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Nyulas KI, Simon-Szabó Z, Pál S, Fodor MA, Dénes L, Cseh MJ, Barabás-Hajdu E, Csipor B, Szakács J, Preg Z, Germán-Salló M, Nemes-Nagy E. Cardiovascular Effects of Herbal Products and Their Interaction with Antihypertensive Drugs-Comprehensive Review. Int J Mol Sci 2024; 25:6388. [PMID: 38928095 PMCID: PMC11203894 DOI: 10.3390/ijms25126388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/05/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Hypertension is a highly prevalent population-level disease that represents an important risk factor for several cardiovascular complications and occupies a leading position in mortality statistics. Antihypertensive therapy includes a wide variety of drugs. Additionally, the potential antihypertensive and cardioprotective effects of several phytotherapy products have been evaluated, as these could also be a valuable therapeutic option for the prevention, improvement or treatment of hypertension and its complications. The present review includes an evaluation of the cardioprotective and antihypertensive effects of garlic, Aloe vera, green tea, Ginkgo biloba, berberine, ginseng, Nigella sativa, Apium graveolens, thyme, cinnamon and ginger, and their possible interactions with antihypertensive drugs. A literature search was undertaken via the PubMed, Google Scholar, Embase and Cochrane databases. Research articles, systematic reviews and meta-analyses published between 2010 and 2023, in the English, Hungarian, and Romanian languages were selected.
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Affiliation(s)
- Kinga-Ilona Nyulas
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania
| | - Zsuzsánna Simon-Szabó
- Department of Pathophysiology, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania
| | - Sándor Pál
- Department of Laboratory Medicine, Department of Transfusion Medicine, Medical School, University of Pécs, 7622 Pécs, Hungary
| | - Márta-Andrea Fodor
- Department of Laboratory Medicine, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania
| | - Lóránd Dénes
- Department of Anatomy and Embryology, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania
| | - Margit Judit Cseh
- Master Program of Nutrition and Dietetics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania
| | - Enikő Barabás-Hajdu
- Department of Cell Biology and Microbiology, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania
| | - Bernadett Csipor
- Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania
| | - Juliánna Szakács
- Department of Biophysics, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania
| | - Zoltán Preg
- Department of Family Medicine, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania
| | - Márta Germán-Salló
- Department of Internal Medicine III, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania
| | - Enikő Nemes-Nagy
- Department of Chemistry and Medical Biochemistry, Faculty of Medicine in English, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, 540139 Târgu Mureș, Romania;
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An L, Wang Y, Liu L, Miao C, Xu L, Wang G, Zhu D, Wu S, Hong J. High serum uric acid is a risk factor for arterial stiffness in a Chinese hypertensive population: a cohort study. Hypertens Res 2024; 47:1512-1522. [PMID: 38321103 DOI: 10.1038/s41440-024-01591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 01/09/2024] [Accepted: 01/13/2024] [Indexed: 02/08/2024]
Abstract
The prospective cohort study was to explore the association between serum uric acid (SUA) and arterial stiffness in a Chinese hypertensive population. A total of 7444 participants with hypertension who completed two or more measurements of brachial-ankle pulse wave velocity (baPWV) and baseline SUA detection were followed-up in the Kailuan Study from 2010 to 2020. A restricted cubic spline curve was used to verify whether there was a linear association between baseline SUA and arterial stiffness. A Cox proportional hazard regression model was used to explore the association of between baseline SUA and the incidence of arterial stiffness. Our results showed that the restricted cubic spline curve revealed a linear relationship between baseline SUA and arterial stiffness in total participants (p < 0.001). After follow-up 4.6 ± 2.8 years, Kaplan-Meier survival curves indicated that the risk of arterial stiffness was increased in the high level of baseline SUA (Log-rank p = 0.0002). After adjusting for potential confounding factors, the HR (95% CI) for risk of stiffness was 1.33 (1.17-1.52, p < 0.001) in the highest SUA group. Hierarchical analysis showed that the HRs (95% CI) for risk of arterial stiffness were 1.45 (1.25-1.69), 1.38 (1.19-1.60), 1.41 (1.21-1.64), and 1.35 (1.15-1.58) in the highest SUA group of males, <65 years old, not taking antihypertensive drugs, and failure to achieve the control targets of blood pressure respectively (p < 0.001). These results reveal that high SUA is a risk factor for arterial stiffness in the Chinese hypertensive population.
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Affiliation(s)
- Lina An
- Department of Geriatrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Shanghai, 200080, China
| | - Yujing Wang
- Department of Internal and Emergency Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Shanghai, 200080, China
| | - Lizhen Liu
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Shanghai, 200080, China
| | - Congliang Miao
- Department of Internal and Emergency Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Shanghai, 200080, China
| | - Lina Xu
- Department of Internal and Emergency Medicine, Shanghai General Hospital of Nanjing Medical University, 100 Haining Road, Shanghai, 200080, China
| | - Guokun Wang
- Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai, China
| | - Desheng Zhu
- Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China.
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, 063000, China.
| | - Jiang Hong
- Department of Internal and Emergency Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 100 Haining Road, Shanghai, 200080, China.
