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Rosa D, Pengo MF, Adorni R, Bilo G, Parati G, Steca P. Psychometric Properties of a Brief Version of the Perception of Risk of Heart Disease Scale in an Italian Sample. High Blood Press Cardiovasc Prev 2023; 30:475-484. [PMID: 37847486 PMCID: PMC10600277 DOI: 10.1007/s40292-023-00603-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/20/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION The number of Italian citizens unaware of their risk of cardiovascular disease it is still very high. AIM This study aimed to translate and preliminarily validate a brief Italian version of the Perception of Risk of Heart Disease Scale (PRHDS). METHODS PRHDS was culturally adapted to the Italian context. Then, the scale was administered to 772 healthy adults. By randomly dividing the sample into two subsamples, we tested the scale dimensionality through Exploratory Factor Analysis (EFA) followed by Confirmatory Factor Analysis (CFA). Finally, we evaluated internal consistency. RESULTS Psychometric properties of the scale were appropriate. EFA and CFA evidenced a unidimensional structure of a brief version of the scale, composed of six items. Internal consistency was adequate. CONCLUSIONS Italian version of the brief PRHDS is a promising self-report questionnaire to measure cardiovascular risk perception among Italian adults.
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Affiliation(s)
- Debora Rosa
- Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Martino Francesco Pengo
- Istituto Auxologico Italiano IRCCS, Milan, Italy.
- University of Milano-Bicocca, Faculty of Medicine, Milan, Italy.
| | - Roberta Adorni
- University of Milano-Bicocca, Department of Psychology, Milan, Italy
| | - Grzegorz Bilo
- Istituto Auxologico Italiano IRCCS, Milan, Italy
- University of Milano-Bicocca, Faculty of Medicine, Milan, Italy
| | - Gianfranco Parati
- Istituto Auxologico Italiano IRCCS, Milan, Italy
- University of Milano-Bicocca, Faculty of Medicine, Milan, Italy
| | - Patrizia Steca
- University of Milano-Bicocca, Department of Psychology, Milan, Italy
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2
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Bruno RM, Varbiro S, Pucci G, Nemcsik J, Lønnebakken MT, Kublickiene K, Schluchter H, Park C, Mozos I, Guala A, Hametner B, Seeland U, Boutouyrie P. Vascular function in hypertension: does gender dimension matter? J Hum Hypertens 2023; 37:634-643. [PMID: 37061653 DOI: 10.1038/s41371-023-00826-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/27/2023] [Accepted: 03/27/2023] [Indexed: 04/17/2023]
Abstract
Blood pressure and vascular ageing trajectories differ between men and women. These differences develop due to sex-related factors, attributable to sex chromosomes or sex hormones, and due to gender-related factors, mainly related to different sociocultural behaviors. The present review summarizes the relevant facts regarding gender-related differences in vascular function in hypertension. Among sex-related factors, endogenous 17ß-estradiol plays a key role in protecting pre-menopausal women from vascular ageing. However, as vascular ageing (preceding and inducing hypertension) has a steeper increase in women than in men starting already from the third decade, it is likely that gender-related factors play a prominent role, especially in the young. Among gender-related factors, psychological stress (including that one related to gender-based violence and discrimination), depression, some psychological traits, but also low socioeconomic status, are more common in women than men, and their impact on vascular ageing is likely to be greater in women. Men, on the contrary, are more exposed to the vascular adverse consequences of alcohol consumption, as well as of social deprivation, while "toxic masculinity" traits may result in lower adherence to lifestyle and preventive strategies. Unhealthy diet habits are more prevalent in men and smoking is equally prevalent in the two sexes, but have a disproportional negative effect on women's vascular health. In conclusion, given the major and complex role of gender-related factors in driving vascular alterations and blood pressure patterns, gender dimension should be systematically integrated into future research on vascular function and hypertension and to tailor cardiovascular prevention strategies.
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Affiliation(s)
- Rosa-Maria Bruno
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France.
- Pharmacology Unit, Hôpital Européen Georges Pompidou, Paris, France.
