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International Journal of Molecular... Dec 2015Adulthood hypertension can be programmed in response to a suboptimal environment in early life. However, developmental plasticity also implies that one can prevent... (Review)
Review
Adulthood hypertension can be programmed in response to a suboptimal environment in early life. However, developmental plasticity also implies that one can prevent hypertension in adult life by administrating appropriate compounds during early development. We have termed this reprogramming. While the risk of hypertension has been assessed in many mother-child cohorts of human developmental programming, interventions necessary to prove causation and provide a reprogramming strategy are lacking. Since the developing kidney is particularly vulnerable to environmental insults and blood pressure is determined by kidney function, renal programming is considered key in developmental programming of hypertension. Common pathways, whereby both genetic and acquired developmental programming converge into the same phenotype, have been recognized. For instance, the same reprogramming interventions aimed at shifting nitric oxide (NO)-reactive oxygen species (ROS) balance, such as perinatal citrulline or melatonin supplements, can be protective in both genetic and developmentally programmed hypertension. Furthermore, a significantly increased expression of gene Ephx2 (soluble epoxide hydrolase) was noted in both genetic and acquired animal models of hypertension. Since a suboptimal environment is often multifactorial, such common reprogramming pathways are a practical finding for translation to the clinic. This review provides an overview of potential clinical applications of reprogramming strategies to prevent programmed hypertension. We emphasize the kidney in the following areas: mechanistic insights from human studies and animal models to interpret programmed hypertension; identified risk factors of human programmed hypertension from mother-child cohorts; and the impact of reprogramming strategies on programmed hypertension from animal models. It is critical that the observed effects on developmental reprogramming in animal models are replicated in human studies.
Topics: Animals; Antihypertensive Agents; Epoxide Hydrolases; Humans; Hypertension; Kidney; Prehypertension; Reactive Oxygen Species
PubMed: 26712746
DOI: 10.3390/ijms17010023 -
Hypertension (Dallas, Tex. : 1979) Feb 2020Hypertension, a multifactorial disorder resulting from the interplay between genetic predisposition and environmental risk factors, affects ≈30% of adults. Emerging... (Review)
Review
Hypertension, a multifactorial disorder resulting from the interplay between genetic predisposition and environmental risk factors, affects ≈30% of adults. Emerging evidence has shown that nonalcoholic fatty liver disease (NAFLD), as an underestimated metabolic abnormality, is strongly associated with an increased risk of incident prehypertension and hypertension. However, the role of NAFLD in the development of hypertension is still obscure and is highly overlooked by the general public. Herein, we highlight the epidemiological evidence and putative mechanisms focusing on the emerging roles of NAFLD in hypertension, with the purpose of reinforcing the notion that NAFLD may serve as an independent risk factor and an important driving force in the development and progression of hypertension. Finally, we also briefly summarize the current potential treatments for NAFLD that might also be beneficial approaches against hypertension.
Topics: Gene-Environment Interaction; Humans; Hypertension; Non-alcoholic Fatty Liver Disease; Prehypertension; Public Health; Risk Factors
PubMed: 31865799
DOI: 10.1161/HYPERTENSIONAHA.119.13419 -
Cardiac Electrophysiology Clinics Mar 2021Hypertension (HT) confers the highest population-attributable risk among factors leading to atrial fibrillation (AF). Data also are accumulating regarding the... (Review)
Review
Hypertension (HT) confers the highest population-attributable risk among factors leading to atrial fibrillation (AF). Data also are accumulating regarding the association between pre-HT, aortic stiffness, and increased incident AF or AF recurrence. Atrial remodeling due to HT is progressive but also reversible. Although inhibition of the renin-angiotensin-aldosterone system has shown the greatest promise in improving AF outcomes, optimal blood pressure targets in individuals with HT and AF remain elusive. AF management demands an integrated care approach. HT is best treated alongside a comprehensive risk factor management program where other AF risk factors are targeted, with involvement of a multidisciplinary team.
