Current Trends in Hypertension Identification and Management: Insights from the National Health and Nutrition Examination Survey (NHANES) Following the 2017 ACC/AHA High Blood Pressure Guidelines

Twenty years population-based trends in prevalence, awareness, treatment, and control of hypertension in Geneva, Switzerland

Objective

Hypertension is a leading cause of cardiovascular disease and affects about 1.3 billion adults worldwide. Despite interventions, awareness and control remain suboptimal and might have worsened due to the COVID-19 pandemic. This population-based study examines 20-year trends in hypertension prevalence, awareness, treatment, and control in Geneva, Switzerland (2005-2023).

Methods

This is a year-trends population-based study (Bus Sante) ongoing in Geneva, Switzerland. Data collected in this study were between 2005 and 2023. Hypertension trends and prevalence were stratified by sex, age, education, and income. Multivariable regression models adjusted for sociodemographic and health factors identified determinants of outcomes.

Results

Overall, 11,278 individuals participated. Hypertension prevalence decreased from 38.9 % to 35.2 %, with greater reductions in individuals with primary education (-6.1 %) and low income (-6.1 %). Awareness remained stable with time. Uncontrolled hypertension decreased (44.9 % to 42.2 %, p = 0.01), with improvements in lower socioeconomic groups, and individuals with diabetes. Older women were more likely to have untreated (+16.1 %) and uncontrolled hypertension, while younger men exhibited higher unawareness rates (57.7 %). Having a doctor visit in the past 12 months was not associated with increased awareness.

Conclusions

Hypertension prevalence and control improved overall, with reduced socioeconomic disparities. However, some groups remain at risk and primary care is essential for better screening, awareness, treatment, and control of hypertension.

Enhanced body shape change coupled with PA is the key to hypertension management for urban residents

The present study aimed to assess the relationship between body shape, physical activity (PA), and systolic blood pressure (SBP) and diastolic blood pressure (DBP). A novel visualization method was used to examine the effects of body shape combined with physical activity on hypertension. Data from 54,303 participants were obtained from the China Health and Nutrition Survey (CHNS) and analyzed using logistic regression models and standardized regression coefficients of linear models. These models were used to explore factors and effects of body shape indices and other parameters on SBP and DBP. The logistic regression model revealed that compared to transport-related PA, the aggregated variables (weight and waist) were associated with a 2.44-fold and 1.65-fold increase in the risk of hypertension, respectively (p < .05). The average aggregated standardized coefficient of the linear model, based on 1000 bootstrap resamples, indicated that the Base Shape group had the strongest explanatory power for hypertension, followed by the Habits group. However, the explanatory power of the PA group was around 10 and 22 times lower than that of the Base Shape group for DBP and SBP, respectively (p < .05). These results demonstrate that increasing physical activity, with emphasizing a healthy body shape, and adopting positive lifestyle habits can effectively contribute to the prevention and control of hypertension.

Blood Lead Mediates the Relationship between Biological Aging and Hypertension: Based on the NHANES Database

Hypertension remains a major global public health crisis due to various contributing factors, such as age and environmental exposures. This study delves into exploring the intricate association between biological aging, blood lead levels, and hypertension, along with examining the mediating role of blood lead levels in the relationship between biological aging and hypertension. We analyzed data from two cycles of the NHANES, encompassing 4473 individuals aged 18 years and older. Our findings indicate that biological aging potentially escalates the risk of hypertension and the incidences of systolic blood pressure (SBP) and diastolic blood pressure (DBP) abnormalities. Utilizing weighted quantile sum (WQS) and quantile g-computation (QGC) model analyses, we observed that exposure to heavy metal mixtures, particularly lead, may elevate the likelihood of hypertension, SBP, and DBP abnormalities. Further mediation analysis revealed that lead significantly mediated the relationship between biological aging and hypertension and between biological aging and SBP abnormalities, accounting for 64% (95% CI, 49% to 89%) and 64% (95% CI, 44% to 88%) of the effects, respectively. These outcomes emphasize the criticality of implementing environmental health measures.

Non-linear Association of CAR with all-Cause and Cardiovascular Mortality in Coronary Heart Disease: A Retrospective Cohort Study from NHANES

OBJECTIVE

To investigate the relationship between C-reactive protein and albumin ratios (CAR) and all-cause and cardiovascular disease(CVD)-specific mortality in individuals with coronary heart disease(CHD).

METHODS

The data from 1895 patients were extracted from the National Health and Nutrition Examination Survey (NHANES) database from 1999-2010. We used weighted COX regression analyses to explore the association between CAR, all-cause, and CVD-specific mortality. Restricted cubic spline(RCS) regression models and threshold effects analysis were used to analyze nonlinear relationships. Subgroup analyses were also performed to explore these relationships further.

RESULTS

During a mean follow-up of 115.78 months, 61.48% of deaths occurred, and 21.85% were due to CVD. After adjusting for potential confounders, each 1-unit increase in CAR was associated with a 65% increase in all-cause mortality and a 67% increase in CVD-specific mortality. The RCS model revealed a non-linear association between CAR and the risk of all-cause mortality and CVD-specific mortality in CHD patients (all non-linear P < 0.001). Threshold effects analysis identified inflection points in regression models of all-cause mortality (0.04, P < 0.001) and CVD-specific mortality (0.05, P = 0.0024). The interaction tests found sex, smoking and diabetes influenced the association between CAR and all-cause mortality and sex, smoking and HF influenced its association with CVD-specific mortality (all P < 0.05).

CONCLUSION

There was a nonlinear association between CAR and all-cause mortality and CVD mortality in patients with CHD, with a higher hazard ratio before the inflection point. Sex, smoking, diabetes, and HF might have an effect on the associations between CAR and death risks.