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Current Hypertension Reports Oct 2017Hypertension is an important preventable risk factor for disease and death worldwide. In light of the world's population growth and aging, hypertension is a global... (Review)
Review
Hypertension is an important preventable risk factor for disease and death worldwide. In light of the world's population growth and aging, hypertension is a global public health issue. Many studies have shown associations between pre-hypertension and a higher risk of the future development of hypertension and cardiovascular disease in general populations. However, pre-hypertension per se is not a disease with an immediate high risk, and the clinical value of the identification of pre-hypertension is the potential detection of the early stage of the risk of hypertension and/or cardiovascular disease over an individual's lifespan. We recently assessed the impacts of age-related differences in risk factors on new-onset hypertension among normotensive individuals. As risk factors of the new onset of hypertension, the impact of diastolic blood pressure compared with systolic blood pressure (SBP), men compared with women, and higher body mass index were greater in the younger adults, whereas in the older adults, the impact of SBP and female sex were greater. Proteinuria was a risk factor for hypertension in both younger and older adults. Non-pharmacological approaches such as body weight reduction, low-salt diet, physical exercise, and good sleep hygiene should be first-line treatments for pre-hypertension. In addition, careful observation to detect the new onset of hypertension and the identification of the appropriate timing of pharmacologic treatment should be conducted, especially in adults with pre-hypertension and the risk factors mentioned above.
Topics: Comorbidity; Health Behavior; Humans; Hypertension; Prehypertension; Risk Factors; Risk Reduction Behavior; Weight Loss
PubMed: 29046988
DOI: 10.1007/s11906-017-0789-z -
Journal of Human Hypertension Jan 2019The association between pre-hypertension (pre-HTN) and subclinical carotid damage is poorly defined. We performed a meta-analysis of ultrasonographic studies assessing... (Meta-Analysis)
Meta-Analysis Review
The association between pre-hypertension (pre-HTN) and subclinical carotid damage is poorly defined. We performed a meta-analysis of ultrasonographic studies assessing carotid intima-media thickness (IMT) in untreated pre-HTN subjects. The OVID-MEDLINE, PubMed, and Cochrane CENTRAL databases were searched for English-language articles without time restriction up to February 2018 through focused, high sensitive search strategies. Studies were identified by crossing the following search terms: "pre-hypertension", "high normal blood pressure", "carotid intima-media thickness", "carotid atherosclerosis", "ultrasonography". Overall, 7645 subjects (3374 normotensive, 1936 untreated pre-HTN, and 2335 HTN individuals) of both genders were included in seven studies. In the pooled study population, common carotid IMT showed a progressive increase from normotensive (723 ± 39 µm) to pre-HTN (779 ± 45 µm) (standardized mean difference, SMD 0.36 ± 0.08, CI 0.34-0.46, p < 0.0001) and to HTN subjects (858 ± 82 µm) (SMD 0.39 ± 0.07, CI 0.26-0.54, p = 0.002 vs. pre-HT). The statistical difference did not change after correction for publication bias and was not affected by a single study effect. Our meta-analysis shows that carotid IMT in pre-HTN subjects is intermediate between normotensive and HTN individuals. These findings support the view that pre-HTN is an unfavourable condition that should be properly managed in order to prevent vascular damage.
