151
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Okekunle AP, Asowata OJ, Akpa OM, Fakunle AG, Bodunde I, Komolafe M, Arulogun O, Sarfo FS, Obiako R, Osaigbovo G, Ogbole G, Bello A, Adeniyi S, Calys-Tagoe B, Appiah L, Jenkins C, Oyinloye O, Dambatta H, Balogun O, Singh A, Olalere A, Mensah Y, Ogah OS, Ibinaiye P, Adebayo O, Adebajo O, Adebayo P, Chukwuonye I, Akinyemi R, Ovbiagele B, Owolabi M. Dietary patterns associated with hypertension among stroke-free indigenous Africans: insights from the Stroke Investigative Research and Educational Network study. J Hypertens 2024; 42:620-628. [PMID: 38230616 DOI: 10.1097/hjh.0000000000003662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND The dietary factors associated with the high burden of hypertension among indigenous Africans remain poorly understood. We assessed the relationship between dietary patterns and hypertension among indigenous Africans. METHOD In this study, 1550 participants with hypertension matched (for age: ± 5 years, sex and ethnicity) with 1550 participants without hypertension were identified from the stroke-free population in the Stroke Investigative Research and Educational Network study in Ghana and Nigeria. Food consumption was assessed using a food frequency questionnaire, and dietary information was summarized using principal component analysis to identify seven dietary patterns. Conditional logistic regression was applied to compute the odds ratio (OR) and 95% confidence interval (CI) for the risk of hypertension by tertiles of dietary patterns adjusting for age, education, income, smoking, alcohol use, physical inactivity, family history of cardiovascular diseases, obesity and salt intake at a two-sided P less than 0.05. RESULTS Multivariable-adjusted OR [95% confidence interval (CI)] for risk of hypertension by second and third tertiles [using the lowest (first) tertile as reference] of dietary patterns were 0.62 (0.48-0.80), 0.70 (0.54-0.90) for whole grains and fruit drinks; 0.87 (0.68-1.12), 0.83 (0.64-1.08) for fruits; 0.85 (0.65-1.10), 0.97 (0.75-1.26) for vegetables, legumes and potatoes; 0.78 (0.60-1.00), 0.84 (0.65-1.08) for fried foods and sweetened drinks; 1.13 (0.88-1.45), 0.80 (0.62-1.03) for poultry product and organ meat; 1.11 (0.86-1.43), 0.88 (0.68-1.14) for red meat; and 1.14 (0.88-1.48), 1.09 (0.84-1.43) for processed foods ( P < 0.05). CONCLUSION A higher adherence to dietary consumption of whole grains and fruits was inversely associated with low odds of hypertension in this population.
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Affiliation(s)
- Akinkunmi Paul Okekunle
- Department of Medicine, University of Ibadan, Nigeria
- Department of Food and Nutrition, Seoul National University, Korea
| | | | - Onoja Matthew Akpa
- Department of Epidemiology and Medical Statistics
- Institute of Cardiovascular Diseases, University of Ibadan
| | - Adekunle Gregory Fakunle
- Department of Medicine, University of Ibadan, Nigeria
- Department of Public Health, Osun State University, Osogbo, Osun State
| | | | - Morenikeji Komolafe
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife
| | - Oyedunni Arulogun
- Department of Health Promotion and Education, University of Ibadan, Nigeria
| | - Fred Stephen Sarfo
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Ghana
| | | | | | - Godwin Ogbole
- Department of Radiology, College of Medicine, University of Ibadan
| | - Abiodun Bello
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Sunday Adeniyi
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Benedict Calys-Tagoe
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Ghana
| | - Lambert Appiah
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Ghana
| | | | - Olalekan Oyinloye
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife
| | | | | | - Arti Singh
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | | | - Yaw Mensah
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Ghana
| | | | | | | | | | | | | | - Rufus Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training College of Medicine
- Center for Genomic and Precision Medicine, University of Ibadan, Nigeria
| | - Bruce Ovbiagele
- Weill Institute for Neurosciences, University of California San Francisco, USA
| | - Mayowa Owolabi
- Department of Medicine, University of Ibadan, Nigeria
- Center for Genomic and Precision Medicine, University of Ibadan, Nigeria
- Lebanese American University of Beirut, Lebanon
- Blossom Specialist Medican Centre, Ibadan, Nigeria
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152
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Sagara K, Goto K, Maeda M, Murata F, Fukuda H. Medication adherence and associated factors in newly diagnosed hypertensive patients in Japan: the LIFE study. J Hypertens 2024; 42:718-726. [PMID: 38230627 DOI: 10.1097/hjh.0000000000003661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Hypertension is the leading cardiovascular risk factor worldwide. However, in Japan, only 30% of patients have their blood pressure controlled under 140/90 mmHg, and nonadherence to antihypertensives is thought to be a reason for the poor control of hypertension. We therefore sought to assess the adherence to hypertension treatment and to evaluate factors influencing patients' adherence in a large, representative sample of the Japanese population. To this end, we analyzed claims data from the LIFE Study database, which includes 112 506 Japanese adults with newly diagnosed hypertension. Medication adherence was measured for a year postdiagnosis using the proportion of days covered (PDC) method. Factors associated with adherence to antihypertensives were also assessed. Among the total 112 506 hypertensive patients, the nonadherence rate (PDC ≤ 80%) for antihypertensives during the first year after initiation of the treatment was 26.2%. Younger age [31-35 years: odds ratio (OR), 0.15; 95% confidence interval (95% CI), 0.12-0.19 compared with 71-74-year-old patients], male gender, monotherapy, and diuretics use [OR, 0.87; 95% CI, 0.82-0.91 compared with angiotensin II receptor blockers (ARBs)] were associated with poor adherence in the present study. Cancer comorbidity (OR, 0.84; 95% CI, 0.79-0.91 compared with no comorbidity), prescription at a hospital, and living in a medium-sized to regional city were also associated with poor adherence. Our present findings showing the current status of adherence to antihypertensive medications and its associated factors using claims data in Japan should help to improve adherence to antihypertensives and blood pressure control.
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Affiliation(s)
- Kumi Sagara
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka City
| | - Kenichi Goto
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka City
| | - Megumi Maeda
- Department of Healthcare Administration and Management, Graduate School of Medical Sciences, Kyushu University Fukuoka City, Fukuoka, Japan
| | - Fumiko Murata
- Department of Healthcare Administration and Management, Graduate School of Medical Sciences, Kyushu University Fukuoka City, Fukuoka, Japan
| | - Haruhisa Fukuda
- Department of Healthcare Administration and Management, Graduate School of Medical Sciences, Kyushu University Fukuoka City, Fukuoka, Japan
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153
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Park CH, Kim HW, Joo YS, Park JT, Chang TI, Yoo TH, Park SK, Kim YH, Sung S, Hyun YY, Oh KH, Kang SW, Han SH. Findings from the KNOW-CKD Study indicate that higher systolic blood pressure time in target range is associated with a lower risk of chronic kidney disease progression. Kidney Int 2024; 105:835-843. [PMID: 38159679 DOI: 10.1016/j.kint.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
Time-in-target range (TTR) of systolic blood pressure (SBP) is determined by the proportion of time during which SBP remains within a defined optimal range. TTR has emerged as a useful metric for assessing SBP control over time. However, it is uncertain if SBP-TTR can predict the progression of chronic kidney disease (CKD). Here, we investigated the association between SBP-TTR during the first year of enrollment and CKD progression among 1758 participants from the KNOW-CKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease). Baseline median estimated glomerular filtration rate (eGFR) was 51.7 ml/min per 1.73 m2. Participants were categorized into four SBP-TTR groups (0%, 1-50%, 51-99%, and 100%). The primary outcome was CKD progression defined as 50% or more decline in eGFR from baseline measurement or the initiation of kidney replacement therapy. During the follow-up period (9212 person-years over a median 5.4 years), the composite outcome occurred in 710 participants. In the multivariate cause-specific hazard model, a one-standard deviation increase in SBP-TTR was associated with an 11% lower risk of the composite outcome with hazard ratio, 0.89 (95% confidence interval, 0.82-0.97). Additionally, compared to patients with SBP-TTR 0%, the respective hazard ratios for those with SBP-TTR 1-50%, 51-99%, and 100% were 0.85 (0.68-1.07), 0.76 (0.60-0.96), and 0.72 (0.55-0.94), and the respective corresponding slopes of eGFR decline were -3.17 (-3.66 to -2.69), -3.02 (-3.35 to -2.68), -2.62 (-2.89 to - 2.36), and -2.33 (-2.62 to -2.04) ml/min/1.73 m2. Thus, higher SBP-TTR was associated with a decreased risk of CKD progression in patients with CKD.
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Affiliation(s)
- Cheol Ho Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Hyung Woo Kim
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Young Su Joo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea; Division of Nephrology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Tae Ik Chang
- Department of Internal Medicine, National Health Insurance Service Medical Center, Ilsan Hospital, Goyang, Republic of Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Sue Kyung Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yeong Hoon Kim
- Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Suah Sung
- Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Young Youl Hyun
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Kidney Research Institute, Seoul, Republic of Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea.
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154
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Jia G, Sowers JR, Whaley-Connell A. Obesity in Hypertension: The Role of the Expanding Waistline Over the Years and Insights Into the Future. Hypertension 2024; 81:687-690. [PMID: 38018438 PMCID: PMC10954419 DOI: 10.1161/hypertensionaha.123.21719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Affiliation(s)
- Guanghong Jia
- Department of Medicine-Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO, 65212, USA
- Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
| | - James R. Sowers
- Department of Medicine-Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO, 65212, USA
- Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, 65212, USA
- Department of Medicine–Nephrology and Hypertension, University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Adam Whaley-Connell
- Department of Medicine-Endocrinology and Metabolism, University of Missouri School of Medicine, Columbia, MO, 65212, USA
- Research Service, Harry S Truman Memorial Veterans Hospital, Research Service, 800 Hospital Dr, Columbia, MO, 65201, USA
- Department of Medicine–Nephrology and Hypertension, University of Missouri School of Medicine, Columbia, MO 65212, USA
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155
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Song Y, Wang Q, Jia L. Omega-3 fatty acids and their influence on hypertension and coronary atherosclerosis: Insights from a Mendelian randomization approach. J Clin Hypertens (Greenwich) 2024; 26:382-390. [PMID: 38450969 PMCID: PMC11007784 DOI: 10.1111/jch.14782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/14/2024] [Accepted: 01/16/2024] [Indexed: 03/08/2024]
Abstract
It has been suggested that Omega-3 fatty acids may improve endothelial thickness and thereby reduce the onset of cardiovascular diseases such as coronary atherosclerosis and hypertension. However, published observational epidemiological studies on the relationship between cardiovascular disease (CVD) and Omega-3 fatty acids remain inconclusive. Here, we performed a two-sample Mendelian randomisation analysis using publicly available GWAS pooled statistics to study a GWAS dataset of 16 380 466 SNPs in 23 363 cases and 195 429 controls (also of European ancestry) to determine genetic susceptibility to hypertension. We performed random-effects Inverse Variance Weighted (IVW) Mendelian Randomization (MR) analyses supplemented by a series of sensitivity assessments to measure the robustness of the findings and to detect any violations of the MR assumptions. During the course of the study, we used IVW, MR-Egger, and weighted median regression to infer that Omega-3 intake has a potentially adverse effect against atherosclerosis, although the trend was not significant (OR = 1.1198; 95%; CI: 0.9641-1.3006, p = .130). Meanwhile, our analyses showed a statistically significant negative association between Omega-3 fatty acid levels and risk of hypertension (OR = 0.9006; 95% CI: 0.8179-0.9917, p = .033). In addition, we explored the causal relationship between atherosclerosis and hypertension and found a significant correlation (OR = 1.3036; 95% CI: 1.0672-1.5923, p = .009). In conclusion, our extensive data investigated by MR suggest that elevated levels of Omega-3 fatty acids may be associated with an decreased risk of hypertension. Although there is no direct link between hypertension and atherosclerosis, the possibility of a subtle association cannot be categorically excluded.
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Affiliation(s)
- Yuchen Song
- College of Integrated Chinese and Western MedicineLiaoning University of Traditional Chinese MedicineShenyangLiaoningChina
| | - Qun Wang
- Key Laboratory of Ministry of Education for TCM Viscera‐State Theory and ApplicationsMinistry of Education of ChinaLiaoning University of Traditional Chinese MedicineShenyangLiaoningChina
| | - Lianqun Jia
- Key Laboratory of Ministry of Education for TCM Viscera‐State Theory and ApplicationsMinistry of Education of ChinaLiaoning University of Traditional Chinese MedicineShenyangLiaoningChina
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156
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Bruns BE, Lorenzo-Castro SA, Hale GM. Controlling Blood Pressure During a Pandemic: The Impact of Telepharmacy for Primary Care Patients. J Pharm Pract 2024; 37:364-368. [PMID: 36300296 PMCID: PMC9606639 DOI: 10.1177/08971900221136629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Introduction: Studies have shown positive clinical outcomes in chronic conditions, such as hypertension, through pharmacist-delivered medication therapy management and medication adherence services. Given the need for social distancing during the COVID-19 pandemic, increased utilization of telepharmacy strategies has been employed for managing blood pressure control. Methods: A retrospective single-center cohort study that compared in-person pharmacist visits and telepharmacy visits in primary care patients with hypertension via electronic chart review from January 2018 to July 2022. Subjects were included who were at least 18 years of age with hypertension. Comparator groups were patients who underwent an in-person pharmacy (pre-COVID-19) visit vs a telepharmacy visit (post-COVID-19). The primary outcome was the number of patients with controlled blood pressure based on a blood pressure goal of less than or equal to 130/80 following telepharmacy visit vs in-person visit. Medication adherence, pharmacist intervention, incidence of antihypertensive side-effects, and blood pressure maintenance based on a goal of ≤140/90 were also evaluated. Results: A total of 77 patients were included. There was no difference in the primary outcome following in person pharmacy visits compared to telepharmacy visits (P = .690). There was also no difference found for the secondary endpoints of blood pressure goal less than or equal to 140/90 mmHg (P = .481), medication adherence (P = 1.00), or antihypertensive adverse events (P = .344). Conclusion: Telepharmacy visits had a nonsignificant change in blood pressure control when compared to in-person visits. Results suggest that the utilization of either in-person or telepharmacy strategies benefit the management of hypertension.