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Del Pinto R, Agabiti Rosei C, Borghi C, Cipollini F, Cottone S, De Giorgi GA, Di Guardo A, Dugnani M, Fabris B, Giannattasio C, Giacchetti G, Minuz P, Mulè G, Nazzaro P, Parati G, Rattazzi M, Saladini F, Salvetti M, Sarzani R, Savoia C, Tocci G, Veglio F, Volpe M, Vulpis V, Baldini G, Ferri C, Muiesan ML. May Measure Month 2022 in Italy: A Focus on Fixed-dose Combination, Therapeutic Adherence, and Medical Inertia in a Nationwide Survey. High Blood Press Cardiovasc Prev 2024; 31:309-320. [PMID: 38825650 PMCID: PMC11161440 DOI: 10.1007/s40292-024-00642-4] [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: 02/29/2024] [Accepted: 04/04/2024] [Indexed: 06/04/2024] Open
Abstract
INTRODUCTION Hypertension is the main risk factor for cardiovascular diseases (CVD). Notably, only about half of hypertensive patients manage to achieve the recommended blood pressure (BP) control. Main reasons for the persistence of uncontrolled BP during treatment are lack of compliance on the patients' side, and therapeutic inertia on physicians' side. METHODS During the global BP screening campaign "May Measure Month" (MMM) (May 1st to July 31st, 2022), a nationwide, cross-sectional, opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults ≥ 18 years to raise awareness of the health issues surrounding high BP. A questionnaire on demographic/clinical features and questions on the use of fixed-dose single-pills for the treatment of hypertension was administered. BP was measured with standard procedures. RESULTS A total of 1612 participants (mean age 60.0±15.41 years; 44.7% women) were enrolled. Their mean BP was 128.5±18.1/77.1±10.4 mmHg. About half of participants were sedentary, or overweight/obese, or hypertensive. 55.5% individuals with complete BP assessment had uncontrolled hypertension. Most were not on a fixed-dose combination of antihypertensive drugs and did not regularly measure BP at home. Self-reported adherence to BP medications was similar between individuals with controlled and uncontrolled BP (95% vs 95.5%). CONCLUSIONS This survey identified a remarkable degree of therapeutic inertia and poor patients' involvement in the therapeutic process and its monitoring in the examined population, underlining the importance of prevention campaigns to identify areas of unsatisfactory management of hypertension, to increase risk factors' awareness in the population with the final purpose of reducing cardiovascular risk.
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Affiliation(s)
- Rita Del Pinto
- Department of Life, Health and Environmental Sciences, Internal Medicine unit, ESH Excellence Center, S. Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | | | - Claudio Borghi
- ESH Excellence Center, Sant'Orsola-Malpighi University Hospital, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Franco Cipollini
- San Jacopo Hospital, PIOT San Marcello Pistoiese, Pistoia, Italy
| | - Santina Cottone
- ESH Excellence Center, P. Giaccone Hospital, University of Palermo, Palermo, Italy
| | | | | | | | - Bruno Fabris
- Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Cristina Giannattasio
- ESH Excellence Center, Niguarda Hospital, University of Milano-Bicocca, Milan, Italy
| | | | - Pietro Minuz
- ESH Excellence Center, Policlinico G.B. Rossi, University of Verona, Verona, Italy
| | - Giuseppe Mulè
- ESH Excellence Center, P. Giaccone Hospital, University of Palermo, Palermo, Italy
| | - Pietro Nazzaro
- Hypertension clinic A.M.Pirrelli, University of Bari, Bari, Italy
| | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Istituto Auxologico Italiano, IRCCS, St. Luke Hospital, Milan, Italy
| | - Marcello Rattazzi
- Hypertension clinic, Cà Foncello Hospital, University of Padua, Treviso, Italy
| | | | - Massimo Salvetti
- Department of Medical and Surgical Sciences, Spedali Civili, University of Brescia, Brescia, Italy
| | - Riccardo Sarzani
- ESH Excellence Center, IRCCS-INRCA, Università Politecnica delle Marche, Ancona, Italy
| | - Carmine Savoia
- Clinical and Molecular Medicine Department, Sapienza University, Rome, Italy
| | - Giuliano Tocci
- Clinical and Molecular Medicine Department, Sapienza University, Rome, Italy
| | - Franco Veglio
- Department Medical Sciences, ESH Excellence Center, AOU Città della Salute e della Scienza, University of Turin, Turin, Italy
| | | | - Vito Vulpis
- Emergency Medicine, Hypertension and Cardiovascular Risk Unit-Policlinico Hospital, Bari, Italy
| | - Gianluca Baldini
- Department of Life, Health and Environmental Sciences, Internal Medicine unit, ESH Excellence Center, S. Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Claudio Ferri
- Department of Life, Health and Environmental Sciences, Internal Medicine unit, ESH Excellence Center, S. Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.
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Filipiak KJ, Barrios V, Ferri C, Fozilov K, Freire Castro SJ, Kuzior A, Martinez-Martin FJ, Mullabaeva G, Nguyen LH, Nizamov U, Tomaszuk-Kazberuk A, Trigulova R, Gąsecka A. STRUGGLE FOR. Italian-Polish-Spanish-Uzbek-Vietnamese Expert Forum Position Paper 2023 for better control of classical modifiable risk factors in clinical practice. Cardiol J 2023; 30:859-869. [PMID: 37987561 PMCID: PMC10713228 DOI: 10.5603/cj.96912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/07/2023] [Accepted: 09/19/2023] [Indexed: 11/22/2023] Open
Abstract
The progress in pharmacotherapy that has been made in recent years, including the introduction of very effective and safe lipid-lowering and antihypertensive drugs, has not yet translated into the expected universal control of blood pressure, lipid disorders and diabetes. In the STRUGGLE FOR Italian- -Polish-Spanish-Uzbek-Vietnamese Expert Forum Position Paper 2023, experts from five countries recounted several points about the paradigms of cardiological and cardiometabolic care for better control of classical modifiable risk factors in the year 2023. It is believed herein, that the need to intensify treatment, actively search for patients with cardiovascular risk factors, especially with arterial hypertension, hypercholesterolemia and diabetes, should go hand in hand with the implementation of the latest therapy, based on single pill combinations including proven, effective antihypertensive, lipid-lowering and antidiabetic molecules, many of which are listed in the present document. There is a need to use both new technological concepts, completely new drugs, as well as novel treatment concepts such as metabolic treatment in coronary artery disease, try to intensify the fight against smoking in every way, including the available range of drugs and procedures reducing the harm. This approach will provide substantially better control of the underlying cardiovascular risk factors in countries as varied as Italy, Poland, Spain, Uzbekistan and Vietnam.
