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Jiang M, Pan Z, George J, Eslam M. Clinical features and mortality outcomes of patients with MASLD only compared to those with MAFLD and MASLD. Hepatol Int 2024:10.1007/s12072-024-10721-2. [PMID: 39196505 DOI: 10.1007/s12072-024-10721-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/08/2024] [Indexed: 08/29/2024]
Abstract
BACKGROUND AND AIMS The applicability of the proposed metabolic dysfunction-associated steatotic liver disease (MASLD) definition has not been validated. We aimed to characterize the profiles and long-term survival of people meeting the criteria for MASLD, but not that of metabolic dysfunction-associated fatty liver disease (MAFLD), i.e. MASLD only. METHODS Using data from the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, 7791 adult participants were included and categorized into four distinct groups: no SLD, non-MAFLD MASLD, MASLD-MAFLD, and cryptogenic SLD (steatosis without metabolic dysfunction). RESULTS Participants in the MASLD-only group were younger and had better metabolic profiles and fibrosis degree compared to those with MASLD-MAFLD and those with no SLD. Their profiles were comparable to those with cryptogenic SLD. Similarly, the MASLD-only group tend to have lower cumulative incidence of all-cause and cardiovascular mortality. Clustering analysis showed that MASLD only clusters differently from individuals with MASLD-MAFLD. CONCLUSIONS MASLD only is a distinct clinical group with substantial heterogeneity compared to those captured using the MAFLD criteria.
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Affiliation(s)
- Mingqian Jiang
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, 2145, Australia
- Department of Endocrinology and Metabolism, People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Ziyan Pan
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, 2145, Australia
| | - Jacob George
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, 2145, Australia
| | - Mohammed Eslam
- Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, 2145, Australia.
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Gallagher BD, Moreno JO. Can a Bedside Measure of Visceral Adiposity Predicts Progression of Prehypertension to Hypertension? Am J Hypertens 2024; 37:546-548. [PMID: 38708566 DOI: 10.1093/ajh/hpae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/01/2024] [Indexed: 05/07/2024] Open
Affiliation(s)
- Benjamin D Gallagher
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jorge O Moreno
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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Gower B, Blacket C, Girard D, Boyle T, Davison K. Prospective associations between systolic blood pressure, serum cholesterol, and physical activity behaviour and the development of cardiovascular disease. Prev Med 2024; 183:107958. [PMID: 38657686 DOI: 10.1016/j.ypmed.2024.107958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/22/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
AIMS To systematically appraise and summarise meta-analyses of longitudinal studies to determine the effect size, and quality and certainty of the evidence summaries for systolic blood pressure (SBP), serum cholesterol, and physical activity behaviour in developing cardiovascular disease (CVD). METHODS AND RESULTS An umbrella review was conducted by searching MEDLINE, Embase, and Scopus databases. Eligible meta-analyses were longitudinal studies investigating the association between SBP, serum cholesterol, or physical activity behaviour on CVD development. Summary risk estimates were extracted. Quality and certainty of the evidence summaries of included records were performed using AMSTAR 2 and GRADE, respectively. Forty-one eligible records were found of which thirteen related to SBP, five to cholesterol, and twenty-three to physical activity behaviour. The quality and certainty of the evidence summaries were variable, with most studies rating 'low'. Reported risk estimates for the risk of developing CVD ranged from: no change to a 68% decreased risk for lower SBP; a 21% increased risk to a 44% decreased risk for lower cholesterol; and a 1% decreased risk to a 56% decreased risk for higher physical activity levels. CONCLUSIONS There were strong associations with CVD risk at the meta-analysis level for all three exposures, with a proportionally greater number of meta-analyses and primary studies for physical activity than SBP or serum cholesterol. Given the number of meta-analyses and similar CVD risk reductions and certainty of evidence associated with physical activity behaviour, there is a strong case for its routine assessment alongside SBP and serum cholesterol in primary CVD prevention.
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Affiliation(s)
- Bethany Gower
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia.
| | - Chloe Blacket
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia
| | - Danielle Girard
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia
| | - Terry Boyle
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; University of South Australia, Australian Centre for Precision Health, Adelaide, Australia
| | - Kade Davison
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Adelaide, Australia
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Dimitrijev I, Radovanovic S, Vesic Z, Colakovic G, Selakovic V, Lackovic A, Djordjevic SS, Pesic M, Nesovic D, Lazarevic R, Djordjevic O, Mihaljevic O, Obradovic A, Vukicevic V, Janicijevic N, Radovanovic J. Demographic and Socioeconomic Predictors of Prehypertension and Hypertension in the Adult Population: Serbian National Health Survey. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:824. [PMID: 38793007 PMCID: PMC11122849 DOI: 10.3390/medicina60050824] [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: 03/11/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: Prehypertension and hypertension are the most common cardiovascular disorders worldwide and are increasingly considered one of the most serious public health problems, particularly in developing countries. The objective of this study was to determine the frequency and demographic and socioeconomic predictors of prehypertension and hypertension in the adults in Serbia, and to examine the relationship between prehypertension and hypertension and health behavior determinants (smoking, alcohol use, physical activity) and individual aspects of health (a health self-assessment, multimorbidity, BMI, depressive symptoms). Materials and Methods: The research is part of the fourth National Population Health Survey conducted in 2019, which was conducted by the Republic Institute of Statistics, in cooperation with the Institute of Public Health of Serbia and the Ministry of Health of the Republic of Serbia. As a research instrument, questionnaires were used in accordance with the methodology of the European Health Survey. For the purposes of this research, data on the adult population aged 20 and over were used. Results: Women are at a reduced risk for both prehypertension (OR = 0.328) and hypertension (OR = 0.349) by nearly 70%. Similarly, those aged below 60 years have a lower risk for prehypertension and those younger than 40 years have a lower risk for hypertension (OR = 0.995), whereas people with a lower education have a 4.3 times higher risk of prehypertension (OR = 4.323) and a 1.6 times higher risk of hypertension (OR = 1.614). The poor have a 1.4 times higher risk of prehypertension (OR = 1.413) and a 1 times higher risk of hypertension (OR = 1.035). People with multimorbidity have a 1.2 times higher risk of both prehypertension (OR = 1.218) and a 4.8 times higher risk of hypertension (OR = 4.867). Conclusions: Male gender, lower education, poverty, age and the presence of multimorbidity are significant predictors of prehypertension and hypertension in the Serbian adult population, so preventive strategies should be aimed at these sensitive population groups.
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Affiliation(s)
- Igor Dimitrijev
- Department of the High School of Health, Academy of Applied Studies Belgrade, 11000 Belgrade, Serbia; (I.D.); (S.S.D.)
| | - Snezana Radovanovic
- Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Institute for Public Health Kragujevac, 34000 Kragujevac, Serbia
- Center for Research on Harmfull Effects of Biological and Chemical Hazards, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Zoran Vesic
- Faculty of Political Sciences, University of Belgrade, 11000 Belgrade, Serbia;
| | - Goran Colakovic
- Institute for Emergency Medicine of Belgrade, 11000 Belgrade, Serbia; (G.C.); (A.O.); (V.V.)
| | - Viktor Selakovic
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (V.S.); (M.P.); (J.R.)
| | - Ana Lackovic
- Health Center “Dr Milutin Ivković” Palilula, 11000 Belgrade, Serbia;
| | - Slavica S. Djordjevic
- Department of the High School of Health, Academy of Applied Studies Belgrade, 11000 Belgrade, Serbia; (I.D.); (S.S.D.)
| | - Maja Pesic
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (V.S.); (M.P.); (J.R.)
| | - Danijela Nesovic
- Clinical Hospital Center Zemun, Surgery Clinic, Baromedicine Department, 11000 Belgrade, Serbia;
| | | | - Ognjen Djordjevic
- Department of Epidemiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Olgica Mihaljevic
- Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Aleksandra Obradovic
- Institute for Emergency Medicine of Belgrade, 11000 Belgrade, Serbia; (G.C.); (A.O.); (V.V.)
| | - Verica Vukicevic
- Institute for Emergency Medicine of Belgrade, 11000 Belgrade, Serbia; (G.C.); (A.O.); (V.V.)
| | - Nikoleta Janicijevic
- Department of Hygiene and Ecology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
| | - Jovana Radovanovic
- Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia; (V.S.); (M.P.); (J.R.)
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Goel A, Goel P. Investigating the Relationship Between Hypertension and Obesity in Schoolchildren From Lower-Middle Socioeconomic Strata in Urban Mumbai. Cureus 2024; 16:e55203. [PMID: 38558667 PMCID: PMC10980969 DOI: 10.7759/cureus.55203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Background In light of escalating rates of childhood obesity, understanding the gender-specific correlation between body mass index (BMI) and hypertension has become crucial for effective public health interventions. This study investigates the interplay between BMI and hypertension among school-aged children, with a particular emphasis on gender stratification to identify distinct trends. Methodology A cross-sectional study was conducted with a diverse sample of 702 schoolchildren aged 5-16 years from a lower-middle-income school in urban Mumbai. This cohort consisted of 491 boys and 211 girls within the gender subset. BMI was calculated using height and weight measurements, while blood pressure readings determined hypertension prevalence. The children were categorized based on the Indian Academy of Pediatrics (IAP) growth chart BMI calculations and blood pressure percentiles. SPSS Statistics version 23 (IBM Corp., Armonk, NY, USA) was used for data analysis. Data were analyzed using the chi-square test, with p-values <0.05 deemed significant. Results The overall prevalence of overweight was 16.52%, with 15.89% in boys and 18.10% in girls, revealing no significant gender difference (p = 0.487). In terms of obesity, the overall prevalence was 10.83%, with 10.99% in boys and 10.34% in girls, revealing no significant gender difference (p = 0.823). The prevalence of pre-hypertension was 7%, exhibiting a significantly higher prevalence in high BMI males (overweight and obese) versus non-high BMI males (normal and underweight) (p < 0.001); however, no such difference was observed in females (p = 0.289). The prevalence of hypertension was 15.95% with a significantly higher prevalence in high BMI males (overweight and obese) versus non-high BMI males (normal and underweight) (p < 0.001) and high BMI females (overweight and obese) versus non-high BMI females (normal and underweight) (p < 0.001). Hypertension was significantly higher in children with high BMI (overweight and obese) compared to their non-high BMI (normal and underweight) counterparts. Conclusions In lower-middle socioeconomic strata schoolchildren in urban Mumbai, the prevalence of obesity and hypertension was alarmingly high, attributed to shifting lifestyles and unhealthy dietary habits. Hypertension rates were notably elevated among overweight and obese individuals compared to normal and underweight individuals. More than a third of both boys and girls with obesity were diagnosed with hypertension, emphasizing a concerning surge in hypertension cases among children. Prioritizing age-specific blood pressure assessments can facilitate early identification and timely interventions.
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Affiliation(s)
- Ashish Goel
- Department of Cardiology, Fayth Clinic Medical Institute, Mumbai, IND
| | - Paula Goel
- Department of Pediatrics, Fayth Clinic Medical Institute, Mumbai, IND
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Sheng CS, Wang H, Liu Y, Li Y, Hou T, Qiu M, Lu Y, Sun S, Yang J, Song X, Ning G, Tian J. Long-term effects of blood pressure 130-139/80-89 mmHg on all-cause and cardiovascular mortality among Chinese adults with different glucose metabolism. Cardiovasc Diabetol 2023; 22:353. [PMID: 38129837 PMCID: PMC10740290 DOI: 10.1186/s12933-023-02088-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND This study aimed to investigate the risks of all-cause and cardiovascular mortality associated with blood pressure (BP) levels of 130-139/80-89 mmHg in Chinese adults with different glucose metabolism, during a long-term follow-up of over 20 years. METHODS A prospective population-based cohort of 2,132 adults in Shanghai was established in 2002 and followed for 21 years. The association between BP categories and mortality was assessed, and the risk was further analyzed using multiple Cox regression analysis by combining BP and blood glucose categories. RESULTS The final analysis included 2,004 participants, with 397 all-cause and 166 cardiovascular mortality. The incidence of all-cause and cardiovascular mortality per 1,000 person-years for different BP categories were as follows: BP < 130/80 mmHg (4.5 and 1.3), 130-139/80-89 mmHg (7.7 and 2.9), and ≥ 140/90 mmHg or treated groups (19.9 and 8.7), respectively. After adjusting for age, sex, and other factors, BP ≥ 140/90 mmHg was significantly associated with a higher risk of mortality across different blood glucose categories. However, using BP < 130/80 mmHg and normoglycemia as the reference, a BP of 130-139/80-89 mmHg was significantly associated with higher risks of all-cause (hazard ratio 3.30 [95% confidence interval 1.48-7.38], P < 0.01) and cardiovascular mortality (9.60 [1.93-47.7], P < 0.01) in diabetes, but not in those with normoglycemia or prediabetes. CONCLUSIONS BP of 130-139/80-89 mmHg may lead to a significantly higher risk of all-cause and cardiovascular mortality in Chinese adults with diabetes, but not in those with normoglycemia or prediabetes. This suggests that the targeted BP for people with diabetes should be < 130-139/80-89 mmHg.
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Affiliation(s)
- Chang-Sheng Sheng
- Department of Cardiovascular Medicine, Center for Epidemiological Studies and Clinical Trials, Center for Vascular Evaluation, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Haiyan Wang
- Pingliang Community Health Service Center, Yangpu District, Shanghai, China
- Acute infectious disease control Department, Shanghai Hongkou Center for Disease Control and Prevention, Shanghai, China
| | - Yanjun Liu
- College of Food Science and Engineering, Ocean University of China, Qingdao, Shandong Province, China
| | - Yanyun Li
- Division of Chronic Non-Communicable Disease and Injury, Shanghai municipal center for disease control and prevention, Shanghai, 200336, China
| | - TianZhiChao Hou
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Miaoyan Qiu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yao Lu
- Department of Endocrinology, Xinhua Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200092, China
| | - Siming Sun
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junhan Yang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaomin Song
- Department of Endocrinology and metabolism, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jingyan Tian
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Chou YT, Chen HY, Shen WC, Wu IH, Su FL, Lee WH, Hsu HL, Tai JT, Li CY, Chao TH. Blood pressure levels within normotensive range are independently associated with increased risk of arterial stiffness in adults without hypertension or prehypertension. Nutr Metab Cardiovasc Dis 2023; 33:2363-2371. [PMID: 37788952 DOI: 10.1016/j.numecd.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/30/2023] [Accepted: 08/13/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND AND AIMS High blood pressure (BP) indices, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) predict cardiovascular diseases and mortality. However, the association of these BP indices with arterial stiffness (AS) in the normotensive population (BP < 120/80 mmHg) remains unclear. METHODS AND RESULTS Study participants who underwent health checkups at a tertiary referred center were recruited between November 2018 to December 2019. 2129 participants were enrolled after excluding those aged <18 years old, with elevated BP, history of hypertension, cardiovascular disease, and stroke, or with incomplete data. The brachial-ankle pulse wave velocity (baPWV) values were examined for evaluation of AS. Participants with higher blood pressure indices had significantly higher baPWV. Multiple linear regression revealed that all BP indices were positively associated with baPWV. According to the binary logistic regression analysis, participants in the higher SBP and MAP quartiles were significantly related to AS. The odds ratio (OR) for SBP Q2, Q3 and Q4 vs. Q1 were 6.06, 10.06 and 17.78 whereas the OR for MAP Q2, Q3 and Q4 vs. Q1 were: 5.07, 5.28 and 10.34. For DBP and PP, only participants belonging to the highest quartile were associated with AS(OR for DBP Q4 vs. Q1: 2.51; PP Q4 vs Q1: 1.94). CONCLUSIONS BP indices were linearly related to the baPWV. Normotensive participants with higher quartiles of SBP, DBP, MAP, and PP, remained associated with increased AS. The SBP and MAP levels exhibited a more prominent relationship with AS.