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Affiliation(s)
- Bailey E. Bruns
- Nova Southeastern University College of Pharmacy, Palm Beach Gardens, FL, USA
| | | | - Genevieve M. Hale
- Nova Southeastern University College of Pharmacy, Palm Beach Gardens, FL, USA
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157
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Astudillo Y, Kibrom S, Pereira T, Solomon S, Krishnan S, Samsonov D. Association between anxiety and elevated blood pressure in adolescent patients: a single-center cross-sectional study. J Hypertens 2024; 42:644-649. [PMID: 38230613 PMCID: PMC10906197 DOI: 10.1097/hjh.0000000000003652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 11/16/2023] [Accepted: 12/03/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Although anxiety is known to be associated with elevated blood pressure and hypertension in adults, this has not been studied in children. The aim of this study was to determine the association between anxiety and elevated blood pressures in adolescents. METHODS Adolescents, aged 12-18 years old, referred to the nephrology clinic were eligible to participate. Elevated blood pressure was defined as either SBP or DBP measurement above the 95th percentile for age, height, and sex. Participants were evaluated for anxiety using the validated Screen for Child Anxiety Related Disorders questionnaire filled independently by the child (SCARED-C) and parent (SCARED-P) evaluating the child. RESULTS Two hundred adolescents participated in this study. Thirty-one (53%) of SCARED-P-positive participants were found to have elevated blood pressure compared with 27 (19%) of SCARED-P negative, P 0.03. Twenty-five (43%) of SCARED-P positive had elevated DBP compared with 31 (28%) of SCARED-P negative ( P 0.003). In SCARED-P positive, mean DBP (78.4 ± 9.9) was higher compared with SCARED-P negative (74.9 ± 9.2) ( P 0.03). In a subgroup of adolescents (№ 130) not treated with blood pressure medications mean DBP was higher in both SCARED-P (79.0 ± 10.1) and SCARED-C (77.1 ± 10.4) positive groups compared with SCARED-P (73.6 ± 9.3) and SCARED-C (73 ± 8.9) negative, respectively. CONCLUSION Our study demonstrates an association between anxiety and elevated DBP in adolescent children. Screening adolescents for anxiety should be a part of the routine evaluation of adolescent children.
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Affiliation(s)
- Yaritzy Astudillo
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Sara Kibrom
- Stanford University School of Medicine, Stanford Children's Health, San Francisco, California, USA
| | - Tanya Pereira
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Sonia Solomon
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Sankaran Krishnan
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
| | - Dmitry Samsonov
- Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, New York
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158
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Neupane D, Mukhtar Q, Krajan Pardo EK, Acharya SD, Delles C, Sharman JE, Cobb L, Lackland DT, Moran A, Weber MA, Olsen MH. Emerging Authors Program for building cardiovascular disease prevention and management research capacity in low- and middle-income countries: a collaboration of the U.S. Centers for Disease Control and Prevention, the Lancet Commission on Hypertension Group, Resolve to Save Lives, and the World Hypertension League. J Hum Hypertens 2024; 38:380-381. [PMID: 38082183 DOI: 10.1038/s41371-023-00880-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/17/2023] [Accepted: 11/29/2023] [Indexed: 04/10/2024]
Affiliation(s)
- Dinesh Neupane
- Lancet Commission on Hypertension Group, London, UK.
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Qaiser Mukhtar
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Christian Delles
- Lancet Commission on Hypertension Group, London, UK
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - James E Sharman
- Lancet Commission on Hypertension Group, London, UK
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Laura Cobb
- Resolve to Save Lives, New York, NY, USA
| | - Daniel T Lackland
- World Hypertension League, Charleston, SC, USA
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Michael A Weber
- World Hypertension League, Charleston, SC, USA
- State University of New York, New York, NY, USA
| | - Michael H Olsen
- Lancet Commission on Hypertension Group, London, UK
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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159
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Sani RN, Connelly PJ, Toft M, Rowa-Dewar N, Delles C, Gasevic D, Karaye KM. Rural-urban difference in the prevalence of hypertension in West Africa: a systematic review and meta-analysis. J Hum Hypertens 2024; 38:352-364. [PMID: 35430612 PMCID: PMC11001577 DOI: 10.1038/s41371-022-00688-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/16/2022] [Accepted: 03/30/2022] [Indexed: 12/16/2022]
Abstract
Urbanisation is considered a major contributor to the rising prevalence of hypertension in West Africa, yet the evidence regarding rural-urban differences in the prevalence of hypertension in the region has been mixed. A systematic literature search of four electronic databases: PubMed, Embase, African Journals Online, and WHO's African Index Medicus; and reference lists of eligible studies was carried out. Original quantitative studies describing the rural-urban difference in the prevalence of hypertension in one or more countries in West Africa, and published in English language from the year 2000 to 2021 were included. A random effects meta-analysis model was used to estimate the odds ratio of hypertension in rural compared to urban locations. A limited sex-based random effects meta-analysis was conducted with 16 studies that provided sex-disaggregated data. Of the 377 studies screened, 22 met the inclusion criteria (n = 62,907). The prevalence of hypertension was high in both rural, and urban areas, ranging from 9.7% to 60% in the rural areas with a pooled prevalence of 27.4%; and 15.5% to 59.2% in the urban areas with a pooled prevalence of 33.9%. The odd of hypertension were lower in rural compared to urban dwellers [OR 0.74, 95% CI: 0.66-0.83; p < 0.001]. The pooled prevalence of hypertension was 32.6% in males, and 30.0% in females, with no significant difference in the odds of hypertension between the sexes [OR 0.91, 95% CI: 0.8-1.05, p = 0.196]. Comprehensive hypertension control policies are needed for both rural, and urban areas in West Africa, and for both sexes.
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Affiliation(s)
- Ruqayya Nasir Sani
- Department of Medicine, Aminu kano Teaching Hospital, Kano, Nigeria.
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK.
| | - Paul J Connelly
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Mette Toft
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Neneh Rowa-Dewar
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Christian Delles
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Danijela Gasevic
- Center for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kamilu Musa Karaye
- Department of Medicine, Aminu kano Teaching Hospital, Kano, Nigeria
- Bayero University Kano, Kano, Nigeria
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160
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Kobayashi Y, Yatsu K, Haruna A, Kawano R, Ozawa M, Haze T, Komiya S, Suzuki S, Ohki Y, Fujiwara A, Saka S, Hirawa N, Toya Y, Tamura K. ATP2B1 gene polymorphisms associated with resistant hypertension in the Japanese population. J Clin Hypertens (Greenwich) 2024; 26:355-362. [PMID: 38430457 PMCID: PMC11007809 DOI: 10.1111/jch.14785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/07/2024] [Accepted: 02/11/2024] [Indexed: 03/03/2024]
Abstract
Single-nucleotide polymorphisms (SNP) of ATP2B1 gene are associated with essential hypertension but their association with resistant hypertension (RHT) remains unexplored. The authors examined the relationship between ATP2B1 SNPs and RHT by genotyping 12 SNPs in ATP2B1 gene of 1124 Japanese individuals with lifestyle-related diseases. Patients with RHT had inadequate blood pressure (BP) control using three antihypertensive drugs or used ≥4 antihypertensive drugs. Patients with controlled hypertension had BP controlled using ≤3 antihypertensive drugs. The association between each SNP and RHT was analyzed by logistic regression. The final cohort had 888 (79.0%) and 43 (3.8%) patients with controlled hypertension and RHT, respectively. Compared with patients homozygous for the minor allele of each SNP in ATP2B1, a significantly higher number of patients carrying the major allele at 10 SNPs exhibited RHT (most significant at rs1401982: 5.8% vs. 0.8%, p = .014; least significant at rs11105378: 5.7% vs. 0.9%, p = .035; most nonsignificant at rs12817819: 5.1% vs. 10%, p = .413). After multivariate adjustment for age, sex, systolic BP, and other confounders, the association remained significant for rs2681472 and rs1401982 (OR: 7.60, p < .05 and OR: 7.62, p = .049, respectively). Additionally, rs2681472 and rs1401982 were in linkage disequilibrium with rs11105378. This study identified two ATP2B1 SNPs associated with RHT in the Japanese population. rs1401982 was most closely associated with RHT, and major allele carriers of rs1401982 required significantly more antihypertensive medications. Analysis of ATP2B1 SNPs in patients with hypertension can help in early prediction of RHT and identification of high-risk patients who are more likely to require more antihypertensive medications.
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Affiliation(s)
- Yusuke Kobayashi
- Center for Novel and Exploratory Clinical Trials (Y‐NEXT)Yokohama City UniversityYokohamaJapan
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
| | | | - Aiko Haruna
- Department of Nephrology and HypertensionYokohama City University Medical CenterYokohamaJapan
| | - Rina Kawano
- Department of Nephrology and HypertensionYokohama City University Medical CenterYokohamaJapan
| | - Moe Ozawa
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
- Department of Nephrology and HypertensionSaiseikai Yokohamashi Nanbu HospitalYokohamaJapan
| | - Tatsuya Haze
- Center for Novel and Exploratory Clinical Trials (Y‐NEXT)Yokohama City UniversityYokohamaJapan
- Department of Nephrology and HypertensionYokohama City University Medical CenterYokohamaJapan
| | - Shiro Komiya
- Department of Nephrology and HypertensionSaiseikai Yokohamashi Nanbu HospitalYokohamaJapan
| | - Shota Suzuki
- Department of Nephrology and HypertensionYokohama City University Medical CenterYokohamaJapan
| | - Yuki Ohki
- Department of Nephrology and HypertensionYokohama City University Medical CenterYokohamaJapan
| | - Akira Fujiwara
- Department of Nephrology and HypertensionYokohama City University Medical CenterYokohamaJapan
| | - Sanae Saka
- Department of Nephrology and HypertensionSaiseikai Yokohamashi Nanbu HospitalYokohamaJapan
| | - Nobuhito Hirawa
- Department of Nephrology and HypertensionYokohama City University Medical CenterYokohamaJapan
| | - Yoshiyuki Toya
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal MedicineYokohama City University Graduate School of MedicineYokohamaJapan
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161
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Soua S, Ghammam R, Maatoug J, Zammit N, Ben Fredj S, Martinez F, Ghannem H. The prevalence of high blood pressure and its determinants among Tunisian adolescents. J Hum Hypertens 2024; 38:371-379. [PMID: 35396537 PMCID: PMC11001578 DOI: 10.1038/s41371-022-00677-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/15/2022] [Accepted: 03/09/2022] [Indexed: 11/09/2022]
Abstract
Hypertension can originate in childhood and remain undetected unless special screening is performed. The burden of hypertension in adolescents in Tunisia is unknown. The aim of this study was to investigate the prevalence of blood pressure (BP) within the hypertension range and its association with other risk factors among Tunisian adolescents. A cross-sectional study that included 1385 secondary school students in Sousse, Tunisia, was performed during 2017-2018. A two-stage cluster sampling strategy was used to obtain a representative sample of the study population. BP within the hypertension range (HBP)was classified following the European guideline recommendations for measuring BP in children and adolescents. Anthropometric indices were measured using a standard protocol. A structured questionnaire collected information about sociodemographic characteristics, lifestyle, mental health status, and addictions. Adjusted logistic regression models were used to assess hypertension-related risk factors. Our study included 39.5% boys and 60.5% girls. The mean age of our population was 17 ± 1.5 years. The prevalence of HBP was 15.4% (13.1-18.0%), and it was significantly higher in boys (22.8%) than in girls (10.6%, p value < 0.001). In the multivariate logistic regression model, overweight [OR = 1.72(1.18-2.51)] and obesity [OR = 3.73(2.55-5.41)] were independent risk factors for HBPrange, (p value < 0.001), whereas female sex [OR = 0.41(0.29-0.56), p value < 0.001] and depression [OR = 0.67(0.51-0.88), p value = 0.008] were independent protective factors. Among Tunisian secondary school adolescents, the prevalence of HBP was high and associated with excess body weight. A comprehensive strategy for the prevention of hypertension and its risk factors among youth is urgently needed.
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Affiliation(s)
- Sarra Soua
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisia.
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisia.
| | - Rim Ghammam
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisia
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisia
| | - Jihene Maatoug
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisia
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisia
| | - Nawel Zammit
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisia
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisia
| | - Sihem Ben Fredj
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisia
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisia
| | - Fernando Martinez
- Cardiometabolic and renal research group, Research Foundation of the Clinical Hospital of Valencia, Valencia, Spain
- University of Valencia, Valencia, Spain
| | - Hassen Ghannem
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisia
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisia
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Musimbaggo DJ, Kimera ID, Namugenyi C, Schwartz JI, Ssenyonjo R, Ambangira F, Kizza L, Mbuliro M, Katwesigye R, Ssinabulya I, Muddu M, Neupane D, Olsen MH, Pareek M, Semitala FC. Factors associated with blood pressure control in patients with hypertension and HIV at a large urban HIV clinic in Uganda. J Hum Hypertens 2024; 38:345-351. [PMID: 36476778 PMCID: PMC11001571 DOI: 10.1038/s41371-022-00786-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/20/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
Globally, people living with HIV on antiretroviral therapy have an increased risk of cardiovascular disease. Hypertension is the most important preventable risk factor for cardiovascular disease and is associated with increased morbidity. We conducted an exploratory survey with hypertensive persons living with HIV who received integrated HIV and hypertension care in a large clinic in Uganda between August 2019 and March 2020 to determine factors associated with blood pressure control at six months. Controlled blood pressure was defined as <140/90 mmHg. Multivariable logistic regression was used to determine baseline factors associated with blood pressure control after 6 months of antihypertensive treatment. Of the 1061 participants, 644 (62.6%) were female. The mean age (SD) was 51.1 (9.4) years. Most participants were overweight (n = 411, 38.7%) or obese (n = 276, 25.9%), and 98 (8.9%) had diabetes mellitus. Blood pressure control improved from 14.4% at baseline to 66.1% at 6 months. Comorbid diabetes mellitus (odds ratio (OR) = 0.41, 95% confidence interval (CI) = 0.26-0.64, p < 0.001) and HIV status disclosure (OR = 0.73, 95% CI = 0.55-0.98, p = 0.037) were associated with the absence of controlled blood pressure at 6 months. In conclusion, comorbid diabetes mellitus and the disclosure of an individual's HIV status to a close person were associated with poor blood pressure control among persons living with HIV who had hypertension. Therefore, subpopulations of persons living with HIV with hypertension and comorbid diabetes mellitus may require more thorough assessments and intensive antihypertensive management approaches to achieve blood pressure targets.
