Uncontrolled Hypertension Increases with Age in an Older Community-Dwelling Chinese Population in Shanghai

Associations of healthy eating patterns with biological aging: national health and nutrition examination survey (NHANES) 1999-2018

BACKGROUND

Healthy dietary patterns have been negatively associated with methylation-based measures of biological age, yet previous investigations have been unable to establish the relationship between them and biological aging assessed through blood chemistry-based clinical biomarkers. We sought to assess the associations of 4 dietary metrics with 4 measures of biological age.

METHODS

Among 16,666 participants in NHANES 1999-2018, 4 dietary metrics [Dietary inflammatory index (DII), Dietary approaches to stop hypertension index (DASH), Alternate mediterranean diet score (aMED), and Healthy eating index-2015 (HEI-2015)] were calculated through the 'dietaryindex' R package. Twelve blood chemistry parameters were utilized to compute 4 indicators of biological age [homeostatic dysregulation (HD), allostatic load (AL), Klemera-Doubal method (KDM), and phenotypic age (PA)]. Binomial logistic regression models and restricted cubic spline (RCS) regression were employed to evaluate the associations.

RESULTS

All 4 dietary metrics were significantly associated with biological age acceleration or deceleration. In comparison to the lowest DII, the odds ratios (ORs) for accelerated HD, AL, KDM, and PA were 1.25 (1.08,1.45), 1.29 (1.11,1.50), 1.34 (1.08,1.65), and 1.61 (1.39,1.87) for the highest. The multivariable-adjusted ORs of the highest quartile of DASH, aMED, and HEI-2015 were 0.85 (0.73,0.97), 0.88 (0.74,1.04), and 0.84 (0.74,0.96) for HD, 0.64 (0.54,0.75), 0.61 (0.52,0.72), and 0.70 (0.59,0.82) for AL, 0.68 (0.54,0.85), 0.62 (0.50,0.76), and 0.71 (0.58,0.87) for KDM, and 0.50 (0.42,0.59), 0.64 (0.54,0.76), and 0.51 (0.44,0.58) for PA when compared with the lowest level. The findings were validated by the best-fitting dose-response curves for the associations. Among participants consuming dietary supplements (Pinteraction < 0.05), the positive effects of a healthy dietary pattern on biological aging were more pronounced. Systemic immune inflammation index (SII) and atherogenic index of plasma (AIP) were identified as being involved in and mediating the associations.

CONCLUSIONS

Biological aging assessed through blood chemistry-based clinical biomarkers is negatively associated with diet quality. The anti-aging benefits of improving the diet may be due to its ability to reduce inflammation and lower blood lipids.

Uncontrolled blood pressure among the established hypertensive elderly people in Jashore, Bangladesh: A cross-sectional type of observational study

Objectives

Hypertension is one of the major modifiable risk factors for cardiovascular mortality and morbidity throughout the world. Increased life expectancy leads to increase prevalence of non-communicable diseases among the elderly people including Bangladesh. However, different studies reported high prevalence of uncontrolled hypertension ranging from 52.6% to 67.9% among the elderly people in different countries. With this view, we aimed to assess the frequency of uncontrolled blood pressure (BP) among the elderly hypertensive people and its associated risk factors and treatment pattern in Bangladesh.

Methodology

This cross-sectional type of observational study recruited 246 eligible hypertensive elderly patients attending in 250 Bedded General Hospital, Jashore, Bangladesh dated from 1st July to 31st December 2022. A structured questionnaire was developed and data on associated risk factors, treatment pattern and current blood pressure (BP) measurement were collected by face-to-face interview for the purposive sampling technique.

Results

The mean age of our study patients was 72 ± 7 years with a male and female ratio nearly 1:1. Of the total hypertensive patients aged over 65 years or more, 56.5% remained with uncontrolled hypertension even on their prescribed antihypertensive medications. The mean systolic (SBP) and diastolic (DBP) blood pressure were significantly high (P < 0.001) as 167 ± 22 mm Hg and 95 ± 11 mm Hg, respectively, among the uncontrolled hypertensive patients. However, we noticed the mean SBP and DBP among the total hypertensive patients were also significantly high (P < 0.001) as 148 ± 27 mm Hg and 87 ± 13 mm Hg, respectively. In this study, we reported that the mean number of last prescribed antihypertensive medications used by the total patients was 2 ± 1 (P =0.224) which was similar among the controlled and uncontrolled hypertensive patient groups. Among the elderly hypertensive patients, the most commonly prescribed antihypertensive medications were Amlodipine 39.8% (P =0.006), Olmesartan 29.3% (P = 0.186), Losartan 24.4% (P = 0.127), Bisoprolol 15.0% (P = 0.266) and Atenolol 14.6% (P = 0.224).