Topics: Blood Pressure; Carotid Arteries; Carotid Artery Diseases; Carotid Intima-Media Thickness; Humans; Prehypertension; Risk Factors; Ultrasonography
PubMed: 30242246
DOI: 10.1038/s41371-018-0114-6 -
Arquivos Brasileiros de Cardiologia Oct 2021
Topics: Adolescent; Humans; Hypertension; Prehypertension; Prevalence
PubMed: 34709292
DOI: 10.36660/abc.20210702 -
Clinica Chimica Acta; International... Dec 2015Even though several studies have implicated the role of inflammation in the pathogenesis of hypertension and other cardiovascular disease, there are only limited studies... (Review)
Review
Even though several studies have implicated the role of inflammation in the pathogenesis of hypertension and other cardiovascular disease, there are only limited studies about inflammatory markers in prehypertension. The objective of the present article was to review the role of markers like C-reactive protein, interleukin-6, tumor necrosis factor-α and sialic acid in prehypertension. An extensive literature search was made in Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/) using phrases such as prehypertension, inflammation, C-reactive protein, cardiovascular disease, cytokines and sialic acid. Several investigators have reported increased inflammatory markers like C-reactive protein, interleukin-6, tumor necrosis factor-α and sialic acid in prehypertension indicating the role of inflammation in the pathogenesis of prehypertension and its complications. Elevated inflammatory markers may enhance the risk for cardiovascular disease in subjects with prehypertension.
Topics: Biomarkers; C-Reactive Protein; Humans; Inflammation; Interleukin-6; N-Acetylneuraminic Acid; Prehypertension; Tumor Necrosis Factor-alpha
PubMed: 26525963
DOI: 10.1016/j.cca.2015.10.022 -
Current Hypertension Reports Dec 2013Pre-hypertension, defined as blood pressure 120-139/80-89 mmHg, affects ~70 million people in the US. Blood pressures in the upper half of the pre-hypertensive range... (Review)
Review
Pre-hypertension, defined as blood pressure 120-139/80-89 mmHg, affects ~70 million people in the US. Blood pressures in the upper half of the pre-hypertensive range are linked with roughly threefold greater risk of incident hypertension than normal blood pressure <120/<80 mmHg, with an incidence rate of 8-20 % annually. Blood pressures in the upper half of the pre-hypertensive range also roughly double risk for cardiovascular events, even in the absence of progression to hypertension. Despite excess risk, guidelines recommend lifestyle interventions only for people with pre-hypertension in the absence of diabetes mellitus or clinical cardiovascular or chronic kidney disease. While efficacious, lifestyle changes have limited population effectiveness as Americans are heavier and their nutritional patterns less DASH-like than before DASH was published. Prevalent hypertension is higher in African Americans than Caucasians, but prevalent pre-hypertension is similar. African Americans experience a more rapid transition from pre-hypertension to hypertension than Caucasians with pre-hypertension. Interventions that normalize racial differences in incident hypertension could, over time, improve racial equity in prevalent hypertension and related clinical complications. Individuals with pre-hypertension can be safely treated with antihypertensive medications to significantly reduce incident hypertension. Given the evidence, practical clinical trials in African Americans with pre-hypertension to reduce and eliminate racial disparities in incident hypertension have merit. The results of these trials could provide the foundation for clinical guidelines to reduce racial disparities in prevalent hypertension and associated clinical cardiovascular and renal diseases.
Topics: Animals; Antihypertensive Agents; Blood Pressure Determination; Heart Diseases; Humans; Prehypertension; Risk Factors
PubMed: 24142744
DOI: 10.1007/s11906-013-0387-7 -
Microbiome Feb 2017Recently, the potential role of gut microbiome in metabolic diseases has been revealed, especially in cardiovascular diseases. Hypertension is one of the most prevalent...
BACKGROUND
Recently, the potential role of gut microbiome in metabolic diseases has been revealed, especially in cardiovascular diseases. Hypertension is one of the most prevalent cardiovascular diseases worldwide, yet whether gut microbiota dysbiosis participates in the development of hypertension remains largely unknown. To investigate this issue, we carried out comprehensive metagenomic and metabolomic analyses in a cohort of 41 healthy controls, 56 subjects with pre-hypertension, 99 individuals with primary hypertension, and performed fecal microbiota transplantation from patients to germ-free mice.