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Affiliation(s)
| | | | | | - Jeremy I Schwartz
- Department of Medicine, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, USA
| | | | | | - Lubega Kizza
- Makerere University Joint AIDS Program, Kampala, Uganda
| | - Mary Mbuliro
- Makerere University Joint AIDS Program, Kampala, Uganda
| | | | - Isaac Ssinabulya
- Department of Medicine, Makerere University College of Health Science, Kampala, Uganda
- Uganda Heart Institute, Kampala, Uganda
| | - Martin Muddu
- Makerere University Joint AIDS Program, Kampala, Uganda
| | - Dinesh Neupane
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael Hecht Olsen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Cardiology Section, Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Manan Pareek
- Department of Medicine, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, USA
| | - Fred C Semitala
- Makerere University Joint AIDS Program, Kampala, Uganda
- Department of Medicine, Makerere University College of Health Science, Kampala, Uganda
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163
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Takajo D, Przybycien TS, Balakrishnan PL, Natarajan G, Singh GK, Aggarwal S. Left ventricle hypertrophy and re-modeling in children with essential hypertension: does the race matter? Cardiol Young 2024; 34:906-913. [PMID: 37968238 DOI: 10.1017/s1047951123003840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
BACKGROUND This is the first study to report on the impact of race on differences in the prevalence of echocardiographic left ventricular hypertrophy and left ventricular adaptation at the time of diagnosis of essential hypertension in children. METHODS This cross-sectional, single-centre study included patients aged 3-18 years who had newly diagnosed essential hypertension. Echocardiography was used to assess left ventricular mass index and left ventricular relative wall thickness. An left ventricular mass index > the 95th percentile for age and gender, and an left ventricular relative wall thickness > 0.42, were used to diagnose left ventricular hypertrophy and concentric adaptation. Various echocardiographic parameters were compared between African Americans and Caucasians. RESULTS The study included 422 patients (289 African Americans and 133 Caucasians) diagnosed with essential hypertension at a median age of 14.6 (interquartile range; 12.1-16.3) years. Eighty-eight patients (20.9%) had left ventricular hypertrophy. There was no statistically significant difference in the prevalence of left ventricular hypertrophy between African Americans and Caucasians (22.5% versus 17.3%, p=0.22). The median left ventricular relative wall thickness was 0.35 (0.29-0.43), and 114 patients (27.0%) had an left ventricular relative wall thickness > 0.42. The presence of an left ventricular relative wall thickness > 0.42 was significantly higher among African Americans compared to Caucasians (30.1% versus 20.3%, p = 0.04). The African American race was a strong predictor for an left ventricular relative wall thickness > 0.42 (odds ratio 1.7, p = 0.04), but not for left ventricular mass index > the 95th percentile (p = 0.22). Overweight/obesity was a strong predictor for an left ventricular mass index > the 95th percentile. CONCLUSIONS There was no difference in the prevalence of left ventricular hypertrophy in children with essential hypertension of different races. Obesity, rather than being African American, is associated with left ventricular hypertrophy.
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Affiliation(s)
- Daiji Takajo
- Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
| | - Thomas S Przybycien
- Division of Pediatric Cardiology, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
| | - Preetha L Balakrishnan
- Division of Pediatric Cardiology, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
| | - Girija Natarajan
- Division of Neonatal & Perinatal Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
| | - Gautam K Singh
- Division of Pediatric Cardiology, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
| | - Sanjeev Aggarwal
- Division of Pediatric Cardiology, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI, USA
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164
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Zhao S, Deng Y, Wang Y, Yu S, Han J, Cai J, Zhang Y. Incidence and prognosis of cardiac conduction system diseases in hypertension: the STEP trial. Nat Aging 2024; 4:483-490. [PMID: 38514823 DOI: 10.1038/s43587-024-00591-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 02/14/2024] [Indexed: 03/23/2024]
Abstract
Patients with cardiac conduction system diseases (CSD) may have increased incidence and mortality of cardiovascular events. Here we report a post hoc analysis of the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) randomized clinical trial (ClinicalTrials.gov number, NCT03015311) concerning the effect of intensive blood pressure (BP) control on the incidence of new-onset CSD and the prognostic implications of preexisting or new-onset CSD. The incidence of new-onset CSD was similar in the intensive (n = 205, 6.42%) and standard (n = 188, 5.94%) treatment arms. Participants with preexisting CSD had a higher risk for acute decompensated heart failure. Increased age, male sex and increased body mass index were independently associated with increased risk for new-onset CSD. Our results suggest that intensive BP control may not reduce the incidence of new-onset CSD compared with standard BP control.
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Affiliation(s)
- Song Zhao
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yue Deng
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yixuan Wang
- Hypertension Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jun Han
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jun Cai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
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165
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Harding CC, Goldstein KM, Goldstein SA, Wheeler SM, Mitchell NS, Copeland LA. Maternal chronic hypertension in women veterans. Health Serv Res 2024; 59:e14277. [PMID: 38234056 PMCID: PMC10915474 DOI: 10.1111/1475-6773.14277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVE To describe the prevalence of maternal chronic hypertension (MCH), assess how frequently blood pressure is controlled before pregnancy among those with MCH, and explore management practices for antihypertensive medications (AHM) during the pre-pregnancy and pregnancy periods. DATA SOURCES, STUDY SETTING, AND STUDY DESIGN We conducted a descriptive observational study using data abstracted from the Veterans Health Administration (VA) inclusive of approximately 11 million Veterans utilizing the VA in fiscal years 2010-2019. DATA COLLECTION/EXTRACTION METHODS Veterans aged 18-50 were included if they had a diagnosis of chronic hypertension before a documented pregnancy in the VA EMR. We identified chronic hypertension and pregnancy with diagnosis codes and defined uncontrolled blood pressure as ≥140/90 mm Hg on at least one measurement in the year before pregnancy. Sensitivity models were conducted for individuals with at least two blood pressure measurements in the year prior to pregnancy. Multivariable logistic regression explored the association of covariates with recommended and non-recommended AHMs received 0-6 months before pregnancy and during pregnancy. PRINCIPAL FINDINGS In total, 8% (3767/46,178) of Veterans with a documented pregnancy in VA data had MCH. Among 2750 with MCH meeting inclusion criteria, 60% (n = 1626) had uncontrolled blood pressure on at least one BP reading and 31% (n = 846) had uncontrolled blood pressure on at least two BP readings in the year before pregnancy. For medications, 16% (n = 437) received a non-recommended AHM during pregnancy. Chronic kidney disease (OR = 3.2; 1.6-6.4) and diabetes (OR = 2.3; 1.7-3.0) were most strongly associated with use of a non-recommended AHM during pregnancy. CONCLUSIONS Interventions are needed to decrease the prevalence of MCH, improve preconception blood pressure control, and ensure optimal pharmacologic antihypertensive management among Veterans of childbearing potential.
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Affiliation(s)
- Ceshae C. Harding
- Department of Medicine, Division of General Internal MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Karen M. Goldstein
- Department of Medicine, Division of General Internal MedicineDuke UniversityDurhamNorth CarolinaUSA
- Durham VA Health Care SystemDurhamNorth CarolinaUSA
| | - Sarah A. Goldstein
- Department of Medicine, Division of Cardiovascular MedicineYale New Haven Health SystemNew HavenConnecticutUSA
| | - Sarahn M. Wheeler
- Department of Obstetrics and Gynecology, Division of Maternal‐Fetal MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Nia S. Mitchell
- Department of Medicine, Division of General Internal MedicineDuke UniversityDurhamNorth CarolinaUSA
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Ordunez P, Campbell NRC, DiPette DJ, Jaffe MG, Rosende A, Martinez R, Gamarra A, Lombardi C, Parra N, Rodriguez L, Rodriguez Y, Brettler J. HEARTS in the Americas: Targeting Health System Change to Improve Population Hypertension Control. Curr Hypertens Rep 2024; 26:141-156. [PMID: 38041725 PMCID: PMC10904446 DOI: 10.1007/s11906-023-01286-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE OF REVIEW HEARTS in the Americas is the regional adaptation of Global Hearts, the World Health Organization initiative for cardiovascular disease (CVD) prevention and control. Its overarching goal is to drive health services to change managerial and clinical practice in primary care settings to improve hypertension control and CVD risk management. This review describes the HEARTS in the Americas initiative. First, the regional epidemiological situation of CVD mortality and population hypertension control trends are summarized; then the rationale for its main intervention components: the primary care-oriented management system and the HEARTS Clinical Pathway are described. Finally, the key factors for accelerating the expansion of HEARTS are examined: medicines, team-based care, and a system for monitoring and evaluation. RECENT FINDINGS Thus far, 33 countries in Latin America and the Caribbean have committed to integrating this program across their primary healthcare network by 2025. The increase in hypertension coverage and control in primary health care settings compared with the traditional model is promising and confirms that the interventions under the HEARTS umbrella are feasible and acceptable to communities, patients, providers, decision-makers, and funders. This review highlights some cases of successful implementation. Scaling up effective treatment for hypertension and optimization of CVD risk management is a pragmatic way to accelerate the reduction of CVD mortality while strengthening primary healthcare systems to respond effectively, with quality, and equitably, to the challenge of non-communicable diseases, not only in low-middle income countries but in all communities globally.
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Affiliation(s)
- Pedro Ordunez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA.
| | - Norm R C Campbell
- Department of Medicine, Libin Cardiovascular Institute, The University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Donald J DiPette
- University of South Carolina and University of South Carolina School of Medicine, Columbia, SC, USA
| | - Marc G Jaffe
- Department of Endocrinology, The Permanente Medical Group, Kaiser San Francisco Medical Center, San Francisco, CA, USA
| | - Andres Rosende
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Ramon Martinez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Angelo Gamarra
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Cintia Lombardi
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Natalia Parra
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Libardo Rodriguez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Yenny Rodriguez
- Department of Non-Communicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Jeffrey Brettler
- Southern California Permanente Medical Group, Department of Health Systems Science, Regional Hypertension Program, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, USA
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167
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Satapathy P, Khatib MN, Gaidhane S, Zahiruddin QS, Gaidhane AM, Rustagi S, Serhan HA, Padhi BK. Association of neighborhood deprivation and hypertension: A systematic review and meta-analysis. Curr Probl Cardiol 2024; 49:102438. [PMID: 38301916 DOI: 10.1016/j.cpcardiol.2024.102438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Hypertension impacts nearly one billion individuals and is a primary health challenge. While traditional perspectives have focused on individual behavior and genetics as principal risk factors, recent research underscores the profound influence of socioeconomic factors within neighborhoods on the risk of hypertension. This systematic review and meta-analysis is aimed to elucidate the association between neighborhood deprivation and the risk of hypertension. METHODS A comprehensive literature search was conducted across PubMed, Embase, and Web of Science from inception until December 25, 2023. Observational studies defining neighborhood deprivation and reporting hypertension incidence were included. Nested Knowledge software was used for screening and data extraction, with study quality assessed using the Newcastle-Ottawa Scale. Statistical analysis was performed with R software (V 4.3), using a random-effects model to calculate the pooled relative risk (RR). RESULTS Twenty-six studies were included in the qualitative analysis and 22 in the meta-analysis, covering over 62 million participants. The pooled RR was 1.139 (95% CI: 1.006 - 1.290), p=0.04, indicating a higher hypertension risk in deprived neighborhoods. Subgroup analyses showed variability by country and deprivation assessment methods. RR varied from 1.00 in Japan (95% CI: 0.93-1.08) to 1.60 (95% CI: 1.07-2.39) in France and 1.57 (95% CI: 0.67-3.70) in Germany, with significant heterogeneity observed in measures of neighborhood deprivation. CONCLUSION Our analysis confirms a significant association between neighborhood deprivation and hypertension, underscoring the importance of socioeconomic factors in public health. It highlights the need for targeted local assessments and interventions. Future research should explore the causal mechanisms and effectiveness of interventions addressing neighborhood deprivation.