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Affiliation(s)
- Yu-Tsung Chou
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Yu Chen
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Chen Shen
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - I-Hsuan Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fei-Lin Su
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Huang Lee
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Lung Hsu
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Gastroenterology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jui-Ting Tai
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Ting-Hsing Chao
- Department of Health Management Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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8
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Divison-Garrote JA, Carbayo-Herencia JA, Simarro-Rueda M, Molina-Escribano F, Escobar-Cervantes C, Artigao-Rodenas LM, Gil-Guillén V, Banegas JR. Prognosis of Systolic Pressure 130 to 139 According to Risk. A Prospective Cohort Study Between 1992 and 2019. Hypertension 2023; 80:2485-2493. [PMID: 37694400 DOI: 10.1161/hypertensionaha.123.21732] [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: 06/25/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Guidelines recommend pharmacological treatment for systolic blood pressure (SBP) of 130 to 139 mm Hg in secondary prevention. However, uncertainty persists in primary prevention in low cardiovascular risk patients (CVR). METHODS Cohort study representative of the general population of Albacete/Southeast Spain. We examined 1029 participants with untreated blood pressure and free of cardiovascular disease, followed-up during 1992 to 2019. Cox regression modeled the association of SBP with cardiovascular morbidity and mortality (outcome-1) and cardiovascular morbidity and all-cause mortality (outcome-2). RESULTS Participants' mean age was 44.8 years (53.8%, women; 77.1% at low-CVR); 20.3% had SBP 120 to 129; 13.0% 130 to 139 at low-CVR and 3.4% at high-CVR; and 27.4% ≥140 mm Hg. After a 25.7-year median follow-up, 218 outcome-1 and 302 outcome-2 cases occurred. Unadjusted hazard ratios of outcome-1 for these increasing SBP categories (versus <120) were 2.72, 2.27, 11.54, and 7.52, respectively; and 2.69, 2.32, 10.55, and 7.34 for outcome-2 (all P<0.01). After adjustment for other risk factors, hazard ratio (95% CI) of outcome-1 were 1.49 (0.91-2.44), 1.65 (0.94-2.91, P=0.08), 1.36 (0.72-2.57), and 1.82 (1.15-2.88), respectively, and 1.39 (0.91-2.11), 1.69 (1.05-2.73), 1.09 (0.63-1.88), and 1.64 (1.11-2.41) for outcome-2. Compared with 130 to 139 at low-CVR, hazard ratio for 130 to 139 at high-CVR was 4.85 for outcome-1 (P<0.001) and 4.43 for outcome-2 (P<0.001). CONCLUSIONS In this primary prevention population of relatively young average age, untreated SBP of 130 to 139 mm Hg at low-CVR had long-term prognostic value and might benefit from stricter SBP targets. High-CVR patients had nonsignificant higher risk (limited sample size) but 4-fold greater risk when compared with low-CVR. Overall, results indicate the importance of risk stratification, supporting risk-based decision-making.
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Affiliation(s)
- Juan A Divison-Garrote
- Casas Ibáñez Primary Care Center (J.A.D.-G., F.M.-E.), Atención Primaria Albacete, Spain
- Department of Medicine, Universidad Católica de Murcia (UCAM), Spain (J.A.D.-G.)
- GEVA (Grupo Enfermedades Vasculares Albacete), Spain (J.A.D.-G., J.A.C.-H., M.S.-R., F.M.-E., L.M.A.-R., V.G.-G., J.R.B.)
| | - Julio A Carbayo-Herencia
- GEVA (Grupo Enfermedades Vasculares Albacete), Spain (J.A.D.-G., J.A.C.-H., M.S.-R., F.M.-E., L.M.A.-R., V.G.-G., J.R.B.)
- Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Alicante, Spain (J.A.C.-H., V.G.-G.)
| | - Marta Simarro-Rueda
- Villamalea Primary Care Center (M.S.-R.), Atención Primaria Albacete, Spain
- GEVA (Grupo Enfermedades Vasculares Albacete), Spain (J.A.D.-G., J.A.C.-H., M.S.-R., F.M.-E., L.M.A.-R., V.G.-G., J.R.B.)
| | - Francisca Molina-Escribano
- Casas Ibáñez Primary Care Center (J.A.D.-G., F.M.-E.), Atención Primaria Albacete, Spain
- GEVA (Grupo Enfermedades Vasculares Albacete), Spain (J.A.D.-G., J.A.C.-H., M.S.-R., F.M.-E., L.M.A.-R., V.G.-G., J.R.B.)
| | | | - Luis M Artigao-Rodenas
- GEVA (Grupo Enfermedades Vasculares Albacete), Spain (J.A.D.-G., J.A.C.-H., M.S.-R., F.M.-E., L.M.A.-R., V.G.-G., J.R.B.)
| | - Vicente Gil-Guillén
- Department of Clinical Medicine, Universidad Miguel Hernández de Elche, Alicante, Spain (J.A.C.-H., V.G.-G.)
- Institute of Health and Biomedical Research of Alicante, Hospital General Universitario de Alicante, Spain (V.G.-G.)
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain (V.G.-G.)
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz and CIBERESP, Madrid, Spain (J.R.B.)
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9
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Zhang J, Jia L, Zhu T, Zhu H, Shu L. The relationship and interaction between triglyceride glucose index and obesity in the risk of prehypertension population: a cross-sectional study from a survey in Anhui, Eastern China. BMC Cardiovasc Disord 2023; 23:336. [PMID: 37393221 PMCID: PMC10314550 DOI: 10.1186/s12872-023-03365-x] [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: 03/28/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index has been regarded as an effective proxy of Insulin resistance (IR). Studies on the TyG index, obesity and the risk of prehypertension (PHT) in elderly people are not apparent currently. The study sought to investigate the predictive value of TyG index and the associations with PHT risk and obesity. METHODS A community-based cross-sectional study was conducted in Bengbu City, Anhui province, China. Participants older than 65 years accepted questionnaire surveys, physical examinations and blood biochemistry tests. Based on the testing results, indicators including BMI (body mass index), WC (waist circumference), WHtR (waist-to-height-ratio), LAP(Lipid accumulation products) and TyG were calculated. Residents were classified into quartiles by their TyG indexes. Receiver operating characteristic curve (ROC) analysis was carried out to predict obesity indices for PHT. The three additive interaction indicators, RERI (relative excess risk due to interaction), AP (attributable proportion due to interaction) and S (synergy index) were used to assess the interaction impacts. RESULTS Two thousand six hundred sixty-six eligible elderly people were included in study and the prevalence of PHT was 71.04% (n = 1894). With increasing TyG index quartile, PHT became more prevalent. After adjusting for confounding factors, the prevalence of PHT risk with TyG levels in the fourth quartile (Q4, male: 2.83, 95%CI: 1.77-4.54; female: 2.75, 95%CI:1.91-3.97) was greater than that in the first quartile (Q1:ref). TyG index (AUC: 0.626, 95%CI: 0.602 to 0.650) was superior than BMI (AUC: 0.609, 95%CI: 0.584 to 0.633) in predicting PHT among females. Eventually, there were significant interactions of TyG index with obesity in males (General obesity: AP = 0.87, 95%CI: 0.72 to 1.02, S = 10.48, 95%CI: 3.43 to 31.97; Abdominal obesity: AP = 0.60,95%CI: 0.38 to 0.83, S = 3.53, 95%CI: 1.99 to 6.26) and females (General obesity: AP = 0.89, 95%CI: 0.79 to 0.98, S = 12.46, 95%CI: 5.61 to 27.69; Abdominal obesity: AP = 0.66, 95%CI: 0.51 to 0.82, S = 3.89, 95%CI:2.54 to 5.98). CONCLUSION TyG index and PHT risk are tightly correlated. The risk of chronic disease in the elderly can be decreased by early detection of PHT utilizing the TyG index. In this research, the TyG index was more predictable than other indicators of obesity.
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Affiliation(s)
- Jiaye Zhang
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Linlin Jia
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Tongying Zhu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Hao Zhu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Li Shu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
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10
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Elfassy T, German C, Muntner P, Choi E, Contreras G, Shimbo D, Yang E. Blood Pressure and Cardiovascular Disease Mortality Among US Adults: A Sex-Stratified Analysis, 1999-2019. Hypertension 2023; 80:1452-1462. [PMID: 37254774 PMCID: PMC10330349 DOI: 10.1161/hypertensionaha.123.21228] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/03/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Most research examining the association between blood pressure (BP) and cardiovascular disease (CVD) is sex-agnostic. Our goal was to assess sex-specific associations between BP and CVD mortality. METHODS We combined ten cycles of the National Health and Nutrition Examination Survey (1999-2018), N=53 289. Blood pressure was measured 3× and averaged. Data were linked to National Death Index data, and CVD mortality through December 31, 2019, was defined from International Classification of Diseases, Tenth Revision codes. We estimated sex-stratified, multivariable-adjusted incidence rate ratios (IRRs) for CVD mortality. RESULTS Over a median follow-up of 9.5 years, there were 2405 CVD deaths. Associations between categories of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with CVD mortality differed by sex (P<0.01). Among men, compared with SBP of 100 to <110 mm Hg, CVD mortality was 76% higher with SBP ≥160 mm Hg (IRR, 1.76 [95% CI, 1.27-2.44]). Among women, compared with SBP 100 to < 110 mm Hg, CVD mortality was 61% higher with SBP 130 to 139 mm Hg (IRR, 1.61 [95% CI, 1.02-2.55]), 75% higher with SBP 140 to 159 mm Hg (IRR, 1.75 [95% CI, 1.09-2.80]), and 113% higher with SBP≥160 mm Hg (IRR, 2.13 [95% CI, 1.35-3.36]). Compared with DBP 70 to <80 mm Hg, CVD mortality was higher with DBP <70 mm Hg and DBP≥80 mm Hg among men, and higher with DBP <50 mm Hg and DBP≥80 mm Hg among women. CONCLUSIONS The association between BP and CVD mortality differed by sex, with increased CVD mortality risk present at lower levels of systolic blood pressure among women compared with men.
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Affiliation(s)
- Tali Elfassy
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL
| | - Charles German
- Department of Medicine, University of Chicago Medicine, Chicago, IL
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham AL
| | - Eunhee Choi
- Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Gabriel Contreras
- Katz Family Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL
| | - Daichi Shimbo
- Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Eugene Yang
- Division of Cardiology, University of Washington School of Medicine, Seattle, WA
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11
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Purnell JQ. What is Obesity?: Definition as a Disease, with Implications for Care. Gastroenterol Clin North Am 2023; 52:261-275. [PMID: 37197872 DOI: 10.1016/j.gtc.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Advances in the understanding of weight regulation provide the framework for the recognition of obesity as a chronic disease. Lifestyle approaches are foundational in the prevention of obesity and should be continued while weight management interventions, including antiobesity medications and metabolic-bariatric procedures, are offered to eligible patients. Clinical challenges remain, however, including overcoming obesity stigma and bias within the medical community toward medical and surgical approaches, ensuring insurance coverage for obesity management (including medications and surgery), and promoting policies that reverse the upward worldwide trend in obesity and adiposity complications in populations.
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Affiliation(s)
- Jonathan Q Purnell
- Knight Cardiovascular Institute and Division of Endocrinology, Diabetes, and Clinical Nutrition, Oregon Health & Science University, Mailcode: HRC5N, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA.
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12
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Moftakhar L, Rezaianzadeh A, Seif M, Ghoddusi Johari M, Hosseini SV, Dehghani SS. The effect of prehypertension and hypertension on the incidence of cardiovascular disease: A population-based cohort study in Kharameh, a city in the South of Iran. Health Sci Rep 2023; 6:e1264. [PMID: 37251525 PMCID: PMC10210051 DOI: 10.1002/hsr2.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Background and Aim Prehypertension and hypertension are important risk factors for cardiovascular diseases. This study was carried out to evaluate the effect of prehypertension and hypertension on the development of cardiovascular diseases. Methods This prospective cohort study was performed on 9442 people aged 40-70 in Kharameh, southern Iran. Individuals were divided into three groups: normal blood pressure (N = 5009), prehypertension (N = 2166), and hypertension (N = 2267). In this study, demographic data, disease histories, behavioral habits, and biological parameters were studied. At first, the incidence density was calculated. Then Firth's Cox regression models were used to investigate the association between prehypertension and hypertension with the incidence of cardiovascular diseases. Results The incidence density in the three groups of individuals with normal blood pressure, prehypertension, and hypertension was 1.33, 2.02, and 3.29 cases per 100,000 person-days, respectively. The results of multiple Firth's Cox regression by controlling all factors showed that the risk of occurrence of cardiovascular disease in people with prehypertension was 1.33 times (hazard ratio [HR] = 1.32, 95% confidence interval [CI]: 1.01-1.73, p = 0.03) and those with hypertension were 1.85 times higher (HR = 1.77, 95% CI: 1.38-2.29, p < 0.0001) than the individuals with normal blood. Conclusion Prehypertension and hypertension have played an independent role in the risk for developing cardiovascular diseases. Therefore, early detection of individuals with these factors and control of other risk factors in them can contribute to reducing the occurrence of cardiovascular diseases.
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Affiliation(s)
- Leila Moftakhar
- Student Research CommitteeShiraz University of Medical SciencesShirazIran
| | - Abbas Rezaianzadeh
- Colorectal Research CenterShiraz University of Medical ScienceShirazIran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Faculty of BiostatisticsShiraz University of Medical SciencesShirazIran
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13
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Turkson-Ocran RAN, Cluett JL, Fitzpatrick SL, Kraemer KM, McManus K, Mukamal KJ, Davis RB, Elborki M, Ferro K, Ismail N, Laura Aidoo E, Larbi Kwapong F, Castilla-Ojo N, Grobman B, Seager R, Hines AL, Miller ER, Crews DC, Juraschek SP. Rationale and Design of the Groceries for Black Residents of Boston to Stop Hypertension Among Adults Without Treated Hypertension (GoFresh) Trial. Am J Hypertens 2023; 36:256-263. [PMID: 37061794 PMCID: PMC11004932 DOI: 10.1093/ajh/hpad008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Poor diet quality significantly contributes to hypertension disparities affecting Black adults. While the Dietary Approaches to Stop Hypertension (DASH) eating pattern lowers blood pressure (BP), access to DASH-patterned groceries is a major barrier for residents of urban food deserts. METHODS The Groceries for Black Residents of Boston to Stop Hypertension among Adults without Treated Hypertension (GoFresh) study is one of five projects in the RESTORE Network, an AHA-funded initiative focused on hypertension prevention. GoFresh is testing whether online, dietitian-assisted, home-delivered, DASH-patterned groceries lowers BP among Black adults with elevated BP. This individual-level, parallel-arm trial will enroll up to 176 Black adults with SBP (systolic blood pressure) between 120 and <150 mm Hg residing in Boston-area communities with reduced grocery store access. Following randomization, half of the participants will be assigned to weekly sessions with a dietitian who will assist participants in ordering DASH-patterned groceries online for home delivery; the remainder will receive a $500 monthly stipend. Both interventions will last 3 months, followed by a 9-month maintenance phase. RESULTS The primary outcome is the difference in SBP after 3 months. Secondary outcomes include a change in 24-hour ambulatory BP, body mass index, 24-hour urine sodium and potassium, hemoglobin A1C, lipids, fruit and vegetable intake, and saturated fat intake. Qualitative interviews with 45 participants 6 months after baseline assessments will determine barriers and facilitators to long-term maintenance of DASH-patterned grocery shopping. DISCUSSION Findings from this study will inform ongoing work on scalable interventions to prevent hypertension among Black adults with implications for public and healthcare-based food supplementation programs. TRIAL REGISTRATION NCT05121337. Registered on 16 November 2021, at ClinicalTrials.gov: https://clinicaltrials.gov/ct2/show/NCT05121337.