Conclusion

We noticed high frequency of uncontrolled blood pressure among the elderly hypertensive patients, despite of using multiple antihypertensive medications in Jashore, Bangladesh.

U-shaped association between sleep duration and biological aging: Evidence from the UK Biobank study

Previous research on sleep and aging largely has failed to illustrate the optimal dose-response curve of this relationship. We aimed to analyze the associations between sleep duration and measures of predicted age. In total, 241,713 participants from the UK Biobank were included. Habitual sleep duration was collected from the baseline questionnaire. Four indicators, homeostatic dysregulation (HD), phenoAge (PA), Klemera-Doubal method (KDM), and allostatic load (AL), were chosen to assess predicted age. Multivariate linear regression models were utilized. The association of sleep duration and predicted age followed a U-shape (All p for nonlinear <0.05). Compared with individuals who sleep for 7 h/day, the multivariable-adjusted beta of ≤5 and ≥9 h/day were 0.05 (95% CI 0.03, 0.07) and 0.03 (95% CI 0.02, 0.05) for HD, 0.08 (95% CI 0.01, 0.14) and 0.36 (95% CI 0.31, 0.41) for PA, and 0.21 (95% CI 0.12, 0.30) and 0.30 (95% CI 0.23, 0.37) for KDM. Significant independent and joint effects of sleep and cystatin C (CysC) and gamma glutamyltransferase (GGT) on predicted age metrics were future found. Similar results were observed when conducting stratification analyses. Short and long sleep duration were associated with accelerated predicted age metrics mediated by CysC and GGT.

The Association of Lipoprotein(a) and Neutrophil-to-Lymphocyte Ratio Combination with Atherosclerotic Cardiovascular Disease in Chinese Patients

Objective

The association of lipoprotein(a) [Lp(a)] with atherosclerotic cardiovascular disease (ASCVD) risk can be modified by chronic systemic inflammation. The neutrophil-to-lymphocyte ratio (NLR) is a reliable and easily available marker of immune response to various infectious and non-infectious stimuli. The purpose of this study was to assess the combined effects of Lp(a) and NLR in predicting the ASCVD risk and coronary artery plaque traits.

Methods

This study included 1618 patients who had coronary computed tomography angiography (CTA) with risk assessment of ASCVD. CTA was used to evaluate the traits of coronary atherosclerotic plaques, and the association of ASCVD with Lp(a) and NLR was assessed by multivariate logistic regression models.

Results

Plasma Lp(a) and NLR were significantly increased in patients having plaques. High Lp(a) was defined as the plasma Lp(a) level > 75 nmol/L and high NLR as NLR > 1.686. The patients were grouped into four categories according to normal or high NLR and plasma Lp(a) as nLp(a)/NLR-, hLp(a)/NLR-, nLp(a)/NLR+ and hLp(a)/NLR+. The patients in the latter three groups had higher risk of ASCVD compared to the reference group nLp(a)/NLR-, with the highest ASCVD risk in the hLp(a)/NLR+ group (OR = 2.39, 95% CI = 1.49-3.83, P = 0.000). The occurrence of unstable plaques was 29.94% in the hLp(a)/NLR+ group, which was significantly higher than groups nLp(a)/NLR+, hLp(a)/NLR- and nLp(a)/NLR- with 20.83%, 26.54% and 22.58%, respectively, and there was a significantly increased risk of unstable plaque in the hLp(a)/NLR+ group compared to the nLp(a)/NLR- group (OR = 1.67, 95% CI = 1.04-2.68, P = 0.035). The risk of stable plaque was not significantly increased in the hLp(a)/NLR+ group compared to the nLp(a)/NLR- group (OR = 1.73, 95% CI = 0.96-3.10, P = 0.066).

Conclusion

The concomitant presence of elevated Lp(a) and higher NLR is associated with increased unstable coronary artery plaques in patients with ASCVD.