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Affiliation(s)
- Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India; School of Pharmacy, Graphic Era Hill University, Dehradun, India; Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil 51001, Iraq
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- South Asia Infant Feeding Research Network (SAIFRN), Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Abhay M Gaidhane
- Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education, Wardha, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar.
| | - Bijaya K Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Smith-Ray R, Feng L, Singh T, Rudkin K, Emmons S, Groves E, Kirkham H. Pharmacists as clinical care partners: How a pharmacist-led intervention is associated with improved medication adherence in older adults with common chronic conditions. J Manag Care Spec Pharm 2024; 30:345-351. [PMID: 38555630 DOI: 10.18553/jmcp.2024.30.4.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
BACKGROUND Hypertension, hyperlipidemia, and type 2 diabetes (T2D) are 3 of the most common chronic conditions, but related medication adherence rates are far below 80%. Consequences of poor adherence include high health care utilization/costs and increased mortality. There is accumulating evidence in support of the benefits of affording pharmacists the opportunity to practice at the full scope of their licensure by engaging in patients' clinical care. OBJECTIVE To examine the impact of a large national pharmacy chain's pharmacist-led interventions to improve medication adherence among older adults with hypertension, hyperlipidemia, or T2D. A secondary objective was to estimate the potential cost savings associated with improved adherence. METHODS Participants were Medicare patients aged 18 years or older who had 2 or more prescription fills in at least 1 of the 3 therapeutic classes. The primary outcome, optimal adherence, was defined as proportion of days covered (PDC) of 80% or higher. A difference-in-differences (DID) design with a generalized linear model analytical approach was applied to examine differences between intervention participants and controls. The study period spanned from 2020 to 2022. RESULTS Intervention participants (n = 317,613, age 70.1 years, female sex 57.0%) had lower baseline optimal adherence than controls (n = 943,389, age 73.3, female sex 56.1%) for diabetes (76.9% vs 79.8%), hypertension (79.0% vs 83.0%), and cholesterol (78.6% vs 82.1%). The DID results showed that between 2020 and 2022, optimal adherence had significant absolute increases for intervention participants (diabetes: +4.0%, hypertension: +6.3%, cholesterol: +6.1%) vs controls who declined in adherence (diabetes: -1.6%, hypertension: -0.4%, cholesterol: -1.4%). All DID models were significant at P < 0.0001. Total cost of care was projected based on improvements in adherence. Based on PDC improvements for the test population, we estimate that the pharmacist consultations were associated with annual total health care cost savings of $10,329,284 ($109 per capita), $31,640,660 ($122 per capita), and $21,589,875 ($75 per capita) for test population patients with diabetes, hypertension, and hyperlipidemia, respectively. CONCLUSIONS The study found that the pharmacist-led interventions were significantly associated with increased optimal adherence over 2 years. These findings demonstrate the potential of pharmacist-led interventions to improve medication adherence among older adults with chronic conditions. Strategies to expand pharmacist-provided care must be further examined.
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Liu Z, Zhao D, Dai S, Liang Y, Zhao M, Liu M, Zhong Z, Liang L, Tian Z, Yang Y. Inverse Association between the Global Diet Quality Score and New-Onset Hypertension in Adults: A Nationwide Cohort Study. J Nutr 2024; 154:1252-1261. [PMID: 38360116 DOI: 10.1016/j.tjnut.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/30/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND The Global Diet Quality Score (GDQS) is a simple and practical dietary metric associated with a number of chronic diseases. The GDQS included various foods related to blood pressure, especially diverse plant-based foods that have shown to lower blood pressure. However, studies on the role of the GDQS in reducing the risk of new-onset hypertension and whether its performance differs from that of other dietary metrics are lacking. OBJECTIVE We aimed to examine the association between the GDQS and new-onset hypertension and to compare its performance with that of other dietary patterns, including the Plant-based Diet Index (PDI), alternate Mediterranean diet (aMED) score, Alternative Healthy Eating Index-2010, and Dietary Approaches to Stop Hypertension (DASH) score in Chinese adults. METHODS We included a total of 12,002 participants (5644 males and 6358 females) aged >18 y from the China Health and Nutrition Survey (1997-2015). Dietary intake was estimated using average food intakes from 3 consecutive 24-h dietary recalls. Multivariable relative risks (RRs) were computed for hypertension using modified Poisson regression models. RESULTS With ≤18 y of follow-up (mean 8.7± 5.4 y), we ascertained 4232 incident cases of hypertension. Compared with participants with a low GDQS score (<15), the multivariable-adjusted RR of hypertension was 0.72 [95% confidence interval (CI): 0.62, 0.83] among participants with a high score (≥23). A 25% increment in the GDQS was associated with a 30% (RR, 0.70; 95% CI: 0.64, 0.76) lower risk of new-onset hypertension, which was comparable with the RRs of new-onset hypertension associated with every 25% increment in the PDI (RR, 0.84; 95% CI: 0.76, 0.93), DASH score (RR, 0.84; 95% CI: 0.78, 0.91), and aMED score (RR, 0.89; 95% CI: 0.84, 0.93). CONCLUSION A higher GDQS was associated with a lower risk of new-onset hypertension, with comparable associations of new-onset hypertension with PDI, DASH, and aMED scores in Chinese adults.
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Affiliation(s)
- Zhihao Liu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Dan Zhao
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Suming Dai
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Ying Liang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Mingzhu Zhao
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Meitong Liu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Zepei Zhong
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Lihan Liang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Zezhong Tian
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
| | - Yan Yang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Sun Yat-sen University, Shenzhen, Guangdong Province, China; Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
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Campbell NRC, McKay DW, Petrella R, Kaczorowski J. The Urgent Need to Re-establish a Health Coalition Focused on Hypertension Prevention and Control in Canada. Can J Cardiol 2024; 40:610-612. [PMID: 38416078 DOI: 10.1016/j.cjca.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 11/25/2023] [Accepted: 11/27/2023] [Indexed: 02/29/2024] Open
Affiliation(s)
- Norm R C Campbell
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Donald W McKay
- Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Robert Petrella
- Department of Family Practice, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia. Canada
| | - Janusz Kaczorowski
- Department of Family and Emergency Medicine, University of Montréal, Montréal, Québec, Canada
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171
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Wang HY, Wang J, Wang Q, Yang C, Huang Y, Chen M. Blood pressure in the longevous population with different status of hypertension and frailty. Hypertens Res 2024; 47:959-969. [PMID: 37985739 DOI: 10.1038/s41440-023-01499-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/22/2023]
Abstract
Blood pressure(BP) of the longevous population with hypertension and/or frailty was under-investigated. To investigate the association between age, BP, variation of BP, and survival among the old adults with different status of hypertension and frailty, the present study included adults ≥65 years in the Chinese Longitudinal Healthy Longevity Survey (2008-2018), defined frailty using the Fried criteria, and identified hypertension by self-report or SBP/DBP ≥ 140/90 mm Hg. The association between age and BP were investigated using linear regression models. Variation of BP was defined if annual change of BP lower than quartile 1(sharp decrease) or higher than quartile 3(sharp increase). The association between age and BP variation were investigated using multinominal logistic regression models. The association between BP and survival was analyzed using Cox regression models. Among 13,447 adults (centenarian: 1965[14.6%]), age was positively associated with SBP in robust hypertensive elderly but negatively associated with it in frail hypertensive elderly. Annual change of BP was more likely to be increment among the normotensive elderly, but be decrement among the hypertensive elderly, especially among those with frailty. SBP < 120 mmHg was the risk factor of mortality among the frail oldest-old (≥85 years) while SBP ≥ 150 mmHg was that among the robust young-old (65-84 years). DBP ≥ 90 mmHg was the risk factor of mortality both in the robust young-old and the frail oldest old. In conclusion, age and frailty might be the criteria to predict the change of BP to guide the BP management of the longevous population.
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Affiliation(s)
- Huai-Yu Wang
- National Institute of Traditional Chinese Medicine Constitution and Preventive Treatment of Diseases, Beijing University of Chinese Medicine, Beijing, China.
| | - Jinwei Wang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Qin Wang
- Department of Nephrology, Xiangya Hospital, Central South University, Changsha, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
| | - Yuming Huang
- First Nephrology Department, Affiliated Hospital of Youjiang Medical College for Nationalities, Baise, Guangxi, China
| | - Min Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China
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Mousavi Mele M, Tahavorgar A, Salimi Z, Shaker A, Askarpour SA, Mohammadian MK, Mirshafaei SR, Saeedirad Z, Torkaman M, Mahmoudi Z, Tajadod S, Khoshdooz S, Doaei S, Kooshki A, Gholamalizadeh M. The Association of Iron Intake and Hypertension, Does Iron Intake Decrease Blood Pressure? Cardiovasc Toxicol 2024; 24:345-350. [PMID: 38561455 DOI: 10.1007/s12012-024-09848-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
Previous studies reported that iron may have an indispensable role in the risk of hypertension (HTN). However, the result of the studies on the relationship between iron and risk of HTN is inconsistent. This study aimed to assess the association between the association of dietary iron intake and HTN in the Iranian population. This case-control study was conducted on 4184 people aged 35 to 70, including 1239 people with HTN and 2945 people with normal blood pressure (BP) in Sabzevar, Iran. Dietary intake was assessed using a food frequency questionnaire (FFQ). The Nutritionist IV software was used in terms of the assessment of dietary intake of iron. An inverse association was found between iron intake and HTN (OR = 0.97, CI 95%: 0.94-0.99, P = 0.04). The association remained significant after adjustment for age, gender, smoking, drinking alcohol, calorie intake, and BMI (OR = 0.94, CI 95%: 0.89-0.98, P = 0.01). As a conclusion, iron intake was inversely associated with HTN. Further longitudinal studies on the effect of iron intake on BP are required to confirm this finding.
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Affiliation(s)
- Mahdi Mousavi Mele
- Department of Nutrition, School of Public Health, International Campus, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Atefeh Tahavorgar
- School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Salimi
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Shaker
- Cellular and Molecular Biology, Islamic Azad University of Mashhad, Mashhad, Iran
| | - Seyed Ali Askarpour
- Division of Food Safety and Hygiene, Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Seyed Reza Mirshafaei
- Department of Applied Mathematics, Faculty of Mathematical Sciences, Roudsar & Amlash Branch, Islamic Azad University, Roudsar, Iran
| | - Zahra Saeedirad
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdie Torkaman
- Department of Chemical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Zahra Mahmoudi
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Shirin Tajadod
- Department of nutrition, School of Public health, International campus, Iran University of Medical Sciences, International Campus, Tehran, Iran
| | | | - Saeid Doaei
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Akram Kooshki
- Non-Communicable Diseases Research Center, Department of Nutrition & Biochemistry, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ghammam R, Maatoug J, Harrabi I, Ben Fredj S, Zammit N, Laatikainen T, Vartiainen E, Neupane D, Ghannem H. Effectiveness of a 3-year community-based intervention for blood pressure reduction among adults: a repeated cross-sectional study with a comparison area. J Hum Hypertens 2024; 38:336-344. [PMID: 35396538 PMCID: PMC11001574 DOI: 10.1038/s41371-022-00672-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/15/2022] [Accepted: 03/04/2022] [Indexed: 11/09/2022]
Abstract
Raised blood pressure is the leading risk factor for cardiovascular diseases. We aimed to demonstrate the effectiveness of a 3-year community-based healthy lifestyle promotion intervention at a neighbourhood level for blood pressure reduction among adults in the context of a political transition. We conducted repeated cross-sectional surveys including 1880 (940 from each area) participants at baseline and 1977 (1001 in the intervention area; 976 comparison area) participants at follow-up. Data collection was conducted through home visits. Multiple linear regression models were used to identify the intervention effect and factors associated with blood pressure change in each area. The prevalence of hypertension was 4.4% lower (35.8% vs. 31.4%) in the intervention area after 3 years (p = 0.044). The mean systolic and diastolic blood pressures changed significantly in the intervention area, from 132.4 ± 19.2 mmHg at baseline to 130.6 ± 17.7 mmHg at follow-up (p = 0.035) and from 78.7 ± 11.8 mmHg to 76.9 ± 11.1 mmHg (p < 10-3), respectively. In the control group, the mean systolic blood pressure increased from 129.4 ± 17.8 mmHg to 130.4 ± 17.9 mmHg (p = 0.38). A significant protective effect of the intervention on systolic (β = -0.4; 95% CI: -0.76; -0.06) and diastolic blood pressures (β = -0.22; 95% CI: -0.38; -0.07) was found in the intervention area. In the control area, the effect was not significant for systolic blood pressure. Lifestyle intervention at the neighbourhood level, in the context of a sociopolitical transition, was found to be effective for reducing blood pressure in Sousse, Tunisia. This approach could be scaled up and applied in other similar settings. Future research also needs to focus on designing, implementing, and evaluating multisectoral action plans and legislative measures.
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Affiliation(s)
- Rim Ghammam
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie.
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie.
| | - Jihene Maatoug
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie
| | - Imed Harrabi
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie
| | - Sihem Ben Fredj
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie
| | - Nawel Zammit
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie
| | | | - Erkki Vartiainen
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Dinesh Neupane
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Hassen Ghannem
- Université de Sousse, Faculté de Médecine de Sousse, 4000, Sousse, Tunisie
- Hôpital Farhat Hached, Service d'Epidémiologie, «LR19SP03», 4000, Sousse, Tunisie
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174
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Okah E, Jetty A, Jabbarpour Y, Sloane P. Duration of Residence and Hypertension in Black Foreign-Born Residents: NHIS, 2004-2017. J Racial Ethn Health Disparities 2024; 11:591-597. [PMID: 36853405 DOI: 10.1007/s40615-023-01543-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/12/2023] [Accepted: 02/16/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Black Americans have the highest prevalence of hypertension in the USA. Black immigrants, who, by definition, have time-limited exposure to the USA, may provide insight into the relationship between exposure to the US environment, Black race, and hypertension. METHODS This is a cross-sectional analysis of pooled National Health Interview Survey (2004-2017) data of foreign-born White European and Black adults (N = 11,516). Multivariable robust Poisson regressions assessed the relationship between self-reported hypertension and duration of the residency (< 5, 5-9, 10-14, ≥ 15 years) among Black, Black African, Black Caribbean, and White European foreign-born residents. RESULTS In multivariable analyses-controlling for age, sex, education, poverty-to-income ratio, insurance status, recent encounter with a clinician, and BMI-Black foreign-born residents (PR = 1.40, 95% CI = 1.03, 1.90) and Black Africans (10-14 years.: PR = 1.70, 95% CI = 1.13, 2.56; ≥ 15 years.: PR = 1.56, 95% CI = 1.04, 2.34) with a duration of residency of at least 15 and 10 years, respectively, had a greater prevalence of hypertension than those with duration less than 5 years. A nonsignificant positive association between a duration of residency of at least 15 years (compared to less than 5 years) and self-reported hypertension was observed for White Europeans (PR 1.49, 95% CI = 0.88, 2.51) and Black Caribbeans (PR = 1.09, 95% CI = 0.69, 1.72). CONCLUSION Duration of residency is particularly associated with hypertension among Black Africans after migration to the USA. This discrepancy may be explained by differences in primary care utilization and awareness of hypertension diagnoses among recent African immigrants, along with greater stress associated with living in the USA.
