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Medicine Mar 2022To determine the prevalence of prehypertension (PH) and hypertension (AH) in quilombola children and adolescents, as well as to analyze sociodemographic, behavioral, and...
To determine the prevalence of prehypertension (PH) and hypertension (AH) in quilombola children and adolescents, as well as to analyze sociodemographic, behavioral, and health characteristics.Prevalence study conducted in random samples of quilombola children and adolescents from 06 to 19 years of age, in remaining quilombo communities in Cachoeira-Bahia. Identification, sociodemographic, behavioral, anthropometric, and blood pressure (BP) data were used. Descriptive analyses of the variables of interest were performed based on absolute (N) and included frequencies (percentage, prevalence). Pearson's Chi-square (χ2) and Fisher Exact tests determined possible differences.Of the 668 participants, 54.3% were children, 51.2% were male, and 29.4% presented alterations in BP. PH and AH were found in 12.7% and 14.3% of the children, respectively; for adolescents, these values were 12.5% and 15.4%, respectively. No statistically significant difference was found between the prevalence of AH in the 2 population groups, nor between the PH measurements. Most families reported a low socioeconomic status. Among children, 6.6% were underweight, 14.6% were overweight, 10.7% were obese, 12.7% presented a Waist-to-Height Ratio (WHtR) > 0.5; 70.1% were inactive and 88.4% had a sedentary lifestyle; 5.6% of the adolescents were underweight, 12.8% were overweight, 9.2% were obese, 11.5% presented a WHtR > 0.5; 78% were inactive and 92.1% had a sedentary lifestyle. Normotensive children and adolescents, and those with alterations in BP differed only in terms of the Body Mass Index (P = .007) and WHtR (P < .001). The consumption of unhealthy foods was high.The high prevalence of PH and AH, as well as of exposure to potential risk factors for AH in quilombola children and adolescents, reveals a worrisome situation, and demands further studies to identify risk factors for this disease and the need for interventions beyond the health sector, especially as regards disease prevention and control in the early stages of life, aiming to reduce its prevalence as adults.
Topics: Adolescent; Adult; Blood Pressure; Body Mass Index; Child; Humans; Hypertension; Male; Overweight; Prehypertension; Prevalence; Risk Factors; Waist Circumference; Waist-Height Ratio
PubMed: 35356905
DOI: 10.1097/MD.0000000000028991 -
Heart Failure Reviews May 2023Pulmonary hypertension is a clinical syndrome that may include multiple clinical conditions and can complicate the majority of cardiovascular and respiratory diseases.... (Review)
Review
Pulmonary hypertension is a clinical syndrome that may include multiple clinical conditions and can complicate the majority of cardiovascular and respiratory diseases. Pulmonary hypertension secondary to left heart disease is the prevalent clinical condition and accounts for two-thirds of all cases. Type 2 diabetes mellitus, which affects about 422 million adults worldwide, has emerged as an independent risk factor for the development of pulmonary hypertension in patients with left heart failure. While a correct diagnosis of pulmonary hypertension secondary to left heart disease requires invasive hemodynamic evaluation through right heart catheterization, several scores integrating clinical and echocardiographic parameters have been proposed to discriminate pre- and post-capillary types of pulmonary hypertension. Despite new emerging evidence on the pathophysiological mechanisms behind the effects of diabetes in patients with pre- and/or post-capillary pulmonary hypertension, no specific drug has been yet approved for this group of patients. In the last few years, the attention has been focused on the role of antidiabetic drugs in patients with pulmonary hypertension secondary to left heart failure, both in animal models and in clinical trials. The aim of the present review is to highlight the links emerged in the recent years between diabetes and pre- and/or post-capillary pulmonary hypertension and new perspectives for antidiabetic drugs in this setting.