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Affiliation(s)
- Krzysztof J Filipiak
- Institute of Clinical Science, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Vivencio Barrios
- Cardiology Department, University Hospital Ramon y Cajal, Alcalá University, Madrid, Spain
| | - Claudio Ferri
- University of L'Aquila, MeSVA Department, UOC Internal Medicine and Nephrology, Hypertension and Cardiovascular Prevention Unit, San Salvatore Hospital, Coppito, AQ, Italy
| | - Khurshid Fozilov
- Republican Specialised Center of Cardiology, Tashkent, Uzbekistan
| | | | - Agnieszka Kuzior
- Endocrinology and Nutrition Department at Hospitales Universitarios San Roque, Las Palmas de Gran Canaria, Spain
| | - Francisco Javier Martinez-Martin
- Endocrinology and Nutrition Department at Hospitales Universitarios San Roque, Las Palmas de Gran Canaria, Spain
- Endocrinology and Nutrition Department at Hospital Universitario de Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain
| | - Guzal Mullabaeva
- Department of Mini-invasive Cardiac Surgery and Rehabilitation, Republican Specialised Center of Cardiology, Tashkent, Uzbekistan
| | - Lan Hieu Nguyen
- Cardiology Department, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Ulugbek Nizamov
- Republican Specialised Center of Cardiology, Tashkent, Uzbekistan
| | - Anna Tomaszuk-Kazberuk
- Department of Cardiology, Lipidology and Internal Medicine with Intensive Cardiac Care Unit, Medical University of Bialystok, Poland
| | - Raisa Trigulova
- Department of Ischemic Heart Disease and Atherosclerosis, Republican Specialised Center of Cardiology, Tashkent, Uzbekistan
| | - Aleksandra Gąsecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
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Luque del Moral R, Gastelurrutia MA, Martinez-Martinez F, Jacomé JA, Dago A, Suarez B, Fikri-Benbrahim N, Martí M, Nuñez C, Sierra-Alarcón S, Fernandez-Gomez FJ. Effect of Pharmaceutical Intervention in Pharmacologically Treated Hypertensive Patients-A Cluster-Randomized Clinical Trial: AFPRES-CLM Study. J Pers Med 2023; 13:1484. [PMID: 37888095 PMCID: PMC10608270 DOI: 10.3390/jpm13101484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Evaluate the effect of a community pharmaceutical intervention on the control of blood pressure in hypertensive patients treated pharmacologically. METHODS A cluster-randomized clinical trial of 6 months was carried out. It was conducted in the Autonomous Community of Castilla-La Mancha (Spain). Sixty-three community pharmacies and 347 patients completed the study. Intervention patients received the community pharmaceutical intervention based on a protocol that addresses the individual needs of each patient related to the control of their blood pressure, which included Health Education, Pharmacotherapy Follow-up and 24 h Ambulatory Blood Pressure Measurement. Control patients received usual care in the community pharmacy. RESULTS The pharmaceutical intervention resulted in better control of blood pressure (85.8% vs. 66.3% p < 0.001), lower use of emergencies (p = 0.002) and improvement trends in the physical components of quality of life, measured by SF-36 questionnaire, after 6 months of pharmaceutical intervention. No significant changes were observed for any of these variables in the control group. There were also detected 354 negative medication-related outcomes that were satisfactorily resolved in a 74.9% of the cases and 330 healthcare education interventions and 29 Ambulatory Blood Pressure Monitorings were performed in order to increase adherence to pharmacological treatment and minimize Negative Outcomes associated with Medication and prevent medication-related problems. CONCLUSIONS Community pharmaceutical intervention can increase hypertensive patients with controlled blood pressure, after 6 months, compared with usual care.
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Affiliation(s)
- Raúl Luque del Moral
- Pharmaceutical Care Research Group, University of Granada, 18011 Granada, Spain; (M.A.G.); (F.M.-M.); (B.S.); (N.F.-B.)
- Council of Official Associations of Pharmaceutics of Castilla-La Mancha, 45005 Toledo, Spain
- Group of Cellular and Molecular Pharmacology, Department of Pharmacology, CEIR Campus Mare Nostrum, University of Murcia, Campus de Ciencias de la Salud, 30120 Murcia, Spain; (C.N.); (F.-J.F.-G.)
| | - Miguel A. Gastelurrutia
- Pharmaceutical Care Research Group, University of Granada, 18011 Granada, Spain; (M.A.G.); (F.M.-M.); (B.S.); (N.F.-B.)
| | - Fernando Martinez-Martinez
- Pharmaceutical Care Research Group, University of Granada, 18011 Granada, Spain; (M.A.G.); (F.M.-M.); (B.S.); (N.F.-B.)
| | - Julio A. Jacomé
- Pharmaceutical Care Foundation, 08017 Barcelona, Spain; (J.A.J.); (A.D.); (M.M.)
| | - Ana Dago
- Pharmaceutical Care Foundation, 08017 Barcelona, Spain; (J.A.J.); (A.D.); (M.M.)
| | - Blanca Suarez
- Pharmaceutical Care Research Group, University of Granada, 18011 Granada, Spain; (M.A.G.); (F.M.-M.); (B.S.); (N.F.-B.)
- Council of Official Associations of Pharmaceutics of Castilla-La Mancha, 45005 Toledo, Spain
| | - Narjis Fikri-Benbrahim
- Pharmaceutical Care Research Group, University of Granada, 18011 Granada, Spain; (M.A.G.); (F.M.-M.); (B.S.); (N.F.-B.)
| | - Mercé Martí
- Pharmaceutical Care Foundation, 08017 Barcelona, Spain; (J.A.J.); (A.D.); (M.M.)
| | - Cristina Nuñez
- Group of Cellular and Molecular Pharmacology, Department of Pharmacology, CEIR Campus Mare Nostrum, University of Murcia, Campus de Ciencias de la Salud, 30120 Murcia, Spain; (C.N.); (F.-J.F.-G.)