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Affiliation(s)
- Ebiere Okah
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 717 Delaware Street SE, Minneapolis, MN, 55414, USA.
| | - Anuradha Jetty
- The Robert Graham Center, 1133 Connecticut Avenue NW, Washington, DC, 20036, USA
| | - Yalda Jabbarpour
- The Robert Graham Center, 1133 Connecticut Avenue NW, Washington, DC, 20036, USA
| | - Philip Sloane
- Department of Family Medicine, University of North Carolina School of Medicine, 590 Manning Dr, Chapel Hill, NC, 27514, USA
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Babu BV, Hazarika CR, Raina SK, Masoodi SR, Basappa YC, Thomas N, Kerketta AS, Menon NK, Jebasingh FK. Prevalence of type 2 diabetes among tribal population of india: a multi-centric cross-sectional study. J Natl Med Assoc 2024; 116:153-164. [PMID: 38290904 DOI: 10.1016/j.jnma.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/12/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND The perception among healthcare workers is that the Indian tribal (indigenous) population are less affected by diabetes. This paper reports the prevalence of type 2 diabetes and its associated factors among tribal populations from six districts across India. METHODOLOGY Random blood glucose (RBG) and fasting blood glucose (FBG) were measured for 8486 and 3131 adults, respectively, with a glucose meter. FBG ≥ 126 mg/dL (7.0 mmol/L) and RBG ≥ 200 mg/dL (11.1 mmol/L) were used to diagnose diabetes. In addition, blood pressure, anthropometric (height, weight, waist and hip circumferences), socio-demographic (age, gender, education, type of tribe and type of village) and behavioural data (tobacco smoking, non-smoking tobacco use and alcohol consumption) were collected. RESULTS The overall prevalence of type 2 diabetes, based on RBG, was 4.77% (95% CI: 4.33-5.25). The prevalence of type 2 diabetes and prediabetes, based on FBG, was 6.80% (95% CI: 5.95-7.74) and 8.69% (7.72-9.73), respectively. The prevalence of type 2 diabetes was significantly associated with age (p<0.001), smokeless tobacco use (p < 0.05), hypertension (p < 0.001) and obesity (p < 0.01). CONCLUSION The prevalence of type 2 diabetes among the Indian tribal population reported in this study is less than the national average of 7.3% for the general population. Hypertension and obesity were the major risk factors. Due to changing behavioural patterns, including dietary behaviour, there is likely to be an increase in the prevalence of hypertension and obesity, which further leads to increased prevalence of type 2 diabetes. Hence, appropriate interventions are to be initiated by the primary healthcare system.
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Affiliation(s)
- Bontha V Babu
- Socio Behavioral, Health Systems and Implementation Research Division, Indian Council of Medical Research, New Delhi, India.
| | - Chaya R Hazarika
- Socio Behavioral, Health Systems and Implementation Research Division, Indian Council of Medical Research, New Delhi, India
| | - Sunil K Raina
- Department of Community Medicine, Dr Rajendra Prasad Government Medical College, Tanda, Kangra, Himachal Pradesh, India
| | - Shariq R Masoodi
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Nihal Thomas
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
| | | | | | - Felix K Jebasingh
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
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Craver AE, Chen GF, Cohen JM. Association between atopic dermatitis and hypertension and hyperlipidemia: A cross-sectional study in the All of Us Research Program. J Am Acad Dermatol 2024; 90:819-821. [PMID: 38008413 DOI: 10.1016/j.jaad.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/06/2023] [Accepted: 11/17/2023] [Indexed: 11/28/2023]
Affiliation(s)
| | | | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut; Section of Biomedical Informatics and Data Science, Yale School of Medicine, New Haven, Connecticut.
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Araujo-Moura K, Nascimento-Ferreira MV, Schaan B, Bloch K, de Carvalho K, Cureau F, Ferreira De Moraes AC. Serum Vitamin D Levels Mediate the Association Between Physical Activity and Blood Pressure in Adolescents. J Phys Act Health 2024; 21:333-340. [PMID: 38253051 DOI: 10.1123/jpah.2022-0532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 01/24/2024]
Abstract
Individuals with low levels of vitamin D are associated with cardiovascular risks, such as elevated blood pressure (BP), and are; therefore, more likely to develop hypertension. Patients with vitamin D deficiency may face an increased risk of cardiovascular events. In this study, a multicenter, cross-sectional, and school-based investigation was conducted as part of the ERICA project. The sample comprised 1152 adolescents aged 12-17 years from 4 Brazilian cities. Anthropometric variables, BP measurements, and hydroxyvitamin D concentrations were assessed. A 2-level linear regression was fitted to examine the relationship between each level of BP and independent variables. Our findings indicate that movement behaviors were not associated with BP levels, with the exception of sleep time, which demonstrated a positive association. However, after adjustment, this association was found to be nonsignificant. Our study's mediation analysis revealed that vitamin D mediates up to 12.9% of the association between physical activity and systolic BP. Vitamin D is inversely associated with BP in adolescents. In addition to mediating the physical activity and systolic BP association, engaging in physical activity, particularly outdoors, can provide a dual benefit for adolescents by increasing serum vitamin D levels and assisting in the control of BP levels.
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Affiliation(s)
- Keisyanne Araujo-Moura
- Department of Epidemiology, Graduate Program in Public Health and Graduate Program in Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, SP, Brazil
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Marcus Vinicius Nascimento-Ferreira
- YCARE (Youth/Child and cArdiovascular Risk and Environmental) Research Group, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- HEALth, pHYsical Activity and Behavior ReseArch (HEALTHY-BRA) Group, Federal University of Tocantins, Campus Miracema, Miracema, TO, Brazil
| | - Beatriz Schaan
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Faculty of Medicine, Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Kátia Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Kênia de Carvalho
- Human Nutrition Program, Universidade de Brasília, Brasilia, DF, Brazil
| | - Felipe Cureau
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Augusto César Ferreira De Moraes
- The University of Texas Health Science Center at Houston, School of Public Health in Austin, Department of Epidemiology, Michael & Susan Dell Center for Healthy Living, Austin, TX, USA
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178
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Kubra KT, Moni MA. Level of Vitamin D and Its Relation with Incident Hypertension among Bangladeshi Adults. Mymensingh Med J 2024; 33:476-485. [PMID: 38557529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Effect of vitamin D level on incident hypertension was not elucidated in our country perspective. The objective of the study was to report the level of vitamin D and its relation with incident hypertension among the Bangladeshi adults. This cross-sectional assessment was conducted in Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh for a period of one year (1st January 2019 to 31st December 2019). A total of 187 participants who had no known history of hypertension and comorbidities were included. Vitamin D assay and risk factors assessment for hypertension were performed for each patient. Data collection was done using a structured questionnaire and the study was conducted in compliance with current declaration of Helsinki. Analysis was conducted with SPSS 26.0. Out of 187 participants 33(17.6%) was newly diagnosed with hypertension. Predominant age group was 31-40 years (30.5%) and the average of incidence ±SD was 36.76±12.14 years. Sufficient, insufficient and deficient vitamin D was present in 11.8%, 32.6% and 55.6% cases, respectively. Mean±SD SBP and DBP were 117.41±12.84 and 76.87±9.46 mm of Hg. Hypertension was significantly more common in male than female (p=0.047), but there was no association of vitamin D with hypertension (p=0.262). Both hypertensive and normotensive patients shared similar risk factor profile in terms of age, gender, BMI, unhealthy food habit, extra salt intake, tobacco use, caffeine consumption, hormonal contraceptive of female (p>0.05 for all). Nearly one-fifth participants had newly diagnosed hypertension and more than fifty percent had vitamin D deficiency. However, vitamin D level didn't have any statistically significant association with incident hypertension.
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Affiliation(s)
- K T Kubra
- Dr Khadija Tul Kubra, Medical Officer, OSD, DGHS, Dhaka, Bangladesh; E-mail:
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Ayhan Başer D, Gümüştakim RŞ. Addressing the Urgent Concerns of Disaster-Related Hypertension After the 2023 Turkey Earthquake: Letter to Editor. Disaster Med Public Health Prep 2024; 18:e51. [PMID: 38557450 DOI: 10.1017/dmp.2024.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Duygu Ayhan Başer
- Hacettepe, University, Faculty of Medicine, Department of Family Medicine, Ankara, Turkey
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180
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Kawasoe S, Kubozono T, Salim AA, Ojima S, Yamaguchi S, Ikeda Y, Miyahara H, Tokushige K, Miyata M, Ohishi M. Association between anthropometric indices and 5-year hypertension incidence in the general Japanese population. Hypertens Res 2024; 47:867-876. [PMID: 37964069 DOI: 10.1038/s41440-023-01505-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/16/2023]
Abstract
No existing reports demonstrate the association between anthropometric indices (body mass index, waist circumference, body roundness index, a body shape index) and hypertension according to sex and age in the general Japanese population. This retrospective analysis involved individuals aged 30-69 years who underwent annual medical checkups at Kagoshima Koseiren Hospital in 2005-2019, and who did not meet hypertension criteria at baseline. The outcome was hypertension incidence after 5 years, and its association with baseline anthropometric indices was evaluated using multivariable logistic regression analysis by sex and age. In 41,902 participants (age 52.3 ± 10.2 years, 47.7% men), 7622 individuals (18.2%) developed hypertension after 5 years. Body mass index, waist circumference, and body roundness index were significantly associated with the development of hypertension in both men and women across all age categories from 30 s to 60 s. In the population with a body mass index <25 kg/m2, waist circumference and body roundness index were significantly associated with hypertension after 5 years. A body shape index was significantly associated with the development of hypertension in men in their 40 s and 50 s but not in women of any age group. The area under the curve values were lower for a body shape index than for body mass index, waist circumference, and body roundness index in both men and women of all age groups. A body shape index was not a stronger indicator for 5-year hypertension incidence than body mass index, waist circumference, or body roundness index in both men and women across age groups from their 30s-60 s. The results of this study will help to more efficiently identify populations at high risk of developing hypertension and provide preventive interventions. A total of 41,902 participants from health checkup programs were stratified by gender and age to investigate the association between baseline anthropometric indices and hypertension incidence over a 5-year period. BMI, WC, and BRI were almost equally effective and showed a better association with risk of developing hypertension in women and young adults compared to men and old adults. Conversely, ABSI showed no greater association than BMI or WC in any age group in both men and women. ABSI, a body shape index; AUC, area under the curve from receiver operating characteristic curve analysis; BMI, body mass index; BRI, body roundness index; WC, waist circumference.
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Affiliation(s)
- Shin Kawasoe
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takuro Kubozono
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
| | - Anwar Ahmed Salim
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Satoko Ojima
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Satoshi Yamaguchi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | | | - Masaaki Miyata
- School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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181
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Mallipeddi VP, Levy M, Byrne M, Monroe A, Happ LP, Moeng LR, Castel AD, Horberg M, Wilcox R. Evaluation of New Hypertension Guidelines on the Prevalence and Control of Hypertension in a Clinical HIV Cohort: A Community-Based Study. AIDS Res Hum Retroviruses 2024; 40:223-234. [PMID: 37526367 DOI: 10.1089/aid.2022.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
The prevalence and control of hypertension (HTN) among people with HIV (PWH) have not been widely studied since the release of newer 2017 ACC/AHA guidelines ("new guidelines"). To address this research gap, we evaluated and compared the prevalence and control of HTN using both 2003 JNC 7 ("old guidelines") and new guidelines. We identified 3,206 PWH with HTN from the DC Cohort study in Washington, DC, between January 2018 and June 2019. We defined HTN using International Classification of Diseases (ICD)-9/-10 diagnosis codes for HTN or ≥2 blood pressure (BP) measurements obtained at least 1 month apart (>139/89 mm Hg per old or >129/79 mm Hg per new guidelines). We defined HTN control based on recent BP (≤129/≤79 mm Hg per new guidelines). We identified socio-demographics, cardiovascular risk factors, and co-morbidities associated with HTN control using multivariable logistic regression [adjusted odds ratio (aOR); 95% confidence interval (CI)]. The prevalence of HTN was 50.9% per old versus 62.2% per new guidelines. Of the 3,206 PWH with HTN, 887 (27.7%) had a recent BP ≤129/≤79 mm Hg, 1,196 (37.3%) had a BP 130-139/80-89 mm Hg, and 1,123 (35.0%) had a BP ≥140/≥90 mm Hg. After adjusting for socio-demographics, cardiovascular risk factors, and co-morbidities, factors associated with HTN control included age 60-69 (vs. <40) years (aOR: 1.42; 95% CI: 1.03-1.98), Hispanic (vs. non-Hispanic Black) race/ethnicity (aOR 1.49; 95% CI: 1.04-2.15), receipt of HIV care at a hospital-based (vs. community-based) clinic (aOR 1.21; 95% CI: 1.00-1.47), being unemployed (aOR 1.42; 95% CI: 1.11-1.83), and diabetes (aOR 1.35; 95% CI: 1.13-1.63). In a large urban cohort of PWH, nearly two-thirds had HTN and less than one-third of those met new guideline criteria. Our data suggest that more aggressive HTN control is warranted among PWH, with additional attention to younger patients and non-Hispanic Black patients.
