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Scientific Reports Jul 2022Sudden cardiac arrest (SCA) is a medical disaster for both the victim and the society. Despite intrinsic limitations in the management of SCA, primary prevention has...
Sudden cardiac arrest (SCA) is a medical disaster for both the victim and the society. Despite intrinsic limitations in the management of SCA, primary prevention has been overlooked and risk factors for SCA are not fully understood. We aimed to evaluate whether hypertension and diabetes mellitus (DM), including pre-hypertension and impaired fasting glucose (IFG), are associated with increased risk of SCA. We performed a nationwide population-based analysis using the Korean National Health Insurance Service. People who underwent a national health check-up in 2009 were enrolled. The risk of SCA was evaluated in people with hypertension and DM with a clinical follow-up through December 2018. A total of 4,056,423 people with 33,345,378 person-years of follow-up and 16,352 SCA events were examined. People with hypertension had 65.4% increased risk of SCA (adjusted hazard ratio [HR] = 1.654 [1.572-1.739]; p < 0.001). Pre-hypertension was also associated with 21.3% increased risk of SCA (adjusted HR = 1.213 [1.158-1.272]; p < 0.001). People who had IFG and DM showed 7.5% (adjusted HR = 1.075 [1.035-1.117]; p < 0.001) and 80.1% (adjusted HR = 1.801 [1.731-1.875]; p < 0.001) increased risk of SCA, respectively. People with DM who took anti-diabetic medication showed significantly lower risk of SCA compared with uncontrolled DM patients (fasting glucose ≥ 200 mg/dL) (adjusted HR = 0.625 [0.533-0.733]; p < 0.001). Coexistence of hypertension and DM was associated with an even higher risk of SCA (adjusted HR = 3.078 [2.877-3.293]; p < 0.001). In conclusion, the risk of SCA is significantly higher in people with hypertension and DM, including pre-hypertension and IFG. Adequate control of blood pressure and serum glucose can have a profound impact for the primary prevention of SCA in the general population.
Topics: Blood Glucose; Death, Sudden, Cardiac; Diabetes Mellitus; Humans; Hypertension; Prediabetic State; Prehypertension; Risk Factors
PubMed: 35854061
DOI: 10.1038/s41598-022-16543-2 -
Environmental Health Perspectives Feb 2023
PubMed: 37489935
DOI: 10.1289/EHP12836 -
Ciencia & Saude Coletiva Dec 2021The objective was to estimate the prevalence and factors associated with prehypertension and hypertension among health workers who work in high-complexity services for...
The objective was to estimate the prevalence and factors associated with prehypertension and hypertension among health workers who work in high-complexity services for critically-ill and chronic patients. An epidemiological, cross-sectional study was carried out with 490 health workers in the macroregional region of Northern Minas Gerais, Brazil. The dependent variable blood pressure (BP) was categorized as normal BP, prehypertension and hypertension. Multinomial Logistic Regression was used for the multiple analysis. The prevalence of arterial hypertension was 21.8% and that of prehypertension was 25.9%. The chances of developing arterial hypertension and prehypertension were higher in male professionals, aged ≥40 years, in civil servant workers and those who were obese or overweight. The use of continuous medication and night shift work were associated with hypertension and prehypertension, respectively. The prevalence of arterial hypertension in the group of workers was lower than that of the Brazilian population. It is necessary to carry out studies with workers from this group and investments are required in preventive measures that encourage a change to a healthy lifestyle.
Topics: Cross-Sectional Studies; Health Personnel; Humans; Hypertension; Male; Prehypertension; Risk Factors
PubMed: 34909998
DOI: 10.1590/1413-812320212612.14952021 -
Journal of Family Medicine and Primary... Jan 2023There is a paucity of data on the burden and factors associated with hypertension among the Nagas (collective term for tribal ethnic groups predominantly residing in...
BACKGROUND
There is a paucity of data on the burden and factors associated with hypertension among the Nagas (collective term for tribal ethnic groups predominantly residing in Nagaland) living in an urban environment. Insights from this study will aid in mapping focused community-based and primary care interventions for hypertension.
OBJECTIVES
To determine the prevalence and risk factors associated with hypertension among Nagas aged 30-50 years residing in urban Dimapur, Nagaland.
METHODS
A community-based cross-sectional study was conducted between January and July 2019. This study screened 660 participants for hypertension using a digital blood pressure apparatus. A semi-structured questionnaire was used to assess the risk factors, and anthropometric measurements were recorded using standard guidelines.