Uncontrolled blood pressure and contributing factors among patients with hypertension at outpatient care of Bedele General Hospital, Southwest Ethiopia: A cross-sectional study

Objective

This study aimed to assess uncontrolled blood pressure and contributing factors among patients with hypertension.

Methods

Hospital-based cross-sectional study was conducted from January to April 2021 at Bedele General Hospital. Data were collected using the semi-structured questionnaire. All patients with hypertension were included using consecutive sampling technique unless ineligible. EpiData 4.4.2 was used for data entry, and SPSS 24.0 was employed for analysis. Binary logistic regression analysis was performed to identify factors associated with uncontrolled blood pressure.

Results

A total of 219 patients with hypertension were included in the study. About 60.3% of participants were male. The mean age of the study participants was 48.54 ± 12.93 years. The prevalence of uncontrolled blood pressure among the study participants was 56.2%. The factors significantly associated with uncontrolled blood pressure were age >60 years (adjusted prevalence ratio = 4.42; 95% confidence interval = (1.71, 11.46); p = 0.002) and the presence of comorbidity (adjusted prevalence ratio = 2.16; 95% confidence interval = (1.22, 3.82); p = 0.008).

Conclusion

More than half of the study participants had uncontrolled blood pressure. Older age and comorbidity were the predictors of uncontrolled blood pressure. Attaining controlled blood pressure is important to avoid consequences of high blood pressure. So, healthcare provider should focus on achieving target blood pressure goal.

High visit-to-visit blood pressure variability predicts global cognitive decline: The Multi-Ethnic Study of Atherosclerosis

Background

Research of hypertension-related risk factors for Alzheimer's disease has typically focused on blood pressure (BP) levels, despite evidence that high blood pressure variability (BPV) over time may predict poorer cardiovascular, neuropathological, and neurocognitive outcomes. We evaluated associations between BPV and cognitive function in the Multi-Ethnic Study of Atherosclerosis (MESA).

Methods

Multivariable linear and logistic regression analyses of BP data across six examinations were used to determine associations that BPV (average real variability [ARV], variability independent of the mean [VIM]) and group-based latent BP trajectories have with cognitive function, decline, and impairment, measured by the Cognitive Abilities Screening Instrument (CASI), Digit Symbol Coding (DSC), and Digit Span tests.

Results

Participants (N = 1314; mean baseline age = 57) were 50% female, and 48% White. Higher systolic (β = -0.06, 95% confidence interval [CI]: -0.12, -0.0001) and diastolic (β = -0.08, 95% CI: -0.14, -0.02) ARV predicted increased global cognitive decline after covariate adjustment. Stronger relationships between BPV and global cognition were in older, White and Black participants, apolipoprotein E (APOE) ε4 non-carriers, male participants, and non-antihypertensive medication users.

Conclusion

Results suggest that higher systolic and diastolic BPV is an independent risk factor for cognitive dysfunction and decline in this multi-ethnic cohort. This relationship differs across demographic and clinical characteristics.

Insulin resistance surrogates predict hypertension plus hyperuricemia

AIMS/INTRODUCTION

To compare the association of hypertension plus hyperuricemia with four insulin resistance surrogates, including glucose and triglycerides (TyG index), TyG index with body mass index (TyG-BMI), the ratio of triglycerides divided by high-density lipoprotein cholesterol (TG/HDL-C) and metabolic score for insulin resistance (METS-IR).

MATERIALS AND METHODS

Data from a cross-sectional epidemiological study enrolling a representative population sample aged ≥65 years were used to calculate the four indexes. The association with hypertension plus hyperuricemia and insulin resistance surrogates was examined with multivariate logistic regression and receiver operating characteristic.

RESULTS

A total of 4,352 participants were included, including 93 (2.1%) patients with hyperuricemia alone, 2,875 (66.1%) with hypertension alone and 587 (13.5%) with hypertension plus hyperuricemia. Mutivariate logistic regression showed that TyG index, TyG-BMI, TG/HDL-C and METS-IR were all significantly correlated with hyperuricemia, hypertension and hypertension plus hyperuricemia. Compared with the lowest quartile, the odds ratios (OR) of the highest quartile of the four indicators for hypertension plus hyperuricemia were TyG index: OR 6.39 (95% confidence interval [CI] 4.17-9.78); TyG-BMI: OR 8.54 (95% CI 5.58-13.09); TG/HDL-C: OR 7.21 (95% CI 4.72-11.01); METS-IR: OR 9.30 (95% CI 6.00-14.43), respectively. TyG-BMI and METS-IR had moderate discriminative abilities for hypertension plus hyperuricemia and the AUC values were 0.72 (95% CI 0.70-0.74) and 0.73 (95% CI 0.70-0.75).