- Murcia Research Institute of Health Sciences (IMIB), 30120 Murcia, Spain
| | - Sandra Sierra-Alarcón
- Group of Cellular and Molecular Pharmacology, Department of Pharmacology, CEIR Campus Mare Nostrum, University of Murcia, Campus de Ciencias de la Salud, 30120 Murcia, Spain; (C.N.); (F.-J.F.-G.)
- Murcia Research Institute of Health Sciences (IMIB), 30120 Murcia, Spain
| | - Francisco-José Fernandez-Gomez
- Group of Cellular and Molecular Pharmacology, Department of Pharmacology, CEIR Campus Mare Nostrum, University of Murcia, Campus de Ciencias de la Salud, 30120 Murcia, Spain; (C.N.); (F.-J.F.-G.)
- Murcia Research Institute of Health Sciences (IMIB), 30120 Murcia, Spain
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Villar JC, Vásquez SM, Balcázar AM, López LAT, Barrera EC, Moreno AM. Reporting of blood pressure levels and self-monitoring practices: a survey among outpatients diagnosed with hypertension in Bogotá, Colombia. BMC PRIMARY CARE 2023; 24:185. [PMID: 37710151 PMCID: PMC10503071 DOI: 10.1186/s12875-023-02111-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/19/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Routine blood pressure (BP) self-monitoring is recommended for patients already diagnosed with hypertension. How often these patients can report their BP levels is unknown, particularly in low-and-middle income countries. METHODS We surveyed (January 2021 to May 2022) representative samples of patients with established diagnosis of hypertension from 3 health care networks (involving 74 outpatient clinics) and 2 university hospitals in Bogotá, Colombia. Trained health care professionals conducted a telephone survey including questions on demographics, medical history, and general understanding about hypertension and its potential complications. The outcome variables were the self-report of participant's BP levels (primary) and monitoring practices among participants. RESULTS Out of 2609 consecutively contacted patients sampled from institutional records, 2323 were invited and 1566 (mean age 66.5, SD = 12.1 years, 74.4% females, 64.0% living low socio-economic strata) gave consent to participate. While 66% of participants had over 5 years of diagnosis, 39.5% had most (≥ 60%) of their follow-up visits with the same doctor. Overall, 645 (41.5%, 95%CI 39.1 -43.9) participants reported their BP levels. This proportion was independent of time from diagnosis, but higher among those of younger age, living in higher socio-economic strata, having more years of education and using more information technologies. Also, more patients reported their BP levels if seen ≥ 60% of the times by the same physician (43.4% Vs. 36.7%). Those reporting closer BP self-monitoring more often used electronic devices, received 2 + medications, and had better knowledge about hypertension. CONCLUSION A minority of hypertensive patients seen in Bogotá were aware of their own BP levels. Those in such capacity were in a better social position, more often seen by the same doctor, knew their condition better and handled more complex treatments. Hypertensive patients from Bogotá may benefit from a more continuous medical care, patient education programs and promoting BP home monitoring.
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Affiliation(s)
- Juan Carlos Villar
- Centro de Investigaciones, Fundación Cardioinfantil – Instituto de Cardiología, Calle 163 A # 13B – 60 Torre H, Piso 3, Bogotá, Colombia
| | - Skarlet Marcell Vásquez
- Centro de Investigaciones, Fundación Cardioinfantil – Instituto de Cardiología, Calle 163 A # 13B – 60 Torre H, Piso 3, Bogotá, Colombia
- Facultad de Ciencias de La Salud, Universidad Autónoma de Bucaramanga, Avenida 42 #48 - 11, Bucaramanga, Santander Colombia
| | - Angela Manuela Balcázar
- Centro de Investigaciones, Fundación Cardioinfantil – Instituto de Cardiología, Calle 163 A # 13B – 60 Torre H, Piso 3, Bogotá, Colombia
| | - Luz Angela Torres López
- Centro de Investigaciones, Fundación Cardioinfantil – Instituto de Cardiología, Calle 163 A # 13B – 60 Torre H, Piso 3, Bogotá, Colombia
| | - Edgar Camilo Barrera
- Centro de Investigaciones, Fundación Cardioinfantil – Instituto de Cardiología, Calle 163 A # 13B – 60 Torre H, Piso 3, Bogotá, Colombia
| | - Angélica María Moreno
- Centro de Investigaciones, Fundación Cardioinfantil – Instituto de Cardiología, Calle 163 A # 13B – 60 Torre H, Piso 3, Bogotá, Colombia
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Sozmen K, Ergor G, Sakarya S, Dinc Horasan G, Sahan C, Ekinci B, Arikan A, Sis S, Unal B. Evaluation of Blood Pressure Status and Mortality in Turkey: Findings from Chronic Diseases and Risk Factors Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1366. [PMID: 37629656 PMCID: PMC10456768 DOI: 10.3390/medicina59081366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/11/2023] [Accepted: 07/23/2023] [Indexed: 08/27/2023]
Abstract
Background and objectives: An important Non-Communicable Disease risk factor, hypertension (HT), is highly prevalent and controlled HT rates are not sufficient which increases the risk of developing premature deaths. The purpose of the study is to evaluate differences in all-cause and cardiovascular-related mortality according to HT status by using national data from Chronic Diseases and Risk Factors Survey in Turkey (2011-2017). Materials and Methods: Cox regression models were used to estimate hazard ratios (HR) for predicting the all-cause and cardiovascular system-related mortalities. Median follow-up period was 6.2 years. Results: Among individuals with HT, 41.8% was untreated, 30.1% received treatment and had controlled blood pressure, and 28.1% were under treatment but had uncontrolled BP levels. The hazard for mortality among treated & uncontrolled hypertensive participants was significantly higher for all-cause (HR = 1.32, 95% CI = 1.06-1.65), cardiovascular (HR = 2.11, 95% CI = 1.46-3.06), heart disease (HR = 2.24, 95% CI = 1.46-3.43), and Coronary Heart Disease mortality (HR = 2.66, 95% CI = 1.56-4.53) compared to normotensive participants. Conclusions: Individuals with HT who were treated but do not have controlled blood pressure in Turkey had a significantly increased risk of Cardiovascular Disease and all-cause mortality. Along with studies investigating the causes of uncontrolled blood pressure despite initiation of treatment, support should be provided to patients in cases of non-adherence to antihypertensive medication or life change recommendations.