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Affiliation(s)
- Ruth-Alma N Turkson-Ocran
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer L Cluett
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Kristen M Kraemer
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Kathy McManus
- Department of Nutrition, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Kenneth J Mukamal
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Roger B Davis
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Marwa Elborki
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Kayla Ferro
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Norah Ismail
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Emily Laura Aidoo
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Fredrick Larbi Kwapong
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | | | - Ben Grobman
- Harvard Medical School, Boston, Massachusetts, USA
| | - Reva Seager
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Anika L Hines
- Health Behaviour and Policy, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Edgar R Miller
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Deidra C Crews
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Stephen P Juraschek
- Division of General Medicine, Section for Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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14
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Rigonatto RRF, Vitorino PVO, Oliveira AC, Sousa ALL, Jardim PCBV, Cunha PMGM, Barbosa ECD, Xaplanteris P, Vlachopoulos C, Barroso WKS. SAGE Score in Normotensive and Pre-Hypertensive Patients: A Proof of Concept. Arq Bras Cardiol 2023; 120:e20200291. [PMID: 36856235 PMCID: PMC9972660 DOI: 10.36660/abc.20220291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 10/05/2022] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The SAGE score was developed to detect individuals at risk for increased pulse wave velocity (PWV). So far, studies have been focused on hypertensive patients. OBJECTIVE To assess the ability of the score to detect non-hypertensive and pre-hypertensive patients at risk for increased PWV. METHODS Retrospective cross-sectional study of analysis of central blood pressure data and calculation of the SAGE score of non-hypertensive and pre-hypertensive patients. Each score point was analyzed for sensitivity, specificity, positive and negative predictive values, using the cut-off point for positive diagnosis a PVW ≥ 10m/s, ≥9.08 m/s (75thpercentile) and ≥7.30 m/s (50thpercentile). A p<0.05 was considered statistically significant. RESULTS The sample was composed of 100 normotensive and pre-hypertensive individuals, with mean age of 52.64 ± 14.94 years and median PWV of 7.30 m/s (6.03 - 9.08). The SAGE score was correlated with age (r=0.938, p<0.001), glycemia (r=0.366, p<0.001) and glomerular filtration rate (r=-0.658, p<0.001). The area under the ROC curve was 0.968 (p<0.001) for PWV ≥ 10 m/s, 0.977 (p<0.001) for PWV ≥ 9.08 m/s and 0.967 (p<0.001) for PWV ≥ 7.30 m/s. The score 7 showed a specificity of 95.40% and sensitivity of 100% for PWV≥10 m/s. The cut-off point would be of five for a PWV≥9.08 m/s (sensitivity =96.00%, specificity = 94.70%), and two for a PWV ≥ 7.30 m/s. CONCLUSION The SAGE score could identify individuals at higher risk of arterial stiffness, using different PWV cutoff points. However, the development of a specific score for normotensive and pre-hypertensive subjects is needed.
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Affiliation(s)
- Rayne Ramos Fagundes Rigonatto
- Universidade Federal de GoiásPrograma de Pós-graduação em Ciências da SaúdeGoiâniaGOBrasilUniversidade Federal de Goiás – Programa de Pós-graduação em Ciências da Saúde, Goiânia, GO – Brasil,Pontifícia Universidade Católica de GoiásEscola de Ciências Sociais e da SaúdeGoiâniaGOBrasilPontifícia Universidade Católica de Goiás – Escola de Ciências Sociais e da Saúde, Goiânia, GO – Brasil
| | - Priscila Valverde Oliveira Vitorino
- Universidade Federal de GoiásPrograma de Pós-graduação em Ciências da SaúdeGoiâniaGOBrasilUniversidade Federal de Goiás – Programa de Pós-graduação em Ciências da Saúde, Goiânia, GO – Brasil,Pontifícia Universidade Católica de GoiásEscola de Ciências Sociais e da SaúdeGoiâniaGOBrasilPontifícia Universidade Católica de Goiás – Escola de Ciências Sociais e da Saúde, Goiânia, GO – Brasil,Universidade Federal de GoiásLiga de Hipertensão ArterialGoiâniaGOBrasilUniversidade Federal de Goiás – Liga de Hipertensão Arterial, Goiânia, GO – Brasil
| | - Adriana Camargo Oliveira
- Universidade Federal de GoiásPrograma de Pós-graduação em Ciências da SaúdeGoiâniaGOBrasilUniversidade Federal de Goiás – Programa de Pós-graduação em Ciências da Saúde, Goiânia, GO – Brasil
| | - Ana Luiza Lima Sousa
- Universidade Federal de GoiásPrograma de Pós-graduação em Ciências da SaúdeGoiâniaGOBrasilUniversidade Federal de Goiás – Programa de Pós-graduação em Ciências da Saúde, Goiânia, GO – Brasil,Universidade Federal de GoiásLiga de Hipertensão ArterialGoiâniaGOBrasilUniversidade Federal de Goiás – Liga de Hipertensão Arterial, Goiânia, GO – Brasil
| | - Paulo César Brandão Veiga Jardim
- Universidade Federal de GoiásPrograma de Pós-graduação em Ciências da SaúdeGoiâniaGOBrasilUniversidade Federal de Goiás – Programa de Pós-graduação em Ciências da Saúde, Goiânia, GO – Brasil,Universidade Federal de GoiásLiga de Hipertensão ArterialGoiâniaGOBrasilUniversidade Federal de Goiás – Liga de Hipertensão Arterial, Goiânia, GO – Brasil
| | | | - Eduardo Costa Duarte Barbosa
- Complexo Hospitalar Santa Casa de Misericórdia de Porto AlegrePorto AlegreRSBrasilComplexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS – Brasil
| | - Panagiotis Xaplanteris
- Université Libre de BruxellesCardiology DepartmentBruxelasBélgicaUniversité Libre de Bruxelles – Cardiology Department, Bruxelas – Bélgica,National and Kapodistrian University of AthensSchool of MedicineDepartment of CardiologyAtenasGréciaNational and Kapodistrian University of Athens School of Medicine – First University Department of Cardiology, Atenas – Grécia
| | - Charalambos Vlachopoulos
- National and Kapodistrian University of AthensSchool of MedicineDepartment of CardiologyAtenasGréciaNational and Kapodistrian University of Athens School of Medicine – First University Department of Cardiology, Atenas – Grécia
| | - Weimar Kunz Sebba Barroso
- Universidade Federal de GoiásPrograma de Pós-graduação em Ciências da SaúdeGoiâniaGOBrasilUniversidade Federal de Goiás – Programa de Pós-graduação em Ciências da Saúde, Goiânia, GO – Brasil,Universidade Federal de GoiásLiga de Hipertensão ArterialGoiâniaGOBrasilUniversidade Federal de Goiás – Liga de Hipertensão Arterial, Goiânia, GO – Brasil
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15
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Li X, Gao Y, Wu M, Wei D, Xiong X, Yang Y, Jiang Y, Pan X, Zhao R, Yang F, Sun J, Yang S, Tian L, Ban L, Li X, Chang P, Xing Y. Effect of Tai Chi versus aerobic exercise on blood pressure in prehypertension patients (TCOBPP): a study protocol for a 12-month single-blind randomized controlled trial. Trials 2022; 23:1001. [PMID: 36510218 PMCID: PMC9743705 DOI: 10.1186/s13063-022-06840-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 10/14/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Compared with optimal blood pressure (BP), the prehypertension increases the risk of incident hypertension, cardiovascular (CV) events, and death. Moderate intensity of regular physical activity can reduce BP. However, aerobic exercise has some limitations. As a safe, low-impact, enjoyable, and inexpensive form of exercise that requires minimal equipment and space, Tai Chi is expected as a viable alternative to aerobic exercise. The study aimed to assess the effect of Tai Chi intervention program, compared with aerobic exercise, on the BP in prehypertension patients. METHODS This study is a 12-month, two-center, single-blind, parallel, randomized controlled trial. Three hundred forty-two patients with prehypertension [with a systolic blood pressure (SBP) in the range of 120 mmHg to 139 mmHg and/or a diastolic blood pressure (DBP) in the range of 80 mmHg to 89 mmHg] are randomized to one of two intervention groups in a 1:1 ratio: Tai Chi or aerobic exercise. BP monitoring methods of office blood pressure, ambulatory blood pressure monitoring (ABPM), and home blood pressure monitoring (HBPM) are used at the same time to detect BP in multiple dimensions. The primary outcome is the comparison of SBP change from baseline to 12 months in Tai Chi group and SBP change from baseline to 12 months in aerobic exercise group. The secondary endpoints are as following: (1) the comparison of DBP of office blood pressure change from baseline to 12 months between Tai Chi group and aerobic exercise group, (2) the comparison of BP and the variability of BP assessed through ABPM change from baseline to 12 months between Tai Chi group and aerobic exercise group, (3) the comparison of BP assessed through HBPM change from baseline to 12 months between Tai Chi group and aerobic exercise group. DISCUSSION This will be the first randomized controlled trial to specifically study the benefits of Tai Chi on the blood pressure control in patients with prehypertension. The successful completion of this study will help to provide evidence for whether Tai Chi is more desirable than aerobic exercise. TRIAL REGISTRATION Trial registration number: Chinese Clinical Trial Registry, ChiCTR1900024368. Registered on 7 July 2019, http://www.chictr.org.cn/edit.aspx?pid=39478&htm=4.
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Affiliation(s)
- Xinye Li
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, 100029 China ,grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Yonghong Gao
- grid.412073.3Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Min Wu
- grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Dawei Wei
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, 100029 China ,grid.412073.3Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Xingjiang Xiong
- grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Yan Yang
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, 100029 China ,grid.412073.3Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Yuchen Jiang
- grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Xiandu Pan
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, 100029 China ,grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Ran Zhao
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, 100029 China ,grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Fan Yang
- grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Jiahao Sun
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, 100029 China ,grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Shengjie Yang
- grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Li Tian
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, 100029 China ,grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
| | - Linqiang Ban
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Xingye Li
- grid.24695.3c0000 0001 1431 9176Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Peifen Chang
- grid.412073.3Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Yanwei Xing
- grid.464297.aGuang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053 China
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16
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Shakil SS, Ojji D, Longenecker CT, Roth GA. Early Stage and Established Hypertension in Sub-Saharan Africa: Results From Population Health Surveys in 17 Countries, 2010-2017. Circ Cardiovasc Qual Outcomes 2022; 15:e009046. [PMID: 36252134 PMCID: PMC9771997 DOI: 10.1161/circoutcomes.122.009046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/19/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Multiple studies have reported a high burden of hypertension in sub-Saharan Africa, but none have examined early stage hypertension. We examined contemporary prevalence of diagnosed, treated, and controlled stage I (130-139/80-89 mm Hg) and II (≥140/90 mm Hg) hypertension in the general population of sub-Saharan Africa. METHODS We analyzed World Health Organization STEPwise Approach to Noncommunicable Disease Risk Factor Surveillance surveys from 17 sub-Saharan Africa countries including 85 371 respondents representing 85 million individuals from 2010 to 2017. We extracted demographic variables, blood pressure, self-reported hypertension diagnosis/awareness, and treatment status to estimate prevalence of stage I and II hypertension and treatment by country. We examined diagnosis and treatment trends by national sociodemographic index, a marker of development. RESULTS Stage I hypertension prevalence (regardless of diagnosis/treatment) was >25% in 13 of 17 countries, highest in Sudan (35.3% [95% CI, 33.7%-37.0%]), and lowest in Eritrea (20.2% [18.8%-21.6%]). Combined stages I and II hypertension prevalence was >50% in 13 countries; <20% were diagnosed in every country. Treatment among those diagnosed ranged from 26% to 63%, and control (<140/90 mm Hg) from 4% to 17%. In 8 of 9 countries reporting on behavioral interventions (eg, salt reduction, weight loss, exercise, and smoking cessation), <60% of diagnosed individuals received counseling. Rates of diagnosis, but not treatment, were positively associated with sociodemographic index (P=0.008), although there was substantial variation between countries even at similar levels of development. CONCLUSIONS Hypertension is common in sub-Saharan Africa but rates of diagnosis, treatment, and control markedly low. There is a large population with early stage hypertension that may benefit from behavioral counseling to prevent progression. Our analyses suggest that success in population hypertension care may be achieved independently of socioeconomic development, highlighting a need for policymakers to identify best practices in those countries that outperform similar or more developed countries.
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Affiliation(s)
- Saate S Shakil
- Division of Cardiology, Department of Medicine (S.S.S., C.T.L., G.A.R.), University of Washington, Seattle
- Institute for Health Metrics and Evaluation (S.S.S., G.A.R.), University of Washington, Seattle
| | - Dike Ojji
- Department of Medicine, Faculty of Clinical Sciences, University of Abuja, Nigeria (D.O.)
- University of Abuja Teaching Hospital, Gwagwalada, Nigeria (D.O.)
| | - Chris T Longenecker
- Division of Cardiology, Department of Medicine (S.S.S., C.T.L., G.A.R.), University of Washington, Seattle
- Department of Global Health (C.T.L.), University of Washington, Seattle
| | - Gregory A Roth
- Division of Cardiology, Department of Medicine (S.S.S., C.T.L., G.A.R.), University of Washington, Seattle
- Institute for Health Metrics and Evaluation (S.S.S., G.A.R.), University of Washington, Seattle
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Daniele A, Lucas SJE, Rendeiro C. Detrimental effects of physical inactivity on peripheral and brain vasculature in humans: Insights into mechanisms, long-term health consequences and protective strategies. Front Physiol 2022; 13:998380. [PMID: 36237532 PMCID: PMC9553009 DOI: 10.3389/fphys.2022.998380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
The growing prevalence of physical inactivity in the population highlights the urgent need for a more comprehensive understanding of how sedentary behaviour affects health, the mechanisms involved and what strategies are effective in counteracting its negative effects. Physical inactivity is an independent risk factor for different pathologies including atherosclerosis, hypertension and cardiovascular disease. It is known to progressively lead to reduced life expectancy and quality of life, and it is the fourth leading risk factor for mortality worldwide. Recent evidence indicates that uninterrupted prolonged sitting and short-term inactivity periods impair endothelial function (measured by flow-mediated dilation) and induce arterial structural alterations, predominantly in the lower body vasculature. Similar effects may occur in the cerebral vasculature, with recent evidence showing impairments in cerebral blood flow following prolonged sitting. The precise molecular and physiological mechanisms underlying inactivity-induced vascular dysfunction in humans are yet to be fully established, although evidence to date indicates that it may involve modulation of shear stress, inflammatory and vascular biomarkers. Despite the steady increase in sedentarism in our societies, only a few intervention strategies have been investigated for their efficacy in counteracting the associated vascular impairments. The current review provides a comprehensive overview of the evidence linking acute and short-term physical inactivity to detrimental effects on peripheral, central and cerebral vascular health in humans. We further examine the underlying molecular and physiological mechanisms and attempt to link these to long-term consequences for cardiovascular health. Finally, we summarize and discuss the efficacy of lifestyle interventions in offsetting the negative consequences of physical inactivity.