CONCLUSIONS

The present study suggested that TyG index, TyG-BMI, TG/HDL-C and METS-IR had a significant correlation with hypertension plus hyperuricemia, and TyG-BMI and METS-IR had discriminative abilities for hypertension plus hyperuricemia.

Associations between PM2.5 exposure duration and physical activity intensity on the health of hypertension in urban residents of Beijing

Hypertension is reported to be associated with air pollution and physical activity (PA), and they have different or even conflicting effects on blood pressure (BP). The study evaluated the combined effects of PM2.5 exposure duration and physical activity intensity on systolic blood pressure (SBP) and diastolic blood pressure (DBP) of hypertension. A total of 2613 patients (≥18-year-olds) at baseline who attended surveys from the China Health and Nutrition Survey (2011-2015) in Beijing were selected, as well as the PM2.5 data collected in the same period. The mixed linear effects model and multivariate analysis of variance (MANOVA) were used to explore the multiple effects of PM2.5 exposure duration and PA intensity on SBP and DBP, respectively. The correlation results indicated PM2.5 exposure duration (>15 days) occurred more significant correlations with DBP and longer PM2.5 exposures duration (>60 day) with SBP. The mixed linear effects model showed the important random terms of gender, PA levels, and BMI classification for both SBP and DBP. It also indicated the significant fixed effect from age for both SBP and DBP, and the significant fixed effects from PM2.5 and weight, as well as the interaction in DBP. The random effects of PA levels put effects on different weight people for SBP and on different age people for DBP, while the person of SBP exposed to PM2.5 environments may tend to be affected by BMI classification. The model's main effects showed PA and the interaction with gender could put significant effects on BP. The gender effects and the PA level effects were also improved by the MANOVA results. We concluded that the more PM2.5 exposure duration may lead to more significant correlation with higher BP values. The PA levels could lead to the different effects on the health showing the variations in age, gender, and BMI classification. For SBP of people who are exposed to PM2.5 environments, it may tend to be affected by BMI classification, which also may influence the DBP through weight adjusting first and then cause hypertension. The gender difference of BP may be affected by PA showing the higher PA level and the more gender difference.

Association Between Renal Dysfunction and Low HDL Cholesterol Among the Elderly in China

Objective: Chronic kidney disease (CKD) and cardiovascular disease (CVD) have a high morbidity and mortality among the elderly. Low levels of high-density lipoprotein cholesterol (HDL-C), a traditional risk marker for CVD, are common in CKD patients. Little is known about the association of low HDL-C with renal dysfunction in the community dwelling population. Methods: This was a population-based cross-sectional study included 4,753 participants enrolled in a prospective study, the Shanghai Elderly Cardiovascular Health (SHECH) study. Estimated glomerular filtration rate (eGFR), calculated by the Chinese Modification of Diet in Renal Disease (C-MDRD equation), was used to assess renal dysfunction. Associations between renal dysfunction and low HDL-C were evaluated using multiple logistic regression models and restricted cubic splines. Results: Of 4,649 individuals who met inclusion criteria, 620 (13.34%) had low HDL-C at <40 mg/dl. In the fully adjusted model, lower eGFR of <60 ml/min/1.73 m2 (OR, 2.03; 95% CI, 1.21-3.43) and marginal eGFR of 60 to 90 ml/min/1.73 m2 (OR, 1.26; 95% CI, 1.01-1.58) were significantly associated with low HDL-C, compared with normal eGFR of ≥90 ml/min/1.73 m2. Moreover, consistent findings were obtained in subsidiary analyses using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Fully adjusted cubic spline models indicated a significant dose-response relationship between eGFR and low HDL-C (P for non-linearity, 0.356). Conclusion: In this general elderly population, renal dysfunction was independently and significantly associated with low HDL-C, and the prevalence of low HDL-C increased with decreasing eGFR, such that even slight changes in renal function may be associated with altered lipid levels.