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Affiliation(s)
- Kaan Sozmen
- Department of Public Health, Faculty of Medicine, Izmir Katip Celebi University, Izmir 35620, Türkiye
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Gul Ergor
- Department of Public Health, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Türkiye; (G.E.); (C.S.)
| | - Sibel Sakarya
- Department of Public Health, Faculty of Medicine, Koc University, Istanbul 34010, Türkiye
| | - Gonul Dinc Horasan
- Department of Public Health, Faculty of Medicine, Izmir University of Economics, Izmir 35330, Türkiye;
| | - Ceyda Sahan
- Department of Public Health, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Türkiye; (G.E.); (C.S.)
| | - Banu Ekinci
- Department of Chronic Diseases and Elderly Health, General Directorate of Public Health of Turkey, Ankara 06430, Türkiye; (B.E.); (A.A.); (S.S.)
| | - Ahmet Arikan
- Department of Chronic Diseases and Elderly Health, General Directorate of Public Health of Turkey, Ankara 06430, Türkiye; (B.E.); (A.A.); (S.S.)
| | - Secil Sis
- Department of Chronic Diseases and Elderly Health, General Directorate of Public Health of Turkey, Ankara 06430, Türkiye; (B.E.); (A.A.); (S.S.)
| | - Belgin Unal
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Department of Public Health, Faculty of Medicine, Dokuz Eylul University, Izmir 35340, Türkiye; (G.E.); (C.S.)
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Sakboonyarat B, Poovieng J, Srisawat P, Hatthachote P, Mungthin M, Rangsin R, Jongcherdchootrakul K. Prevalence, awareness, and control of hypertension and associated factors among Royal Thai Army personnel in Thailand from 2017 to 2021. Sci Rep 2023; 13:6946. [PMID: 37117457 PMCID: PMC10141845 DOI: 10.1038/s41598-023-34023-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/22/2023] [Indexed: 04/30/2023] Open
Abstract
Hypertension (HTN) is a potential risk factor for cardiovascular diseases. We aimed to determine the prevalence, awareness, and control of HTN among RTA personnel in Thailand. We conducted a series of cross-sectional studies from 2017 to 2021. HTN was defined by systolic blood pressure (BP) ≥ 140 mmHg or a diastolic BP ≥ 90 mmHg from a physical health examination, a history of HTN diagnosed by medical personnel, or taking antihypertensive medication. A total of 504,484 participants were included in the present study. The overall HTN prevalence was 29.4%. The prevalence of HTN among males was 30.5%, while it was 17.1% among females. Of the RTA personnel with HTN, 35.9% were aware of their condition. The overall control of HTN among RTA personnel with HTN was 15.8% in 2017 and 17.6% in 2021. Behavioral factors associated with HTN were current smoking, alcohol consumption, and sedentary behavior. A higher BMI was associated with higher HTN prevalence and HTN awareness but less likely to have controllable HTN. Male participants, younger individuals, current alcohol use, and sedentary behavior were associated with a lower prevalence of HTN awareness and controlled HTN. Current tobacco use was also associated with a lower prevalence of HTN awareness.
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Affiliation(s)
- Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Jaturon Poovieng
- Department of Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Phutsapong Srisawat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Panadda Hatthachote
- Department of Physiology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Kanlaya Jongcherdchootrakul
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
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9
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Lewandowska K, Wasiliew S, Kukfisz A, Hofman M, Woźniak P, Radziemski A, Stryczyński Ł, Lipski D, Tykarski A, Uruski P. Target Blood Pressure Values in Ambulatory Blood Pressure Monitoring. High Blood Press Cardiovasc Prev 2023; 30:29-36. [PMID: 36396904 PMCID: PMC9908722 DOI: 10.1007/s40292-022-00552-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/12/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION 2018 ESC/ESH guidelines have recommended 24-h ambulatory blood pressure monitoring to assess hypotensive therapy in many circumstances. Recommended target blood pressure in office blood pressure measurements is between 120/70 and 130/80 mmHg. Such targets for 24-h ambulatory blood pressure monitoring lacks. AIM We aimed to define target values of blood pressure in 24-h ambulatory blood pressure monitoring in hypertensive patients. METHODS Office blood pressure measurements and 24-h ambulatory blood pressure monitoring data were collected from 1313 hypertensive patients and sorted following increasing systolic (SBP)/diastolic (DBP) blood pressure in office blood pressure measurements. The corresponding 24-h ambulatory blood pressure monitoring to office blood pressure measurements values were calculated. RESULTS Values 130/80 mmHg in office blood pressure measurements correspond in 24-h ambulatory blood pressure monitoring: night-time SBP/DBP mean: 113.74/66.95 mmHg; daytime SBP/DBP mean: 135.02/81.78 mmHg and 24-h SBP/DBP mean: 130.24/78.73 mmHg. Values 120/70 mmHg in office blood pressure measurements correspond in 24-h ambulatory blood pressure monitoring: night-time SBP/DBP mean: 109.50/63.43 mmHg; daytime SBP/DBP mean: 131.01/78.47 mmHg and 24-h SBP/DBP mean: 126.36/75.31 mmHg. CONCLUSIONS The proposed blood pressure target values in 24-h ambulatory blood pressure monitoring complement the therapeutic target indicated in the ESC/ESH recommendations and improves 24-h ambulatory blood pressure monitoring usefulness in clinical practice.