| | - Szabolcs Varbiro
- Workgroup for Science Management, Doctoral School, Semmelweis University, Budapest, Hungary
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Giacomo Pucci
- Internal Medicine Unit, "Santa Maria" Terni Hospital and Department of Medicine and Surgery-University of Perugia, Perugia, Italy
| | - János Nemcsik
- Department of Family Medicine and Health Service of Zuglo (ZESZ), Semmelweis University, Budapest, Hungary
| | - Mai Tone Lønnebakken
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Karolina Kublickiene
- Institution for Clinical Science, Intervention and Technology, Department of Renal Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helena Schluchter
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Chloe Park
- MRC Unit for Lifelong Health and Ageing at UCL, UCL Institute of Cardiovascular Science, University College London, London, UK
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Andrea Guala
- Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- CIBER-CV, Instituto de Salud Carlos III, Madrid, Spain
| | - Bernhard Hametner
- AIT Austrian Institute of Technology, Center for Health & Bioresources, Vienna, Austria
| | - Ute Seeland
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitaetsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Pierre Boutouyrie
- Université Paris Cité, Inserm, PARCC, F-75015, Paris, France
- Pharmacology Unit, Hôpital Européen Georges Pompidou, Paris, France
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Ji W, Zhang Y, Cheng Y, Wang Y, Zhou Y. Development and validation of prediction models for hypertension risks: A cross-sectional study based on 4,287,407 participants. Front Cardiovasc Med 2022; 9:928948. [PMID: 36225955 PMCID: PMC9548597 DOI: 10.3389/fcvm.2022.928948] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo develop an optimal screening model to identify the individuals with a high risk of hypertension in China by comparing tree-based machine learning models, such as classification and regression tree, random forest, adaboost with a decision tree, extreme gradient boosting decision tree, and other machine learning models like an artificial neural network, naive Bayes, and traditional logistic regression models.MethodsA total of 4,287,407 adults participating in the national physical examination were included in the study. Features were selected using the least absolute shrinkage and selection operator regression. The Borderline synthetic minority over-sampling technique was used for data balance. Non-laboratory and semi-laboratory analyses were carried out in combination with the selected features. The tree-based machine learning models, other machine learning models, and traditional logistic regression models were constructed to identify individuals with hypertension, respectively. Top features selected using the best algorithm and the corresponding variable importance score were visualized.ResultsA total of 24 variables were finally included for analyses after the least absolute shrinkage and selection operator regression model. The sample size of hypertensive patients in the training set was expanded from 689,025 to 2,312,160 using the borderline synthetic minority over-sampling technique algorithm. The extreme gradient boosting decision tree algorithm showed the best results (area under the receiver operating characteristic curve of non-laboratory: 0.893 and area under the receiver operating characteristic curve of semi-laboratory: 0.894). This study found that age, systolic blood pressure, waist circumference, diastolic blood pressure, albumin, drinking frequency, electrocardiogram, ethnicity (uyghur, hui, and other), body mass index, sex (female), exercise frequency, diabetes mellitus, and total bilirubin are important factors reflecting hypertension. Besides, some algorithms included in the semi-laboratory analyses showed less improvement in the predictive performance compared to the non-laboratory analyses.ConclusionUsing multiple methods, a more significant prediction model can be built, which discovers risk factors and provides new insights into the prediction and prevention of hypertension.
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Affiliation(s)
- Weidong Ji
- Department of Medical Information, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yushan Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yinlin Cheng
- Department of Medical Information, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yushan Wang
- Center of Health Management, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- *Correspondence: Yushan Wang
| | - Yi Zhou
- Department of Medical Information, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
- Yi Zhou
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Prevalence of Hypertension and Adherence to Dietary Approaches to Stop Hypertension Diet Score in Childbearing Age Tunisian Women: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6686299. [PMID: 34778455 PMCID: PMC8589476 DOI: 10.1155/2021/6686299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 06/11/2021] [Accepted: 10/28/2021] [Indexed: 01/02/2023]
Abstract
Background and Aims The prevalence, awareness, and treatment of hypertension, along with their sociodemographic, anthropometric, and lifestyle associations, were evaluated in a cross-sectional survey of childbearing age Tunisian women. Adherence to the Dietary Approaches to Stop Hypertension diet score was also assessed for hypertensive versus nonhypertensive women. Methods and Results A total of 1689 nonpregnant women, aged 20-49 years, were randomly sampled a regional (Greater Tunis), two-stage, stratified, cross-sectional cluster survey from March 2009 to January 2010. Data on medical history and sociodemographic characteristics were collected using a questionnaire. The average daily intake of energy and nutrients was computed using a specific Tunisian food composition database. The Dietary Approaches to Stop Hypertension diet score (0 to 10) was assessed by adding the individual scores (0 to 1) of ten nutrient components according to dietary guidelines. The overall prevalence of hypertension was 21.4%. Age, obesity, abdominal fat, parity, and family history were significantly associated with hypertension. The mean Dietary Approaches to Stop Hypertension accordance score was 4.93 for hypertensive women and 4.86 for nonhypertensive women (P = 0.0556). After adjustment for age, energy intake, and all nutritional covariates, no associations were observed between hypertension and Dietary Approaches to Stop Hypertension diet components. Conclusion Though no clear-cut associations between hypertension and environmental or behavioral factors were identified in the study, the association with abdominal obesity and multiparity suggests that interventions aimed at lifestyle modifications to reduce these risk factors could be also useful in the prevention of hypertension.