Topics: Animals; Humans; Hypertension, Pulmonary; Diabetes Mellitus, Type 2; Heart Failure; Heart Diseases; Hypoglycemic Agents
PubMed: 35098382
DOI: 10.1007/s10741-021-10208-4 -
Frontiers in Public Health 2023We aimed to address which interventions best control blood pressure (BP) and delay disease progression in prehypertension and to give recommendations for the best option... (Meta-Analysis)
Meta-Analysis
BACKGROUND
We aimed to address which interventions best control blood pressure (BP) and delay disease progression in prehypertension and to give recommendations for the best option following a quality rating.
METHODS
A Bayesian network meta-analysis was used to assess the effect of the intervention on BP reduction, delaying hypertension progression and final outcome, with subgroup analyses for time and ethnicity. Recommendations for interventions were finally based on cumulative ranking probabilities and CINeMA.
RESULTS
From 22,559 relevant articles, 101 eligible randomized controlled trial articles (20,176 prehypertensive subjects) were included and 30 pharmacological and non-pharmacological interventions were evaluated. Moderate-quality evidence demonstrated that angiotensin II receptor blockers, aerobic exercise (AE), and dietary approaches to stop hypertension (DASH) lowered systolic blood pressure (SBP). For lowering diastolic blood pressure (DBP), AE combined with resistance exercise (RE) or AE alone provided high quality evidence, with calcium channel blockers, lifestyle modification (LSM) combined with drug providing moderate quality evidence. LSM produced the best BP lowering effect at 12 months and beyond of intervention. In Asians, TCD bubble was moderate quality evidence for lowering SBP and RE may have had a BP lowering effect in Caucasians. No recommendation can be given for delaying the progression of hypertension and reducing mortality outcomes because of low to very low quality of evidence.
CONCLUSION
AE combined RE are preferentially recommended for BP control in prehypertension, followed by DASH. Long-term BP control is preferred to LSM. Asians and Caucasians add TCD bubble and RE to this list as potentially effective interventions.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022356302, identifier: CRD42022356302.
Topics: Humans; Blood Pressure; Prehypertension; Bayes Theorem; Hypertension
PubMed: 37033077
DOI: 10.3389/fpubh.2023.1139617 -
Ophthalmology. Retina Aug 2021To describe the incidence of subretinal deposits that are similar in structure and stage on OCT imaging to subretinal drusenoid deposits (SDDs) in age-related macular...
PURPOSE
To describe the incidence of subretinal deposits that are similar in structure and stage on OCT imaging to subretinal drusenoid deposits (SDDs) in age-related macular degeneration (AMD) in patients with hypertensive choroidopathy secondary to severe pre-eclampsia and malignant hypertension (MHT) and the implications of this ischemic choroidopathy for the pathophysiologic characteristics of SDDs in AMD.
DESIGN
Retrospective cross-sectional study.
PARTICIPANTS
Thirty-three pre-eclampsia patients and 25 MHT patients with serous retinal detachment (SRD) in at least 1 eye were included.
METHODS
Serial multimodal images, including enhanced depth imaging spectral-domain OCT of eyes with hypertensive choroidopathy secondary to pre-eclampsia and MHT, were reviewed at 2 time points, the acute phase (within 4 weeks of initial hypertensive insult) and the recovery phase (beyond 4 weeks).
MAIN OUTCOME MEASURES
Incidence of SDD-like lesions in patients with hypertensive choroidopathy secondary to pre-eclampsia and MHT.
RESULTS
Subretinal drusenoid deposit-like lesions were observed exclusively in eyes with SRD. Serous retinal detachment occurred in 87.87% of eyes of pre-eclampsia patients and in 94% of eyes of MHT patients. Subretinal drusenoid deposit-like lesions occurred in 28.57% of all eyes with SRD, in 32.76% of eyes with SRD from the pre-eclampsia group, and in 23.40% of eyes with SRD from the MHT group. Vascular imaging suggested underlying choroidal ischemia in all patients (12 eyes) in which it was performed.