Topics: Adult; Aged; Atrial Fibrillation; Atrial Remodeling; Female; Heart Diseases; Humans; Hypertension; Male; Middle Aged; Prehypertension; Renin-Angiotensin System; Risk Factors; Young Adult
PubMed: 33516406
DOI: 10.1016/j.ccep.2020.11.009 -
Current Hypertension Reports Jan 2015Recent guidelines for the diagnosis and management of hypertension reversed the historical trend to recommend lower blood pressure (BP) thresholds to diagnose... (Review)
Review
Recent guidelines for the diagnosis and management of hypertension reversed the historical trend to recommend lower blood pressure (BP) thresholds to diagnose hypertension in high-risk individuals, such as patients with diabetes and elderly patients. The decision to raise the BP thresholds for diagnosis of hypertension in patients with diabetes was mostly based on the findings of the ACCORD trial. Nonetheless, the results of the ACCORD trial are within the predicted benefit to prevent coronary artery disease and stroke by meta-analysis of randomized controlled trials (RCT), particularly in regard to the prevention of stroke. The Eighth Joint National Committee (JNC 8) did not address prehypertension. There are many RCT done in individuals with prehypertension and concomitant cardiovascular disease showing the benefit of treatment of these patients. Trials exploring the efficacy of interventions to prevent cardiovascular disease in individuals with prehypertension free of cardiovascular disease would be hardly feasible in face of the low absolute risk of these individuals. Considering the risks of prehypertension for cardiovascular disease and the fast progression to hypertension of a large proportion of individuals with prehypertension, it is worth to consider drug treatment for individuals with prehypertension. RCT showed that the progression to hypertension can be partially halted by BP-lowering agents. These and ongoing clinical trials are herein revised. Prehypertension may be a window of opportunity to prevent hypertension and its cardiovascular consequences.
Topics: Antihypertensive Agents; Blood Pressure; Disease Progression; Humans; Hypertension; Prehypertension
PubMed: 25432897
DOI: 10.1007/s11906-014-0505-1 -
Hypertension Research : Official... Apr 2023Increased blood pressure (BP) variability and the BP surge have been reported to be associated with increased cardiovascular risk independently of BP levels and can also... (Review)
Review
Increased blood pressure (BP) variability and the BP surge have been reported to be associated with increased cardiovascular risk independently of BP levels and can also be a trigger of cardiovascular events. There are multiple types of BP variation: beat-to-beat variations related to breathing and the autonomic nervous system, diurnal BP variation and nocturnal dipping related to sleep and physical activity over a 24-hr period, day-to-day BP variability with anomalous readings within a several-day period, visit-to-visit BP variability between outpatient visits, and seasonal variations. BP variability is also associated with the progression to hypertension from prehypertension and the progression of chronic kidney disease and cognitive impairments. Our research group proposed the "resonance hypothesis of blood pressure surge" as a new etiological hypothesis of BP variability and surges; i.e., the concept that when the time phases of surges and hypertension-inducing environmental influences coincide, resonance occurs and is amplified into a larger "dynamic surge" that triggers the onset of cardiovascular disease. New devices to assess BP variability as well as new therapeutic interventions to reduce BP variability are being developed. Although there are still issues to be addressed (including measurement accuracy), cuffless devices and information and communication technology (ICT)-based BP monitoring devices have been developed and validated. These new devices will be useful for the individualized optimal management of BP. However, evidence regarding the usefulness of therapeutic interventions to control BP variability is still lacking.
Topics: Humans; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Hypertension; Autonomic Nervous System Diseases; Prehypertension
PubMed: 36759660
DOI: 10.1038/s41440-023-01199-w -
PloS One 2017The study was primarily aimed at estimating the prevalence of hypertension and pre-hypertension and the risk factors of hypertension in the North Indian state of Punjab....
OBJECTIVES
The study was primarily aimed at estimating the prevalence of hypertension and pre-hypertension and the risk factors of hypertension in the North Indian state of Punjab. It also aimed at assessing the magnitude of undiagnosed cases of hypertension in the community and ascertaining the blood pressure control status of those on treatment.
METHODS
A non-communicable disease risk factor survey (based on WHO-STEPS approach) was done in the state of Punjab, India in a multistage stratified sample of 5127 individuals. The study subjects were administered the WHO STEPS-questionnaire and also underwent anthropometric and blood pressure measurements.
