FAILURE IN A GENERAL JAPANESE POPULATION

Objective: There are few population-based prospective studies on heart failure (HF) in non-Western populations. We sought to identify the association between the traditional cardiovascular risk factors and the incident latent HF (LHF) in a general Japanese population. Design and method: We prospectively followed-up 2,774 Suita Study subjects (average age 66.7 ± 10.4 years, initially free of LHF) for incident LHF. Blood pressure (BP) values were taken as the average of the first and second measurements. Each subject was classified into a systolic BP (SBP) category: normal SBP < 120 mmHg; systolic prehypertension (preHT)=120–139 mmHg; or systolic hypertension (HT)>=140 mmHg or antihypertensive drug use. We calculated the subjects’ non- HDLC levels by subtracting the HDLC from the total cholesterol. B-type natriuretic peptide (BNP) was measured by the CLEIA method. LHF was defined as BNP>=100 pg/mL or HF medication from medical records. Each subject's health status and BNP were checked in biannual medical examinations, and all subjects completed annual questionnaires. The endpoint of the follow-up period for incident LHF was whichever occurred first: the date of the first diagnosis of LHF, the date of the last examination, or December 31, 2017. We analyzed Cox proportional hazard ratios (HRs) and 95% CIs for incident LHF after adjusting for cardiovascular risk factors. Results: In 18,134 person-years of follow-up, 294 incident LHF events occurred. Compared to the normal non-HDLC subjects with normal SBP, the adjusted HRs (95%CIs) of incident LHF in the normal non-HDLC subjects with systolic HT and the low non-HDLC subjects with systolic preHT and HT were 1.52 (1.02–2.25), 1.71 (1.02–2.88), and 2.42 (1.60–3.66), respectively. The adjusted HRs (95% CIs) of incident LHF were 1.97 (1.41–2.74) for cardiac murmur or valvular disease, 1.70 (1.14–2.53) for coronary heart disease, 2.49 (1.37–4.49) for atrial fibrillation, 1.64 (1.00–2.70) for cerebral infarction, and 1.51 (1.01–2.26) for excessive drinking (>=4 units/day). Conclusions: This is the first demonstration that systolic HT and preHT with low non-HDLC were positively associated with incident LHF in a general Japanese population. Cardiac murmur/ valvular disease, coronary heart disease, atrial fibrillation, cerebral infarction, and excessive-drinking were also posing an increased risk of incident LHF.

Supplementation with Hydroxytyrosol and Punicalagin Improves Early Atherosclerosis Markers Involved in the Asymptomatic Phase of Atherosclerosis in the Adult Population: A Randomized, Placebo-Controlled, Crossover Trial.

Hydroxytyrosol (HT) and Punicalagin (PC) exert cardioprotective and anti-atherosclerotic effects. This study evaluates the effect of oral supplementation with HT and PC (SAx) on early atherosclerosis markers in middle-aged, seemingly healthy adults. A randomized, double-blinded, placebo-controlled, crossover trial was performed for 20 weeks. There were two treatment sequences (Placebo/SAx, n = 41; SAx/Placebo, n = 43) for which the intervention periods (Placebo and SAx) were 8 weeks long, followed by a 4-week wash out period. The supplement was composed of 9.9 mg of HT and 195 mg of PC, and the placebo was composed of maltodextrin. SAx increased endothelial function (Flow-mediated dilatation [FMD]: 2.36%; p < 0.001) in the endothelial dysfunction subgroup compared to the placebo (2.36 ± 3.9 vs. 0.76 ± 3.5%, p < 0.05). SAx also reduced oxLDL by −28.74 ng/mL (p < 0.05) in subjects with higher levels of oxLDL, which was an improvement compared with the placebo (−28.74 ± 40.2 vs. 25.64 ± 93.8 ng/mL, p < 0.001). The prehypertension and hypertension subgroups exhibited decreased systolic (−15.75 ± 9.9 mmHg; p < 0.001) and diastolic (−6.36 ± 8.7 mmHg; p < 0.001) blood pressure after SAx consumption. Moreover, the systolic prehypertension and hypertension subgroups presented significant differences in systolic blood pressure compared to the placebo (−15.75 ± 9.9 vs. −2.67 ± 12.0 mmHg, p < 0.05). In conclusion, the supplement exerted anti-atherosclerotic effects by improving endothelial function, blood pressure, and levels of circulating oxLDL, especially for persons in whom these parameters were altered.