Dietary supplementation of Huangshan Maofeng green tea preventing hypertension of older C57BL/6 mice induced by desoxycorticosterone acetate and salt

Senile hypertension affects the life quality of aged population. Dietary intervention plays a pivotal role in the prevention of hypertension. There are few reports concerning the effects and mechanisms of green tea supplementation preventing age related hypertension. The current study investigated the effect and mechanism of dietary supplement of Huangshan Maofeng green tea (HSMF) on prevention of hypertension induced by deoxycorticosterone acetate (DOCA) and salt in old C57BL/6 mice. Our results showed that HSMF dose-dependently prevented the increase of systolic blood pressure and diastolic blood pressure induced by DOCA plus salt (DS) at 51-week-old mice. And HSMF significantly reduced the agonists' stimulated contraction of mesenteric arteries isolated from the old mice. The expression of vasoconstrictor genes and inflammatory cytokines in aorta were suppressed observably by HSMF supplementation compared with DS group. The protein expression of PKCα in the aorta was dose-dependently decreased by HSMF compared to DS group. The phosphorylation level of MYPT1, CPI-17and MLC20 was also restrained by HSMF in the aorta. Furthermore, HSMF protected kidney by maintaining integrity of glomeruli and tubules and remarkably decreased the NGAL level in plasma. HSMF also suppressed the kidney inflammation by decreasing inflammatory cytokines expression and the macrophage infiltration. Our results proved that dietary supplement of HSMF remarkably improved the vascular functions and protected kidney injury, and thus prevented hypertension induced by DS in older C57BL/6 mice. Our data indicated that the dietary supplement of HSMF may potentially be used as a food additive for preventing hypertension for aged people.

A Stronger Association of Epicardial Fat Volume with Non-Valvular Atrial Fibrillation Than Measures of General Obesity in Chinese Patients Undergoing Computed Tomography Coronary Angiography

OBJECTIVE

An association of atrial fibrillation (AF) with epicardial fat volume (EFV) varied in different ethnic groups. We evaluated the AF-related risk factors and its association with pericardial fat in Chinese patients.

METHODS

Patients referred for coronary computed tomography angiography (CCTA) in Shanghai East Hospital during 2012 to 2014 (n=2042, 43.8% women, mean age 65.0 years) had AF and cardiovascular risk assessment. Pericardial fat depots were measured from CT and the association of EFV with non-valvular AF risk factors was evaluated by multivariate logistic regression models.

RESULTS

AF was present in 8.5% of patients with 11.6% of AF patients having rheumatic heart disease (RHD) and 8.7% having other valvular diseases. With increasing age, the proportion of RHD-related AF decreased and the risk factors for non-valvular AF increased. There was a significantly higher proportion of risk factors for non-valvular AF in men than in women (p=0.008), but RHD-related AF was more prevalent in women than men (p=0.013). The patients with non-valvular AF had significantly higher BMI and EFV with more pronounced elevation of EFV (p<0.001). Multivariate logistic regression showed a significant association of EFV with AF after adjustment for BMI and clinical risk factors, and the highest EFV quartile was associated with AF independent of left atrial size and obstructive coronary artery disease.

CONCLUSION

The association of EFV with non-valvular AF in Chinese patients was independent of generalized adiposity and clinical risk factors especially in highest EFV quartile. These findings support the growing appreciation of the association of EFV with AF.

Prevalence, risk factors, and management of uncontrolled hypertension among patients with diabetes: A hospital-based cross-sectional study

AIMS

This research examines the prevalence of uncontrolled hypertension and associated risk factors among patients with diabetes in Saudi Arabia.

METHODS

A hospital-based, cross-sectional study was used in patients with diabetes and hypertension attending outpatient diabetes clinics in King Khaled Hospital and Prince Sultan Center for Health Care in Al-Kharj, Riyadh. Patients' information, data on hypertension, type of treatment, and comorbidities were captured through electronic medical records. Uncontrolled hypertension was defined as blood pressure (BP) measurements greater than or equal to 140/90 mmHg. Antihypertensive medication use among these patients was analyzed. Multivariate analysis was performed to detect the associated factors of uncontrolled hypertension.