RESULTS
Compared to the healthy controls, we found dramatically decreased microbial richness and diversity, Prevotella-dominated gut enterotype, distinct metagenomic composition with reduced bacteria associated with healthy status and overgrowth of bacteria such as Prevotella and Klebsiella, and disease-linked microbial function in both pre-hypertensive and hypertensive populations. Unexpectedly, the microbiome characteristic in pre-hypertension group was quite similar to that in hypertension. The metabolism changes of host with pre-hypertension or hypertension were identified to be closely linked to gut microbiome dysbiosis. And a disease classifier based on microbiota and metabolites was constructed to discriminate pre-hypertensive and hypertensive individuals from controls accurately. Furthermore, by fecal transplantation from hypertensive human donors to germ-free mice, elevated blood pressure was observed to be transferrable through microbiota, and the direct influence of gut microbiota on blood pressure of the host was demonstrated.
CONCLUSIONS
Overall, our results describe a novel causal role of aberrant gut microbiota in contributing to the pathogenesis of hypertension. And the significance of early intervention for pre-hypertension was emphasized.
Topics: Animals; Blood Pressure; Cohort Studies; Dysbiosis; Essential Hypertension; Fecal Microbiota Transplantation; Gastrointestinal Microbiome; Gastrointestinal Tract; Germ-Free Life; Humans; Hypertension; Klebsiella; Male; Mice; Mice, Inbred C57BL; Prehypertension; Prevotella; Prospective Studies
PubMed: 28143587
DOI: 10.1186/s40168-016-0222-x -
Journal of Human Hypertension Sep 2022Hypertension is a leading cause of mortality and morbidity globally. This study aimed to obtain an overall regional estimate of the prevalence of hypertension and... (Meta-Analysis)
Meta-Analysis Review
Hypertension is a leading cause of mortality and morbidity globally. This study aimed to obtain an overall regional estimate of the prevalence of hypertension and pre-hypertension and present the disease pattern based on the age and time in the Middle East region. We searched PubMed, Google Scholar, Medline for articles on the prevalence of hypertension, pre-hypertension among countries of the Middle East region from 1999 to 2019. STATA-14 was used to analyze the data. Data were pooled using a random-effects meta-analysis model, and heterogeneity between studies was assessed using I test and subgroup analysis. A total of eighty-three studies with 479816 participants met the criteria for inclusion in the meta-analysis process. The overall prevalence of hypertension and pre-hypertension in the Middle East region were 24.36% (95% CI: 19.06-31.14) and 28. 60% (95% CI: 24.19-33.80), respectively. An increasing trend in the prevalence of hypertension was observed with the increasing age. The prevalence of hypertension in the ≤ 49-year-old age group was 17.13% (95% CI: 13.79-21.27) and in people over 60 years was 61.24% (95% CI: 55.30-67.81) (P < 0.001). This pattern has been similar among both males and females. On the other hand, a decreasing trend in the prevalence of pre-hypertension was observed with the increasing age. The increasing trend in the prevalence of hypertension and decreasing trend in the prevalence of pre-hypertension with age are significant concerns in the Middle East region. Screening for the prevention and control of hypertension should prioritize public health programs.
Topics: Female; Humans; Hypertension; Male; Middle Aged; Middle East; Prehypertension; Prevalence
PubMed: 35031669
DOI: 10.1038/s41371-021-00647-9 -
Current Problems in Cardiology Jul 2022Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact... (Meta-Analysis)
Meta-Analysis Review
Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact prevalence of prehypertension (pre-HTN) and HTN in the Middle East and North Africa is lacking. This meta-analysis was conducted to evaluate prevalence of pre-HTN and HTN, awareness, treatment, and control in the Middle East and North Africa region. PubMed, Web of Science, and Scopus databases were searched from inception to April 30, 2021. Keywords included hypertension, pre-hypertension, awareness, treatment, and control. The quality of the included studies was evaluated using the Hoy scale. A random-effects model was evaluated based on overall HTN. The heterogeneity of the preliminary studies was evaluated using the I test. A total of 147 studies involving 1,312,244 participants were included in the meta-analysis. Based on the results of the random-effects method (95% CI), the prevalence of pre-HTN and HTN were 30.6% (95% CI: 25.2, 36.0%; I = 99.9%), and 26.2% (95% CI: 24.6, 27.9%; I = 99.8%), respectively. The prevalence of HTN awareness was 51.3% (95% CI: 47.7, 54.8; I = 99.0%). The prevalence of HTN treatment was 47.0% (95% CI: 34.8, 59.2; I = 99.9%). The prevalence of HTN control among treated patients was 43.1% (95% CI: 38.3, 47.9; I = 99.3%). Considering the high prevalence of HTN, very low awareness, and poor HTN control in the region, more attention should be paid to preventive programs for HTN reduction.