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Lim LF, Solmi M, Cortese S. Association between anxiety and hypertension in adults: A systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 131:96-119. [PMID: 34481847 DOI: 10.1016/j.neubiorev.2021.08.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
We assessed the association between anxiety and hypertension in adults via a systematic review/meta-analysis. We searched PubMed, Ovid, and PsycINFO through 27 March 2020 with no language or publication type restrictions and systematically contacted study authors for unpublished information/data. We meta-analysed 59 studies including a total of 4,012,775 participants. Study quality was rated with the Newcastle-Ottawa Scale and random-effects analyses were performed. A significant anxiety-hypertension association was found in cross-sectional (OR = 1.37, 95 % CI = 1.21-1.54) and prospective studies (OR = 1.40, 95 % CI = 1.23-1.59). In sensitivity analyses, results were influenced by method of hypertension diagnosis, but not by study quality, method of anxiety diagnosis, study population, and effect size type. In subgroup analyses, study location, in particular country economic status, but not participant age, influenced the results. Longitudinal data and theoretical literature indicate that anxiety may precede hypertension. These findings have important clinical implications for the early detection and treatment of both anxiety and hypertension. Suggestions for future research are discussed.
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Affiliation(s)
- Li-Faye Lim
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK
| | - Marco Solmi
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, UK; Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Samuele Cortese
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK; Centre for Innovation in Mental Health, School of Psychology, University of Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
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Pentikäinen H, Toivo K, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Selänne H, Vasankari T, Kujala UM, Villberg J, Parkkari J, Savonen K. Resting Electrocardiogram and Blood Pressure in Young Endurance and Nonendurance Athletes and Nonathletes. J Athl Train 2021; 56:484-490. [PMID: 33150370 DOI: 10.4085/78-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Much information is available on electrocardiogram (ECG) and blood pressure (BP) changes in senior athletes. However, corresponding data on adolescent athletes are scarce. OBJECTIVE To study the differences in resting ECG and BP values among adolescent endurance athletes, nonendurance athletes, and nonathletes. DESIGN Cross-sectional study. SETTING A total of 154 youth sports clubs in Finland and 100 secondary schools for comparison data. PATIENTS OR OTHER PARTICIPANTS We recruited young athletes (n = 410) aged 14 to 16 years in 10 popular sport disciplines, including winter and summer as well as team and individual sports, and categorized them as endurance or nonendurance sports. Comparison data for age-matched, non-sports club participants (n = 164) were collected via secondary schools. MAIN OUTCOME MEASURE(S) Resting ECG, including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis, and QT interval as well as systolic and diastolic BPs. RESULTS No differences in any ECG variable of interest were found between the endurance and nonendurance athletes. The PR interval was longer in endurance athletes than in nonathletes (P = .05). The QRS amplitude (P = .03) was higher among nonendurance athletes than among nonathletes. Diastolic BP was lower among endurance (P = .002) and nonendurance (P = .02) athletes than among nonathletes. Endurance athletes (odds ratio [OR] = 2.85; 95% CI = 1.81, 4.50) and nonendurance athletes (OR = 2.19; 95% CI = 1.43, 3.35) were more likely to have sinus bradycardia than were nonathletes. Nonendurance athletes were more likely to have elevated systolic BP than were endurance athletes (OR = 1.70; 95% CI = 1.07, 2.72) and nonathletes (OR = 1.73; 95% CI = 1.04, 2.87). CONCLUSIONS Young athletes had similar ECG and BP findings independent of their sports. Physiological adaptations including sinus bradycardia, higher QRS amplitude, and lower diastolic BP, which are commonly seen in adult athletes, were also present in adolescent athletes.
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Affiliation(s)
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, Helsinki, Finland
| | - Olli J Heinonen
- Paavo Nurmi Center & Unit of Health and Physical Activity University of Turku, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Finland.,Center for Life Course Health Research, University of Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Finland
| | - Harri Selänne
- Department of Psychology, University of Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Finland
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High blood pressure in Chinese youth across categories of BMI and waist circumference. Blood Press Monit 2021; 26:124-128. [PMID: 33164992 DOI: 10.1097/mbp.0000000000000500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND BMI and waist circumference (WC) have commonly been used to identify obesity in practice. The aim of the present study was to assess the blood pressure (BP) status among Chinese college students categorized by BMI and WC. METHODS A total of 4226 college students (2107 males and 2119 females) aged 19-22 years included in the study. The WHO BMI cutoffs were used to define underweight, normal weight and overweight. The WC cutoffs (90 cm for man and 80 cm for woman) were used to define central obesity. High BP was defined as SBP/DBP ≥140/90 mmHg. The BP status of subjects within each category across BMI and WC were assessed. RESULTS When subjects were categorized by BMI, overweight males and females had a higher prevalence of high BP than their nonoverweight counterparts. When WC was used to diagnose central obesity, subjects with central obesity had a higher prevalence of high BP than those with normal WC. A positive association between BMI, WC and BP was also observed even in normal-weight subjects, with 'high normal BMI' subgroup (BMI = 23.7-24.9) had a higher BP level and prevalence of high BP than 'low normal BMI' subgroups (BMI = 18.5-19.7 and BMI = 19.8-21.0, P < 0.05). CONCLUSION Prevention of overweight/obesity in youth may be an effective approach for preventing the development of hypertension in the future; for normal-weight youth, it is essential to keep their BMI at a lower level within normal range.