RESULTS

Of 1178 outpatients‬ with diabetes who were included in the study sample, uncontrolled hypertension presented in 846 (71.8%). Most patients were on two antihypertensive medications, and the most frequently used was calcium channel blockers, followed by angiotensin-converting enzyme inhibitors. Individuals most likely to have uncontrolled hypertension were those older than 65 years (OR 1.99, 95%CI: 1.059, 3.77), male (OR = 1.51, 95%CI: 1.031, 2.22), and obese (OR = 2.39, 95%CI: 1.63, 3.504), with two (OR = 3.894, 95% CI: 2.481, 6.114) or three or more comorbidities (OR = 4.020, 95% CI: 2.510, 6.439), and with polypharmacy (OR = 1.814, 95% CI: 1.238, 2.656).

CONCLUSION

The extent of uncontrolled hypertension among patients with diabetes in the study sample was found to be high. Age, sex, obesity, number of comorbidities, and polypharmacy are the most important correlates with increased risk of uncontrolled hypertension.

The effects of Canola oil on cardiovascular risk factors: A systematic review and meta-analysis with dose-response analysis of controlled clinical trials

BACKGROUND AND AIMS

Canola oil (CO) is a plant-based oil with the potential to improve several cardiometabolic risk factors. We systematically reviewed controlled clinical trials investigating the effects of CO on lipid profiles, apo-lipoproteins, glycemic indices, inflammation, and blood pressure compared to other edible oils in adults.

METHODS AND RESULTS

Online databases were searched for articles up to January 2020. Forty-two articles met the inclusion criteria. CO significantly reduced total cholesterol (TC, -0.27 mmol/l, n = 37), low-density lipoprotein cholesterol (LDL-C, -0.23 mmol/l, n = 35), LDL-C to high-density lipoprotein cholesterol ratio (LDL/HDL, -0.21, n = 10), TC/HDL (-0.13, n = 15), apolipoprotein B (Apo B, -0.03 g/l, n = 14), and Apo B/Apo A-1 (-0.02, n = 6) compared to other edible oils (P < 0.05). Compared to olive oil, CO decreased TC (-0.23 mmol/l, n = 9), LDL-C (-0.17 mmol/l, n = 9), LDL/HDL (-0.39, n = 2), and triglycerides in VLDL (VLDL-TG, -0.10 mmol/l, n = 2) (P < 0.05). Compared to sunflower oil, CO improved LDL-C (-0.14 mmol/l, n = 11), and LDL/HDL (-0.30, n = 3) (P < 0.05). In comparison with saturated fats, CO improved TC (-0.59 mmol/l, n = 11), TG (-0.08 mmol/l, n = 11), LDL-C (-0.49 mmol/l, n = 10), TC/HDL (-0.29, n = 5), and Apo B (-0.09 g/l, n = 4) (P < 0.05). Based on the nonlinear dose-response curve, replacing CO with ~15% of total caloric intake provided the greatest benefits.

CONCLUSION

CO significantly improved different cardiometabolic risk factors compared to other edible oils. Further well-designed clinical trials are warranted to confirm the dose-response associations.

An Analysis of Medication Prescriptions for Hypertension in Urban and Rural Residents in Tianjin

INTRODUCTION

This study aims to examine the medication prescriptions for hypertension in Tianjin.

METHODS

Patients with hypertension in Tianjin were enrolled in this study. The patients' ages ranged from 35 to 75 years. A questionnaire survey and physical examination were completed to collect clinical data. Thereafter, a statistical analysis of the medication prescriptions was conducted with different age groups and different grades of hypertension.

RESULTS

The results show that, in the total population, and for the young, middle-aged, and older groups, the proportions of single-drug use were 62.97%, 59.26%, 62.76%, and 63.49%, respectively, and the highest rate was for calcium channel blocker (CCB) use. The rates of the two drug classes were 24.51%, 29.63%, 25.13%, and 23.15%, respectively. The drug use rate of CCBs combined with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor antagonists (ARBs) was the highest. The rates of the three drug classes were 4.08%, 4.94%, 4.36%, and 3.52%, respectively, and the highest was ACEI/ARB and CCB combined with diuretics. The rates of the four drug classes were low. Regarding the hypertension grade, in grade 1, grade 2, and grade 3, the rates of single-drug use were 63.53%, 62.69%, and 58.38%, respectively. The rates of the two drug classes were 24.62%, 23.97%, and 25.05%, while the rates of the three drug classes were 3.86%, 4.39%, and 5.34%, respectively.