Topics: Africa, Northern; Humans; Hypertension; Middle East; Prehypertension; Prevalence; Risk Factors
PubMed: 34843808
DOI: 10.1016/j.cpcardiol.2021.101069 -
British Journal of Clinical Pharmacology Feb 2012People with pre-hypertension (high blood pressure but below the conventional threshold for intervention with antihypertensive drugs) undoubtedly have increased risk of... (Review)
Review
People with pre-hypertension (high blood pressure but below the conventional threshold for intervention with antihypertensive drugs) undoubtedly have increased risk of cardiovascular and other complications. However, the vast majority has low absolute risk and whether treatment would be beneficial is uncertain. While pharmacotherapy has attractions from a public health perspective, clinicians and crucially those with pre-hypertension require robust evidence that drug treatment will lead to short term as well as long term gains. Any changes in recommendations should await adequately powered outcome studies which provide solid evidence of the magnitude of absolute risk reduction in treating pre-hypertension and assessment of the cost-effectiveness.
Topics: Antihypertensive Agents; Blood Pressure; Blood Pressure Determination; Humans; Hypertension; Meta-Analysis as Topic; Prehypertension; Randomized Controlled Trials as Topic; Risk Factors
PubMed: 21883385
DOI: 10.1111/j.1365-2125.2011.04092.x -
West African Journal of Medicine Jul 2021Hypertension is a major cause of morbidity and mortality and has been found to track from childhood to adulthood with long term cardiovascular and renal complications....
BACKGROUND
Hypertension is a major cause of morbidity and mortality and has been found to track from childhood to adulthood with long term cardiovascular and renal complications. Hence early detection and control in children and adolescents is crucial. This study was conceived to add to the body of evidence on the blood pressure pattern; the prevalence of pre-hypertension and hypertension among primary and secondary school children in Port Harcourt, Rivers State, Nigeria.
METHODS
A total of 1,117 children and adolescents aged 6-16 years were recruited into this study from 16 schools (10 primary and 6 secondary schools in Port Harcourt) using a stratified, multistage sampling technique. The average of three blood pressure measurements was taken by the auscultatory method using the standard technique. The weight and height of the subjects were measured using a weighing scale and stadiometer respectively and body mass index (BMI) for age and sex obtained. Data was analyzed using SPSS version 25.
RESULTS
The overall mean systolic blood pressure (SBP) of subjects was 98.6±9.8mmHg while the mean diastolic blood pressure (DBP) was 57.2±8.8mmHg. The females had a significantly higher SBP than males (p<0.01), there was however no significant gender difference in the DBP. The systolic and diastolic blood pressure of the subjects showed a gradual increase with age. Fifty-one (4.3%) subjects had prehypertension (elevated blood pressure) while 52(4.4%) had hypertension. Majority of the hypertensive patients (92.3%) had stage 1 hypertension while 7.7% had stage 2 hypertension. Hypertension was more prevalent in females than males (p<0.001) and overweight/obese children compared to the normal weight and underweight children (p<0.001).
CONCLUSION
The prevalence of pre-hypertension and hypertension in children and adolescents is high with overweight and obesity being associated risk factors.
Topics: Adolescent; Blood Pressure; Body Mass Index; Child; Cross-Sectional Studies; Female; Humans; Hypertension; Male; Nigeria; Prehypertension; Prevalence; Risk Factors; Young Adult
PubMed: 34331050
DOI: No ID Found