CONCLUSIONS
Choroidal ischemia may be the underlying mechanism of SDD-like lesions in patients with pre-eclampsia and MHT choroidopathy. These findings potentially are of utmost importance in understanding the mechanism of the reticular macular disease subtype of AMD. Reticular macular disease is characterized by the known association of choroidal insufficiency and SDD, with choroidal insufficiency postulated, but not proven, to be causative. Pre-eclampsia and MHT choroidopathy seems to be a model for lesions similar to SDD in AMD developing based on choroidal insufficiency and, as such, may offer further insights into the pathoetiologic features of SDD in AMD.
Topics: Adult; Comorbidity; Cross-Sectional Studies; Female; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Humans; Hypertension, Malignant; Macular Degeneration; Ophthalmoscopy; Pre-Eclampsia; Pregnancy; Prognosis; Republic of Korea; Retinal Drusen; Retinal Pigment Epithelium; Retrospective Studies; Tomography, Optical Coherence
PubMed: 33130003
DOI: 10.1016/j.oret.2020.10.018 -
BMC Cardiovascular Disorders Jan 2022Minimal data is available on the prevalence and correlates of hypertension and prehypertension in Dubai. The study aims to measure the prevalence of hypertension and...
BACKGROUND
Minimal data is available on the prevalence and correlates of hypertension and prehypertension in Dubai. The study aims to measure the prevalence of hypertension and pre-hypertension and the associated socio-demographic characteristics, behavioral risk factors and comorbidities among the adult population of Dubai.
METHODS
This study used data from the Dubai Household Health Survey, 2019. A cross-sectional population survey based on a complex stratified cluster random design. The total eligible sample included 2530 adults (18+). Sociodemographic and behavioral factors were considered as independent covariates. The main study outcome variables, pre-hypertension and hypertension, were ordinal, with normotension as the reference group.
RESULTS
The overall prevalence of hypertension in adults was 32.5% (38.37% in males and 16.66% in females). Prehypertension was prevalent in 29.8% of adults in Dubai (28.85% in males and 32.31% in females). The multivariate logistic regression analysis revealed that age groups, gender, occupation, and high Body Mass Index were significantly associated with a higher risk of hypertension at the level of P < 0.05. No clear trend toward a higher correlation of hypertension was noted with the increase in age, except after the age of 50 years. Males were five- times more likely to be hypertensive than females. Participants enrolled in skilled and service works had a five times higher risk of hypertension, compared with the reference group (professionals). Obese subjects had a 5.47-times greater correlation of hypertension compared with normal-weight subjects. Physically active individuals were less likely to develop hypertension. For the correlates with prehypertension in the present analysis, skilled and service workers and those working in elementary jobs had a higher risk of prehypertension, compared with the reference group (professionals) Individuals with a status of overweight were associated with a higher prevalence of prehypertension compared with people of normal weight.
CONCLUSIONS
This study showed a high prevalence of prehypertension and hypertension among adults in Dubai. Some socio-demographic and behavioral risk factors were correlated with prehypertension and hypertension among the studied population. Interventions aiming at increasing public awareness about such risk factors are essential.
Topics: Adolescent; Adult; Blood Pressure; Body Mass Index; Cross-Sectional Studies; Female; Follow-Up Studies; Health Surveys; Humans; Male; Middle Aged; Morbidity; Obesity; Prehypertension; Prevalence; Retrospective Studies; Risk Factors; Sex Factors; United Arab Emirates; Young Adult
PubMed: 35090385
DOI: 10.1186/s12872-022-02457-4 -
Hypertension Research : Official... Mar 2023
Topics: Humans; Body Mass Index; Lipid Accumulation Product; Prehypertension; Prediabetic State; Hypertension; Risk Factors
PubMed: 36635530
DOI: 10.1038/s41440-023-01173-6 -
Arquivos Brasileiros de Cardiologia Jun 2021Uric acid (UA), the end product of purine nucleotide metabolism, participates in the processes of metabolic and cardiovascular diseases. Experimental evidence suggests...