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Affiliation(s)
- Alessio Daniele
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Samuel J. E. Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Catarina Rendeiro
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Catarina Rendeiro,
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18
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Mu T, Xu R, Zhu Q, Chen L, Dong D, Xu J, Shen C. Diet-related knowledge, attitudes, and behaviors among young and middle-aged individuals with high-normal blood pressure: A cross-sectional study in China. Front Public Health 2022; 10:898457. [PMID: 36117602 PMCID: PMC9479537 DOI: 10.3389/fpubh.2022.898457] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/16/2022] [Indexed: 01/22/2023] Open
Abstract
Background Dietary modifications play an important role in the prevention and management of high-normal blood pressure (BP). The aim of this study was to investigate diet-related knowledge, attitudes, and behaviors, and the socio-demographic determinants of these, among young and middle-aged Chinese individuals with high-normal BP. Methods Data from the 2015 China Health and Nutrition Survey (CHNS) were analyzed in this study. A total of 1,756 subjects with high-normal BP were included. A chi-square test and binary logistic regression analysis were conducted to identify the risk factors toward diet-related knowledge, attitudes, and behaviors. Results A total of 37.4% of the participants knew about the Chinese Food Pagoda (CFP) or the Dietary Guidelines for Chinese Residents (DGCR). Overall, 39.8% of the subjects were classified as having adequate diet-related knowledge literacy, 27.8% reported positive diet-related attitudes to healthy eating, and 35.3% reportedly looked for nutrition knowledge. Of note, 72.4% and 80.1% of the participants reported liking to eat fruits and vegetables, respectively. Individuals with a middle school education [odds ratio (OR) = 1.784, 95% CI = 1.236-2.576], high school/vocational education (OR = 1.944, 95% CI = 1.305-2.896), and college degree or above (OR = 2.089, 95% CI = 1.341-3.322), who were living in a rural area (OR = 1.311, 95% CI = 1.048-1.639), proactively looking for nutrition knowledge (OR = 1.529, 95% CI = 1.227-1.906), and reported liking to eat vegetables (OR = 1.939, 95% CI = 1.409-2.688), were more likely to have sufficient dietary knowledge literacy. Managers (OR = 1.655, 95% CI = 1.039-2.635) were more likely to have positive dietary attitudes. Female gender (OR = 1.396, 95% CI = 1.089-1.790), high school/vocational school education (OR = 2.071, 95% CI = 1.269-3.379), college degree and above (OR = 2.207, 95% CI = 1.262-3.862), knowledge about the CFP or DGCR (OR = 8.138, 95% CI = 6.326-10.468), and sufficient dietary knowledge literacy (OR = 1.338, 95% CI = 1.050-1.705) were associated with an increased likelihood of looking for nutrition knowledge. Conclusion Individuals with high-normal BP, predominantly males, living in rural area, with lower education, farmers, workers, service workers, and workers in the non-government employment unit may have poor diet-related knowledge, attitudes, and behaviors.
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Affiliation(s)
- Tingyu Mu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
- School of Nursing, Anhui University of Chinese Medicine, Hefei, China
| | - Rixiang Xu
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qianyin Zhu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lingshan Chen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Die Dong
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiayi Xu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Cuizhen Shen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
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Craighead DH, Freeberg KA, McCarty NP, Rossman MJ, Moreau KL, You Z, Chonchol M, Seals DR. Inspiratory muscle strength training for lowering blood pressure and improving endothelial function in postmenopausal women: comparison with “standard of care” aerobic exercise. Front Physiol 2022; 13:967478. [PMID: 36105300 PMCID: PMC9465043 DOI: 10.3389/fphys.2022.967478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background: High blood pressure (BP), particularly systolic BP (SBP), is the major modifiable risk factor for cardiovascular diseases and related disorders of aging. SBP increases markedly with aging in women such that the prevalence of above-normal SBP (i.e., ≥120 mmHg) in postmenopausal women exceeds rates in age-matched men. This increase in SBP is associated with vascular endothelial dysfunction, mediated by excessive reactive oxygen species-induced oxidative stress and consequent reductions in nitric oxide bioavailability. Moderate-intensity aerobic exercise is a recommended lifestyle strategy for reducing SBP. However, adherence to aerobic exercise guidelines among postmenopausal women is low (<30%) and aerobic exercise does not consistently enhance endothelial function in estrogen-deficient postmenopausal women. High-resistance inspiratory muscle strength training (IMST) is a time-efficient, adherable lifestyle intervention that involves inhaling against resistance through a handheld device (30 breaths/day). Here, we present the protocol for a randomized controlled trial investigating the efficacy of 3 months of high-resistance IMST compared to guideline-based, “standard-of-care” aerobic exercise training for decreasing SBP and improving endothelial function in estrogen-deficient postmenopausal women with above-normal SBP (120–159 mmHg) at baseline (ClinicalTrials.gov Identifier: NCT05000515). Methods: A randomized, single-blind, parallel-group design clinical trial will be conducted in 72 (36/group) estrogen-deficient postmenopausal women with above-normal SBP. Participants will complete baseline testing and then be randomized to either 3 months of high-resistance IMST (30 breaths/day, 6 days/week, 75% maximal inspiratory pressure) or moderate-intensity aerobic exercise training (brisk walking 25 min/day, 6 days/week, 40–60% heart rate reserve). Outcome measures will be assessed after 3 months of either intervention. Following end-intervention testing, participants will abstain from their assigned intervention for 6 weeks, after which BP and endothelial function will be assessed to evaluate the potential persistent effects of the intervention on the primary and secondary outcomes. Discussion: This study is designed to compare the effectiveness of time-efficient, high-resistance IMST to guideline-based aerobic exercise training for lowering SBP and improving endothelial function, and interrogating potential mechanisms of action, in estrogen-deficient postmenopausal women. Clinical Trial Registration:ClinicalTrials.gov, Identifier: NCT05000515.
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Affiliation(s)
- Daniel H. Craighead
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Kaitlin A. Freeberg
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Narissa P. McCarty
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Matthew J. Rossman
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Kerrie L. Moreau
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Veterans Affairs Eastern Colorado Geriatric Research, Educational and Clinical Center, Denver, CO, United States
| | - Zhiying You
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Douglas R. Seals
- Integrative Physiology of Aging Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
- *Correspondence: Douglas R. Seals,
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20
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Al-Kadi H. Prevalence of Prehypertension among Saudi Adults: A Narrative Review. Open Cardiovasc Med J 2022. [DOI: 10.2174/18741924-v16-e2206270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Prehypertension is a pre-disease state wherein an individual has a blood pressure (BP) measurement above normal (≥120/80 mmHg) but below the hypertensive range (<140/90 mmHg). Large population-based studies have shown that individuals with a BP in the prehypertensive range have an increased risk of developing hypertension and cardiovascular events. Despite these risks and high mortality rates associated with pre-hypertension, there are currently no reviews that define the prevalence of pre-hypertension in the Saudi population.
Objective:
To determine the magnitude of the pre-hypertension problem among Saudi adults and identify areas for future research based on the current gaps in the literature.
Methods:
This narrative review considers studies addressing the prevalence of pre-hypertension among Saudi adults; 8 studies were identified for this review.
Results:
In total, 14,782 men and women participated in these studies. The overall prevalence of pre-hypertension in both sexes ranged from 18.5-54.9%. Men had higher rates of pre-hypertension (24.7-66.1%) than women (7-48.1%).A modifiable risk factor reported in the majority of the studies was increased adiposity.
Conclusion:
Lifestyle changes to reduce weight may be effective in preventing or at least delaying the progression to hypertension and its associated cardiovascular events. Large, prospective, epidemiological studies are needed to estimate the risk of incident hypertension and cardiovascular events in pre-hypertension patients. Randomized clinical trials are also needed to evaluate the effectiveness of lifestyle modification and/or pharmacotherapy in reducing the risk of incident hypertension.
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21
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Moussouni A, Sidi-Yakhlef A, Hamdaoui H, Aouar A, Belkhatir D. Prevalence and risk factors of prehypertension and hypertension in Algeria. BMC Public Health 2022; 22:1571. [PMID: 35982441 PMCID: PMC9386961 DOI: 10.1186/s12889-022-13942-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 07/27/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Hypertension, also referred to as the silent killer, is known to be one of the most common chronic diseases in the world today. This study aimed to identify the prevalence and risk factors of prehypertension and hypertension among Algerian population. METHODS This is a descriptive cross-sectional epidemiological study involving individuals aged 18 to 69 years old who were identified in the database of the national survey on non-communicable diseases (NCDs) risk factors conducted in Algeria between 2016 and 2017 using the World Health Organization's (WHO) STEPwise approach. Differences in prevalence between normotensives, prehypertensives and hypertensives were assessed using the chi-square test. We also looked at the role of numerous socio-demographic, economic, geographical, and behavioural factors in blood pressure status using a logistic regression model. RESULTS The prevalence of prehypertension and hypertension was 36.2% (95% confidence interval: 35.2-37.5%) and 31.6% (95% CI: 30.5-32.7%) respectively. Prehypertension was shown to be substantially higher in males than in women, while hypertension was found to be higher in females compared to men. In addition, both sexes had a rise in the prevalence of blood pressure as they grew older. A according to multivariate logistic regression analysis, the main common risk factors for prehypertension and hypertension were ageing, obesity, and abdominal obesity. Moreover hypercholesterolemia, and marital status (separated/divorced) were correlated to hypertension. CONCLUSION Prehypertension and hypertension are high and epidemic in Algeria. Therefore, the urgent quantification and monitoring of their risk factors becomes a necessity to plan appropriate preventive measures, in order to fight against NCDs in general.
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Affiliation(s)
- Abdellatif Moussouni
- National Center for Prehistoric, Anthropological and Historical Research (CNRPAH, Tlemcen's station), Algeria, 03, Rue Franklin Roosevelt, 16500, Alger, Algeria.
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Anthropology, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria.
| | - Adel Sidi-Yakhlef
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
| | - Houari Hamdaoui
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
| | - Amaria Aouar
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
| | - Djamel Belkhatir
- University of Abou Bekr Belkaïd, Algeria. Laboratory of Human Actions' Valorisation for Protection of Environment and Application in Public Health, 22, Rue Abi Ayed Abdelkrim Fg Pasteur B. P 119, 13000, Tlemcen, Algeria
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22
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Vilkov VG, Shalnova SA. Thirty-year trends in the prevalence of cardiometabolic risk factors in the populations of the Russian Federation and the United States of America. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To study trends in the prevalence of hypertension (HTN), obesity, elevated non-high-density lipoprotein cholesterol (non-HDL cholesterol) levels in Russia and the USA from 1975 to 2014.Material and methods. According to the data of cross-sectional population studies in Russia and the USA in 1975-1982 and 2007-2014, the prevalence of risk factors (RFs) in men and women aged 25-64 was studied. The data of Lipid Research Clinics studies, Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF) study, as well as data from National Health And Nutrition Examination Survey (NHANES) studies (USA) were used. The total number of persons analyzed was 41268. The proportion of individuals with risk factors and 95% confidence interval were calculated.Results. In the 1980s, the prevalence of studied RFs in Russia and the United States did not differ in most sex and age groups. Over the next 30 years, both populations are characterized by a decrease in the prevalence of HTN and elevated non-HDL cholesterol (≥ 3.7 mmol/l) and an increase in the prevalence of obesity. In 2012, HTN in men and women in Russia occurred more frequently than in the United States. Obesity was less common in men and women 25-44 years old in Russia and in women >54 years old in the USA. The prevalence of non-HDL cholesterol ≥3,7 mmol/l in Russia compared with the United States was higher in people >44 years old and lower in women 25-34 years old.Conclusion. In the 1980s, there were no differences in the prevalence of cardiometabolic risk factors in Russia and the United States. In the 2010s, HTn and partly dyslipidemia were more common in Russia, and the prevalence of obesity in young and middle-aged people was higher in the United States.
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Affiliation(s)
- V. G. Vilkov
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. A. Shalnova
- National Medical Research Center for Therapy and Preventive Medicine
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23
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Predicting Sensitivity to Adverse Lifestyle Risk Factors for Cardiometabolic Morbidity and Mortality. Nutrients 2022; 14:nu14153171. [PMID: 35956347 PMCID: PMC9370461 DOI: 10.3390/nu14153171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 12/02/2022] Open
Abstract
People appear to vary in their susceptibility to lifestyle risk factors for cardiometabolic disease; determining a priori who is most sensitive may help optimize the timing, design, and delivery of preventative interventions. We aimed to ascertain a person’s degree of resilience or sensitivity to adverse lifestyle exposures and determine whether these classifications help predict cardiometabolic disease later in life; we pooled data from two population-based Swedish prospective cohort studies (n = 53,507), and we contrasted an individual’s cardiometabolic biomarker profile with the profile predicted for them given their lifestyle exposure characteristics using a quantile random forest approach. People who were classed as ‘sensitive’ to hypertension- and dyslipidemia-related lifestyle exposures were at higher risk of developing cardiovascular disease (CVD, hazards ratio 1.6 (95% CI: 1.3, 1.91)), compared with the general population. No differences were observed for type 2 diabetes (T2D) risk. Here, we report a novel approach to identify individuals who are especially sensitive to adverse lifestyle exposures and who are at higher risk of subsequent cardiovascular events. Early preventive interventions may be needed in this subgroup.
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24
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Wang Y, Yang J, Liu J, Qi Y, Tu J, Tian Z, Shi G, Yan S, Wang L, Liu C. Home‐based transcutaneous electrical acupoint stimulation for high‐normal blood pressure: A randomized controlled trial. J Clin Hypertens (Greenwich) 2022; 24:984-992. [PMID: 35789530 PMCID: PMC9380160 DOI: 10.1111/jch.14496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 04/06/2022] [Accepted: 04/18/2022] [Indexed: 11/27/2022]
Abstract
The authors investigated the effectiveness of home‐based transcutaneous electrical acupoint stimulation (TEAS) combined with lifestyle modification on blood pressure (BP) control and explored the feasibility of the trial design in this prospective, randomized controlled trial. The authors recruited individuals with high‐normal BP who had a systolic blood pressure (SBP) of 120–139 mm Hg and a diastolic blood pressure (DBP) of 80–89 mm Hg, or both. Participants were randomly assigned to receive either lifestyle modification combined with TEAS four times weekly for 12 weeks at home (intervention group) or solely lifestyle modification (control group). The primary outcome was the change in mean SBP at week 12 from the baseline measurement. A total of 60 participants were randomized in a 1:1 ratio, and an intention‐to‐treat analysis was performed on all of the outcomes. The mean difference in the change in SBP for the intervention group (compared to the control) at week 12 was −3.85 mm Hg (95% CI: −7.58 to −.12; p = .043); for the DBP, the change was −2.27 mm Hg (95% CI: −5.76 to 1.23; p = .199). There was no difference in the proportion of progression to hypertension, quality of life, body mass index (BMI) or waist circumference. In addition, two participants reported TEAS‐related adverse events. The authors found a reduction in SBP control in the pragmatic, home‐based intervention by using TEAS combined with lifestyle modification in adults with high‐normal BP. Trial Registration: The study was registered in the Chinese Clinical Trial Registry (ChiCTR 1900024982) on August 6, 2019.