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Okosun IS, Nkemjika S, Okosun B, Lyn R, Airhihenbuwa CO. Lifestyle Modification Practices and Drug Prescription Use in Elderly Americans with Metabolic Syndrome: A Nationwide Population-Based Study. J Natl Med Assoc 2020; 112:621-631. [PMID: 32641256 DOI: 10.1016/j.jnma.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/25/2020] [Accepted: 06/02/2020] [Indexed: 10/23/2022]
Abstract
AIM To determine differences in lifestyle modification practices and use of prescription drugs in a representative sample of Mexican American (MA), non-Hispanic White (NHW), and non-Hispanic Black (NHB) elderly Americans with metabolic syndrome (MetS). METHODS Data from the United States National Health and Nutritional Examination Surveys were used in this study. Lifestyle modification practices include ongoing physical activity, weight control, and ongoing diet modifications. Prescription drugs include anti-diabetic, anti-obesity, lipid-lowering, insulin sensitizers, renin-angiotensin system (RAS) blockers, fibrates, and cilostazol. Race/ethnic-specific prevalence odds ratios from the multivariate logistic regression analyses were used to determine associations between selected independent variables and MetS control (defined as the use of lifestyle modification practices or prescription drugs), adjusting for covariates. RESULTS The rates of ongoing weight control (73.4% versus 68.1% in MA and 66.3% in NHW) and diet modification practices (78.1% versus 77.4% in MA and 66.7% in NHW) were higher among NHB, and rate of ongoing physical activity (61.8% versus 52.8% in NHW and 56.4% in NHB) was higher among MA participants compared to their other racial/ethnic elderly counterparts (P < 0.001). Lipid-lowering and insulin-sensitizing drugs were the most commonly used prescription drugs in the last 30 days. The prevalence of nonuse of lifestyle modification practices or prescription drugs for MetS management was 15.1%, 21.3%, and 12.7% in MA, NHW, and NHB participants, respectively. MA, NHB race/ethnicity, a higher level of education, and increased BMI were significantly associated with increased odds of MetS control. Lack of drug prescription insurance and increased age were associated with decreased odds of MetS control. CONCLUSIONS Given the clinical importance of MetS, improving knowledge-based health decisions relative to lifestyle modification practices is very important. Moreover, sources of low-cost medications that links elderly patients with drug prescription coverage programs may help to improve the management of MetS.
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Affiliation(s)
- Ike S Okosun
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA.
| | - Stanley Nkemjika
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Bryan Okosun
- Department of Molecular and Cellular Biology, Kennesaw State University, Kennesaw, GA, USA
| | - Rodney Lyn
- Department of Health Policy and Behavioral Sciences, Georgia State School of Public Health, Atlanta, GA, USA
| | - Collins O Airhihenbuwa
- Department of Health Policy and Behavioral Sciences, Georgia State School of Public Health, Atlanta, GA, USA; Global Research Against Noncommunicable Diseases (GRAND), Georgia State School of Public Health, Atlanta, USA
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Mandini S, Conconi F, Mori E, Grazzi G, Mazzoni G. Guided walking is more effective than suggested walking in reducing the blood pressure of hypertensive sedentary subjects and in modifying their lifestyle. SPORT SCIENCES FOR HEALTH 2020. [DOI: 10.1007/s11332-020-00620-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Zhu Y, You J, Xu C, Gu X. Associations of mitochondrial DNA 3777-4679 region mutations with maternally inherited essential hypertensive subjects in China. BMC MEDICAL GENETICS 2020; 21:105. [PMID: 32414374 PMCID: PMC7229621 DOI: 10.1186/s12881-020-01045-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 05/07/2020] [Indexed: 12/28/2022]
Abstract
Background Nuclear genome or family mitochondrial screening system has become the hot focus of studies into essential hypertension. The role of mitochondrial DNA (mtDNA) in sporadic Chinese patients with hypertension has not been fully understood. The study was to evaluate the associations of mtDNA mutations with maternally inherited essential hypertensive subjects in China. Methods From June 2009 to June 2016, a total of 800 gender-matched Chinese patients with maternally inherited essential hypertension (MIEH) and control group were 1:1 enrolled in this case-control study. Genomic DNA was extracted from each person’s peripheral blood cells. The main mtDNA locations for MIEH were screened with oligodeoxynucleotides 3777-4679 bp, analyzed and compared with the updated consensus Cambridge Sequence. Pathogenic mtDNA mutations were identified from the mitochondrial map. Results MIEH subjects presented significantly higher values than those of control group in abdominal circumference (AC), waist circumference (WC), body mass index (BMI), fasting blood glucose (FBG), triglyceride (TG), low-density lipoprotein cholesterol (LDL) and renal function (P < 0.05). MIEH subjects carried more amino acid changes and coding sequence variants (P < 0.01) than control group. The allele frequencies of the eight single nucleotide polymorphisms (SNPs) were significantly different between the two groups, including m.3970 C > T, m.4048G > A, m.4071C > T, m.4086C > T, m. 4164A > G and m.4248 T > C in ND1 gene, and m.4386 T > C and m.4394C > T in tRNAGln gene(P < 0.001). Fifty-five homoplasmic or heteroplasmic mutations were detected in 5 genes: ND1, tRNAIle, tRNAMet, tRNAGln and ND2 gene. The ND1 gene was the main mutation site, where the most mtDNA mutation was m.3970 C > T. Conclusions The mtDNA mutations were involved in the process of MIEH. We identified mitochondrial genetic characteristics in MIEH patients in China. The present research serves as a solid foundation for further detailed research on the association between MIEH and mitochondrial dysfunction, and their causal relationship in Chinese and other populations with a similar lifestyle.