RESULTS
Overall prevalence of HTN among the study participants was found out to be 40.1% (95% CI: 38.8-41.5%) whereas prevalence of pre-hypertension, isolated diastolic and isolated systolic hypertension were 40.8% (39.5-42.2%), 9.2% (8.4-10.0%) and 6.5% (5.9-7.2%) respectively. Age group (45-69 years), male gender, social group, marital status, alcohol use, obesity and salt intake (> = 5 gms/day) were the risk factors significantly associated with HTN. Among all persons with HTN, only 30.1% were known case of HTN or on treatment, among whom nearly 61% had controlled blood pressure. Patients with uncontrolled BP were more frequently male, obese patients, with sedentary lifestyle and patients with diabetes.
CONCLUSIONS
The study reported alarmingly high prevalence of hypertension, especially of undiagnosed or untreated cases amongst the adult population, a significant proportion of whom have uncontrolled blood pressure levels. This indicates the need for systematic screening and awareness program to identify the undiagnosed cases in the community and offer early treatment and regular follow up.
Topics: Adolescent; Adult; Aged; Cross-Sectional Studies; Female; Humans; Hypertension; India; Male; Middle Aged; Prehypertension; Prevalence; Risk Factors; Surveys and Questionnaires; Young Adult
PubMed: 29267338
DOI: 10.1371/journal.pone.0188619 -
Inquiry : a Journal of Medical Care... 2024Preventing the development of high blood pressure and resulting complication requires estimating the prevalence of prehypertension/hypertension and identifying...
Preventing the development of high blood pressure and resulting complication requires estimating the prevalence of prehypertension/hypertension and identifying associated risk factors. Information about pre-hypertension/hypertension in Ethiopia, especially in the southern region, is scarce, and limited knowledge exists regarding the prevalence and risk factors associated with pre-hypertension/hypertension. Objective of this study was to assess prevalence of pre-hypertension/hypertension and its associated factors among adults in Wolaita Zone of Southern Ethiopia, 2023. This cross-sectional study was conducted among adults attending outpatient departments in governmental hospitals in South Ethiopia in 2023. Face-to-face interviews were used to gather information on sociodemographic data, dietary and behavioral patterns, and medical history. Digital weighing scales, Stadiometers, and digital sphygmomanometers were used to measure height, blood pressure, and weight, respectively. Epi-Data version 3.1 was used to enter the data before exporting it to SPSS version 25 for analysis. To find factors associated with prehypertension/hypertension, binary logistic regressions were conducted and odds ratios with 95% confidence intervals were computed. The overall prevalence of prehypertension/hypertension was 42.8% (95% confidence interval: 39.56, 49.47). Factors associated with prehypertension/hypertension in this study were older age, male gender, obesity, diabetes mellitus comorbidity, alcohol drinking, and family history of hypertension. Lifestyle modification is demanded for pre-hypertensive/hypertensive patients to prevent progression to severe complications, including premature death and permanent disabilities.
Topics: Adult; Humans; Male; Prehypertension; Cross-Sectional Studies; Prevalence; Ethiopia; Hypertension; Risk Factors
PubMed: 38641978
DOI: 10.1177/00469580241246968 -
African Health Sciences Dec 2016We aimed to assess the prevalence of prehypertension and its associated factors in a population of Congolese pre and postmenopausal women.
OBJECTIVES
We aimed to assess the prevalence of prehypertension and its associated factors in a population of Congolese pre and postmenopausal women.
METHODS
We had consecutively recruited 200 women (100 premenopausal and 100 postmenopausal) aged 40 - 60 years at the department of Gynecology and Obstetrics, University of Kinshasa Hospital, and AKRAM Medical Center in Kinshasa, DRC. An interview was carried out using a questionnaire that comprised questions related to lifestyle, menses characteristics, medical history of diabetes, CVD, hypertension, current antihypertensive medication and use of traditional medicine. In addition, physical examination and biological measurements were performed. Multivariate logistic regression analysis was used to assess associated factors with prehypertension.
RESULTS
Of the participants, 34% were normotensive, 38.5 % prehypertensive and 27.5% hypertensive. Compared to normal blood pressure, prehypertension was common in the older (age>50 years of age) women. Menopause, the use of traditional medicine and older age were associated with prehypertension. However, only menopause (aOR: 2.71; 95%CI: 1.10-3.52) and the use of traditional medicine (aOR: 2.24; 95% CI: 1.07-4.7) remained associated with prehypertension in a multivariate logistic regression analysis.