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Affiliation(s)
- Yu Wang
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Jing‐Wen Yang
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Jun‐Hong Liu
- Heyi Community Health Service Center Fengtai District Beijing China
| | - You‐Sheng Qi
- Heyi Community Health Service Center Fengtai District Beijing China
| | - Jian‐Feng Tu
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Zhong‐Xue Tian
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Guang‐Xia Shi
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Shi‐Yan Yan
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Li‐Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Cun‐Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
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Zhu H, Zheng H, Liang X, Huang C, Sun L, Liu X, Qiu M, Mai W, Huang Y. Prevalence and Related Factors of White Coat Hypertension and Masked Hypertension in Shunde District, Southern China. Front Physiol 2022; 13:936750. [PMID: 35846000 PMCID: PMC9283833 DOI: 10.3389/fphys.2022.936750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/06/2022] [Indexed: 11/15/2022] Open
Abstract
Background: White coat hypertension (WCH) and masked hypertension (MH) can increase the risk of target organ damage. Home blood pressure monitoring is an important method for detecting WCH and MH. However, the prevalence and related factors of WCH and MH in China have been rarely reported. Objective: To explore the prevalence and related factors associated with white coat hypertension (WCH) and masked hypertension (MH) in Shunde District, Southern China. Methods: This study recruited subjects from the Physical Examination Center in Shunde Hospital, Southern Medical University. Office blood pressure and home blood pressure values were collected using the home blood pressure monitor with telemedicine device and office blood pressure monitor, and the prevalence of WCH and MH was calculated by the values. Multivariate logistic regression was used to explore the related factors for WCH and MH. Results: Four-hundred and sixty-one participants (61% male), with an average age of 49 years, were included. The prevalence of WCH and MH was 5.1 and 15.2%, respectively. Multivariate logistic regression analysis showed that smoking (OR = 4.71, 95% CI = 1.05–21.15) and family history of coronary heart disease (OR = 4.51, 95% CI = 1.08–18.93) were associated with higher odds of WCH. The associated factors for higher odds of MH were smoking (OR = 2.83, 95% CI = 1.11–7.23), family history of hypertension (OR = 2.17, 95% CI = 1.11–4.26) and family history of coronary heart disease (OR = 2.82, 95% CI = 1.07–7.45). Conclusion: WCH and MH are highly prevalent in the Physical Examination Center in Shunde Hospital, Southern Medical University. We found smoking and family history of coronary heart disease were related factors for WCH, and smoking, family history of hypertension and coronary heart disease were associated with the odds of MH. Home blood pressure monitoring with a telemedicine device should be recommended to identity abnormal BP phenotype.
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Affiliation(s)
- Hailan Zhu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Haoxiao Zheng
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Xiaoyan Liang
- Department of Health Check-up Centre, Shunde Hospital, Southern Medical University, Foshan, China
| | - Chunyi Huang
- Department of Health Check-up Centre, Shunde Hospital, Southern Medical University, Foshan, China
| | - Lichang Sun
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Xiong Liu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Min Qiu
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
| | - Weiyi Mai
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuli Huang
- Department of Cardiology, Shunde Hospital, Southern Medical University, Foshan, China
- The George Institute for Global Health, newtown, NSW, Australia
- *Correspondence: Yuli Huang,
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Kim J, Cho SI, Park JH, Song J, Ahn S, Cho H, Moon S. Risk of hypertension and treatment on out-of-hospital cardiac arrest incidence: A case-control study. Medicine (Baltimore) 2022; 101:e29161. [PMID: 35665725 PMCID: PMC9276230 DOI: 10.1097/md.0000000000029161] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 01/04/2023] Open
Abstract
Hypertension (HTN) is a high risk factor for major cardiovascular adverse events. This study aimed to investigate the effect of HTN risk on out-of-hospital cardiac arrest (OHCA) incidence and determine whether the effect of HTN on OHCA incidence differs according to antihypertensive medication.This case-control study used the Korean Cardiac Arrest Resuscitation Consortium and Korean Community Health Survey (CHS). Cases were defined as emergency medical service-treated adult OHCA patients presumed to have a cardiac etiology from 2015 to 2017. Patients without information on HTN diagnosis were excluded from the study. The Korean CHS database's controls were matched at a 1:2 ratio with strata, including age, gender, and county of residence. Multivariable conditional logistic regression analysis was conducted to estimate HTN risk and antihypertensive treatment on OHCA incidence,A total of 2633 OHCA patients and 5266 community-based controls were enrolled in this study. Among them, 1176 (44.7%) patients and 2049 (38.9%) controls were diagnosed with HTN. HTN was associated with an increased risk of OHCA (adjusted odds ratio [AOR]: 1.19 [1.07-1.32]). On comparing HTN with or without the antihypertensive treatment group with the non-HTN-diagnosed group (as a reference), the HTN without treatment group had the highest AOR (95% confidence interval) (3.41 [2.74-4.24]). The AOR in the HTN treatment group was reduced to that in the non-HTN-diagnosed group (0.96 [0.86-1.08]).HTN increased OHCA risk, and the HTN without treatment group had the highest OHCA risk. Conversely, OHCA risk decreased to the non-HTN-diagnosed group level with HTN treatment.
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Affiliation(s)
- Jooyeong Kim
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Sung-il Cho
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
| | - Jong-Hak Park
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Juhyun Song
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Sejoong Ahn
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Hanjin Cho
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
| | - Sungwoo Moon
- Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea
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27
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Liu L, Cui S, Liu M, Huo X, Zhang G, Wang N. Psoriasis Increased the Risk of Adverse Cardiovascular Outcomes: A New Systematic Review and Meta-Analysis of Cohort Study. Front Cardiovasc Med 2022; 9:829709. [PMID: 35402553 PMCID: PMC8990932 DOI: 10.3389/fcvm.2022.829709] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/02/2022] [Indexed: 12/31/2022] Open
Abstract
Background Several studies have investigated the relationship between psoriasis and adverse cardiovascular outcomes. Previous meta-analyses have shown psoriasis to be a risk factor for adverse cardiovascular outcomes. However, the relationship has become uncertain with the emergence of many new studies. Objective This study aimed to conduct an updated meta-analysis on cohort studies about the relationship between psoriasis and adverse cardiovascular outcomes. Methods Electronic databases (accessed till January 2022) were searched systematically for cohort studies assessing the cardiovascular risk in psoriasis patients. This was a meta-analysis using a random-effect model; pooled analyses of several cardiovascular outcomes were also conducted. Results A total of 31 [hazard ratio (HR), 23; rate ratio (RR), 8] studies involving 665,009 patients with psoriasis and 17,902,757 non-psoriatic control subjects were included for the meta analysis. The pooled analyses according to each cardiovascular outcome revealed that pooled RR of patients for developing myocardial infarction, stroke, cardiovascular death, ischemic heart disease, thromboembolism and arrhythmia were 1.17 (95% confidence interval [CI], 1.11–1.24), 1.19 (95% CI, 1.11–1.27), 1.46 (95% CI, 1.26–1.69), 1.17 (95% CI, 1.02–1.34), 1.36 (95% CI, 1.20–1.55) and 1.35 (95% CI, 1.30–1.40), respectively. Meanwhile, the pooled RR of patients with mild and severe psoriasis for developing adverse cardiovascular outcomes were 1.18 (95% CI, 1.13–1.24) and 1.41 (95% CI, 1.31–1.52), respectively. Conclusion The pooled analyses revealed that psoriasis is associated with all adverse cardiovascular outcomes of interest, especially in severe patients. Psoriasis remains an independent risk factor for adverse cardiovascular outcomes, which needs more attention from clinicians.
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Affiliation(s)
- Lu Liu
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Saijin Cui
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Meitong Liu
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiangran Huo
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guoqiang Zhang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
- Candidate Branch of National Clinical Research Center for Skin Diseases, Beijing, China
- Guoqiang Zhang,
| | - Na Wang
- Cancer Institute, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- *Correspondence: Na Wang,
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28
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Thapa J, Sundar Budhathoki S, Niraula SR, Pandey S, Thakur N, Pokharel PK. Prehypertension and its predictors among older adolescents: A cross-sectional study from eastern Nepal. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001117. [PMID: 36962628 PMCID: PMC10021258 DOI: 10.1371/journal.pgph.0001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/03/2022] [Indexed: 11/18/2022]
Abstract
Prehypertension is a state of transition between normal blood pressure and hypertension. Adolescent prehypertension is a strong predictor of hypertension in adults and is now considered for cardiovascular intervention or risk reduction. This study was conducted among adolescents to assess the burden of pre-hypertension and its predictors. A cross-sectional study was conducted among grade 11 and 12 students in three districts in eastern Nepal namely Jhapa, Morang and Sunsari. Sampling was done using a multistage stratified proportionate random method. A semi-structured questionnaire adapted from the WHO STEPwise approach to the non-communicable disease risk factor surveillance (STEPS) instrument was used as a study tool after modification and pre-testing in addition to the anthropometric and blood pressure measurements by the investigators. The prevalence of prehypertension was assessed along with the identification of its predictors through multivariable binary logistic regression modelling. A total of 806 participants aged 15 to 19 years, with 57.1% female, participated in the study. Prehypertension was found in 20.8% (24.6% in males and 18.0% in females) of the participants, while 7.1% of them were hypertensive (9.2% males and 5.4% females). Obesity and central obesity were seen among 6.3% and 17.7% of the respondents respectively. Age, sex, ethnicity and obesity were found to be significantly associated with prehypertension. A significant proportion of prehypertension was seen among the adolescent population along with a notable presence of risk factors such as smoking, alcohol consumption, obesity, and eating out. This warrants careful consideration and identification of relevant strategies to reduce the burden of prehypertension via school-based interventions to reduce the modifiable risk factors.
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Affiliation(s)
- Jeevan Thapa
- Department of Community Health Sciences, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Shyam Sundar Budhathoki
- Faculty of Medicine, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Surya Raj Niraula
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sagar Pandey
- B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nishant Thakur
- Epidemiology and Disease Control Division, Teku, Kathmandu, Nepal
| | - Paras K Pokharel
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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29
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Cherbuin N, Walsh EI, Shaw M, Luders E, Anstey KJ, Sachdev PS, Abhayaratna WP, Gaser C. Optimal Blood Pressure Keeps Our Brains Younger. Front Aging Neurosci 2021; 13:694982. [PMID: 34675795 PMCID: PMC8523821 DOI: 10.3389/fnagi.2021.694982] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Elevated blood pressure (BP) is a major health risk factor and the leading global cause of premature death. Hypertension is also a risk factor for cognitive decline and dementia. However, when elevated blood pressure starts impacting cerebral health is less clear. We addressed this gap by estimating how a validated measure of brain health relates to changes in BP over a period of 12 years. Methods: Middle-age (44-46 years at baseline, n = 335, 52% female) and older-age (60-64 years, n = 351, 46% female) cognitively intact individuals underwent up to four brain scans. Brain health was assessed using a machine learning approach to produce an estimate of "observed" age (BrainAGE), which can be contrasted with chronological age. Longitudinal associations between blood pressures and BrainAGE were assessed with linear mixed-effects models. Results: A progressive increase in BP was observed over the follow up (MAP = 0.8 mmHg/year, SD = 0.92; SBP = 1.41 mmHg/year, SD = 1.49; DBP = 0.61 mmHg/year, SD = 0.78). In fully adjusted models, every additional 10 mmHg increase in blood pressure (above 90 for mean, 114 for systolic, and 74 for diastolic blood pressure) was associated with a higher BrainAGE by 65.7 days for mean, and 51.1 days for systolic/diastolic blood pressure. These effects occurred across the blood pressure range and were not exclusively driven by hypertension. Conclusion: Increasing blood pressure is associated with poorer brain health. Compared to a person becoming hypertensive, somebody with an ideal BP is predicted to have a brain that appears more than 6 months younger at midlife.
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Affiliation(s)
- Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, Australia
| | - Erin I Walsh
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, Australia
| | - Marnie Shaw
- College of Engineering & Computer Science, Australian National University, Canberra, ACT, Australia
| | - Eileen Luders
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, Australia.,School of Psychology, University of Auckland, Auckland, New Zealand
| | - Kaarin J Anstey
- Neuroscience Research Australia, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | | | - Christian Gaser
- Department of Neurology, Jena University Hospital, Jena, Germany.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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30
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Maloberti A, Rebora P, Occhino G, Alloni M, Musca F, Belli O, Spano F, Santambrogio GM, Occhi L, De Chiara B, Casadei F, Moreo A, Valsecchi MG, Giannattasio C. Prevalence of hypertension mediated organ damage in subjects with high-normal blood pressure without known hypertension as well as cardiovascular and kidney disease. J Hum Hypertens 2021; 36:610-616. [PMID: 34493835 DOI: 10.1038/s41371-021-00604-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/21/2021] [Accepted: 08/26/2021] [Indexed: 11/09/2022]
Abstract
Purpose of our study was to assess the prevalence of hypertension mediated organ damage (HMOD) in healthy subjects with high-normal Blood Pressure (BP) comparing them with subjects with BP values that are considered normal (<130/85 mmHg) or indicative of hypertension (≥140/90 mmHg). Seven hundred fifty-five otherwise healthy subjects were included. HMOD was evaluated as pulse wave velocity (PWV), left ventricular mass index (LVMI), and carotid intima-media thickness (IMT) and plaque. When subjects were classified according to BP levels we found that the high-normal BP group showed intermediate values of PWV and higher values of IMT. This corresponds to intermediate prevalence of arterial stiffness, while there were no differences for increased IMT or carotid plaque. No subjects showed left ventricular hypertrophy. At multivariable analysis, the odds of having arterial stiffness or carotid HMOD in the high-normal group resulted not different to the normal group. In conclusion, in our otherwise healthy population, high-normal BP values were not related to aortic, carotid or cardiac HMOD.