CONCLUSION

The rate of single-drug use was high, and the rate of combined drug use in the youth group was slightly higher than in the middle-aged and older age groups. The combination of two drugs was common. In grades 2 and 3 hypertension, the rate of combined drug use remained low.

Prevalence and associated factors of uncontrolled hypertension among hypertensive patients: a nation-wide survey in Thailand

Objectives

The objectives of the research were to determine the prevalence and factors associated of uncontrolled blood pressure among Thai hypertensive patients in a nationwide survey.

Results

A total of 65,667 patients with hypertension were included in this study. The greater proportion of participants, 40,834 (62.2%), were females. The average age of participants was 63.9 ± 11.1 years. Uncontrolled hypertension was detected among 16,122 patients (24.6%; 95% CI 24.2–24.9). Among males and females, uncontrolled hypertension was 25.6% (95% CI 25.1–26.2) and 23.9% (95% CI 23.5–24.3) respectively. Multivariate analysis showed that the uncontrolled hypertension was significantly associated with being male, age, regions, hospital levels, diabetes comorbidity, higher body mass index, low density lipoprotein cholesterol level and the number of antihypertensive medications.

Intensive Lipid-Lowering Therapy Ameliorates Asymptomatic Intracranial Atherosclerosis

Statins have proven to exert protective effects in patients with symptomatic intracranial atherosclerotic stenosis (SICAS). It is unclear whether intensive lipid-lowering therapy (ILLT) can ameliorate atherosclerosis in asymptomatic ICAS (AICAS). A single-center, prospective cohort study was performed in 71 AICAS patients with lipid-lowering therapy. Vascular stenoses were evaluated with transcranial color-coded sonography (TCCS) before and after statin treatment. With target therapeutic level of low-density lipoprotein cholesterol (LDL-C) ≤ 1.8 mmol/L or ≥ 50% reduction from baseline after the two years of follow-up, patients were divided into intensive statin treatment (IST) group and standard statin treatment (SST) group. A total of 104 stenotic intracranial arteries were detected in 51 patients belonging to the IST group and 47 arteries in 20 patients of the SST group. In the first year, LDL-C levels were significantly decreased in the IST compared with SST groups (1.48 ± 0.26 vs. 2.20 ± 0.58, P=0.000). However, the ratio of regressed ICAS in IST was not significantly higher than that in SST (26.3% vs. 5.9%, P=0.052). Forty-nine branches in 25 patients of the IST group and 16 branches in 7 patients of the SST group were followed up for two years. The LDL-C level was decreased in the IST compared with SST groups (1.55 ± 0.29 vs. 2.36 ± 0.77, P=0.048). The ratio of regressed ICAS in the IST group was significantly higher than that in SST group (34.7% vs. 6.3%, P=0.017). We concluded that the degree of stenosis in AICAS can be ameliorated with intensive lipid-lowering therapy within two years; target LDL-C level can be reached by moderate-intensity statin treatment for Chinese AICAS patients.

Advanced glycation end products and risk of hypertension in Iranian adults: Tehran lipid and glucose study

Background:

Elevated blood pressure is still one of the major risk factors for diseases and disabilities and also a public health challenge worldwide. In the present longitudinal study, we aimed to evaluate the association between risk of hypertension and dietary advanced glycation end products (AGEs) as a recently discussed potential risk factor.

Materials and Methods:

Dietary assessment of 1775 participants in the third phase of Tehran lipid and glucose study to obtain dietary intake of AGEs was performed using a validated semi-quantitative food frequency questionnaire, and they were followed up for a mean duration of approximately 6 years. To determine the incidence of hypertension across quartiles of AGEs intake, logistic regression models with adjustment for potential confounding variables were used. All statistical analyses were conducted using SPSS, and P < 0.05 was considered statistically significant.

Results:

Higher hypertension occurrence risk was generally attributed to higher AGEs intake quartiles after adjusting for age in men (odds ratio [OR] = 1.48, 95% confidence interval [CI] = 1.11–1.52, P = 0.038) and additional adjustment for smoking, drugs, and physical activity in women (OR = 1.38%–95% CI = 1.09–1.42, P = 0.042). Moreover, across the increasing trend of dietary AGEs intake, the percentage of fat intake increased and that of carbohydrate significantly decreased (P < 0.0001).

Conclusion:

In conclusion, it is highly recommended to limit dietary AGEs consumption to prevent and manage hypertension and its complications.