RESULTS
The prevalence of hypertension and pre-hypertension was 25.9% and 44.5%, respectively. Non-modifiable risk factors such as male gender (adjusted odds ratio [AOR]: 2.02; 95% confidence interval [CI]: 1.32-3.09), age > 40 years (AOR: 2.32; 95% CI: 1.57-3.41), family history of hypertension (AOR, 1.87, 95% CI: 1.19-2.92) and modifiable risk factors such as current alcohol consumption (AOR: 2.05; 95% CI: 1.27-3.31), high/very high perceived stress (AOR: 2.15; 95% CI: 1.28-3.62), lack of participation in stress relief activities (AOR: 2.08; 95% CI: 1.17-3.71) and overweight/obesity (AOR: 2.26; 95% CI: 1.55-3.30) were independently associated with hypertension in this study.
CONCLUSION
To avert an impending health crisis in this community, a multipronged approach involving primary-care/family physicians, culturally appropriate awareness, and targeted community-based screening programs with an adept referral system must be implemented to curtail this emerging threat.
PubMed: 37025226
DOI: 10.4103/jfmpc.jfmpc_662_22 -
Biomedicine & Pharmacotherapy =... Apr 2024This study investigated whether sacubitril/valsartan or valsartan are able to prevent left ventricular (LV) fibrotic remodelling and dysfunction in two experimental...
Effect of sacubitril/valsartan on the hypertensive heart in continuous light-induced and lactacystin-induced pre-hypertension: Interactions with the renin-angiotensin-aldosterone system.
This study investigated whether sacubitril/valsartan or valsartan are able to prevent left ventricular (LV) fibrotic remodelling and dysfunction in two experimental models of pre-hypertension induced by continuous light (24 hours/day) exposure or by chronic lactacystin treatment, and how this potential protection interferes with the renin-angiotensin-aldosterone system (RAAS). Nine groups of three-month-old male Wistar rats were treated for six weeks as follows: untreated controls (C), sacubitril/valsartan (ARNI), valsartan (Val), continuous light (24), continuous light plus sacubitril/valsartan (24+ARNI) or valsartan (24+Val), lactacystin (Lact), lactacystin plus sacubitil/valsartan (Lact+ARNI) or plus valsartan (Lact+Val). Both the 24 and Lact groups developed a mild but significant systolic blood pressure (SBP) increase, LV hypertrophy and fibrosis, as well as LV systolic and diastolic dysfunction. Yet, no changes in serum renin-angiotensin were observed either in the 24 or Lact groups, though aldosterone was increased in the Lact group compared to the controls. In both models, sacubitril/valsartan and valsartan reduced elevated SBP, LV hypertrophy and fibrosis and attenuated LV systolic and diastolic dysfunction. Sacubitril/valsartan and valsartan increased the serum levels of angiotensin (Ang) II, Ang III, Ang IV, Ang 1-5, Ang 1-7 in the 24 and Lact groups and reduced aldosterone in the Lact group. We conclude that both continuous light exposure and lactacystin treatment induced normal-to-low serum renin-angiotensin models of pre-hypertension, whereas aldosterone was increased in lactacystin-induced pre-hypertension. The protection by ARNI or valsartan in the hypertensive heart in either model was related to the Ang II blockade and the protective Ang 1-7, while in lactacystin-induced pre-hypertension this protection seems to be additionally related to the reduced aldosterone level.
Topics: Rats; Animals; Male; Renin-Angiotensin System; Renin; Aldosterone; Prehypertension; Tetrazoles; Rats, Wistar; Valsartan; Hypertension; Biphenyl Compounds; Heart Failure; Hypertrophy, Left Ventricular; Drug Combinations; Fibrosis; Stroke Volume; Acetylcysteine; Aminobutyrates
PubMed: 38461685
DOI: 10.1016/j.biopha.2024.116391 -
International Journal of Cardiology.... Sep 2023Driver-based chronic disease models address the public health challenge of cardiometabolic risk. However, there is no data available about the novel Hypertension-Based...
BACKGROUND
Driver-based chronic disease models address the public health challenge of cardiometabolic risk. However, there is no data available about the novel Hypertension-Based Chronic Disease (HBCD) model. This study investigates the prevalence, characteristics, and prognostic significance of HBCD Stages in a primary care cohort.
METHODS
This study included participants aged ≥45 years, randomly selected from the primary care program of a Brazilian medium-sized city. Participants underwent electrocardiogram, tissue Doppler echocardiogram and were followed for a median of 6 years. Participants were classified into HBCD Stages as follows: Stage 1: hypertension risk factors; Stage 2: pre-hypertension; Stage 3: hypertension; and Stage 4: hypertension complications.