The prospective relationship between prehypertension, race, and whole-brain white matter microstructure.

Compared to whites, blacks develop hypertension earlier in life, progress from prehypertension to hypertension at an accelerated rate, and exhibit greater hypertension mediated organ damage (e.g., kidney disease, stroke). In this paper we tested whether the longitudinal associations between elevated systolic blood pressure and disruption of brain white matter structural integrity differs as a function of race. A community sample of 100 middle-aged adults with prehypertension underwent diffusion imaging to quantify indirect metrics of white matter structural integrity, including fractional anisotropy. Blood pressure and diffusion imaging measurements were collected at baseline and at a two-year follow-up. Regression analyses showed that higher systolic blood pressure at baseline was associated with a decrease in fractional anisotropy over two years in blacks only (β = −0.51 [95% C.I. = −0.85, −0.16], t = −2.93, p = .004, ΔR2 = .09). These findings suggest that blacks are more susceptible to the impact of systolic prehypertension on white matter structural integrity.

Hypertension and its risk factors among male adolescents in intermediate and secondary schools in Sakaka City, Aljouf Region of Saudi Arabia.

Hypertension among adolescents is an emerging public health problem. The current study aims to estimate the burden of hypertension and identify its risk factors among male adolescents of intermediate and secondary schools. This is a school-based cross-sectional study that targeted 400 male adolescents in the age group of 15-17 years. Blood pressure was defined as per the "Fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents". An electronic device approved for use by the European Society of Hypertension International Protocol revision 2010, (Omron M3W; HEM-7202-E) was used for measuring blood pressure. CDC's body mass index tool was adopted for defining overweight and obesity. Descriptive analysis for hypertension and the risk factors were carried out. Chi-square test and odds ratios were calculated to assess any association between categorical variables. Overall 36 (9.0%) adolescents had prehypertension and 69 (17.2%) had hypertension. Systolic prehypertension, systolic hypertension, diastolic prehypertension, and diastolic hypertension were present in 6.5%, 17.2%, 5.8%, and 9.0% of the adolescents, respectively. Bivariate analysis revealed that overweight and obesity, no physical activity, or once-a-week physical activity, positive family history of hypertension, and smoking were predictors of systolic prehypertension and showed a significant relationship with systolic hypertension. There is a considerable prevalence of prehypertension and hypertension, among school-going male adolescents. We recommend school-based health education programs and routine screening directed toward the risk factors of noncommunicable diseases like hypertension with special attention to obesity, physical inactivity, and smoking.

Effectiveness of a Multicomponent Intervention Programme on Blood Pressure of School Children

A study was conducted to find out the Effectiveness of a Multicomponent Intervention Programme on blood pressure of school children from selected schools of Kerala. Objectives of the study: (1) To find out the prevalence of pre hypertension and hypertension among school children. (2) To find out the effectiveness of a multi component intervention programme on blood pressure of school children Methodology & Design: Evaluative research approach with pre-test post-test control group design was used. 220 school children with pre hypertension in the age group of 13-16 years studying in 8th and 9th standards were included using simple random sampling in the study after screening 1328 children. A multi component intervention programme aimed at diet, exercise and lifestyle modifications of school children was then implemented. Results: The prevalence of pre systolic hypertension and pre diastolic hypertension among the study population was 265/1000 and 226/1000 respectively. The mean systolic blood pressure in the experimental group was significantly reduced after the multi component intervention programme (117.23 ± 5.36) compared to pretest (119.25 ± 4.90). There was a significant association of systolic blood pressure of school children only with their class of study (x2= 4.98, p=0.026). Conclusion: Multi component intervention programme was effective in reducing the blood pressure of school children. The results of the present study is very much encouraging that similar programmes can definitely help in controlling life style diseases among children which is an emerging public health problem