BACKGROUND
Uric acid (UA), the end product of purine nucleotide metabolism, participates in the processes of metabolic and cardiovascular diseases. Experimental evidence suggests it is an important mediator in the physiological response to blood pressure increase.
OBJECTIVE
To evaluate the association between serum UA levels and pre-hypertension and hypertension in a Chinese population.
METHODS
A cross-sectional study was conducted from March to September 2017, and 1,138 participants aged 35 to 75 were enrolled in this study, where 223 normotensive, 316 pre-hypertensive, and 599 hypertensive subjects were selected to evaluate the association between serum UA levels and hypertension. A p-value <0.05 was considered statistically significant.
RESULTS
Serum UA levels were significantly higher in the pre-hypertension and hypertension group compared to the control group in the entire population (p<0.05 for all). Quantitative trait analysis indicated that serum UA levels were (2.92±0.81, 3.06±0.85, 3.22±0.98 mg/d) linearly increased in normotensive, pre-hypertensive and hypertensive females, with a p value of 0.008. Serum UA levels in the quartiles were positively correlated with DBP (p<0.05), particularly in females. After adjusting for age, gender, body mass index (BMI), glucose (GLU), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), the odds ratios (ORs) and 95% confidence intervals (CIs) of pre-hypertension from the lowest (referent) to the highest levels of serum UA were 1.718 (1.028-2.872), 1.018 (0.627-1.654) and 1.738 (1.003-3.010). Additionally, the second quartile of serum UA levels were significantly associated with hypertension, with an OR (95% CI) of 2.036 (1.256-3.298).
CONCLUSIONS
This study suggests that higher serum UA levels are positively associated with pre-hypertension and hypertension among Chinese adults.
Topics: Adult; China; Cross-Sectional Studies; Female; Humans; Hypertension; Prehypertension; Risk Factors; Uric Acid
PubMed: 34133589
DOI: 10.36660/abc.20200098 -
Maternal and Child Health Journal Nov 2022Women with pre-pregnancy diabetes or pre-pregnancy hypertension have increased risks of complications during pregnancy. Women who obtain prenatal care in the first...
INTRODUCTION
Women with pre-pregnancy diabetes or pre-pregnancy hypertension have increased risks of complications during pregnancy. Women who obtain prenatal care in the first trimester receive necessary routine testing and disease management tools that aid in controlling such conditions. However, research on the association between pre-pregnancy hypertension and pre-pregnancy diabetes and prenatal care timing among US women is limited.
METHODS
This study used data from the 2018 National Vital Statistic System (n = 3,618,853). Trained personnel collected information on prenatal care timing, maternal conditions, and demographics. Multivariate logistic regression models evaluated the association between pre-pregnancy hypertension, pre-pregnancy diabetes and prenatal care timing. A stratified analysis was conducted to determine if race/ethnicity modified the associations.
RESULTS
After adjustment, women with pre-pregnancy hypertension or pre-pregnancy diabetes had statistically significant increased odds of receiving early prenatal care compared to women without these conditions (OR 1.23; 95% CI: 1.21-1.26 and OR 1.27; 95% CI: 1.24-1.31, respectively). Among non-Hispanic White, non-Hispanic Black, and Hispanic women, those with pre-pregnancy hypertension or pre-pregnancy diabetes had statistically significantly increased odds of receiving early prenatal care compared to women without those pre-existing conditions (P < .001).
DISCUSSION
Further research is needed on the transition from preconception care to obstetric care for women with pre-existing diabetes or hypertension. However, these findings suggest that women who have conditions that could cause pregnancy complications are pursuing early prenatal care services to mitigate the development of adverse maternal and infant health conditions.