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Affiliation(s)
- Katarzyna Lewandowska
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland.
| | - Stanisław Wasiliew
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland
| | - Agata Kukfisz
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland
| | - Michał Hofman
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland
| | - Patrycja Woźniak
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland
| | - Artur Radziemski
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland
| | - Łukasz Stryczyński
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland
| | - Dawid Lipski
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland
| | - Andrzej Tykarski
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland
| | - Paweł Uruski
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Długa 1/2, 61-848, Poznan, Poland
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10
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Yokokawa H, Suzuki M, Aoki N, Sato Y, Naito T. Achievement of target blood pressure among community residents with hypertension and factors associated with therapeutic failure in the northern territory of Japan. J Int Med Res 2022; 50:3000605221126878. [PMID: 36314244 PMCID: PMC9623383 DOI: 10.1177/03000605221126878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 08/31/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE This study aimed to determine the rate of achieving the target blood pressure (BP) defined by Japanese hypertension management guidelines and to examine factors associated with achieving the target BP. METHODS This cross-sectional study, which was conducted between January 2012 and December 2015, examined the BP control status and associated factors among 9,016 Japanese community residents with hypertension. Residents were divided into the following six groups: G1, young, middle-aged, and early-phase elderly patients; G2, patients with cerebrovascular disease; G3, patients with coronary artery disease; G4, patients with chronic kidney disease with proteinuria; G5, patients with diabetes; and G6, patients with chronic kidney disease without proteinuria. BP target achievement rates were calculated for each group. A multivariate analysis identified factors associated with "therapeutic failure" of target BP. RESULTS The target BP was achieved by 52.6% participants in G1, 84.3% in G2, 50.6% in G3, 45.6% in G4, 48.7% in G5, and 75.0% in G6. The body mass index and receiving antilipidemic medication were associated with therapeutic failure. CONCLUSION This study shows that achievement rates for treatment goals among Japanese patients with hypertension are still low. Body mass index and treatment of dyslipidemia may be associated with the control of BP.
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Affiliation(s)
- Hirohide Yokokawa
- Department of General Medicine, Juntendo University Faculty of
Medicine, Tokyo, Japan
| | - Mai Suzuki
- Department of General Medicine, Juntendo University Faculty of
Medicine, Tokyo, Japan
| | - Nozomi Aoki
- Department of General Medicine, Juntendo University Faculty of
Medicine, Tokyo, Japan
| | - Yuki Sato
- National Institute of Occupational Safety and Health Japan,
Japan Organization of Occupational Health and Safety, Kawasaki City, Japan
| | - Toshio Naito
- Department of General Medicine, Juntendo University Faculty of
Medicine, Tokyo, Japan
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11
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Del Pinto R, Grassi G, Muiesan ML, Borghi C, Carugo S, Cicero AFG, Di Meo L, Iaccarino G, Minuz P, Mulatero P, Mulè G, Parati G, Pucci G, Salvetti M, Sarzani R, Savoia C, Sechi L, Tocci G, Volpe M, Vulpis V, Ferri C. World Hypertension Day 2021 in Italy: Results of a Nationwide Survey. High Blood Press Cardiovasc Prev 2022; 29:353-359. [PMID: 35416590 PMCID: PMC9006201 DOI: 10.1007/s40292-022-00519-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 03/25/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Hypertension is the biggest contributor to the global burden of cardiovascular diseases and related death, but the rates of hypertension awareness, treatment, and control remain largely perfectible. Methods During the XVII World Hypertension Day (May 17th, 2021), a nationwide cross-sectional opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults ≥ 18 years to raise awareness of high blood pressure (BP). A questionnaire on major demographic/clinical features (sex, age, employment, education, BP status awareness, hypertension family/personal history, antihypertensive medications use) and BP measurement habits (≥1 BP measurement in the previous month/week) was administered. Due to the ongoing SARS-CoV-2 pandemic, BP was measured with standard procedures in a subset of participants (24.4%). Results A total of 1354 participants (mean age 56.3 ± 15.3 years; 57.3% women; mean BP: 131.2 ± 17.5/81.6 ± 10.5 mmHg; 42.3% self-declared hypertensive; 41.4% on antihypertensive medications) were enrolled; 73.6% declared being aware of their BP status. Among treated individuals with measured BP, 26.9% showed BP levels within the predefined therapeutic goals. Interestingly, BP status awareness rates were the highest among individuals with uncontrolled hypertension (85.1%) and the lowest among those with normal measured BP (54.4%). Conclusions This survey provides an updated insight into hypertension awareness and control in a setting of daily clinical practice, emphasizing the centricity of patients in the therapeutic alliance for a successful reduction of cardiovascular risk. Supplementary Information The online version contains supplementary material available at 10.1007/s40292-022-00519-4.