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Affiliation(s)
- Ye Zhu
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China. .,Department of Cardiology, Northern Jiangsu People's Hospital, Nantong West Road No.98, Yangzhou, 225001, Jiangsu, China.
| | - Jia You
- Department of Internal Medicine, Yangzhou Maternal and Child HealthCare Hospital, Yangzhou, 225001, Jiangsu, China
| | - Chao Xu
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Science Center, Oklahoma City, OK, 73104, USA
| | - Xiang Gu
- Clinical Medical College, Yangzhou University, Yangzhou, 225001, Jiangsu, China.,Department of Cardiology, Northern Jiangsu People's Hospital, Nantong West Road No.98, Yangzhou, 225001, Jiangsu, China
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D’Ascenzi F, Fiorentini C, Anselmi F, Mondillo S. Left ventricular hypertrophy in athletes: How to differentiate between hypertensive heart disease and athlete’s heart. Eur J Prev Cardiol 2020; 28:1125-1133. [PMID: 33611377 DOI: 10.1177/2047487320911850] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/18/2020] [Indexed: 12/15/2022]
Abstract
Abstract
Athlete’s heart is typically accompanied by a remodelling of the cardiac chambers induced by exercise. However, although competitive athletes are commonly considered healthy, they can be affected by cardiac disorders characterised by an increase in left ventricular mass and wall thickness, such as hypertension. Unfortunately, training-induced increase in left ventricular mass, wall thickness, and atrial and ventricular dilatation observed in competitive athletes may mimic the pathological remodelling of pathological hypertrophy. As a consequence, distinguishing between athlete’s heart and hypertension can sometimes be challenging. The present review aimed to focus on the differential diagnosis between hypertensive heart disease and athlete’s heart, providing clinical information useful to distinguish between physiological and pathological remodelling.
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Affiliation(s)
- Flavio D’Ascenzi
- Department of Medical Biotechnologies, University of Siena, Italy
| | | | | | - Sergio Mondillo
- Department of Medical Biotechnologies, University of Siena, Italy
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12
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Younes N, Atallah M, Alam R, Chehade NH, Gannagé-Yared MH. HbA1c AND BLOOD PRESSURE MEASUREMENTS: RELATION WITH GENDER, BODY MASS INDEX, STUDY FIELD, AND LIFESTYLE IN LEBANESE STUDENTS. Endocr Pract 2019; 25:1101-1108. [PMID: 31241365 DOI: 10.4158/ep-2019-0163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Objective: The purpose of this study is to determine the prevalence of prediabetes/diabetes in Lebanese university students and to examine the relationship between both hemoglobin A1c (HbA1c) and blood pressure (BP) and gender, body mass index (BMI), study field, and lifestyle factors. Methods: This cross-sectional study was carried out at the Saint-Joseph University of Beirut. A total of 603 students aged 18 to 25 years were recruited from both the medical science campus (MSC) and the social science campus (SSC) between January, 2016, and May, 2018. Waist circumference (WC), BMI, and BP were determined for each student and HbA1c was measured using the Siemens vintage DCA device. Participants completed a self-administered questionnaire about their eating habits and level of physical activity. Results: The mean age of the population was 20.31 ± 1.76 years. The percentage of participants recruited from the MSC was 59.2%. The prevalence of prediabetes was 2.5%. Lower BMI, WC, and HbA1c values, and higher diastolic BP (DBP) were found in MSC students compared to SSC ones. HbA1c, systolic BP (SBP), and DBP were correlated with BMI (P = .02, P<.0001, and P = .017, respectively). HbA1c was not associated with eating habits or physical activity. DBP was inversely associated with physical activity (P = .002), while SBP was positively associated with fast food consumption (P = .003). Conclusion: The present study shows a low prevalence of prediabetes in Lebanese students. BMI and the study field are the main factors predicting HbA1c and BP. Further studies are needed to extrapolate our results to the overall young Lebanese population. Abbreviations: ADA = American Diabetes Association; BMI = body mass index; BP = blood pressure; DBP = diastolic blood pressure; HbA1c = hemoglobin A1c; HTN = hypertension; MSC = medical science campus; SBP = systolic blood pressure; SSC = social science campus; T2D = type 2 diabetes; US = United States; USJ = Saint-Joseph University; WC = waist circumference.