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Affiliation(s)
- Vishnu Priya Mallipeddi
- Department of Cardiovascular Sciences, Louisiana State University Health Shreveport, Shreveport, Louisiana
| | - Matthew Levy
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Morgan Byrne
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Anne Monroe
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Lindsey Powers Happ
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Letumile Rodgers Moeng
- Department of Internal Medicine, Division of Infectious Diseases, Howard University, Washington, District of Columbia, USA
| | - Amanda D Castel
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Michael Horberg
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland, USA
| | - Ronald Wilcox
- Department of Internal Medicine, Division of Infectious Diseases, Howard University, Washington, District of Columbia, USA
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Zhu A, Ostbye T, Naheed A, de Silva HA, Jehan I, Gandhi M, Chakma N, Kasturiratne A, Samad Z, Jafar TH. Ambulatory blood pressure levels in individuals with uncontrolled clinic hypertension across Bangladesh, Pakistan, and Sri Lanka. J Clin Hypertens (Greenwich) 2024; 26:391-404. [PMID: 38450866 PMCID: PMC11007786 DOI: 10.1111/jch.14787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 03/08/2024]
Abstract
Hypertension is a leading risk factor for cardiovascular disease in South Asia. The authors aimed to assess the cross-country differences in 24-h ambulatory, daytime, and nighttime systolic blood pressure (SBP) among rural population with uncontrolled clinic hypertension in Bangladesh, Pakistan, and Sri Lanka. The authors studied patients with uncontrolled clinic hypertension (clinic BP ≥ 140/90 mmHg) who underwent ambulatory blood pressure monitoring (ABPM) during the baseline assessment as part of a community-based trial. The authors compared the distribution of ABPM profiles of patients across the three countries, specifically evaluating ambulatory SBP levels with multivariable models that adjusted for patient characteristics. Among the 382 patients (mean age, 58.3 years; 64.7% women), 56.5% exhibited ambulatory hypertension (24-h ambulatory BP ≥ 130/80 mmHg), with wide variation across countries: 72.6% (Bangladesh), 50.0% (Pakistan), and 51.0% (Sri Lanka; P < .05). Compared to Sri Lanka, adjusted mean 24-h ambulatory, daytime, and nighttime SBP were higher by 12.24 mmHg (95% CI 4.28-20.20), 11.96 mmHg (3.87-20.06), and 12.76 mmHg (4.51-21.01) in Bangladesh, separately. However, no significant differences were observed between Pakistan and Sri Lanka (P > .05). Additionally, clinic SBP was significantly associated with 24-h ambulatory (mean 0.38, 95% CI 0.28-0.47), daytime (0.37, 0.27-0.47), and nighttime SBP (0.40, 0.29-0.50) per 1 mmHg increase. The authors observed substantial cross-country differences in the distribution of ABPM profiles among patients with uncontrolled clinic hypertension in rural South Asia. The authors findings indicated the need to incorporate 24-h BP monitoring to mitigate cardiovascular risk, particularly in Bangladesh.
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Affiliation(s)
- Anqi Zhu
- Program in Health Services & Systems ResearchDuke‐NUS Medical SchoolSingaporeSingapore
| | - Truls Ostbye
- Duke University Department of Family Medicine and Community HealthDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Aliya Naheed
- Health Systems and Population Studies DivisionInternational Centre for Diarrhoeal Disease Research (ICDDR, B)DhakaBangladesh
| | - H Asita de Silva
- Department of PharmacologyFaculty of MedicineUniversity of KelaniyaRagamaSri Lanka
| | - Imtiaz Jehan
- Department of Community Health ScienceAga Khan UniversityKarachiPakistan
| | - Mihir Gandhi
- BiostatisticsSingapore Clinical Research InstituteSingaporeSingapore
- Centre of Quantitative MedicineDuke‐NUS Medical SchoolSingaporeSingapore
- Tampere Center for Child Health ResearchTampere UniversityTampereFinland
| | - Nantu Chakma
- Health Systems and Population Studies DivisionInternational Centre for Diarrhoeal Disease Research (ICDDR, B)DhakaBangladesh
| | | | - Zainab Samad
- Department of MedicineMedical CollegeAga Khan UniversityKarachiPakistan
| | - Tazeen Hasan Jafar
- Program in Health Services & Systems ResearchDuke‐NUS Medical SchoolSingaporeSingapore
- Duke Global Health InstituteDurhamNorth CarolinaUSA
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183
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Srikanth S, Mondal A, Aggarwal S, Alle NR, Odugbemi O, Nayak PR, Vyas A, Desai R. Key hypertension breakthroughs and emerging trends from the AHA's scientific sessions. Curr Probl Cardiol 2024; 49:102434. [PMID: 38309547 DOI: 10.1016/j.cpcardiol.2024.102434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/05/2024]
Abstract
We aim to summarize selected late-breaking science on hypertension management strategies and disease presented at the 2023 American Heart Association (AHA) conference. The trials discussed below encompass stricter goals of blood pressure management and were expanded into different population groups from different countries with varied socioeconomic backgrounds and settings, collectively advancing our understanding of hypertension treatment and its impact on public health. We summarized the china rural health care project (CRHCP), a four-year study involving over 34,000 participants in rural China, emphasizing the potential of stricter blood pressure goals in lowering the incidence of all-cause dementia and cognitive impairment. Next, we explore the US-based CARDIA-SSBP study, which highlights the impact of dietary sodium on systolic blood pressure in middle-aged individuals. Through a randomized-order cross-over design, the study provides compelling evidence supporting the effectiveness of sodium reduction as a non-pharmacological approach to blood pressure control. The UK-based POP-HT trial offers critical insights into postpartum women with a history of hypertensive pregnancy. The trial emphasizes the benefits of self-monitoring and physician-optimized antihypertensive titration, showcasing significant blood pressure reductions in the intervention group. Furthermore, the KARDIA-1 study introduces us to Zilebesiran, an innovative RNA interference drug. This phase 2 study highlights its potential for achieving sustained blood pressure reductions and its favorable safety profile, marking a significant step forward in hypertension treatment. Lastly, we expand the practical application of the previously conducted landmark SPRINT trial, which showed cardiovascular benefit with intensive SBP control to less than 120 mm Hg in high-risk non-diabetic patients with hypertension compared with routine BP control to <140 mm Hg. The ESPRIT trial and the IMPACTS trial build upon the SPRINT trial, demonstrating the effects of intensive blood pressure lowering in Asian hypertensive patients and in 36 health care clinics in medically underserved states in the US: Louisiana and Mississippi. The IMPACTS trial and the "Hypertension Treatment in Nigeria Program" demonstrate the effectiveness of implementing comprehensive blood pressure control strategies in real-world settings. These studies highlight the feasibility and scalability of such interventions, especially in low-resource environments, and their potential to significantly improve public health outcomes.
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Affiliation(s)
- Sashwath Srikanth
- Department of Internal Medicine, East Carolina University Greenville, NC, USA
| | - Avilash Mondal
- Department of Internal Medicine, Nazareth Hospital, PA, USA
| | - Sanjana Aggarwal
- Department of Internal Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Naga Ruthvika Alle
- Department of Medicine, Narayana Medical College, Nellore, Andhra Pradesh, India
| | - Olufemi Odugbemi
- Department of Internal Medicine, Lincoln Medical Center, Bronx, NY, USA
| | - Parth R Nayak
- Department of Physiology Ananya College of Medicine & Research, Kalol, India
| | - Ankit Vyas
- Department of Vascular Medicine, Ochsner Clinic Foundation, New Orleans, LA, USA.
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184
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Maldonado A, Laroche HH, Sewell DK, Afifi R, Hoffman RM, Baquero B, Gilbert PA. The Association Between State Characteristics and Latinx People's Treated Hypertension in Established and New Latinx Destination States: A Multilevel Analysis. Fam Community Health 2024; 47:151-166. [PMID: 38372332 DOI: 10.1097/fch.0000000000000393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
This study sought to quantify the contributions of state-level factors including income inequality, state's legislature political control, and Medicaid expansion in new and established Latinx destination states on Latinx individuals' treated hypertension. Mixed-effects logistic regression analyses were conducted to analyze 2017 Behavioral Risk Factor Surveillance System data from 7524 Latinx adults nested within 39 states. Overall, 70% reported being pharmacologically treated for hypertension, and 66% resided in established destination states. Compared with Latinx people in established destination states, Latinx people in new destinations had lower odds of having treated hypertension (odds ratio [OR] = 0.72, 95% CI = 0.54-0.95). Within established Latinx destinations, the odds of treated hypertension were lower in states where legislatures expanded Medicaid than in states that did not expand Medicaid (OR = 0.84, 95% CI = 0.79-0.89). However, after controlling for the effects of individual-level factors, this association was no longer statistically significant. In new Latinx destination states, Medicaid expansion, legislatures' political control, and income inequality were not associated with treated hypertension. The study results highlight the importance of considering both individual- and state-level factors, as the interplay of such factors could hinder the successful implementation of cardiovascular risk reduction interventions.
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Affiliation(s)
- Adriana Maldonado
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (Dr Maldonado); Department of Pediatrics, Children's Mercy Kansas City and University of Missouri-Kansas City, Kansas City (Dr Laroche); Departments of Biostatistics (Dr Sewell) and Community and Behavioral Health (Drs Afifi and Gilbert), College of Public Health, University of Iowa, Iowa City; Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City (Dr Hoffman); and School of Public Health, Health Systems and Population Health, University of Washington, Seattle (Dr Baquero)
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185
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Burch AE, Lee E, Bolin LP, Shackelford P, Bolin P. Health Screening Among a Rural, Hourly Workforce: North Carolina SERVIRE Project. Am J Prev Med 2024; 66:730-734. [PMID: 37972798 DOI: 10.1016/j.amepre.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Ashley E Burch
- Department of Health Services & Information Management, East Carolina University, Greenville, North Carolina; Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
| | - Elisabeth Lee
- Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Linda P Bolin
- Department of Nursing Science, College of Nursing, East Carolina University, Greenville, North Carolina
| | - Paul Shackelford
- Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Paul Bolin
- Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina
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186
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Perera S, Zheng Z, Wadhera RK. Cardiovascular Health, Lifestyle Factors, and Social Determinants in Asian Subpopulations in the United States. Am J Cardiol 2024; 216:77-86. [PMID: 38369173 DOI: 10.1016/j.amjcard.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 01/01/2024] [Accepted: 01/18/2024] [Indexed: 02/20/2024]
Abstract
Asian Americans are often aggregated in national public health surveillance efforts, which may conceal important differences in the health status of subgroups that are included in this highly diverse population. Little is known about how cardiovascular health varies across Asian subpopulations and the extent to which lifestyle and social risk factors contribute to any observed differences. This national study used data from the National Health Interview Survey to evaluate the burden of cardiovascular risk factors (hypertension, hyperlipidemia, diabetes mellitus) and cardiovascular diseases (heart attack, coronary heart disease, angina, stroke) across Asian groups (Chinese, Asian Indian, Filipino, Other Asian), and determine whether differences are related to lifestyle factors and/or social determinants of health. The weighted study population included 13,592,178 Asian adults. Filipino adults were more likely to have hypertension than Chinese adults (29.4% vs 15.4%; adjusted odds ratio [OR] 2.40, 95% confidence interval [1.91 to 3.02]), as were Asian Indians (15.7%; OR 1.59 [1.25 to 2.02]). These patterns were similar for hyperlipidemia and diabetes mellitus. For cardiovascular diseases, Filipino adults were significantly more likely to have coronary heart disease (4.2% vs 1.9%; OR 2.19 [1.32 to 3.56]), heart attack (2.6% vs 0.9%; OR 2.79 [1.44 to 5.41]), angina (1.8% vs 0.9%; OR 2.15 [1.06 to 4.32]), and stroke (2.1% vs 0.8%; OR 2.54 [1.42 to 4.55]) compared with Chinese adults, whereas there were no differences compared with Asian Indian adults. Adjustments for lifestyle factors and social determinants completely attenuated differences in coronary heart disease, heart attack, and angina among subpopulations. In conclusion, these findings demonstrate that cardiovascular risk factors and diseases vary significantly across Asian subpopulations, with Filipino adults experiencing the highest burden and Chinese adults the lowest, and that differences in cardiovascular disease are largely attenuated after adjustment for lifestyle and social determinants.
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Affiliation(s)
- Sudheesha Perera
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - ZhaoNian Zheng
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Rishi K Wadhera
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
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Lee HJ, Choi JW. Association between waist circumference change after smoking cessation and incidence of hypertension in Korean adults. Public Health 2024; 229:73-79. [PMID: 38402666 DOI: 10.1016/j.puhe.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/14/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study investigates the association between smoking cessation and hypertension incidence, as well as the association between waist circumference change after smoking cessation and hypertension incidence. STUDY DESIGN This was a nationwide population-based cohort study. METHODS We used the Korean Health Screening Cohort data and included 158,505 participants who had undergone two or more health examinations between 2008 and 2011, with follow-ups throughout 2019. Smoking cessation and waist changes were captured based on difference between first and follow-up screening dates. Hazard ratio (HR) and 95% confidence interval (CI) for hypertension risk were estimated using multivariable Cox proportional hazard regression models. RESULTS There were 31,270 cases of hypertension during a median follow-up of 8.50 years. After adjusting for potential confounding factors, HR for hypertension were 1.01 (95% CI: 0.97-1.05), 0.91 (95% CI: 0.87-0.95), and 0.88 (95% CI: 0.85-0.91) for recent quitters, long-term quitters, and non-smokers, respectively, compared with current smokers. HR for hypertension, compared with current smokers, were 0.89 (95% CI: 0.84-0.94), 0.91 (95% CI: 0.85-0.97), and 0.99 (95% CI: 0.91-1.08) for long-term quitters with no waist gain, long-term quitters with waist gain of 0.1-5.0 cm, and long-term quitters with waist gain of ≥5.0 cm, respectively. CONCLUSIONS Long-term smoking cessation was significantly associated with decreased risk of hypertension, and long-term smoking cessation with no waist gain or less than 5.0 cm of waist gain was significantly associated with decreased risk of hypertension. However, more than 5.0 cm of waist gain can attenuate the effect of long-term smoking cessation on lowering the risk of hypertension.