Abstract P298: Combination of Systolic Blood Pressure and Non-HDL Cholesterol Categories Increased the Risk of Incident Latent Heart Failure: The Suita Study

Objective: There are few population based prospective studies on heart failure (HF) in non-Western populations. We hypothesized that the combination of systolic blood pressure (SBP) and non-HDL cholesterol (non-HDLC) categories affect the risk of incident latent HF (LHF) in a general Japanese population. Methods: We prospectively followed-up 2,774 Suita Study subjects (average age 66.7±10.4 years, initially free of LHF) for incident LHF. BP were taken as the average of the first and second measurements. Each subject was classified into an SBP category: normal SBP, &lt;120 mmHg; systolic prehypertension (preHT), 120-139 mmHg; or systolic hypertension (HT), ≥140 mmHg or antihypertensive drug use. The subjects' non-HDLC levels were calculated by subtracting the HDLC from the total cholesterol. B-type natriuretic peptide (BNP) was measured by the CLEIA method. LHF was defined as BNP ≥100 pg/mL or HF medication from medical records. Each subject’s health status and BNP were checked in biannual medical examinations, and all subjects completed annual questionnaires. The endpoint of the follow-up period for incident LHF was whichever occurred first: the date of the first diagnosis of LHF, the date of the last examination, or December 31, 2017. We analyzed Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) for incident LHF after adjusting for cardiovascular risk factors. Results: In 18,134 person-years of follow-up, 294 incident LHF events occurred. Compared to the normal SBP subjects, the adjusted HR (95% CIs) of incident LHF in the systolic HT subjects was 1.64 (1.16-2.30). The adjusted HR (95% CIs) of incident LHF per 20 mmHg of SBP was 1.18 (1.04-1.34). Compared to the normal non-HDLC (130-179 mg/dL) subjects, the adjusted HR (95% CIs) of incident LHF in the low non-HDLC (&lt;130 mg/dL) subjects was 1.47 (1.15-1.88). Compared to the normal non-HDLC subjects with normal SBP, the adjusted HRs (95% CIs) of incident LHF in the normal non-HDLC subjects with systolic HT and low non-HDLC subjects with systolic preHT and HT were 1.53 (1.01-2.31), 1.76 (1.02-3.04), and 2.44 (1.58-3.76), respectively. Conclusion: This is the first demonstration that systolic preHT and low non-HDLC were positively associated with incident LHF in a general Japanese population.

Prevalence of prehypertension and hypertension among jenukuruba tribal children in Mysore district

Introduction: Hypertension is a major public health problem found to have origin very early in life but remains asymptomatic warranting screening of all children. Objective: To study the prevalence of Pre hypertension and Hypertension among traditional Jenukuruba tribal children in Mysore district. Methods: Community based cross sectional study done over a period of 2 years from. About 3864 children between the age group of 2-15 years of Jenukuruba tribal community were enrolled in the study. Anthropometric measurements were recorded. Weight for age, Height for age and BMI were calculated. Blood pressure recording was done by research assistants and classified using American Heart Association fourth task force recommendations. Results: The point prevalence of systolic prehypertension and hypertension among tribal children between 2-15 years was 6.9% and 2.3% respectively and the point prevalence of diastolic prehypertension and hypertension was 9.6% and 4.1% respectively. Conclusion: The prevalence of pre hypertension and hypertension in tribal children is similar and comparable to urban population.

Former Very Preterm Infants Show an Unfavorable Cardiovascular Risk Profile at a Preschool Age.