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Affiliation(s)
- Alessandro Maloberti
- Cardiology IV, "A.De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy. .,University of Milano-Bicocca, Milan, Italy.
| | - Paola Rebora
- Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 center), School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Occhino
- Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 center), School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Marta Alloni
- Cardiology IV, "A.De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy
| | - Francesco Musca
- Cardiology IV, "A.De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy
| | - Oriana Belli
- Cardiology IV, "A.De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy
| | - Francesca Spano
- Cardiology IV, "A.De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy
| | | | - Lucia Occhi
- Cardiology IV, "A.De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy
| | - Benedetta De Chiara
- Cardiology IV, "A.De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy
| | - Francesca Casadei
- Cardiology IV, "A.De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy
| | - Antonella Moreo
- Cardiology IV, "A.De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy
| | - Maria Grazia Valsecchi
- Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 center), School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Cristina Giannattasio
- Cardiology IV, "A.De Gasperis" Department, ASTT GOM Niguarda Ca' Granda, Milan, Italy.,University of Milano-Bicocca, Milan, Italy
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31
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Yoon YH, Park GM, Lee JY, Lee JH, Lee H, Roh JH, Kim JH, Lee PH, Choe J, Kim YH, Lee SW. Association of Stage 1 Hypertension Defined by the ACC/AHA 2017 Guideline With Asymptomatic Coronary Atherosclerosis. Am J Hypertens 2021; 34:858-866. [PMID: 33735371 DOI: 10.1093/ajh/hpab051] [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] [Received: 12/29/2020] [Revised: 02/03/2021] [Accepted: 03/16/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This study sought to assess the relationship between stage 1 hypertension and subclinical coronary atherosclerosis. METHODS A total of 4,666 individuals with available coronary computed tomography angiography (CCTA) results from a health checkup were enrolled. The classification of hypertension was adapted from the American College of Cardiology/American Heart Association (ACC/AHA) 2017 guideline. The presence of coronary plaques and its characteristics, and other CCTA findings were assessed. RESULTS There was a linear relationship between blood pressure (BP), both systolic BP (SBP) and diastolic BP (DBP), and the presence of coronary plaque. Patients were classified into 4 groups according to the BP category: normal BP (SBP <120 mm Hg and DBP <80 mm Hg; n = 2,395; 51.3%), elevated BP (SBP 120-129 mm Hg and DBP <80 mm Hg; n = 467; 10.0%), stage 1 hypertension (SBP 130-139 mm Hg or DBP 80-89 mm Hg; n = 1,139; 24.4%), and stage 2 hypertension (SBP ≥140 mm Hg or DBP ≥90 mm Hg; n = 665; 14.2%). Compared with the normal BP group after multivariate adjustment, the stage 1 hypertension group was significantly associated with the presence of atherosclerotic plaque (adjusted odds ratio [95% confidential interval], 1.37 [1.17-1.62]; P < 0.001), especially in noncalcified and mixed plaques. The relationship between stage 1 hypertension and stenosis >50% was not statistically significant. Isolated diastolic and isolated systolic stage 1 hypertensions were significantly related to the presence of coronary plaque. The elevated BP group was not associated with any positive CCTA findings. CONCLUSIONS Stage 1 hypertension was independently associated with subclinical coronary atherosclerosis.
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Affiliation(s)
- Yong-Hoon Yoon
- Department of Cardiology, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Korea
| | - Gyung-Min Park
- Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jong-Young Lee
- Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hwan Lee
- Department of Cardiology, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Korea
| | - Hanbyul Lee
- Department of Statistics, Kyungpook National University, Daegu, Korea
| | - Jae-Hyung Roh
- Department of Cardiology, Chungnam National University Sejong Hospital, Chungnam National University School of Medicine, Sejong, Korea
| | - Ju Hyeon Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Pil Hyung Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jaewon Choe
- Department of Health Medicine, Health Screening & Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Hak Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Whan Lee
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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32
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Kow CS, Hasan SS, Wong PS, Verma RK. Concordance of recommendations across clinical practice guidelines for the management of hypertension in Southeast Asia with internationally reputable sources. BMC Cardiovasc Disord 2021; 21:354. [PMID: 34320925 PMCID: PMC8317337 DOI: 10.1186/s12872-021-02054-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/30/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES This study aimed to assess the rate of concordance, and to investigate sources of non-concordance of recommendations in the management of hypertension across CPGs in Southeast Asia, with internationally reputable clinical practice guidelines (CPGs). METHODS CPGs for the management of hypertension in Southeast Asia were retrieved from the websites of the Ministry of Health or cardiovascular specialty societies of the individual countries of Southeast Asia during November to December 2020. The recommendations for the management of hypertension specified in the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline and the 2018 European Society of Cardiology (ESC)/European Society of Hypertension (ESH) guideline were selected to be the reference standards; the recommendations concerning the management of hypertension in the included CPGs in Southeast Asia were assessed if they were concordant with the reference recommendations generated from both the 2017 ACC/AHA guideline and the 2018 ESC/ESH guideline, using the population (P)-intervention (I)-comparison (C) combinations approach. RESULTS A total of 59 reference recommendations with unique and unambiguous P-I-C specifications was generated from the 2017 ACC/AHA guideline. In addition, a total of 51 reference recommendations with unique and unambiguous P-I-C specifications was generated from the 2018 ESC/ESH guideline. Considering the six included CPGs from Southeast Asia, concordance was observed for 30 reference recommendations (50.8%) out of 59 reference recommendations generated from the 2017 ACC/AHA guideline and for 31 reference recommendations (69.8%) out of 51 reference recommendations derived from the 2018 ESC/ESH guideline. CONCLUSIONS Hypertension represents a significant issue that places health and economic strains in Southeast Asia and demands guideline-based care, yet CPGs in Southeast Asia have a high rate of non-concordance with internationally reputable CPGs. Concordant recommendations could perhaps be considered a standard of care for hypertension management in the Southeast Asia region.
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Affiliation(s)
- Chia Siang Kow
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Syed Shahzad Hasan
- Department of Pharmacy, University of Huddersfield, Huddersfield, UK.,School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
| | - Pei Se Wong
- School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Rohit Kumar Verma
- School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia.
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33
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Sun S, Liu XC, He GD, Lo K, Feng YQ, Huang YQ. The Non-linear Relationship Between Normal Range Systolic Blood Pressure and Cardiovascular or All-Cause Mortality Among Elderly Population. Front Cardiovasc Med 2021; 8:677189. [PMID: 34386527 PMCID: PMC8353072 DOI: 10.3389/fcvm.2021.677189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 07/02/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: The aim was to explore the association of normal range SBP with cardiovascular and all-cause mortality in older adults without hypertension. Methods: Participants aged ≥ 65 years without hypertension and those had an SBP level between 90 and 129 mmHg were included from the National Health and Nutrition Examination Survey (1999-2014). SBP was categorized into: 90-99, 100-109, 110-119, and 120-129 mmHg. Multivariate Cox regression was performed with hazard ratio (HR) and 95% confidence interval (CI). Results: Of the 1,074 participants, 584 were men (54.38%). Compared with participants with SBP level ranged 110 to 119 mmHg, the HRs for all-cause mortality risk was 1.83 (95% CI: 1.04, 3.23) for SBP level ranged 90 to 99 mm Hg, 0.87 (95% CI: 0.54, 1.41) for SBP level ranged 100 to 109 mmHg, and 1.30 (95% CI: 0.96, 1.75) for SBP level ranged 120 to 129 mmHg (P for trend = 0.448), and the HR for cardiovascular mortality risk was 3.30 (95% CI: 0.87, 12.54) for SBP level ranged 90 to 99 mmHg, 0.35(95% CI: 0.08, 1.56) for SBP level ranged 100 to 109 mmHg, and 1.75 (95% CI: 0.78, 3.94) for SBP level ranged 120 to 129 mm Hg (P for trend = 0.349) after confounders were adjusted. Conclusion: These were a nonlinear association of normal range SBP level with all-cause and cardiovascular death in older adults.
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Affiliation(s)
- Shuo Sun
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiao-Cong Liu
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guo-Dong He
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Kenneth Lo
- Department of Epidemiology, Centre for Global Cardio-Metabolic Health, Brown University, Providence, RI, United States.,Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ying-Qing Feng
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu-Qing Huang
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
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34
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Craighead DH, Heinbockel TC, Freeberg KA, Rossman MJ, Jackman RA, Jankowski LR, Hamilton MN, Ziemba BP, Reisz JA, D’Alessandro A, Brewster LM, DeSouza CA, You Z, Chonchol M, Bailey EF, Seals DR. Time-Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above-Normal Blood Pressure. J Am Heart Assoc 2021; 10:e020980. [PMID: 34184544 PMCID: PMC8403283 DOI: 10.1161/jaha.121.020980] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/22/2021] [Indexed: 12/13/2022]
Abstract
Background High-resistance inspiratory muscle strength training (IMST) is a novel, time-efficient physical training modality. Methods and Results We performed a double-blind, randomized, sham-controlled trial to investigate whether 6 weeks of IMST (30 breaths/day, 6 days/week) improves blood pressure, endothelial function, and arterial stiffness in midlife/older adults (aged 50-79 years) with systolic blood pressure ≥120 mm Hg, while also investigating potential mechanisms and long-lasting effects. Thirty-six participants completed high-resistance IMST (75% maximal inspiratory pressure, n=18) or low-resistance sham training (15% maximal inspiratory pressure, n=18). IMST was safe, well tolerated, and had excellent adherence (≈95% of training sessions completed). Casual systolic blood pressure decreased from 135±2 mm Hg to 126±3 mm Hg (P<0.01) with IMST, which was ≈75% sustained 6 weeks after IMST (P<0.01), whereas IMST modestly decreased casual diastolic blood pressure (79±2 mm Hg to 77±2 mm Hg, P=0.03); blood pressure was unaffected by sham training (all P>0.05). Twenty-four hour systolic blood pressure was lower after IMST versus sham training (P=0.01). Brachial artery flow-mediated dilation improved ≈45% with IMST (P<0.01) but was unchanged with sham training (P=0.73). Human umbilical vein endothelial cells cultured with subject serum sampled after versus before IMST exhibited increased NO bioavailability, greater endothelial NO synthase activation, and lower reactive oxygen species bioactivity (P<0.05). IMST decreased C-reactive protein (P=0.05) and altered select circulating metabolites (targeted plasma metabolomics) associated with cardiovascular function. Neither IMST nor sham training influenced arterial stiffness (P>0.05). Conclusions High-resistance IMST is a safe, highly adherable lifestyle intervention for improving blood pressure and endothelial function in midlife/older adults with above-normal initial systolic blood pressure. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03266510.
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Affiliation(s)
| | | | | | - Matthew J. Rossman
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | - Rachel A. Jackman
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | | | | | - Brian P. Ziemba
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | - Julie A. Reisz
- Department of Biochemistry and Molecular GeneticsUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - Angelo D’Alessandro
- Department of Biochemistry and Molecular GeneticsUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - L. Madden Brewster
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
| | | | - Zhiying You
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - Michel Chonchol
- Division of Renal Diseases and HypertensionUniversity of Colorado Anschutz Medical CampusAuroraCO
| | - E. Fiona Bailey
- Department of PhysiologyUniversity of Arizona College of MedicineTucsonAZ
| | - Douglas R. Seals
- Department of Integrative PhysiologyUniversity of Colorado BoulderBoulderCO
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Övünç Hacıhamdioğlu D, Ceylan Ö, Yardımcı AH. Could arterial stiffness be early reversible target organ damage test in childhood hypertension? Anatol J Cardiol 2021; 25:496-504. [PMID: 34236325 DOI: 10.5152/anatoljcardiol.2021.67927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The recommended treatment for hypertension (HTN) in children has been revised recently. This study aimed to present the changes in target organ damage (TOD) and arterial stiffness parameters after treatment in children with primary HTN who were managed in accordance with the 2016 European Society of Hypertension Guidelines. METHODS Patients with primary HTN included in this study were newly diagnosed, untreated, and were followed-up for a minimum of 6 months. HTN was confirmed by 24-h ambulatory blood pressure monitoring (ABPM). All patients underwent the following assessments: anthropometrical measurements of body mass index (BMI), carotid intima-media thickness (cIMT), left ventricular mass index (LVMI), plasma creatinine, urea, electrolytes, uric acid, fasting plasma glucose, blood lipids, urinalysis, urine culture, and first morning urine albumin tocreatinine ratio. The ABPM device performed measurements such as central blood pressure (cBP) and pulse wave velocity (PWV). RESULTS Thirty-two of 104 patients were enrolled. Seventeen patients were male, and 53% were obese. Compared with pretreatment, creatinine, urea, systolic BP (SBP), diastolic BP (DBP), systolic load, diastolic load, central SBP (cSBP), cSBP z score, cDBP, and PWV z score decreased, whereas LVMI and BMI z scores were unchanged. CONCLUSION After BP improvement, while LVMI did not regress, the cSBP, cSBP z, and PWV z score values, which are markers of arterial stiffness, regressed. This supports the corrective effect of BP control on the cardiovascular system even in a short-term follow-up. Further longitudinal studies are needed for the assessment of BP control on arterial stiffness in childhood.
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Affiliation(s)
- Duygu Övünç Hacıhamdioğlu
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Bahçeşehir University, Medical Park Göztepe Hospital; İstanbul-Turkey;Division of Pediatric Nephrology, Department of Pediatrics, University of Health Sciences, Süleymaniye Women Maternity and Child Diseases Training and Research Hospital; İstanbul-Turkey
| | - Özben Ceylan
- Division of Pediatric Cardiology, Department of Pediatrics, University of Health Sciences, Süleymaniye Women Maternity and Child Diseases Training and Research Hospital; İstanbul-Turkey;Department of Pediatric Cardiology, University of Health Sciences, İstanbul Training and Research Hospital; İstanbul-Turkey
| | - Aytül Hande Yardımcı
- Department of Radiology, University of Health Sciences, İstanbul Training and Research Hospital; İstanbul-Turkey
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Sadeghi F, Cheraghian B, Mohammadi Z, Sepanlou SG, Masoudi S, Rahimi Z, Danehchin L, Paridar Y, Abolnezhadian F, Noori M, Mard SA, Shayesteh AA, Poustchi H. Impact of 2017 ACC/AHA guideline on prevalence, awareness, treatment, control, and determinants of hypertension: a population-based cross-sectional study in southwest of Iran. Popul Health Metr 2021; 19:26. [PMID: 34034752 PMCID: PMC8147370 DOI: 10.1186/s12963-021-00260-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/12/2021] [Indexed: 12/31/2022] Open
Abstract
Background In 2017, the American College of Cardiology/American Heart Association (ACC/AHA) provided a new guideline for hypertension prevention and management. We aimed to update the prevalence, awareness, control, and determinants of hypertension based on this guideline in Khuzestan province, southwest of Iran, and to estimate the number of people who are eligible for non-pharmacologic and pharmacologic intervention. Methods This population-based cross-sectional study was conducted in Khuzestan, a large province in the southwest of Iran. Comprehensive information about the potential relating factors of hypertension was collected, blood pressure was measured, and anthropometric measurements were obtained. Moreover, the dietary pattern was evaluated in 2830 individuals, using a qualitative food frequency questionnaire. Results Among 30,506 participants, 30,424 individuals aged 20–65 years were eligible for the study. In comparison with the previous guideline released by the Joint National Committee (JNC8), the prevalence of hypertension in Khuzestan dramatically increased from 15.81 to 42.85% after implementation of the ACC/AHA guideline, which was more dominant in the male population and the 45–54 age group. The sex and age adjustment of the hypertension prevalence was estimated to be 39.40%. The percentage of hypertension awareness, treatment, and control were 45.85%, 35.42%, and 59.63%, which dropped to 22.72%, 26.37%, and 28.94% after implementation of new guideline, respectively. Conclusions In the ACC/AHA guideline, a higher number of individuals with the pre-hypertension condition were shifted into the hypertension category and the level of awareness, treatment, and control were dramatically decreased, which highlight a great need to expand the public health infrastructure for further managing the substantial increased burden on healthcare system. However, further studies with population over 65 years are required to estimate the eligibility for antihypertensive treatment in this province after implementation of new guideline.