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Factors Associated With Blood Pressure Classification in Korean University Students: A Descriptive Survey. J Nurs Res 2019; 28:e61. [PMID: 31145181 DOI: 10.1097/jnr.0000000000000325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The prevalence of hypertension in young adults has increased. Hypertension is known to be a leading contributor to many diseases. PURPOSE The study aimed to identify factors influencing blood pressure (BP) classification in university students and to establish a basis for the prevention and management of hypertension in young adults. METHODS Four hundred three university students in South Korea were analyzed to determine the factors that influence BP classification. Data were analyzed using the chi-square test, analysis of variance, and multinomial logistic regression. RESULTS The reference group for the logistic regression analysis included students with normal BP. The odds of being male and of having an overweight or obese body mass index were significantly higher in the prehypertension group than in the normal BP group. The odds of regular (≥ 6 months) exercise habits, having subcutaneous and borderline visceral fat types, and social support were significantly lower in the prehypertension group than in the normal BP group. The odds of being male, being overweight or obese, and having more exercise barriers were significantly higher in the hypertension group than in the normal BP group. The odds of having a high or low economic status were higher and lower in the hypertension group, respectively. Finally, the odds of having subcutaneous or borderline visceral fat types and a vigorous physical activity level were significantly lower in the hypertension group than in the normal BP group. CONCLUSIONS Interventions that address the factors related to BP in young adults are necessary to prevent the occurrence and progression of hypertension in young adults.
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Torlasco C, Faini A, Makil E, Bilo G, Pengo M, Beaney T, Xia X, Borghi C, Poulter NR, Tocci G, Galletti F, Desideri G, Veglio F, Ferri C, Parati G. Nation-wide hypertension screening in Italy: data from May Measurements Month 2017-Europe. Eur Heart J Suppl 2019; 21:D66-D70. [PMID: 31043882 PMCID: PMC6479437 DOI: 10.1093/eurheartj/suz058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2019] [Indexed: 12/20/2022]
Abstract
Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative organized by the International Society of Hypertension aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programs worldwide. A similar approach has been used in Italy since 2012, showing inadequate awareness of the consequences of hypertension, a generally increased cardiovascular risk and unsatisfactory BP control in 36% of interviewed individuals. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2017, during the joint MMM and World Hypertension Day events. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. Screenings were conducted both in cities and villages, indoor and outdoor, by health personnel. Eighty-five sites, involving approximately 300 investigators, took part in MMM17/World Hypertension Day in Italy, screening 10 076 individuals during a month-long period. After multiple imputation, 3099 participants were found (30.8%) to have high BP levels. This was the biggest opportunistic BP screening in a single time-point ever reported in Italy. A significant proportion of individuals had high BP, although it was not possible to differentiate between known treated hypertensive patients with inadequate BP control and as yet undiagnosed hypertensive individuals. Opportunistic screening can reach a significant number of individuals, being a powerful tool for raising awareness and carrying out BP screening.
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Affiliation(s)
- Camilla Torlasco
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan, Italy
- Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, , Milan, Italy
| | - Andrea Faini
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan, Italy
- Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, , Milan, Italy
| | - Elhassan Makil
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan, Italy
- Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, , Milan, Italy
| | - Grzegorz Bilo
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan, Italy
- Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, , Milan, Italy
| | - Martino Pengo
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan, Italy
| | - Thomas Beaney
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, UK
| | - Xin Xia
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, UK
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, Faculty of Medicine, Council of the Italian Society of Hypertension, University of Bologna, Via Zamboni 33, Bologna, Italy
| | - Neil R Poulter
- Imperial Clinical Trials Unit, Imperial College London, Stadium House, 68 Wood Lane, London, UK
| | - Giuliano Tocci
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome “Sapienza” Piazzale Aldo Moro 5, Roma, Italy; Sant'Andrea Hospital, IRCCS Neuromed, Pozzilli (IS), Council of the Italian Society of Hypertension, Rome, Italy
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, “Federico II” University of Naples Medical School, Corso Umberto I 40, Naples, Italy
| | - Giovambattista Desideri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, piazza Santa Margherita 2, 67100 L'Aquila, Italy; Council of the Italian Society of Hypertension, L'Aquila, Italy
| | - Franco Veglio
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Via Giuseppe Verdi 8, 10124 Turin, Italy; Council of the Italian Society of Hypertension; and
| | - Claudio Ferri
- Department of Life, Health and Environmental Sciences, University of L'Aquila, piazza Santa Margherita 2, L'Aquila, Italy
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, Milan, Italy
- Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, , Milan, Italy
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Hwang AY, Dave CV, Smith SM. Use of Prescription Medications That Potentially Interfere With Blood Pressure Control in New-Onset Hypertension and Treatment-Resistant Hypertension. Am J Hypertens 2018; 31:1324-1331. [PMID: 30052747 DOI: 10.1093/ajh/hpy118] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 07/20/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Withdrawing medications that interfere with blood pressure (BP) is recommended in patients with uncontrolled BP, yet real-world use of such agents is not well characterized among individuals with hypertension. We aimed to evaluate the use of BP-interfering prescription medications among US patients with hypertension. METHODS This retrospective drug utilization study used medical and prescription claims (January 2008 to December 2014) in the MarketScan commercial claims database. We included adults, aged 18-65 years, with a hypertension diagnosis (International Classification of Diseases, Ninth Revision, code 401) and ≥1 antihypertensive medication fill. Two hypertension cohorts were examined-new antihypertensive drug users (incident hypertension) and patients requiring titration to a fourth antihypertensive (incident treatment-resistant hypertension [TRH]). Patient-level exposure to BP-interfering medications was assessed 6 months before and after the index date, defined as the first prescription fill of an antihypertensive drug or the first occurrence of overlapping use of ≥4 antihypertensive drugs. RESULTS We identified 521,028 patients with incident hypertension and 131,764 patients with incident TRH. The most prevalent BP-interfering prescription medications were nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophens, and hormones. Overall, 18.3% of the incident hypertension cohort and 17.6% of the incident TRH cohort initiated a BP-interfering medication following antihypertensive titration. Among patients previously taking a BP-interfering medication, 57.6% with incident hypertension and 64.9% with incident TRH refilled that medication after antihypertensive intensification. CONCLUSIONS The use of prescription BP-interfering medications, especially NSAIDs, is prevalent among patients requiring intensification of their antihypertensive regimen. Greater efforts to limit the use of these medications, where feasible, may be required among patients with uncontrolled hypertension.