Topics: Pregnancy; United States; Female; Humans; Prenatal Care; Preconception Care; Pre-Eclampsia; Diabetes Mellitus; Hypertension
PubMed: 36149535
DOI: 10.1007/s10995-022-03531-1 -
Journal of Clinical Hypertension... Sep 2023Blood pressure (BP) is the main driver of mortality with 12.8% of all deaths worldwide. Adolescents are not spared, precisely in Cameroon where they constitute more than...
Blood pressure (BP) is the main driver of mortality with 12.8% of all deaths worldwide. Adolescents are not spared, precisely in Cameroon where they constitute more than half of its population. The objective of our work was to describe the prevalence and risk factors of pre-hypertension and high blood pressure (HBP) among adolescents in Cameroonian schools. Descriptive study over 5 months; from January to May 2019. The study population consisted of students from private and public schools in the city of Douala. Sociodemographic, anthropometric, and personal background data were collected. Physical activity (PA) was assessed using the short International Physical Activity Questionnaire (IPAQ). Multivariate logistic regression was used to determine factors associated with pre-hypertension and HBP. Differences were considered significant for p < .05. We recruited 771 students with an average age of 16 ± 1 years with female predominance (51.4%). The prevalences of pre-hypertension and HBP were 6.6% and 3%, respectively. Overweight/obesity (OR = 4.6; p < .0001), hyperglycemia [(OR = 4.06; p = .001)] physical inactivity (OR = 1.85; p = .019), and public institutions (OR = 1.87; p = .02) were associated with pre-hypertension. Similarly, overweight/obesity (OR = 2.99; p = .022), hyperglycemia (OR = 14.05; p < .0001), and physical inactivity (OR = 8.58; p < .0001) were correlated with HBP. Pre-hypertension and HBP are high in Cameroonian school adolescents and their risk factors are overweight/obesity, hyperglycemia, and physical inactivity.
Topics: Humans; Female; Adolescent; Male; Hypertension; Overweight; Prevalence; Cameroon; Prehypertension; Risk Factors; Obesity; Blood Pressure; Hyperglycemia
PubMed: 37561361
DOI: 10.1111/jch.14711 -
Diabetology & Metabolic Syndrome Oct 2021Hypertension and diabetes are among the most important risk factors of cardiovascular diseases. Klotho and SIRT1 are known as anti-aging factors with beneficial effects...
BACKGROUND
Hypertension and diabetes are among the most important risk factors of cardiovascular diseases. Klotho and SIRT1 are known as anti-aging factors with beneficial effects on cardiovascular system. In this study we investigated the serum Klotho and SIRT1 levels in pre-diabetic and pre-hypertensive individuals and then in diabetic and hypertensive patients to see their relationship with these diseases.
METHOD
229 individuals divided into six groups with similar gender and age distribution 1-Control (normal BP and FBS) 2-pre-diabetic (FBS between 100 and 125 mg/dl) 3-diabetic (FBS ≥ 126 mg/dl), 4-pre-hypertensive (SBP 120-139 or DBP 80-89 mm Hg) 5-hypertensive (SBP ≥ 140 or DBP ≥ 90 mm Hg), and 6-patients with combined hypertension/diabetes. Serum levels of Klotho and SIRT1 were measured by ELISA method.
RESULTS
Serum Klotho and STRT1 levels decreased in pre-diabetes and returned to normal in diabetic patients. Their concentration increased in pre-hypertension and recovered to normal in hypertension. In the physiologic range of FBS there is a negative correlation between Klotho and SIRT1 with FBS. When pathologic ranges of FBS added to analysis, the negative correlation abolished/U shaped. Also an inverse U shape correlation observed between Klotho and SIRT1 with MAP in the range of normal to hypertensive BP levels. There was an overall positive relationship between the serum levels of Klotho and SIRT1 themselves.
CONCLUSION
The serum levels of the anti-aging proteins Klotho and SIRT1 increases or reduces at the onset of the disease, as a compensatory mechanism, but as the disease progresses their level recovers.
PubMed: 34670596
DOI: 10.1186/s13098-021-00736-2