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Affiliation(s)
- Fatemeh Sadeghi
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Bahman Cheraghian
- Alimentary Tract Research Center, Imam Khomeini Hospital Clinical Research Development Unit, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sadaf G Sepanlou
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Masoudi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Rahimi
- Hearing Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Yousef Paridar
- School of medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Farhad Abolnezhadian
- Shoshtar Faculty of Medical Sciences, Shoshtar, Iran.,Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Seyed Ali Mard
- Alimentary Tract Research Center, Imam khomeini Hospital Clinical Research Development Unit, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Akbar Shayesteh
- Alimentary Tract Research Center, Imam khomeini Hospital Clinical Research Development Unit, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Zhu Z, Yan W, Wang X, Hu D, Zhu Y, Chen J. Physical Activity, Blood Pressure Control, and Health-Related Quality of Life Among Hypertensive Individuals: A Cross-Sectional Study in Jiangsu Province, China. Asia Pac J Public Health 2021; 33:539-546. [PMID: 34018402 DOI: 10.1177/10105395211014650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hypertension has become one of the most serious chronic diseases that threaten public health. Regulating self-management is considered a priority and in which physical activity plays a vital role. Based on the Fifth National Health Service Survey (NHSS, 2013), a total of 6079 patients with hypertension were investigated by stratified cluster random sampling. This study explored the relationships between blood pressure control and physical activity, and health-related quality of life (HRQoL). Tobit regression and generalized linear regression analysis were used to explore the relationships among participants' socioeconomic characteristics, health behaviors, and HRQoL. The results showed that 4712 respondents (77.51%) had no problems in any aspect, but the proportion of respondents with problems increased significantly with age (P for trend <.001). Blood pressure control was significantly correlated with the health utility value (P < .001). Patients who participated in physical activity and maintained normal daily blood pressure also showed higher health utility value. Physical activity was significantly related to blood pressure control and HRQoL. Therefore, regular physical activity is recommended for hypertensive residents to improve HRQoL.
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Affiliation(s)
- Zhu Zhu
- Nanjing Medical University, Nanjing, China.,Jiangsu Vocational Institute of Commerce, Nanjing, China
| | - Wu Yan
- Nanjing Medical University, Nanjing, China
| | | | - Dan Hu
- Nanjing Medical University, Nanjing, China
| | - Ya Zhu
- Nanjing Medical University, Nanjing, China
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AlAhmad M, Beiram R, AbuRuz S. Application of the American College of Cardiology (ACC/AHA) 2017 Guideline for the Management of Hypertension in Adults and Comparison with the 2014 Eighth Joint National Committee Guideline. J Saudi Heart Assoc 2021; 33:16-25. [PMID: 33936937 PMCID: PMC8084304 DOI: 10.37616/2212-5043.1233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 11/30/2022] Open
Abstract
Objectives This study aims to compare the 2017-ACC/AHA hypertension guideline with 2014-JNC-8 guideline in regard to the number of patients who are eligible for treatment and to determine the physicians’ adherence and the financial impact of implementing the new guideline. Methods A cross-sectional observational study was conducted on adult patients who attended the hospital outpatient setting in UAE during January 1, 2018 till February 28, 2018. Adults who are diagnosed with hypertension and those with blood pressure (BP) levels based on two or more readings obtained on two or more different occasions were screened for inclusion into this study and cardiovascular diseases (CVD) risk was calculated. The two guidelines were compared with respect to the number of patients diagnosed with hypertension and eligible for treatment. Results were extrapolated to the UAE population. Financial impact of applying the 2017-ACC/AHA guideline was also evaluated. Results In comparison with the JNC-8, the 2017-ACC/AHA guideline would increase the proportion of patients diagnosed with hypertension among UAE adults from 40.8% to 76.3% and the number of UAE adults recommended for antihypertensive medications would rise from 2.42 million (32.1%) to 4.71 million (62.5%). Among UAE adults, almost 4.42 million (58.6%) and 0.76 million (10.1%) would have BP above the target according to the 2017-ACC/AHA and JNC-8 guidelines, respectively. The expected increase in the cost of anti-hypertension medications prescribed for the new labeled cases according to 2017-ACC/AHA but not JNC-8 would reach 1.8 billion AED/year. For those who were recommended for antihypertensive medications, who had BP above target, the additional cost would reach 3.5 billion AED/year. Conclusions The current study reveals marked increase in the proportion of patients diagnosed with hypertension in concordance with the 2017-ACC/AHA guideline. This is also will be associated with almost double the number of UAE adults recommended for antihypertensive medications. The poor compliance with the 2017-ACC/AHA reflects the concern regarding the increase risk of adverse events.
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Affiliation(s)
| | - Rami Beiram
- College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
| | - Salah AbuRuz
- College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
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Nutraceuticals and blood pressure control: a European Society of Hypertension position document. J Hypertens 2021; 38:799-812. [PMID: 31977574 DOI: 10.1097/hjh.0000000000002353] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
: High-normal blood pressure (BP) is associated with an increased risk of cardiovascular disease, however the cost-benefit ratio of the use of antihypertensive treatment in these patients is not yet clear. Some dietary components and natural products seems to be able to significantly lower BP without significant side effects. The aim of this position document is to highlight which of these products have the most clinically significant antihypertensive action and wheter they could be suggested to patients with high-normal BP. Among foods, beetroot juice has the most covincing evidence of antihypertensive effect. Antioxidant-rich beverages (teas, coffee) could be considered. Among nutrients, magnesium, potassium and vitamin C supplements could improve BP. Among nonnutrient-nutraceuticals, soy isoflavones could be suggested in perimenopausal women, resveratrol in insulin-resistant patients, melatonin in study participants with night hypertension. In any case, the nutracutical approach has never to substitute the drug treatment, when needed.
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40
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Wang Y, Shi GX, Tian ZX, Liu JH, Qi YS, Tu JF, Yang JW, Wang LQ, Liu CZ. Transcutaneous electrical acupoint stimulation for high-normal blood pressure: study protocol for a randomized controlled pilot trial. Trials 2021; 22:140. [PMID: 33588904 PMCID: PMC7885337 DOI: 10.1186/s13063-021-05039-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 01/09/2021] [Indexed: 01/09/2023] Open
Abstract
Background High-normal blood pressure (BP) is associated with increased all-cause, cardiovascular mortality and frequently progresses to hypertension. Transcutaneous electrical acupoint stimulation (TEAS) might be a non-pharmaceutical therapy option to control BP. This trial aims to determine the effectiveness and safety of TEAS combined with lifestyle modification for high-normal BP. Methods/design This prospective, randomized, and parallel clinical trial will be conducted in a community service center in China. Sixty participants with high-normal BP will be randomly allocated to receive TEAS plus lifestyle modification (intervention group) or lifestyle modification alone (control group) in a 1:1 ratio. In addition to lifestyle modification, the intervention group will receive TEAS at four acupoints for 30 min, 4 times weekly for 12 weeks for a total of 48 sessions at home. The control group will receive same lifestyle modification but no TEAS. The primary outcome will be the change in mean systolic blood pressure at 12 weeks from the baseline measurement. Secondary outcomes include the change of mean diastolic blood pressure, proportion of subjects with progression to hypertension, quality of life, body mass index, and waist circumference. Adverse events during the trial will be monitored. Discussion This trial will explore the feasibility and provide potential evidence for the effectiveness and safety of TEAS plus lifestyle modification for high-normal BP. Furthermore, this pilot trial is being undertaken to determine the feasibility of a full scale definitive randomized controlled trial. The results of this study will be published in a peer-reviewed journal. Trial registration Chinese Clinical Trial Registry, ChiCTR 1900024982. Registered on August 6, 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05039-5.
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Affiliation(s)
- Yu Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Zhong-Xue Tian
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Jun-Hong Liu
- Nanyuan Community Health Service Center, Fengtai District, Beijing, China
| | - You-Sheng Qi
- Nanyuan Community Health Service Center, Fengtai District, Beijing, China
| | - Jian-Feng Tu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Dongcheng District, Beijing, China
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Li-Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China.
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
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Kim H, Lee S, Ha E, Kwon SH, Jeon JS, Noh H, Han DC, Oh HJ, Ryu DR. Age and sex specific target of blood pressure for the prevention of cardiovascular event among the treatment naive hypertensive patients. Sci Rep 2020; 10:21538. [PMID: 33299061 PMCID: PMC7726552 DOI: 10.1038/s41598-020-78641-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/23/2020] [Indexed: 11/10/2022] Open
Abstract
The time at which hypertension treatment should be initiated for different age groups and sexes remains controversial. We aimed to determine whether the association between blood pressure (BP) and major adverse cardiovascular events (MACE) varies with age and sex. This study enrolled 327,328 subjects who had not taken antihypertensive medication in the Korean National Health Service-National Health Screening Cohort between 2002 and 2003. Participants were categorized into four groups according to 2017 American College of Cardiology/American Heart Association hypertension guideline. Primary outcome was MACE characterized by cardiovascular mortality, myocardial infarction, unstable angina, and stroke. During a 10-year follow-up, a significant increase in MACE risk was observed from the stage 1 hypertension group (hazard ratio [HR], 1.23; 95% CI 1.15-1.32; P < 0.001) in time-varying Cox analysis. This relationship was persistent in subjects aged < 70 years, but increased MACE risk was observed only in the stage 2 hypertension group in ≥ 70 years (HR, 1.52; 95% CI 1.32-1.76, P < 0.001). When categorized as per sex, both men and women showed significant MACE risk from stage 1 hypertension. However, on comparing the sexes after stratifying by age, a significantly increased risk of MACE was shown from stage 1 hypertension in men aged < 50 years, but from stage 2 hypertension in men aged ≥ 50 years. Meanwhile, increased MACE risk was observed from stage 2 hypertension in women aged < 60 years, but from stage 1 hypertension in women aged ≥ 60 years. Thus, young male subjects had higher MACE risk than young female subjects, but this difference gradually decreased with age and there was no difference between sexes in subjects aged ≥ 70 years. Therefore, our results suggest that hypertension treatment initiation may need to be individualized depending on age and sex.
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Affiliation(s)
- Hyoungnae Kim
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Seulbi Lee
- Department of Medical Science, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.,Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea.,Research Institute for Human Health Information, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Soon Hyo Kwon
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Jin Seok Jeon
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Hyunjin Noh
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Dong Cheol Han
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Hyung Jung Oh
- Department of Nephrology, Sheikh Khalifa Specialty Hospital, Al Shohadaa Road, Exit 119, Ras Al Khaimah, UAE.
| | - Dong-Ryeol Ryu
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Gonghang-daero 260, Gangseo-gu, Seoul, 07804, Republic of Korea.
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High-normal blood pressure and related cardiovascular risk factors prevalence in the Romanian adult population: insights from the SEPHAR III study. J Hum Hypertens 2020; 35:884-895. [PMID: 32978496 DOI: 10.1038/s41371-020-00417-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/28/2020] [Accepted: 09/15/2020] [Indexed: 11/08/2022]
Abstract
High normal blood pressure (HNBP) is associated with an increased risk of incident high blood pressure (HBP) and of cardiovascular diseases (CVD). To estimate the prevalence of HNBP and related cardiovascular risk factors, a representative sample of 1970 Romanian adults was enrolled in SEPHAR III survey (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk in Romania). All were evaluated for blood pressure values and by a 71-item questionnaire, anthropometric measurements, together with extensive evaluation for target organ damage, blood, and urine sample collection. Prevalence of HNBP was 11% [45.1% had HBP, 43.9% normal BP (NBP)]. HNBP individuals were older (51.14 ± 17.13 years) than subjects with NBP (40.5 ± 15.96 years) but younger than those with HBP (55.79 ± 15.68 years), p < 0.0001 (95% CI 18-85, respectively 18-91). Values of weight, waist circumference, body mass index, total and LDL cholesterol, triglycerides, fasting blood glucose, glycosylated hemoglobin (HbA1c), uric acid, serum creatinine, glomerular filtration rate estimate by CKD-EPI equation, urinary albumin to creatinine ratio, intimae-media thickness, arterial stiffness measurements and diastolic dysfunction, indexed left ventricular mass, interventricular septum and posterior left ventricle wall thickness, left atrial volume, and LA dilatation were significantly higher in HNBP subjects than in NBP. Our study showed that individuals with HNBP represent ~11% and most of them had an elevated total cardiovascular risk. It is essential to educate the public and health care providers to be aware of these individuals and of steps that should be taken to treat modifiable cardiovascular risk factors.
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Ongosi AN, Wilunda C, Musumari PM, Techasrivichien T, Wang CW, Ono-Kihara M, Serrem C, Kihara M, Nakayama T. Prevalence and Risk Factors of Elevated Blood Pressure and Elevated Blood Glucose among Residents of Kajiado County, Kenya: A Population-Based Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17196957. [PMID: 32977566 PMCID: PMC7579460 DOI: 10.3390/ijerph17196957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/03/2020] [Accepted: 09/19/2020] [Indexed: 12/15/2022]
Abstract
Kenya is experiencing a rising burden of non-communicable diseases (NCDs), yet data to inform effective interventions are limited. We investigated the prevalence of elevated blood pressure, elevated blood glucose and their determinants in a rapidly urbanizing area in Kenya. Data on socio-demographics, dietary and behavioural risk factors, anthropometric measurements, blood pressure, blood glucose, plasma lipids and urinary biomarkers were collected from 221 men and 372 women (25-64 years). Multivariable logistic regression models assessed correlates of elevated blood pressure (EBP) and elevated blood glucose (EBG). Participants' mean age was 38.0. ± 11.1 years. The prevalence rates of pre-hypertension and hypertension were 49.0% and 31.6% in men and 43.7% and 20.1% in women, respectively, while those of pre-diabetes and diabetes were 8.4% and 8.0% in men and 11.6% and 7.4% in women, respectively. The prevalence of Body Mass Index (BMI) ≥ 25 kg/m2 was higher in women (60.2%) than in men (39.7%). However, both the risk of EBP and EBG were stronger among men than among women. The high prevalence rates of EBP, EBG and overweight/obesity coupled with low physical activity and low fruit and vegetable intake predispose this population to a higher NCD risk. Interventions to mitigate this risk considering the sex differences are urgently required.
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Affiliation(s)
- Anita Nyaboke Ongosi
- Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe-cho, Sakyo-Ku, Kyoto 606-8501, Japan;
- Correspondence: ; Tel.: +81-090-6660-5961
| | - Calistus Wilunda
- African Population and Health Research Centre, Manga Close, Nairobi P.O. Box 10787-00100, Kenya;
| | - Patou Masika Musumari
- Interdisciplinary Unit for Global Health, Centre for the Promotion of Interdisciplinary Education and Research, Kyoto University, Yoshida hon-machi, Sakyo-ku, Kyoto 606-8501, Japan; (P.M.M.); (T.T.); (M.O.-K.); (M.K.)
- International Institute of Socio-Epidemiology, Kitagosho-cho, Sakyo-ku, Kyoto 606-8336, Japan
| | - Teeranee Techasrivichien
- Interdisciplinary Unit for Global Health, Centre for the Promotion of Interdisciplinary Education and Research, Kyoto University, Yoshida hon-machi, Sakyo-ku, Kyoto 606-8501, Japan; (P.M.M.); (T.T.); (M.O.-K.); (M.K.)