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Affiliation(s)
- Rita Del Pinto
- Internal Medicine and Nephrology Unit, ESH Excellence Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, Department of Clinical Medicine, Public Health, Life and Environmental Sciences, G. Petrini str., 67100, L'Aquila, Italy
| | - Guido Grassi
- Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.,Monza General Hospital, Via Amati, 111, 20900, Monza, Italy
| | - Maria Lorenza Muiesan
- Internal Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy.,IRCCS S. Orsola-Malpighi Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano Carugo
- Division of Cardiology, San Paolo University Hospital, Via Antonio di Rudinì, 8, 20142, Milan, Italy.,Department of Health Sciences, University of Milan, via Festa del Perdono, 7, 20122, Milan, Italy
| | - Arrigo F G Cicero
- Department of Medical and Surgical Sciences, Faculty of Medicine, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy.,IRCCS S. Orsola-Malpighi Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luciano Di Meo
- Hypertension and Cardiovascular Prevention Center-ASL CE, District 14, Via Leonardo 10, Cellole, Italy
| | - Guido Iaccarino
- Interdepartmental Research Center for Hypertension and Related Conditions, University of Naples Federico II, Naples, Italy
| | - Pietro Minuz
- Unit of General Medicine for the Study and Treatment of Hypertensive Disease, Department of Medicine, Policlinico GB Rossi, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy
| | - Paolo Mulatero
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Torino, Via Giuseppe Verdi, 8, 10124, Turin, Italy
| | - Giuseppe Mulè
- Unit of Nephrology and Hypertension, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, European Society of Hypertension Excellence Center, University of Palermo, Piazza Marina, 61, 90133, Palermo, Italy
| | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milan-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126, Milan, Italy.,Department of Cardiovascular, Neural and Metabolic Sciences, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Piazzale Brescia 20, 20149, Milan, Italy
| | - Giacomo Pucci
- Department of Medicine, University of Perugia, Perugia, Italy
| | - Massimo Salvetti
- Internal Medicine Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, 'Hypertension Excellence Centre' of the European Society of Hypertension, IRCCS INRCA, Via Festa del Perdono, 7, 20122, Ancona, Italy.,Department of Clinical and Molecular Sciences, University 'Politecnica delle Marche', via Tronto, 10/a, 60126, Ancona, Italy
| | - Carmine Savoia
- Clinical and Molecular Medicine Department, Cardiology Unit Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 00189, Rome, Italy
| | - Leonardo Sechi
- Division of Internal Medicine, Department of Experimental and Clinical Pathology and Medicine, University of Udine, Udine, Italy
| | - Giuliano Tocci
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00189, Rome, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, 00189, Rome, Italy
| | - Vito Vulpis
- Department of Medicine "Pende-Ferrannini", Bari University Hospital, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Claudio Ferri
- Internal Medicine and Nephrology Unit, ESH Excellence Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, Department of Clinical Medicine, Public Health, Life and Environmental Sciences, G. Petrini str., 67100, L'Aquila, Italy.
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12
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Abid L, Hammami R, Chamtouri I, Drissa M, Boudiche S, Bahloul M, BenSlima H, Sayahi K, Charfeddine S, Allouche E, Rais L, Kaab B, IbnHadjamor H, BenFatma L, Garbaa R, Boukhris S, Halima MB, Amdouni N, Ghorbel C, Soudani S, Khaled I, Triki S, Bouazizi F, Jemai I, Abdeljalil O, Ammar Y, Farah A, Neji A, Oumayma Z, Seghaier S, Mokrani S, Thawaba H, Sarray H, Ouaghlani K, Thabet H, Mnif Z, Boujelban F, Sghaier M, Khalifa R, Fourati S, Kammoun Y, Abid S, Hamza C, Jeddou SB, Sabbah L, Lakhdhar R, Dammak N, Sellami T, Herbegue B, Koubaa A, Triki F, Ellouz T, Hmoudi A, BenAmeur I, Boukhchina M, Abid N, Wachtati W, Nasrallah N, Houidi Y, Meghaieth F, Ghodhbane E, Chayeb M, Chenik S, Kaabachi S, Saadaoui N, BenAmeur I, Affes M, Ouali S, Chaker M, Naanaa H, Dghim M, Jarrar M, Mnif J, Turki A, Zairi I, Langar J, Dardouri S, Hchaichi I, Chettaoui R, Essmat W, Chakroun A, Mzoughi K, Mechmeche R, BenHalima A, BenKhala S, Chtourou S, Maalej A, Ayari M, Hadrich M, Tlili R, Azaiez F, Bouhlel I, Sahnoun S, Jerbi H, BenMrad I, Riahi L, Sahnoun M, BenJemaa A, BenSalem A, Rekik B, BenDoudou M, Boujneh R, Joulak A, Mejdoub Y, Gtif I, Jribi G, Naffeti E, Gamra H, BenYousef S, Sdiri W, BenHalima N, BenAmeur Y, Kachboura S, Kraiem S, Fehri W, Bazdeh L, Mourali M, Milouchi S, Drissa H, Maatouk F, Zakhama L, Addad F, Kammoun S, Abdesselem S. Epidemiologic features and management of hypertension in Tunisia, the results from the Hypertension National Registry (NaTuRe HTN). BMC Cardiovasc Disord 2022; 22:131. [PMID: 35351007 PMCID: PMC8966189 DOI: 10.1186/s12872-022-02584-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertension is the leading cause of morbi-mortality in our country. Thus, we conducted this national survey on hypertension to analyze the profile of the Tunisian hypertensive patient and to assess the level of blood pressure control. METHODS Nature HTN is an observational multicentric survey, including hypertensive individuals and consulting their doctors during the period of the study. Blood pressure measurements were conducted during consultation, using a standardized auscultatory or oscillometric sphygmomanometer after at least 15 min of rest. The diagnosis of new hypertension is based on the 2018 ESC/ESH criteria. The primary endpoint of our study was uncontrolled hypertension defined by a systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. RESULTS Three hundred twenty-one investigators participated in the study. We enrolled 25,890 patients with a female predominance (Sex ratio, 1.21) and an average age of 64.4 ± 12.2 years. Most individuals were treated in the public sector (74%), 39.4% of patients were diabetic, 25.8% were obese, 44.6% were overweight and 14% were smokers. Hypertension was controlled in 51.7% of cases if we consider 140/90 as a BP target, and only in 18.6% if we consider 130/80 as a target. The independent predictors of uncontrolled blood pressure were male sex (OR = 1.09, 95%CI [1.02-1.16]), age > 65 year-old (OR = 1.07, 95% CI[1.01-1.13], diabetes (OR = 1.18, 95% CI [1.11-1.25], Smoking (OR = 1.15, 95% CI [1.05-1.25]), Obesity (OR = 1.14, 95% CI[1.07-1.21]), management in public sector (OR = 1.25, 95% CI [1.16-1.34]), and Heart rate > 80 bpm (OR = 1.59, 95% CI [1.48-1.71]). Contrarily, high educational level (OR = 0.9, 95% CI [0.84-0.97], absence of history of coronary disease (OR = 0.86, 95% CI [0.8-0.93]), salt restriction (OR = 0.48, 95% CI [0.45-0.51]), drug compliance (OR = 0.57, 95% CI[0.52-0.61]), and regular physical activity (OR = 0.77, 95% CI[0.71-0.84]) are strong predictors of blood pressure control. CONCLUSION NaTuRe HTN showed that blood pressure control was reached in more than half of the Tunisian people. The control remains low in patients with high cardiovascular profiles and in those treated in the public sector. A national health program based on therapeutic education, regular control and continuous support to the public institutions is needed to decrease the burden of hypertension incidence rate.