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Affiliation(s)
- H J Lee
- Department of Statistics and Data Science, Yonsei University, Seoul, Republic of Korea
| | - J W Choi
- Health Insurance Research Institute, National Health Insurance Service, Wonju, Republic of Korea.
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Neupane D, Hall B, Mukhtar Q, Delles C, Sharman JE, Cobb LK, Lackland DT, Moran AE, Weber MA, Olsen MH. Emerging Authors Program for Global Cardiovascular Disease Research-A collaboration of the U.S. Centers for Disease Control and Prevention, the Lancet Commission on Hypertension Group, Resolve to Save Lives, and the World Hypertension League. J Hum Hypertens 2024; 38:293-294. [PMID: 35322180 PMCID: PMC8942057 DOI: 10.1038/s41371-022-00678-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/23/2022] [Accepted: 03/09/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Dinesh Neupane
- Lancet Commission on Hypertension Group, London, UK.
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Bethany Hall
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- CDC Foundation, Atlanta, GA, USA
| | - Qaiser Mukhtar
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Christian Delles
- Lancet Commission on Hypertension Group, London, UK
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - James E Sharman
- Lancet Commission on Hypertension Group, London, UK
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | | | - Daniel T Lackland
- World Hypertension League, Charleston, SC, USA
- Medical University of South Carolina, Charleston, SC, USA
| | | | - Michael A Weber
- World Hypertension League, Charleston, SC, USA
- State University of New York, New York, NY, USA
| | - Michael Hecht Olsen
- Lancet Commission on Hypertension Group, London, UK
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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189
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Robles NR, Fici F, Grassi G. Management of hypertensive urgencies: a new opportunity for unattended blood pressure measurement. J Hum Hypertens 2024; 38:295-297. [PMID: 38514866 DOI: 10.1038/s41371-024-00907-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/02/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Affiliation(s)
| | - Francesco Fici
- Cardiovascular Risk Chair, University of Salamanca School of Medicine, Salamanca, Spain
| | - Guido Grassi
- Clinica Medica, Università Milano-Bicocca, Milan, Italy
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190
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Zhang D, Xiao B, Liu B, Cui W, Duan S, Wu B, Wang L, Zhu D, Rong T. Influence of Blood Pressure on Acute Cervical Spinal Cord Injury Without Fracture and Dislocation: Results From a Retrospective Analysis. World Neurosurg 2024; 184:e530-e536. [PMID: 38316177 DOI: 10.1016/j.wneu.2024.01.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE The objective of this study was to investigate the influence of blood pressure on the severity and functional recovery of patients with acute cervical spinal cord injury (SCI) without fracture and dislocation. METHODS A retrospective case control study analyzed the data of 40 patients admitted to our orthopedics department (Beijing Tiantan Hospital, Capital Medical University) from January 2013 to February 2021. They were diagnosed as acute cervical SCI without fracture and dislocation. Gender, age, height, weight, history of hypertension, postinjury American Spinal Injury Association grade, postinjury modified Japanese Orthopaedic Association (mJOA) score, postoperative mJOA score, 1-year follow-up mJOA score, preoperative mean arterial pressure (MAP), intramedullary T2 hyperintensity, and hyponatremia were collected. The patients were divided into groups and subgroups based on their history of hypertension and preoperative MAP. The effects of history of hypertension and preoperative MAP on the incidence of T2 hyperintensity, hyponatremia, the improvement rate of the postoperative mJOA and 1-year follow-up mJOA scores were analyzed. RESULTS Patients with history of hypertension had a lower incidence of intramedullary T2 hyperintensity than patients without history of hypertension (P < 0.05). Patients with history of hypertension and patients with a higher preoperative MAP had better neurological recovery at 1 year of follow-up (P < 0.05). CONCLUSIONS Blood pressure has great influence on acute cervical SCI without fracture and dislocation. Maintaining a higher preoperative MAP is advantageous for better recovery after SCI. Attention should be paid to the dynamic management of blood pressure to avoid the adverse effects of hypotension after SCI.
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Affiliation(s)
- Duo Zhang
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bowei Xiao
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Baoge Liu
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application Capital Medical University, Beijing, China.
| | - Wei Cui
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuo Duan
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bingxuan Wu
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application Capital Medical University, Beijing, China
| | - Lei Wang
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Di Zhu
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tianhua Rong
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application Capital Medical University, Beijing, China
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191
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Armario P, Vinyoles E, Gijon-Conde T, Arranz C, Galceran JM. Hypertension and Vascular Risk already has an impact factor. Now a new challenge begins. Hipertens Riesgo Vasc 2024; 41:73-74. [PMID: 38514299 DOI: 10.1016/j.hipert.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Affiliation(s)
- P Armario
- Área de Enfermedades Cardiovasculares, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, Spain.
| | - E Vinyoles
- Centro de Salud La Mina, Universidad de Barcelona, Barcelona, Spain
| | - T Gijon-Conde
- Centro de Salud Universitario Cerro del Aire, Majadahonda, Madrid, Spain
| | - C Arranz
- Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, IQUIMEFA-CONICET, Buenos Aires, Argentina
| | - J M Galceran
- Servicio de Nefrología, Fundación ALTHAIA, Manresa, Barcelona, Spain
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192
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Rai P, Sahadevan P, Mensegere AL, Issac TG, Muniz‐Terrera G, Sundarakumar JS. Rural-urban disparities in the diagnosis and treatment of hypertension and diabetes among aging Indians. Alzheimers Dement 2024; 20:2943-2951. [PMID: 38460118 PMCID: PMC11032561 DOI: 10.1002/alz.13771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION Hypertension and diabetes are modifiable risk factors for dementia. We aimed to assess rural-urban disparities in the diagnosis and treatment of these conditions among aging Indians. METHODS Participants (n = 6316) were from two parallel, prospective aging cohorts in rural and urban India. Using self-report and clinical/biochemical assessments, we subdivided participants with diabetes and hypertension into undiagnosed and untreated groups. Logistic regression and Fairlie decomposition analysis were the statistical methods utilized. RESULTS There was a significant rural-urban disparity in undiagnosed hypertension (25.14%), untreated hypertension (11.75%), undiagnosed diabetes (16.94%), and untreated diabetes (11.62%). Further, sociodemographic and lifestyle factors, such as age and tobacco use were the common contributors to the disparities in both undiagnosed hypertension and undiagnosed diabetes, whereas education and body mass index (BMI) were significant contributors to the disparity in untreated hypertension. DISCUSSION Rural Indians face significant healthcare disadvantages as compared to their urban counterparts, which prompts the urgent need for strategies for equitable healthcare.
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Affiliation(s)
- Pooja Rai
- Centre for Brain ResearchIndian Institute of ScienceBangaloreIndia
| | - Pravin Sahadevan
- Centre for Brain ResearchIndian Institute of ScienceBangaloreIndia
| | | | - Thomas G. Issac
- Centre for Brain ResearchIndian Institute of ScienceBangaloreIndia
| | - Graciela Muniz‐Terrera
- Edinburgh Dementia PreventionUniversity of EdinburghEdinburghUK
- Heritage College of Osteopathic MedicineOhio UniversityAthensOhioUSA
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Dai S, Tian Z, Zhao D, Liang Y, Zhong Z, Xu Y, Hou S, Yang Y. The Association between the Diversity of Coenzyme Q10 Intake from Dietary Sources and the Risk of New-Onset Hypertension: A Nationwide Cohort Study. Nutrients 2024; 16:1017. [PMID: 38613050 PMCID: PMC11013836 DOI: 10.3390/nu16071017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Coenzyme Q10 (CoQ10) is a food active component with blood-pressure-improving properties. However, the association between the variety and quantity of different sources of dietary CoQ10 and new-onset hypertension remains uncertain. We aimed to investigate the associations between the diversity and quantity of CoQ10 intake from eight major food sources and new-onset hypertension risk. A total of 11,489 participants were included. Dietary intake was evaluated via three consecutive 24 h recalls and household food inventory. The diversity score of CoQ10 sources was calculated by the sum of food groups consumed in the ideal range. Cox proportional hazard models were used for evaluating their associations with hypertension. Model performance was assessed by ROC analyses and 200-times ten-fold cross-validation. The relationships between CoQ10 and hypertension were U-shaped for meat, egg, vegetable, and fruit sources, inverse J-shaped for fish, and nut sources, and L-shaped for dairy products sources (all p-values < 0.001). A higher diversity score was associated with lower hypertension risk (HR (95% CI): 0.66 (0.64, 0.69)). The mean areas under the ROC curves for 6, 12 and 18 years were 0.81, 0.80 and 0.78, respectively. There is a negative correlation between the diversity of CoQ10 with moderate intake from different sources and new-onset hypertension. One diversity score based on CoQ10 was developed.
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Affiliation(s)
- Suming Dai
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (S.D.); (Z.T.); (D.Z.); (Z.Z.); (Y.X.); (S.H.)
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Shenzhen 518107, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zezhong Tian
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (S.D.); (Z.T.); (D.Z.); (Z.Z.); (Y.X.); (S.H.)
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Shenzhen 518107, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Dan Zhao
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (S.D.); (Z.T.); (D.Z.); (Z.Z.); (Y.X.); (S.H.)
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Shenzhen 518107, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ying Liang
- The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen 518033, China;
| | - Zepei Zhong
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (S.D.); (Z.T.); (D.Z.); (Z.Z.); (Y.X.); (S.H.)
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Shenzhen 518107, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yixuan Xu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (S.D.); (Z.T.); (D.Z.); (Z.Z.); (Y.X.); (S.H.)
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Shenzhen 518107, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shanshan Hou
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (S.D.); (Z.T.); (D.Z.); (Z.Z.); (Y.X.); (S.H.)
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Shenzhen 518107, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yan Yang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China; (S.D.); (Z.T.); (D.Z.); (Z.Z.); (Y.X.); (S.H.)
- Guangdong Engineering Technology Center of Nutrition Transformation, Sun Yat-sen University, Shenzhen 518107, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
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Zhang X, Guo B, Zhu H, Li D, Zhao Y, Liu Q, Hou J. H-type Hypertension Status and Influencing Factors of the Elderly People Over 80 Years Old Based on Random Forest Model. Int Heart J 2024; 65:263-270. [PMID: 38479846 DOI: 10.1536/ihj.23-488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Hypertension is a common chronic disease in elderly people over 80 years old. Clinically, H-type hypertension occurs when hypertension coexists with hyperhomocysteinemia level of ≥ 10 umol/L. Effective identification of risk factors for H-type hypertension in the elderly can greatly improve patient prognosis.Consecutively, 494 patients with hypertension admitted to the Fourth Affiliated Hospital of Harbin Medical University from January 2019 to December 2021 were selected as the study population. They were divided into H-type hypertension (n = 197) and non-H-type hypertension groups (n = 297). Patient data were collected, including basic information, history, and clinical data. The random forest model and LASSO analysis were used to screen the influencing factors for H-type hypertension. Multiple stepwise regression analysis was used to analyze the selected variables.A total of 197 elderly people over 80 years old suffered from H-type hypertension, with an incidence rate of 39.88%. The random forest model and LASSO analysis results showed that the top 8 independent variables in importance ranking were ejection fraction (EF), fibrinogen, glycated hemoglobin (HbA1c), B-type natriuretic peptide, creatinine, fasting blood glucose, uric acid, and serum triiodothyronine levels. The results of multivariate analysis showed that EF was the protective factor, while fibrinogen, HbA1c, and creatinine were the risk factors for H-type hypertension in elderly people over 80 years old (P < 0.05).Healthcare professionals can indirectly assess the prevalence of H-type hypertension by focusing on EF, fibrinogen, creatinine, and HbA1c in elderly hypertensive patients. This provided proactive intervention and medical services to improve prognosis outcomes.
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Affiliation(s)
- Xiaobo Zhang
- Department of Cardiology Organization, The Second Affiliated Hospital, Harbin Medical University
- Department of Gerontology, The Fourth Affiliated Hospital, Harbin Medical University
| | - Botang Guo
- Department of General Practice, The Affiliated Luohu Hospital of Shenzhen University Health Science Center
| | - Hong Zhu
- Department of Health Policy, Health Management College, Harbin Medical University
- Department of Pharmacy Administration, Humanities and Social Science College, Harbin Medical University
| | - Dahe Li
- Department of Gerontology, The Fourth Affiliated Hospital, Harbin Medical University
| | - Yuanyuan Zhao
- Department of Gerontology, The Fourth Affiliated Hospital, Harbin Medical University
| | - Qi Liu
- Department of Cardiology Organization, The Second Affiliated Hospital, Harbin Medical University
- The Key Laboratory of Myocardial Ischemia Organization, Chinese Ministry of Education
| | - Jingbo Hou
- Department of Cardiology Organization, The Second Affiliated Hospital, Harbin Medical University
- The Key Laboratory of Myocardial Ischemia Organization, Chinese Ministry of Education
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195
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Madede T, Mavume Mangunyane E, Munguambe K, Govo V, Beran D, Levitt N, Damasceno A. Human resources challenges in the management of diabetes and hypertension in Mozambique. PLoS One 2024; 19:e0297676. [PMID: 38551894 PMCID: PMC10980202 DOI: 10.1371/journal.pone.0297676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 01/11/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The major burden of non-communicable diseases (NCDs) globally occurs in low-and middle-income countries, where this trend is expected to increase dramatically over the coming years. The resultant change in demand for health care will imply significant adaptation in how NCD services are provided. This study aimed to explore self-reported training and competencies of healthcare providers, and the barriers they face in NCD services provision. METHODS A qualitative design was used to conduct this study. Data was collected through semi-structured interviews with government officials within the Mozambican Ministry of Health, district health authorities, health facility managers, and health providers at urban and rural health facilities of Maputo, in Mozambique. The data was then analyzed under three domains: provider´s capacity building, health system structuring, and policy. RESULTS A total of 24 interviews of the 26 planed with managers and healthcare providers at national, district, and health facility levels were completed. The domains analyzed enabled the identification and description of three themes. First, the majority of health training courses in Mozambique are oriented towards infectious diseases. Therefore, healthcare workers perceive that they need to consolidate and broaden their NCD-related knowledge or else have access to NCD-related in-service training to improve their capacity to manage patients with NCDs. Second, poor availability of diagnostic equipment, tools, supplies, and related medicines were identified as barriers to appropriate NCD care and management. Finally, insufficient NCD financing reflects the low level of prioritization felt by managers and healthcare providers. CONCLUSION There is a gap in human, financial, and material resources to respond to the country's health needs, which is more significant for NCDs as they currently compete against major infectious disease programming, which is better funded by external partners. Healthcare workers at the primary health care level of Mozambique's health system are inadequately skilled to provide NCD care and they lack the diagnostic equipment and tools to adequately provide such care. Any increase in global and national responses to the NCD challenge must include investments in human resources and appropriate equipment.