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Affiliation(s)
- Andrew Y Hwang
- Department of Clinical Sciences, Fred Wilson School of Pharmacy, High Point University, High Point, North Carolina, USA
| | - Chintan V Dave
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Steven M Smith
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, USA
- Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
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Aynaci G, Akdemir O. The Relationship Between Lifestyle, Health Promotion Lifestyle Profile II And High Blood Pressure In University Students. Open Access Maced J Med Sci 2018; 6:1756-1761. [PMID: 30338003 PMCID: PMC6182521 DOI: 10.3889/oamjms.2018.314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Identifying and controlling systemic arterial blood pressure is important in young people, and it is possible to reduce the frequency of systemic arterial hypertension by improving the lifestyle. AIM The aim of the study is to assess the relationship between healthy lifestyle behaviors and systemic blood pressure in university students. MATERIALS The study sample consisted of 200 university students from a state university in Edirne. Lifestyles and habits were evaluated with Health Promotion Lifestyle Profile II. Students' blood pressure was measured from both arms twice. RESULTS The mean HPLP-II score of those who frequently feel good was significantly higher than those who rarely feel good. The mean score of those who frequently wake up between 06:00-09:00 in the morning was statistically significantly higher than those who wake up outside these hours. Those who perform social or artistic activities during their leisure times had a mean scale score higher than those who don't perform. Although there wasn't a statistically significant difference according to smoking status, the mean score of non-smokers was higher than smokers. The mean scale scores were higher in frequent salt users than non-frequent users; participants with low saturated fatty acid intake had higher scores than those with high intake, and rare fast food consumers had higher scores than frequent consumers. The statistically significant difference between blood pressure values of females and males was due to higher blood pressure in male students. Those working in a part-time job had higher blood pressure values than those who weren't working. Among the students whose body mass indexes could be evaluated, there were differences in blood pressure values. CONCLUSION It has been observed in our study that health-related responsibilities and lifestyle behaviours increase with better leisure time activities, improved eating habits and a positive outlook on life. Turning youngs' tendencies towards healthy lifestyle behaviours to habits can make them healthier, more collective and more productive regarding physical, social and psychological well-being.
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Comparison Among Recommendations for the Management of Arterial Hypertension Issued by Last US, Canadian, British and European Guidelines. High Blood Press Cardiovasc Prev 2017; 25:9-16. [PMID: 29094260 DOI: 10.1007/s40292-017-0236-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/17/2017] [Indexed: 12/23/2022] Open
Abstract
Guidelines for the management of hypertension have been issued by different hypertension societies or organizations. Despite many similarities one can identify major differences in the diagnosis, management and treatment of the hypertensive patients among ESH/ESC, NICE, Canadian and NJC8 guidelines. Differences that can be identified are in the definition of hypertension in the elderly population, the optimal blood pressure targets in different hypertensive populations such as patients with diabetes and chronic kidney disease patients and the choose of the initial and appropriate antihypertensive agent depending on comorbidities of the treated population. Everyday clinical praxis physicians are confused by these differences and these incongruities contribute to doctor and patient inertia to reduce blood pressure levels at an optimal level. Community physicians cannot easily distinguish what recommendations are the best to be used for their patients. The critical view of these differences can also help the guidelines committees to make appropriate changes and finally to agree to a global view of recommendations for the management and treatment of hypertension.
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Yang MH, Kang SY, Lee JA, Kim YS, Sung EJ, Lee KY, Kim JS, Oh HJ, Kang HC, Lee SY. The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients. Korean J Fam Med 2017; 38:173-180. [PMID: 28775806 PMCID: PMC5541164 DOI: 10.4082/kjfm.2017.38.4.173] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 08/02/2016] [Accepted: 08/16/2016] [Indexed: 12/31/2022] Open
Abstract
Background Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents. Methods This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic. Results Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control. Conclusion Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.