RESULTS
Overall, 633 participants were included in the cross-sectional analysis and 560 that had follow-up data were included in the prognostic analysis. From 633 participants, 1.3% had no identifiable risk factors for HBCD, 10.0% were Stage 1, 14.7% Stage 2, 51.5% Stage 3, and 22.5% Stage 4. Increasing HBCD stages had worse glomerular filtration rates, echocardiographic markers, and higher body mass index, waist circumference, blood glucose levels, and prevalence of type 2 diabetes. Rates of all-cause mortality or cardiovascular hospitalization increased across HBCD Stages: Stage 1: 3.6%; Stage 2: 4.8%, Stage 3: 7.6%; and Stage 4: 39.5%. Kaplan-Meier curves showed composite outcome worsened across HBCD Stages 1-4 (p < 0.001).
CONCLUSIONS
HBCD is a conceptually and prognostically valid model. Remarkably, HBCD stages were associated with progressively worsening markers of heart disease, declining kidney function and higher rates of all-cause mortality or cardiovascular hospitalization.
PubMed: 37664167
DOI: 10.1016/j.ijcrp.2023.200204 -
Ghana Medical Journal Mar 2020There are indications that prehypertension precedes hypertension. Like hypertension, it is associated with increased cardiovascular risk.
BACKGROUND
There are indications that prehypertension precedes hypertension. Like hypertension, it is associated with increased cardiovascular risk.
OBJECTIVE
To determine the prevalence, awareness and correlates of prehypertension and hypertension among adults in Delta State, Nigeria.
METHODS
This was a cross-sectional study. We recruited adults aged ≥18 years from two communities in Delta State, Nigeria, using the multi-stage sampling technique. The study instrument was a modified WHO-STEPS questionnaire. Prehypertension and hypertension were defined using the JNC-7 criteria. Ethical approval was obtained before the recruitment of participants.
RESULTS
Of the 852 adults studied, the mean (±SD) age was 42.64 (±16.07) years, females (55.9%) and urban dwellers (55.8%). The prevalence of prehypertension and hypertension were 42.5% and 29.3%, respectively; both were higher among urban dwellers. The peak age-group for prehypertension and hypertension were 25-34 and 35-44 years, respectively. Awareness of hypertension was low; 12.0% (102/852). Blood pressure category significantly correlated with age, body mass index, place of residence, level of education, employment status and fruit intake.
CONCLUSION
The prevalence of prehypertension and hypertension in this study were high. Based on the premise that prehypertension is a precursor of hypertension and occurred more among youths, the higher prevalence of prehypertension gives an inkling to rising prevalence of hypertension.
FUNDING
Nil.
Topics: Adult; Age Factors; Blood Pressure Determination; Body Mass Index; Cross-Sectional Studies; Educational Status; Employment; Female; Fruit; Humans; Hypertension; Male; Middle Aged; Nigeria; Prehypertension; Prevalence; Residence Characteristics; Risk Factors; Sex Factors
PubMed: 32863413
DOI: 10.4314/gmj.v54i1.8 -
Journal of Clinical Hypertension... May 2021Improved understanding of the current burden of hypertension, including awareness, treatment, and control, is needed to guide relevant preventative measures in Nigeria.... (Meta-Analysis)
Meta-Analysis
Improved understanding of the current burden of hypertension, including awareness, treatment, and control, is needed to guide relevant preventative measures in Nigeria. A systematic search of studies on the epidemiology of hypertension in Nigeria, published on or after January 1990, was conducted. The authors employed random-effects meta-analysis on extracted crude hypertension prevalence, and awareness, treatment, and control rates. Using a meta-regression model, overall hypertension cases in Nigeria in 1995 and 2020 were estimated. Fifty-three studies (n = 78 949) met our selection criteria. Estimated crude prevalence of pre-hypertension (120-139/80-89 mmHg) in Nigeria was 30.9% (95% confidence interval [CI]: 22.0%-39.7%), and the crude prevalence of hypertension (≥140/90 mmHg) was 30.6% (95% CI: 27.3%-34.0%). When adjusted for age, study period, and sample, absolute cases of hypertension increased by 540% among individuals aged ≥20 years from approximately 4.3 million individuals in 1995 (age-adjusted prevalence 8.6%, 95% CI: 6.5-10.7) to 27.5 million individuals with hypertension in 2020 (age-adjusted prevalence 32.5%, 95% CI: 29.8-35.3). The age-adjusted prevalence was only significantly higher among men in 1995, with the gap between both sexes considerably narrowed in 2020. Only 29.0% of cases (95% CI: 19.7-38.3) were aware of their hypertension, 12.0% (95% CI: 2.7-21.2) were on treatment, and 2.8% (95% CI: 0.1-5.7) had at-goal blood pressure in 2020. Our study suggests that hypertension prevalence has substantially increased in Nigeria over the last two decades. Although more persons are aware of their hypertension status, clinical treatment and control rates, however, remain low. These estimates are relevant for clinical care, population, and policy response in Nigeria and across Africa.