Cardiovascular disease is the leading cause of death worldwide. Evidence points towards an unfavorable cardiovascular risk profile of former preterm infants in adolescence and adulthood. The aim of this study was to determine whether cardiovascular risk predictors are detectable in former very preterm infants at a preschool age. Five- to seven-year-old children born at <32 weeks’ gestational age were included in the study. Same-aged children born at term served as controls. Basic data of study participants were collected by means of follow-up databases and standardized questionnaires. At study visit, anthropometric data, blood pressure readings and aortic intima-media thickness were assessed. Blood samples were obtained after an overnight fast. In comparison to children born at term, former preterm infants had higher systolic and diastolic blood pressure readings (odds ratio [95% confidence interval] per 1-SD higher blood pressure level 3.2 [2.0–5.0], p<0.001 and 1.6 [1.1–1.2], p = 0.008), fasting glucose levels (OR [95% CI] 5.2 [2.7–10.1], p<0.001), homeostasis model assessment index (OR [95% CI] 1.6 [1.0–2.6], p = 0.036), and cholesterol levels (OR [95% CI] 2.1 [1.3–3.4], p = 0.002). Systolic prehypertension (23.7% vs. 2.2%; OR [95% CI] 13.8 [3.1–60.9], p = 0.001), elevated glucose levels (28.6% vs. 5.9%; OR [95% CI] 6.4 [1.4–28.8], p = 0.016), and hypercholesterolemia (77.4% vs. 52.9%; OR [95% CI] 3.0 [1.3–7.1], p = 0.010) were significantly more prevalent in the preterm group. As former very preterm infants display an unfavorable cardiovascular risk profile already at a preschool age, implementation of routine cardiovascular follow-up programs might be warranted.

Cardiovascular disease risks in adult Native and MexicanAmericans with a history of alcohol use disorders: association with cardiovascular autonomic control.

Hypertension and obesity are serious health problems that have been associated with an increased risk of cardiovascular disease (CVD). We recently showed a relationship between hypertension, obesity and cardiovagal control in a sample of Native and MexicanAmericans at high risk of alcohol use disorders (AUD). While studies have shown that Native and MexicanAmericans exhibit high rates of AUD, the consequences of AUD on CVD risk factors and their relationship with cardiovascular autonomic control is not well understood in these ethnic groups. This study investigated whether an association could be demonstrated between cardiovascular autonomic control and several CVD risk factors in Native and Mexican American men and women (n=228) who are literate in English and are residing legally in San Diego County. Participants with lifetime history of AUD showed higher rates of systolic and diastolic hypertension and obesity than participants without lifetime AUD. Lifetime AUD was significantly associated with reduced HR response to deep breathing (HRDB) measure of cardiovagal control, higher current drinking quantity, and obesity. Reduced HRDB was also associated with increased systolic pre-hypertension or hypertension (pre-/hypertension) and with higher diastolic blood pressure in a linear regression model that included several diagnostic and demographic variables. HRDB and time- and frequency-domain measures of cardiovagal control were significantly reduced in participants with diastolic pre-/hypertension. These data suggest that lower cardiovagal control may play a role in the prevalence of systolic and diastolic pre-/hypertension in a community sample with a history of alcohol and substance use disorders.

Screening of cardiovascular risk factors among, urban, semiurban, and rural residents in Jammu district of Jammu and Kashmir

Background: The prevalence of cardiovascular disease risk factors has increased in the developing countries. Objective: To study the cardiovascular disease risk factors in urban, semiurban, and rural population. Materials and Methods: A cross-sectional study was conducted by the Department of Cardiology of Super Speciality Hospital in the urban, semiurban, and rural areas of Jammu district of Jammu and Kashmir state, India, for a period of 2 years. Of the 4,050 volunteers screened, 1,030 were in urban, 1,270 in semiurban, and 1,750 in rural areas; the demographic profile, blood pressure, and blood sugar were observed, and the results were evaluated in percentages. Result: The mean age of the screened subjects was above 50 years of age, and the male to female ratio was, approximately, 1.5:1 at urban, 4:1 at semiurban, and 2.5:1 at rural areas. The majority of them were smokers, and about 58.9% of urban, 60% of semiurban, and 39.9% of rural volunteers were overweight and obese. The systolic prehypertension was 30%, 29.8%, and 30.9% and hypertension was 42.7%, 44.2%, and 44.9% among urban, semiurban, and rural population, respectively. The random blood sugar was positive in 9.3%, 12.8%, and 11.5% in urban, semiurban, and rural population, respectively. Conclusion: Hypertension, obesity, smoking, and increased blood sugar are the cardiovascular risk factors, and their prevalence has increased in urban, semiurban, and rural population, and these screening programs further help in the management of the disease.