CONCLUSION
This study showed that prehypertension is common among Congolese menopausal women, and that menopause and the use of traditional medicine were the main factors associated with prehypertension.
Topics: Adult; Age Factors; Alcohol Drinking; Antihypertensive Agents; Blood Pressure; Body Mass Index; Cardiovascular Diseases; Cross-Sectional Studies; Democratic Republic of the Congo; Diabetes Mellitus; Female; Humans; Life Style; Logistic Models; Medicine, African Traditional; Middle Aged; Postmenopause; Prehypertension; Premenopause; Prevalence; Risk Factors; Smoking; Socioeconomic Factors
PubMed: 28479890
DOI: 10.4314/ahs.v16i4.14 -
Journal of Human Hypertension May 2018In Bangladesh, morbidity and mortality due to non-communicable diseases (NCDs) has increased over the last few decades. Hypertension is an important risk factor for...
In Bangladesh, morbidity and mortality due to non-communicable diseases (NCDs) has increased over the last few decades. Hypertension is an important risk factor for NCDs, specifically cardiovascular disease. The objective of this study was to assess prevalence and risk factors for hypertension and pre-hypertension among adults in Bangladesh. Data for this analysis were collected during the national NCD Risk Factor Survey of Bangladesh conducted in 2010 from a representative sample of men and women, aged 25 years or above. The survey adopted a multistage, geographically clustered, probability-based sampling approach. WHO STEPS questionnaire was used to collect data on demographics, behavioral risk factors, and physical measurements. Overall, 20% of the study population were hypertensive at study measurement. The prevalence of hypertension increased with age and body mass index (BMI). Twelve percent of the population were previously diagnosed with hypertension. Among these individuals, nearly half were not taking any medications to control their hypertension. Additionally, the prevalence of pre-hypertension was 43%, with higher levels among males, older age groups, and those with higher education, higher wealth index and high BMI. Predictors of hypertension, included older age, high BMI, and diabetes comorbidity. Based on this study, we estimate that 1 out of 5 Bangladeshi adults have hypertension. The risk of hypertension increases with older age and high BMI. Additionally, prevalence of pre-hypertension is high in Bangladesh in both rural and urban areas. Findings from this study can be used to inform public health programming to control the spread of NCDs in Bangladesh.
Topics: Adult; Aged; Antihypertensive Agents; Bangladesh; Cross-Sectional Studies; Female; Humans; Hypertension; Male; Middle Aged; Prehypertension; Prevalence; Risk Factors
PubMed: 29230005
DOI: 10.1038/s41371-017-0018-x -
Cell Biochemistry and Biophysics Mar 2015Elevated blood pressure is regarded as an independent risk factor for cardiovascular diseases and diabetes. We examined the relation between hematocrit and...
Elevated blood pressure is regarded as an independent risk factor for cardiovascular diseases and diabetes. We examined the relation between hematocrit and pre-hypertension as well as the effect of sex, obesity, fasting glucose, and lipids in Chinese adults. The study samples were from a community-based health examination survey in China and included a total of 2,3691 patients with blood pressure in normal range. The odds ratios [ORs, 95 % confidence interval (CI)] of pre-hypertension across increasing quartiles of hematocrit were 1.000, 1.176 (1.050-1.318), 1.213 (1.081-1.363), and 1.364 (1.209-1.540) (P for trend < 0.001), when adjusted for age, sex, body mass index, glutamic-pyruvic transaminase, glutamic-oxalocetie transaminase, serum uric acid, glucose, and lipids. Associations were significant in both men and women, but not in individuals older than 60 years. In addition, low-density lipoprotein cholesterol significantly interacted with hematocrit (P for interaction <0.024). The associations were more evident in patients with low (P < 0.001) and median LDL-C levels (P < 0.013) than those with high glucose levels. Hematocrit was associated with pre-hypertension, and was independent of metabolic risk factors. These associations were not significant in older individuals and low-density lipoprotein cholesterol may modify these associations.
Topics: Adolescent; Adult; Age Distribution; Aged; Blood Glucose; China; Comorbidity; Female; Hematocrit; Humans; Male; Middle Aged; Obesity; Prehypertension; Prevalence; Reproducibility of Results; Risk Assessment; Sensitivity and Specificity; Sex Distribution; Young Adult
PubMed: 25476140
DOI: 10.1007/s12013-014-0318-5