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Affiliation(s)
- Myung Hwa Yang
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seo Young Kang
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Ah Lee
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Sik Kim
- Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Ju Sung
- Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ka-Young Lee
- Department of Family Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jun-Su Kim
- Department of Family Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Han Jin Oh
- Department of Family Medicine, Vievisnamuh Hospital, Seoul, Korea
| | - Hee Chul Kang
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Yeoup Lee
- Department of Family Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
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Caselli S, Vaquer Sequì A, Lemme E, Quattrini F, Milan A, D'Ascenzi F, Spataro A, Pelliccia A. Prevalence and Management of Systemic Hypertension in Athletes. Am J Cardiol 2017; 119:1616-1622. [PMID: 28325568 DOI: 10.1016/j.amjcard.2017.02.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 01/14/2023]
Abstract
The aim of the present study was to evaluate the prevalence, determinants, and clinical management of systemic hypertension in a large cohort of competitive athletes: 2,040 consecutive athletes (aged 25 ± 6 years, 64% men) underwent clinical evaluation including blood test, electrocardiogram, exercise test, echocardiography, and ophthalmic evaluation. Sixty-five athletes (3%) were identified with hypertension (men = 57; 87%) including 5 with a secondary cause (thyroid dysfunction in 3, renal artery stenosis in 1, and drug induced in 1). The hypertensive athletes had greater left ventricular hypertrophy and showed more often a concentric pattern than normotensive ones. Moreover, they showed a mildly reduced physical performance and were characterized by a higher cardiovascular risk profile compared with normotensive athletes. Multivariate logistic regression analysis showed that family hypertension history (odds ratio 2.05; 95% confidence interval 1.21 to 3.49; p = 0.008) and body mass index (odds ratio 1.32; 95% confidence interval 1.23 to 1.40; p <0.001) were the strongest predictors of hypertension. Therapeutic intervention included successful lifestyle modification in 57 and required additional pharmacologic treatment in 3 with essential hypertension. Secondary hypertension was treated according to the underlying disorder. After a mean follow-up of 18 ± 6 months, all hypertensive athletes had achieved and maintained optimal control of the blood pressure, without restriction to sport participation. In conclusion, the prevalence of hypertension in athletes is low (3%) and largely related to family history and overweight. In the vast majority of hypertensives, lifestyle modifications were sufficient to achieve an optimal control of blood pressure values.
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Volpe M, Tocci G, Borghi C, Parati G. New Opportunities for Monitoring Blood Pressure Control and Awareness in the Population: Insights from 12-Year Editions of the World Hypertension Day. High Blood Press Cardiovasc Prev 2016; 23:333-335. [PMID: 27744587 DOI: 10.1007/s40292-016-0172-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 09/25/2016] [Indexed: 12/29/2022] Open
Affiliation(s)
- Massimo Volpe
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine, Sant'Andrea Hospital, University of Rome Sapienza, Via di Grottarossa 1035-9, 00189, Rome, Italy. .,IRCCS Neuromed, Pozzilli, Italy.
| | - Giuliano Tocci
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine, Sant'Andrea Hospital, University of Rome Sapienza, Via di Grottarossa 1035-9, 00189, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
| | - Claudio Borghi
- Internal Medicine, University of Bologna, Bologna, Italy
| | - Gianfranco Parati
- Department of Clinical Medicine and Prevention, Centro Ricerche Cliniche, Istituto Auxologico Italiano IRCCS, University of Milano Bicocca, Milan, Italy
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Gender differences in the relationships between psychosocial factors and hypertension. Maturitas 2016; 93:58-64. [PMID: 27338977 DOI: 10.1016/j.maturitas.2016.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 05/25/2016] [Accepted: 06/01/2016] [Indexed: 12/19/2022]
Abstract
Gender differences in the epidemiology, pathophysiology, clinical manifestations and outcomes of cardiovascular disease are well established but there is still a lack of awareness of this both in the general population and among healthcare providers. In addition to the traditionally recognized cardiovascular risk factors, more recently psychosocial risk factors such as stress, mood disorders, low socioeconomic status and sleep disorders have been linked to cardiovascular diseases and hypertension. Psychosocial factors may have different cardiovascular consequences in men and women; thus further efforts are required to explore pathophysiological mechanisms, to obtain gender-specific data from clinical trials and to translate this knowledge into everyday clinical practice.
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Volpe M, Borghi C. National Cross-Sectional Survey on Blood Pressure: A Gateway to a Better Appraisal of Hypertension in the Young. High Blood Press Cardiovasc Prev 2016; 23:141-2. [PMID: 27117157 DOI: 10.1007/s40292-016-0146-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 04/02/2016] [Indexed: 10/21/2022] Open
Affiliation(s)
- Massimo Volpe
- Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Via di Grottarossa 1035-39, 00189, Rome, Italy. .,IRCCS Neuromed, Pozzilli, IS, Italy.
| | - Claudio Borghi
- Chair of Internal Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
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