Topics: Adult; Awareness; Blood Pressure; Cross-Sectional Studies; Female; Humans; Hypertension; Male; Nigeria; Prehypertension; Prevalence; Young Adult
PubMed: 33600078
DOI: 10.1111/jch.14220 -
Clinical, Metabolic and Hormonal Profiles of Bangladeshi Adolescents with Polycystic Ovary Syndrome.TouchREVIEWS in Endocrinology Apr 2021The features of polycystic ovary syndrome (PCOS) vary greatly among adolescent girls and adult women. Some of the features of PCOS may overlap with features of normal... (Review)
Review
The features of polycystic ovary syndrome (PCOS) vary greatly among adolescent girls and adult women. Some of the features of PCOS may overlap with features of normal pubertal development in girls. This cross-sectional study was conducted among adolescents newly diagnosed with PCOS attending a tertiary hospital in Bangladesh. The relevant clinical, metabolic and hormonal profiles of 175 participants were evaluated. The mean age of the study participants was 16.8 (±1.7) years. Oligomenorrhea was the predominant menstrual irregularity (88%). More than one-quarter of participants (27.4%) had a first-degree relative with PCOS, and 12% had a first-degree relative with type 2 diabetes. More than three-quarters (77.7%) had acanthosis nigricans. The majority (69.1%) were overweight (29.7%) or obese (39.4%), whereas 6.3% were underweight. A total of 65.7% had abdominal obesity. One-fifth (20%) of participants had pre-hypertension, and 3.4% were hypertensive. Around one-quarter (24%) had abnormal glucose tolerance (prediabetes 21.1%, diabetes 2.9%) and the majority (90.9%) had dyslipidaemia. The median Ferriman-Gallwey score was 12, 94.9% of participants had hirsutism and 33.7% had biochemical hyperandrogenism. Metabolic syndrome was present in 42.3% of participants. Higher body mass index and presence of hirsutism were associated with higher risks of metabolic syndrome. The clinical, metabolic and hormonal profiles of Bangladeshi adolescents with PCOS highlight risk factors and the need for clinical vigilance with respect to metabolic disease.
PubMed: 35118446
DOI: 10.17925/EE.2021.17.1.54 -
Biology of Sex Differences Mar 2022We assessed the sex differences in the association between blood pressure categories and glucose intolerance status with overall and ischemic stroke among Iranian adults.
BACKGROUND
We assessed the sex differences in the association between blood pressure categories and glucose intolerance status with overall and ischemic stroke among Iranian adults.
METHODS
This prospective study was conducted on 5349 individuals (2446 men) aged ≥ 40 years. Cox models were used to estimate adjusted hazard ratios (HRs) and men-to-women ratios of HRs (RHRs) of overall and ischemic stroke for systolic (SBP) and diastolic (DBP) blood pressure, pre-hypertension, hypertension, fasting plasma glucose (FPG), pre-diabetes and type 2 diabetes (T2D).
RESULTS
Each 0.55 mmol/L increase in FPG was associated with a higher HR of overall stroke in men than women [RHRs 1.05 (1.01-1.09)]. The associations between each 10 mmHg increase in DBP and stroke events were stronger in men than women, with RHRs of 1.20 (1.00-1.45) and 1.29 (1.04-1.60) for overall and ischemic stroke, respectively. Hypertension was associated with a higher HR of overall [RHRs: 2.41 (1.21-4.8)] and ischemic stroke [2.37 (1.12-5.01)] in men than women. We also found that T2D was associated with higher risks of overall and ischemic stroke in men than women: the RHRs were 2.16 (1.24-3.75) and 1.93 (1.05-3.55) for overall and ischemic stroke, respectively.
CONCLUSION
Hypertension and T2D induced higher risk of overall and ischemic stroke in men than women among Iranian population.
Topics: Adult; Blood Glucose; Diabetes Mellitus, Type 2; Female; Glucose; Humans; Hypertension; Iran; Ischemic Stroke; Lipids; Male; Prospective Studies; Risk Factors; Sex Characteristics; Stroke
PubMed: 35292081
DOI: 10.1186/s13293-022-00421-7