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Affiliation(s)
- Tavares Madede
- Department of Community Health, Faculty of Medicine, University Eduardo Mondlane, Maputo, Mozambique
- Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Elzier Mavume Mangunyane
- Department of Community Health, Faculty of Medicine, University Eduardo Mondlane, Maputo, Mozambique
| | - Khátia Munguambe
- Department of Community Health, Faculty of Medicine, University Eduardo Mondlane, Maputo, Mozambique
| | - Valério Govo
- Research Unit, Department of Medicine, Maputo Central Hospital, Maputo, Mozambique
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - Naomi Levitt
- Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Albertino Damasceno
- Research Unit, Department of Medicine, Maputo Central Hospital, Maputo, Mozambique
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
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196
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Liu Z, Fang T. Association between dietary carbohydrate to fiber ratio and metabolic dysfunction associated fatty liver disease in adults: evidence from the NHANES 2017-2020. J Health Popul Nutr 2024; 43:43. [PMID: 38549151 PMCID: PMC10979600 DOI: 10.1186/s41043-024-00543-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/23/2024] [Indexed: 04/01/2024]
Abstract
This study aimed to explore the association of carbohydrate to fiber ratio (CFR) with metabolic dysfunction-associated fatty liver disease (MAFLD) in adults. In this study, data from the 2 cycles (2017-2018 and 2019-2020) of the NHANES were used. Univariate and multivariate weighted logistic regression analyses were applied to evaluate the association between CFR and MAFLD. Odds ratios (ORs) and 95% confidence levels (CIs) were estimated. Subgroup analysis was further performed in terms of gender, age and comorbidity (diabetes, hypertension). A total of 3180 individuals were included, with 1408 (44.28%) in the non-MAFLD group and 1772 (55.72%) in the MAFLD group. After adjusting different variables, a dietary fiber intake of 11.15-18.40 g was associated with significantly lower odds of MAFLD compared with a fiber intake < 11.15 g (OR = 0.71, 95% CI 0.54-0.93). In contrast to a dietary CFR < 12.58, a CFR > 19.91 was associated with significantly higher odds of MAFLD (OR = 1.57, 95% CI 1.09-2.27). Compared with females with a dietary CFR < 12.58, those with a CFR > 19.91 had significantly increased odds of MAFLD (OR = 1.87, 95% CI 1.29-2.73). Among individuals aged < 65 years, a dietary CFR > 19.91 was associated with higher odds of MAFLD than a dietary CFR < 12.58 (OR = 1.52, 95% CI 1.02-2.25). For participants without diabetes (OR = 1.79, 95% CI 1.26-2.54) or hypertension (OR = 1.93, 95% CI 1.02-3.65), a dietary CFR > 19.91 was associated with elevated odds of MAFLD than a CFR < 12.58. In summary, a higher CFR was associated with significantly greater odds of MAFLD, indicating the negative association between carbohydrate quality and MAFLD. The research would be conducive to metabolic dysfunction-associated fatty liver disease treatment.
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Affiliation(s)
- Zhenmin Liu
- Department of Gastroenterology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Taiyong Fang
- Department of Gastroenterology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China.
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197
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Lu SY, Hsu HY, Hsieh YW, Lu CR, Huang HY, Chang SS. Prescribing cascades of antigout medications from thiazide diuretics in gout-naïve hypertensive adults receiving first-line pharmacological management. Sci Rep 2024; 14:7402. [PMID: 38548957 PMCID: PMC10978838 DOI: 10.1038/s41598-024-58153-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
Prescribing cascade is a significant clinical problem but is often overlooked. We explore the incidence of the prescribing cascades of antigout medications related to thiazide treatment in gout-naïve hypertensive adults newly exposed to the pharmacological treatment. This population-based, retrospective cohort study used the Taiwan National Health Insurance Registry Database. Gout-naïve hypertensive adults who were newly dispensed first-line antihypertensive drugs between January 1, 2000, and December 31, 2016, were enrolled. Patients were divided into the thiazide group (n = 4192) and the non-thiazide group (n = 81,083). The non-thiazide group included patients who received an angiotensin-converting enzyme inhibitor, angiotensin II receptor blocker, calcium channel blocker, or beta-blocker. The study utilized propensity score matching and multivariable Cox regression models to investigate the prescribing cascade of antigout agents following antihypertensive treatment, adjusting for factors like age, sex, comorbidities, and concurrent medications. After propensity score matching, each group consisted of 4045 patients, with the thiazide group exhibiting a higher risk of being prescribed antigout medications across different time intervals post-treatment initiation. Specifically, adjusted hazard ratios (aHRs) for the thiazide group were 2.23, 2.07, and 2.41 for < 30 days, 31-180 days, and > 180 days, respectively, indicating a sustained and significant risk over time. Comparative analyses revealed thiazide diuretics were associated with a higher risk of antigout medication prescriptions compared to other antihypertensive classes, particularly evident after 180 days. Subgroup analyses across various demographics and comorbidities consistently showed an increased risk in the thiazide cohort. Gout-naïve hypertensive adults newly dispensed thiazide had a higher risk of subsequently adding antigout agents than those taking other first-line antihypertensive medications. The awareness and interruption of these prescribing cascades are critical to improving patient safety.
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Affiliation(s)
- Shang-Yeh Lu
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, No. 91, Xueshi Rd., Taichung, Taiwan
| | - Hsing-Yu Hsu
- Department of Pharmacy, China Medical University Hospital, No. 2, Yuder Rd., Taichung, Taiwan
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, No.33, Linsen S. Rd., Taipei, Taiwan
| | - Yow-Wen Hsieh
- Department of Pharmacy, China Medical University Hospital, No. 2, Yuder Rd., Taichung, Taiwan
- School of Pharmacy, College of Pharmacy, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, Taiwan
| | - Chiung-Ray Lu
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung, Taiwan
| | - Hsin-Yi Huang
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung, Taiwan
| | - Shih-Sheng Chang
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung, Taiwan.
- School of Medicine, College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung City, Taiwan.
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198
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M G Mascarenhas-Nakano B, R Correa-Silva S, Fracacio SMR, W Brock P, F Dias R, Binda ESS, Santos-Neto PF, Portari LHC, Sanudo A, Abucham J. The risk of COVID-19 in Cushing's disease is independently related to disease activity (hypercortisolism) and obesity. Arch Endocrinol Metab 2024; 68:e220313. [PMID: 38557479 DOI: 10.20945/2359-4292-2022-0313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Objective To evaluate the cumulative incidence, risk factors, and outcomes of COVID-19 in patients with Cushing's disease (CD). Subjects and methods In all, 60 patients with CD following up in our outpatient clinic answered via phone interview a questionnaire about the occurrence of COVID-19 infection documented by RT-PCR (including the diagnosis date and clinical outcome) and vaccination status. Clinical and biochemical data on disease activity (hypercortisolism) and comorbidities (obesity, diabetes mellitus, and hypertension) were obtained from the patients' electronic medical records. Risk ratios (RRs) of risk factors were obtained using univariate and multivariate analyses. Results The cumulative incidence of COVID-19 in patients with CD during the observation period was 31.7%, which was higher than that in the general reference population (9.5%). The cumulative incidence of COVID-19 was significantly higher in patients with hypercortisolism (57% versus 17% in those without hypercortisolism, p = 0.012) and obesity (54% versus 9% in those without obesity, p < 0.001) but not in patients with hypertension or diabetes mellitus. On multivariate analysis, hypercortisolism and obesity were each independent risk factors for COVID-19 (RR 2.18, 95% CI 1.06-4.46, p = 0.033 and RR 5.19, 95% CI 1.61-16.74, p = 0.006, respectively). Conclusion The incidence of COVID-19 in patients with CD was associated with hypercortisolism, as expected, and obesity, a novel and unexpected finding. Thus, correction of hypercortisolism and obesity should be implemented in patients with CD during the current and future COVID-19 outbreaks.
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Affiliation(s)
- Bruna M G Mascarenhas-Nakano
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Silvia R Correa-Silva
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil,
| | - Silvia M R Fracacio
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Paola W Brock
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Rossella F Dias
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Eduarda S S Binda
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Pedro F Santos-Neto
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Luiz H C Portari
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Adriana Sanudo
- Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Julio Abucham
- Unidade de Neuroendocrinologia, Divisão de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
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199
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Godbharle S, Kesa H, Jeyakumar A. Processed food consumption and risk of non-communicable diseases (NCDs) in South Africa: evidence from Demographic and Health Survey (DHS) VII. J Nutr Sci 2024; 13:e19. [PMID: 38572366 PMCID: PMC10988147 DOI: 10.1017/jns.2024.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 04/05/2024] Open
Abstract
We aimed to analyse the association between processed food consumption and the risk of non-communicable diseases (NCDs) in South Africa. In this empirical study, we analysed nationally representative secondary data obtained from the South African Demographic and Health Survey (SADHS) VII. The survey included 13,288 occupied households, of which 11,083 were interviewed. In the interviewed households, 12,717 eligible adults aged 15 and older were identified and 10,336 were successfully interviewed. The study included four processed food groups (i.e. fried foods, takeaway foods/fast foods, salty snacks/packed chips, and processed meats) and eight NCDs (i.e. hypertension, cardiac arrest, cancer, stroke, hypercholesterolaemia, diabetes, chronic bronchitis, and asthma). As per the logistic regression results following adjustment, none of the disease states showed association with all four processed food groups. However, at least three processed food groups showed a significant positive association with hypertension, cardiac arrest, and diabetes. Two processed food groups showed significant positive association with stroke, and chronic bronchitis; one with hypercholesterolaemia and asthma; and cancer was not associated with any food groups. Processed meat and salted snacks/packed chips were each associated with five chronic conditions. In summary, we found that the consumption of any of the processed food groups increased the risk of NCDs in the South African population. Enabling policy and regulatory efforts in the production and distribution of processed foods, combined with improved awareness among the population need to be prioritised for immediate action. Facilitating the populations to choose traditional healthy diets would be a sustainable strategy for the prevention of NCDs.
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Affiliation(s)
- Swapnil Godbharle
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa
- Department of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Hema Kesa
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa
| | - Angeline Jeyakumar
- Food Evolution Research Laboratory (FERL), School of Tourism and Hospitality, College of Business and Economics, University of Johannesburg, Johannesburg, South Africa
- Department of Nutrition, University of Nevada, Reno, Nevada, USA
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200
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Cheng T, Lou C, Jing X, Ding S, Hong H, Ding G, Shen L. Phthalate exposure and blood pressure in U.S. children aged 8-17 years (NHANES 2013-2018). Eur J Med Res 2024; 29:192. [PMID: 38528598 DOI: 10.1186/s40001-024-01785-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/11/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Current evidence from epidemiologic studies suggested that phthalate metabolites might be associated with blood pressure (BP) changes. However, the special relationship between phthalate metabolites and BP changes in children has not been clearly elucidated in existing researches. OBJECTIVES We investigated the links between phthalate metabolites and various BP parameters, including systolic/diastolic BP, mean arterial pressure (MAP), and the presence of hypertension. METHODS The population sample consisted of 1036 children aged 8 to 17 years from the 2013-2018 NHANES in the United States. High performance liquid chromatography-electrospray ionization-tandem mass spectrometry was used to measure urinary concentrations of 19 phthalate metabolites. Systolic/diastolic BP were derived from the average of three valid measurements, and MAP was calculated as (systolic BP + 2 × diastolic BP)/3. Hypertension was defined as mean systolic BP and/or diastolic BP that was ≥ 95th percentile for gender, age, and height reference. Linear regression, logistic regression, and weighted quantile sum (WQS) regression models were employed to assess the associations between phthalate exposure and systolic/diastolic BP, MAP, and hypertension. RESULTS Ten of 19 phthalate metabolites including MCNP, MCOP, MECPP, MBP, MCPP, MEP, MEHHP, MiBP, MEOHP, and MBzP had detection frequencies > 85% with samples more than 1000. MCNP, MCOP, MECPP, MBP, MCPP, MEHHP, MiBP, MEOHP, and MBzP were generally negatively associated with systolic/diastolic BP and MAP, but not protective factors for hypertension. These associations were not modified by age (8-12 and 13-17 years) or sex (boys and girls). The above-mentioned associations were further confirmed by the application of the WQS analysis, and MCOP was identified as the chemical with the highest weight. CONCLUSION Phthalate metabolites were associated with modest reductions in systolic/diastolic BP, and MAP in children, while appeared not protective factors for hypertension. Given the inconsistent results among existing studies, our findings should be confirmed by other cohort studies.
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Affiliation(s)
- Tan Cheng
- Department of Cardiothoracic Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengcheng Lou
- Department of Anesthesiology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Xiaoping Jing
- Department of Traditional Chinese Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Sirui Ding
- Department of Cardiothoracic Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haifa Hong
- Department of Cardiothoracic Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guodong Ding
- Department of Pediatric Respiratory Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
| | - Li Shen
- Department of Cardiothoracic Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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