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Affiliation(s)
- Leila Abid
- Tunisian Society of Cardiology and Cardiovascular Surgery, Tunis, Tunisia.
| | - Rania Hammami
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Ikram Chamtouri
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Meriam Drissa
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | - Selim Boudiche
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | | | - Hedi BenSlima
- Cardiology Department, Hospital of Menzel Bourguiba, Bizerte, Tunisia
| | - Khaled Sayahi
- Cardiology Department, ElKef Hospital, Elkef, Tunisia
| | - Selma Charfeddine
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Emna Allouche
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - Lamia Rais
- Nephrology Department, La Rabta University Hospital, Tunis, Tunisia
| | - Badr Kaab
- Nephrology Department, La Rabta University Hospital, Tunis, Tunisia
| | | | - Lilia BenFatma
- Nephrology Department, La Rabta University Hospital, Tunis, Tunisia
| | | | - Sabrine Boukhris
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | - Manel Ben Halima
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | - Nesrine Amdouni
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Chaima Ghorbel
- Cardiology Department, Habib Bourguiba Hospital, Medenine, Tunisia
| | - Sabrine Soudani
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | | | - Syrine Triki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | - Imen Jemai
- Habib Bourguiba Hospital, Medenine, Tunisia
| | - Ouday Abdeljalil
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | - Amani Farah
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | - Zeineb Oumayma
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | | | | | | | - Hela Sarray
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Khalil Ouaghlani
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - Houssem Thabet
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | | | | | - Roueida Khalifa
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | | | - Yasmin Kammoun
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | | | - Syrine Ben Jeddou
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | | | | | - Najla Dammak
- Nephrology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | | | | | - Faten Triki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Tarek Ellouz
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | | | | | | | - Wejdene Wachtati
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | | | | | - Fathia Meghaieth
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | | | | | - Sarra Chenik
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | | | | | | | | | - Sana Ouali
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | - Mouna Chaker
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | | | - Meriem Dghim
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | | | | | - Ahmed Turki
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Ihsen Zairi
- Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Safa Dardouri
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | | | | | | | - Khadija Mzoughi
- Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia
| | | | - Afef BenHalima
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Ariana, Tunisia
| | | | | | | | | | | | - Rami Tlili
- Cardiology Department, Mongi Slim Hospital, Tunis, Tunisia
| | - Fares Azaiez
- Cardiology Department, Mongi Slim Hospital, Tunis, Tunisia
| | - Imen Bouhlel
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | | | | | | | - Leila Riahi
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | | | | | - Amel BenSalem
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - Bassem Rekik
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | | | | | | | - Yosra Mejdoub
- Community Medicine Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
| | - Imen Gtif
- Laboratory of Screening Cellular and Molecular Process, Centre of Biotechnology of Sfax, Sfax, Tunisia
| | - Gouider Jribi
- Cardiology Department, Farhat Hached Hospital, Sousse, Tunisia
| | - Elyes Naffeti
- Cardiology Department, University Hospital Sahloul, Sousse, Tunisia
| | - Habib Gamra
- Cardiology Department A, Fatouma Bourguiba Hospital, Monastir, Tunisia
| | - Soraya BenYousef
- Cardiology Department, Internal Security Forces Hospital, Tunis, Tunisia
| | - Wissem Sdiri
- Cardiology Department, Bougatfa Hospital, Bizerte, Tunisia
| | - Najeh BenHalima
- Cardiology Department, Ibn El Jazzar Hospital, Kairouan, Tunisia
| | | | - Salem Kachboura
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Ariana, Tunisia
| | - Sondes Kraiem
- Cardiology Department, Habib Thameur Hospital, Tunis, Tunisia
| | - Wafa Fehri
- Cardiology Department, The Main Military Instruction Hospital of Tunis, Tunis, Tunisia
| | - Leila Bazdeh
- Cardiology Department, Charles Nicole University Hospital, Tunis, Tunisia
| | - MohamedSami Mourali
- Cardiology Department, La Rabta 1 (Pr Mourali) University Hospital, Tunis, Tunisia
| | - Sami Milouchi
- Cardiology Department, Habib Bourguiba Hospital, Medenine, Tunisia
| | - Habiba Drissa
- Cardiology Department, La Rabta 2 (Pr Drissa) University Hospital, Tunis, Tunisia
| | - Faouzi Maatouk
- Cardiology Department B, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Lilia Zakhama
- Cardiology Department, Internal Security Forces Hospital, Tunis, Tunisia
| | - Faouzi Addad
- Cardiology Department, Abderrahmen Mami-Ariana Hospital, Ariana, Tunisia
| | - Samir Kammoun
- Cardiology Department, Hedi Chaker-Sfax University Hospital, Sfax, Tunisia
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