Prevalence of hypertension and pre-hypertension among adolescent school children in Thiruvananthapuram, Kerala, India

Background: The foundations of hypertension in a person are laid in childhood and adolescence. The phenomenon of tracking of blood pressure is one where those children and adolescents who are in a high blood pressure category tend to fall in the same category when they become adults. Early diagnosis of hypertension and prehypertension in children and adolescents will help in reducing the prevalence of hypertension and its complications in the future adult population of any country. The objective of this study was to find out the prevalence of hypertension and pre-hypertension among school children 13-17 years in Thiruvananthapuram City Corporation, Kerala. Methods: A two stage sampling technique was applied; in the first stage the schools were stratified as government, aided and unaided schools using probability proportionate to size. In the second stage, from the selected schools one division or class from each standard was identified at random as a cluster and all the eligible children in the selected cluster were studied. A single BP measurement was taken using a standardized digital sphygmomanometer (OMRON IA1). Hypertension and prehypertension was defined as per national high blood pressure education program (USA), working group on hypertension control in children and adolescents blood pressure tables. The data was entered in MS excel and further analysis was done using SPSS 16.0 version software and proportions of outcomes were analyzed. Results: The total number of children studied were 2438, Boys 1274 (52.3%, 95% CI 50.28-54.32) and girls 1164 (47.7%, 95% CI 45.68-49.72). The prevalence of hypertension was found to be 21.4% (95% CI 19.64% - 22.96%). The overall prevalence of systolic hypertension is slightly high among the girls (19.4%) than the boys (18.2%), (P value>0.05). The prevalence of pre-hypertension among the study subjects was 21.3 % (19.65-22.95%). The prevalence of systolic pre-hypertension was found to be 21.4% (95% CI 19.74%- 23.06%) and diastolic pre-hypertension 5.3% (95% CI 4.4%-6.2%). Conclusions: The overall prevalence of pre-hypertension and hypertension was 42.6%. These facts show us that preventive interventions are urgent.

Abstract 12264: A Risk Score for the Prediction of Atrial Fibrillation in the Japanese Community: The Suita Study

Introduction: Atrial fibrillation (AF) is the most common chronic arrhythmia and is a strong risk factor for all-cause mortality and stroke. However, there is no risk score for incident AF in non-Westerners. Aim: We aimed to develop and validate a risk score for AF incidence in a Japanese general population. Methods: A total of 6,906 participants (30-84 years old) initially free of AF were prospectively followed up for incident AF in the Suita Study. Standard 12-lead ECGs were obtained from all subjects in the supine position. Each record was coded independently by 2 well-trained physicians. Participants were diagnosed with AF if AF or atrial flutter was present on ECGs obtained during a biannual routine health examination or if AF was indicated as a present illness by either annual questionnaires responses or participants' medical records during follow-up. Cox proportional hazard ratios were analyzed after adjusting for cardiovascular risk factors at baseline. The model discrimination was evaluated by the area under the receiver operating characteristic curve. Results: In 88,663 person-years of follow-up, 253 incident AF events occurred. Age, sex, body mass index, valvular disease and/or heart murmur, systolic blood pressure, ischemic heart disease, smoking, and excessive drinking were associated with incident AF (C-statistic 0.73; 95% confidence intervals, 0.70-0.75). The risk scores for participants in their 30s, 40s, 50s, 60s, and 70s, sex (women), smoking 1~19 and ≥20 cigarettes/day, excessive drinking (4 units/day or more of alcohol), systolic prehypertension with overweight or obesity, systolic hypertension with normal weight/overweight or obesity, ischemic heart disease, and valvular disease and/or heart murmur were -6, 0, 6, 18, 27, -6, 2, 5, 5, 6, 5, 10, 7, and 12, respectively. Individuals scoring ≤19 and ≥40 points, for example, had ≤3.5% and ≥8.5% predicted probability of developing AF in 10 years, respectively. Conclusions: We developed a risk score to predict 10-year incident AF risk using variables that are easily available in healthy examination in Japan. This risk score can be useful for a person with higher risk of AF in order to consult a doctor and encourage lifestyle improvements before onset of AF.