- International Institute of Socio-Epidemiology, Kitagosho-cho, Sakyo-ku, Kyoto 606-8336, Japan
| | - Chia-Wen Wang
- Population Health Research Centre, College of Public Health, National Taiwan University, Taipei 100, Taiwan;
| | - Masako Ono-Kihara
- Interdisciplinary Unit for Global Health, Centre for the Promotion of Interdisciplinary Education and Research, Kyoto University, Yoshida hon-machi, Sakyo-ku, Kyoto 606-8501, Japan; (P.M.M.); (T.T.); (M.O.-K.); (M.K.)
| | - Charlotte Serrem
- Department of Consumer Science, School of Agriculture and Biotechnology, University of Eldoret, Eldoret P.O. Box 1125-30100, Kenya;
| | - Masahiro Kihara
- Interdisciplinary Unit for Global Health, Centre for the Promotion of Interdisciplinary Education and Research, Kyoto University, Yoshida hon-machi, Sakyo-ku, Kyoto 606-8501, Japan; (P.M.M.); (T.T.); (M.O.-K.); (M.K.)
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe-cho, Sakyo-Ku, Kyoto 606-8501, Japan;
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Arsenaki E, Georgakopoulos P, Mitropoulou P, Koutli E, Thomas K, Charakida M, Georgiopoulos G. Cardiovascular Disease in Juvenile Idiopathic Arthritis. Curr Vasc Pharmacol 2020; 18:580-591. [DOI: 10.2174/1570161118666200408121307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 03/10/2020] [Accepted: 03/19/2020] [Indexed: 01/21/2023]
Abstract
Juvenile idiopathic arthritis (JIA), is a term used to describe a group of inflammatory disorders
beginning before the age of 16 years. Although for the majority of children remission is achieved
early, those with systemic or polyarticular form of the disease may present persistent symptoms in
adulthood. Considering that there is overlap in the pathogenesis of JIA with adult rheumatic diseases,
concerns have been raised as to whether JIA patients could be at increased cardiovascular (CV) risk in
the long-term. In this review, we summarize evidence for CV involvement in JIA and present data on
CV risk factors and surrogate markers of arterial disease. We also provide information on beneficial and
harmful CV effects of anti-inflammatory medications in the context of JIA and suggest strategies for
CV screening. Overall, patients with systemic forms of JIA demonstrate an adverse lipid profile and
early arterial changes relevant to accelerated arterial disease progression. Although there is paucity of
data on CV outcomes, we recommend a holistic approach in the management of JIA patients, which
includes CV risk factor monitoring and lifestyle modification as well as use, when necessary, of antiinflammatory
therapies with documented CV safety.
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Affiliation(s)
| | - Panagiotis Georgakopoulos
- National Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Evangelia Koutli
- UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, United Kingdom
| | - Konstantinos Thomas
- Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Marietta Charakida
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, United Kingdom
| | - Georgios Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King’s College, London, United Kingdom
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Dillon GA, Greaney JL, Shank S, Leuenberger UA, Alexander LM. AHA/ACC-defined stage 1 hypertensive adults do not display cutaneous microvascular endothelial dysfunction. Am J Physiol Heart Circ Physiol 2020; 319:H539-H546. [PMID: 32734817 DOI: 10.1152/ajpheart.00179.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In 2017, the American Heart Association (AHA) and American College of Cardiology (ACC) redefined stage 1 hypertension to systolic blood pressure (BP) 130-139 mmHg or diastolic BP 80-89 mmHg; however, the degree to which microvascular endothelial dysfunction is evident in adults with stage 1 hypertension remains equivocal. We tested the hypotheses that cutaneous microvascular endothelial dysfunction would be present in adults with stage 1 hypertension (HTN1) compared with normotensive adults (NTN; BP <120/<80 mmHg) but would be less severe compared with adults with stage 2 hypertension (HTN2; systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg) and that this graded impairment would be mediated by reductions in nitric oxide (NO)-dependent dilation. This retrospective analysis included 20 NTN (5 men; 45-64 yr; BP 94-114/60-70 mmHg), 22 HTN1 (11 men; 40-74 yr; BP 110-134/70-88 mmHg), and 44 HTN2 (27 men; 40-74 yr; BP 128-180/80-110 mmHg). BP and nocturnal dipping status were also assessed using 24-h ambulatory BP monitoring. Red cell flux (laser Doppler flowmetry) was measured during intradermal microdialysis perfusion of acetylcholine (ACh; 10-10 to 10-1M) alone and concurrently with the nonspecific nitric oxide (NO) synthase inhibitor NG-nitro-l-arginine methyl ester (l-NAME; 15 mM). ACh-induced dilation was impaired in HTN2 (P < 0.01), but not in HTN1 (P = 0.85), compared with NTN. Furthermore, reductions in NO-dependent dilation were evident in HTN2 (P < 0.01) but not in HTN1 (P = 0.76). Regardless of BP, endothelium-dependent dilation was impaired in nondippers (nighttime drop in systolic BP <10%) compared with dippers (nighttime drop in systolic BP ≥10%, P < 0.05). In conclusion, functional impairments in NO-mediated endothelium-dependent dilation were not evident in HTN1. However, regardless of BP classification, the lack of a nocturnal dip in BP was associated with blunted endothelium-dependent dilation.NEW & NOTEWORTHY This is the first study to pharmacologically assess the mechanistic regulation of endothelial function in adults with hypertension, classified according to the 2017 clinical guidelines set for by the American Heart Association (AHA) and American College of Cardiology (ACC). Compared with that in normotensive adults, nitric oxide-mediated endothelium-dependent dilation is impaired in adults with stage 2, but not stage 1, hypertension. Adults lacking a nighttime dip in blood pressure demonstrated reductions in endothelium-dependent dilation.
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Affiliation(s)
- Gabrielle A Dillon
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - Jody L Greaney
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania.,Department of Kinesiology, University of Texas Arlington, Arlington, Texas
| | - Sean Shank
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - Urs A Leuenberger
- Department of Medicine, Pennsylvania State College of Medicine, Hershey, Pennsylvania
| | - Lacy M Alexander
- Noll Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
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46
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Craighead DH, Freeberg KA, Seals DR. Vascular Endothelial Function in Midlife/Older Adults Classified According to 2017 American College of Cardiology/American Heart Association Blood Pressure Guidelines. J Am Heart Assoc 2020; 9:e016625. [PMID: 32815446 PMCID: PMC7660773 DOI: 10.1161/jaha.120.016625] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background Impaired endothelial function is thought to contribute to the increased cardiovascular risk associated with above‐normal blood pressure (BP). However, the association between endothelial function and BP classified by 2017 American College of Cardiology/American Heart Association guidelines is unknown. Our objective was to determine if endothelial function decreases in midlife/older adults across the 2017 American College of Cardiology/American Heart Association guidelines BP classifications and identify associated mechanisms of action. Methods and Results A retrospective analysis of endothelial function (brachial artery flow‐mediated dilation) from 988 midlife/older adults (aged 50+ years) stratified by BP status (normal BP; elevated BP; stage 1 hypertension; stage 2 hypertension) was performed. Endothelium‐independent dilation (sublingual nitroglycerin), reactive oxygen species–mediated suppression of endothelial function (∆brachial artery flow‐mediated dilation with vitamin C infusion), and endothelial cell and plasma markers of oxidative stress and inflammation were assessed in subgroups. Compared with normal BP (n=411), brachial artery flow‐mediated dilation was 12% (P=0.04), 15% (P<0.01) and 20% (P<0.01) lower with elevated BP (n=173), stage 1 hypertension (n=248) and stage 2 hypertension (n=156), respectively, whereas endothelium‐independent dilation did not differ (P=0.14). Vitamin C infusion increased brachial artery flow‐mediated dilation in those with above‐normal BP (P≤0.02) but not normal BP (P=0.11). Endothelial cell p47phox (P<0.01), a marker of superoxide/reactive oxygen species–generating nicotinamide adenine dinucleotide phosphate oxidase, and circulating interleukin‐6 concentrations (P=0.01) were higher in individuals with above‐normal BP. Conclusions Vascular endothelial function is progressively impaired with increasing BP in otherwise healthy adults classified by 2017 American College of Cardiology/American Heart Association guidelines. Impaired endothelial function with above‐normal BP is mediated by excessive reactive oxygen species signaling associated with increased endothelial expression of nicotinamide adenine dinucleotide phosphate oxidase and circulating interleukin‐6.
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Affiliation(s)
- Daniel H Craighead
- Department of Integrative Physiology University of Colorado Boulder Boulder CO
| | - Kaitlin A Freeberg
- Department of Integrative Physiology University of Colorado Boulder Boulder CO
| | - Douglas R Seals
- Department of Integrative Physiology University of Colorado Boulder Boulder CO
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Liu XZ, Chen DS, Di FP, Shi CY, Li HH, Wang JM, Ji YX. Association between cardiovascular risk factors and stage 1 hypertension defined by the 2017 ACC/AHA guidelines. Clin Exp Hypertens 2020; 42:483-489. [PMID: 31955636 DOI: 10.1080/10641963.2020.1714639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND A blood pressure (BP) of 130-139/80-89 mmHg has been defined as stage 1 hypertension by the 2017 American College of Cardiology/American Heart Association High Blood Pressure Clinical Practice Guidelines. This study was conducted to assess the association of cardiovascular risk factors (CRFs) and newly defined stage 1 hypertension in China. METHODS We analyzed the data of 84,489 adults with a BP of <140/90 mmHg. The 10-year cardiovascular disease (CVD) risk score was calculated using the China-PAR equation. Logistic analysis was used to assess the association between CRFs and stage 1 hypertension. RESULTS The mean values of CRFs, the proportion of metabolic abnormalities, the prevalence of ≥2 CRFs, and the 10-year CVD risk of individuals with a BP of 130-139/80-89 mmHg were significantly higher than those of the population with a BP of <130/80 mmHg. The adjusted odds ratios (ORs) of waist circumference, fasting plasma glucose (FPG), and triglycerides were 1.362 (CI 95% = 1.081-1.715, p = .009), 1.264 (CI 95% = 1.093-1.462, p = .002), and 1.331 (CI 95% = 1.009-1.755, p = .043), respectively. Other CRFs were not significantly associated with stage 1 hypertension. CONCLUSIONS Multidisciplinary and targeted interventions are required to manage the CRFs (especially abdominal obesity, elevated FPG, and hypertriglyceridemia) of the population with a BP of 130-139/80-89 mmHg in China.
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Affiliation(s)
- Xing Zhen Liu
- The First Convalescence Area, Hangzhou Aeronautical Sanatorium of Chinese Air Force , Hangzhou, China
| | - Dong Shui Chen
- The First Convalescence Area, Hangzhou Aeronautical Sanatorium of Chinese Air Force , Hangzhou, China
| | - Fu Ping Di
- The First Convalescence Area, Hangzhou Aeronautical Sanatorium of Chinese Air Force , Hangzhou, China
| | - Cheng Yong Shi
- Department of Cardiology, No. 903 Hospital of People's Liberation Army , Hangzhou, China
| | - Hui Hua Li
- Departmemt of Endocrinology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai, China
| | - Jun Min Wang
- Management department, Hangzhou Aeronautical Sanatorium of Chinese Air Force , Hangzhou, China
| | - Yi Xin Ji
- Management department, Hangzhou Aeronautical Sanatorium of Chinese Air Force , Hangzhou, China
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48
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Aronow WS. Should elevated blood pressure be treated with antihypertensive drug therapy? J Clin Hypertens (Greenwich) 2020; 22:1635-1637. [PMID: 32790147 DOI: 10.1111/jch.13981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 06/29/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Wilbert S Aronow
- Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Vaslhalla, New York, USA
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Machado CLF, Bgeginski R, De Castro C, Wilhelm EN, Pinto RS. Acute Hemodynamic Responses to Repetitions to Failure Using Different Resistance Exercises and Protocols in Normotensive Men: A crossover study. Clin Exp Hypertens 2020; 42:401-408. [PMID: 31594394 DOI: 10.1080/10641963.2019.1676772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present crossover design study investigated acute hemodynamic responses to two sets of leg press (LP) and bench press (BeP) at 10 and 20 repetition maximum (RM) in ten normotensive young men. At the end of each set, an increase in systolic blood pressure (SBP), heart rate (HR), and rate pressure product (RPP) was observed (p < .01), with no differences between intensities, but SBP was greater during the LP exercise (p < .01). Lower resting values of diastolic blood pressure (DBP) were observed in the post-BeP exercise period (p < .05), suggesting that DBP post-exercise hypotension may be more evident after upper-limb exercise.
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Affiliation(s)
- Carlos Leonardo Figueiredo Machado
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul - Porto Alegre, Rio Grande do Sul, Brazil
| | - Roberta Bgeginski
- R. Samuel McLaughlin Foundation - Exercise and Pregnancy Lab, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada
| | - Clarissa De Castro
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul - Porto Alegre, Rio Grande do Sul, Brazil
| | - Eurico Nestor Wilhelm
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul - Porto Alegre, Rio Grande do Sul, Brazil
| | - Ronei Silveira Pinto
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul - Porto Alegre, Rio Grande do Sul, Brazil
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50
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Cai X, Zheng S, Liu Y, Zhang Y, Lu J, Huang Y. Nonalcoholic fatty liver disease is associated with increased risk of atrial fibrillation. Liver Int 2020; 40:1594-1600. [PMID: 32279432 DOI: 10.1111/liv.14461] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 03/28/2020] [Accepted: 03/30/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Whether nonalcoholic fatty liver disease (NAFLD) is associated with risk of incident atrial fibrillation (AF) independent of established cardiovascular risk factors remains controversial. We aimed to provide a quantitative estimate of the association between NAFLD and risk of AF after adjustment for cardiometabolic risk factors. METHODS In this study, we searched PubMed and Embase for studies published from database inception until January 31, 2020. Cohort studies reported adjusted relative risks (RRs) and 95% confidence intervals (CIs) for AF of NAFLD compared with non-NAFLD were included for analysis. RESULTS A total of 6 cohort studies were included, comprising 614 673 individuals for analysis. The median follow-up duration was 10.0 years with 7271 cases of incident AF. Compared with non-NAFLD, minimally adjusted models without adjustment for cardiometabolic risk factors showed that NAFLD was associated with increased risk of AF (RR 1.65, 95% CI 1.23-2.20, I2 = 63.0%). After adjustment for multiple cardiometabolic risk factors, the association between NAFLD and risk of AF was still higher than that in non-NAFLD (RR 1.19, 95% CI 1.04-1.31, I2 = 54.0%). There was significant heterogeneity for the risk of AF between minimally and maximally adjusted models (I2 = 77.1%, P for heterogeneity = 0.04). Compared with non-NAFLD, the absolute risk increase in NAFLD for AF was 1.3 (95% CI 0.5-2.1) per 1000 person-years. CONCLUSIONS NAFLD is associated with increased risk of incident AF. The strength of the association between NAFLD and AF is partially attributed to the co-existing cardiometabolic risk factors.
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Affiliation(s)
- Xiaoyan Cai
- Department of Scientific Research and Education, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, China
| | - Sulin Zheng
- Department of Cardiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, China
| | - Ying Liu
- VIP Clinic Center, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, China
| | - Yan Zhang
- Department of Cardiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, China
| | - Jianhua Lu
- Department of Cardiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, China
| | - Yuli Huang
- Department of Cardiology, Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, China.,The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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