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Circulation May 2018Although the prevalence of hypertension (HTN) continues to increase in developing countries, including China, recent data are lacking. A nationwide survey was conducted...
BACKGROUND
Although the prevalence of hypertension (HTN) continues to increase in developing countries, including China, recent data are lacking. A nationwide survey was conducted from October 2012 to December 2015 to assess the prevalence of HTN in China.
METHODS
A stratified multistage random sampling method was used to obtain a nationally representative sample of 451 755 residents ≥18 years of age from 31 provinces in mainland China from October 2012 to December 2015. Blood pressure (BP) was measured after resting for 5 minutes by trained staff using a validated oscillometric BP monitor. HTN was defined as systolic BP (SBP) ≥140 mm Hg/or diastolic BP (DBP) ≥90 mm Hg or use of antihypertensive medication within 2 weeks. Pre-HTN was defined as SBP 120 to 139 mm Hg and DBP 80 to 89 mm Hg without antihypertensive medication. HTN control was defined as SBP <140 mm Hg and DBP<90 mm Hg. In addition, the prevalence of HTN (SBP ≥130 or DBP ≥80 mm Hg) and control rate (SBP <130 and DBP <80 mm Hg) of HTN were also estimated according to the 2017 American College of Cardiology/American Heart Association High Blood Pressure Guideline.
RESULTS
Overall, 23.2% (≈244.5 million) of the Chinese adult population ≥18 years of age had HTN, and another 41.3% (≈435.3 million) had pre-HTN according to the Chinese guideline. There were no significant differences of HTN prevalence between urban and rural residents (23.4% versus 23.1%, =0.819). Among individuals with HTN, 46.9% were aware of their condition, 40.7% were taking prescribed antihypertensive medications, and 15.3% had controlled HTN. Calcium channel blockers were the most commonly used antihypertensive medication (46.5%) as monotherapy, and 31.7% of treated hypertensive patients used ≥2 medications. The prevalence of HTN based on the 2017 American College of Cardiology/American Heart Association guideline was twice as high as that based on 2010 Chinese guideline (46.4%), whereas the control rate fell to 3.0%.
CONCLUSIONS
In China, there is a high prevalence of HTN and pre-HTN, and awareness, treatment, and control of HTN were low. Management of medical therapy for HTN needs to improve.
Topics: Adolescent; Adult; Aged; Antihypertensive Agents; Blood Pressure; Body Mass Index; China; Educational Status; Female; Health Surveys; Humans; Hypertension; Male; Middle Aged; Prehypertension; Prevalence; Risk Assessment; Young Adult
PubMed: 29449338
DOI: 10.1161/CIRCULATIONAHA.117.032380 -
BMC Medicine Sep 2013Hypertension is one of the most important and common cardiovascular risk factors. Defining the level at which blood pressure starts causing end-organ damage is...
Hypertension is one of the most important and common cardiovascular risk factors. Defining the level at which blood pressure starts causing end-organ damage is challenging, and is not easily answered. The threshold of blood pressure defining hypertension has progressively been reduced over time, from systolic >160 mmHg to >150 mmHg, then to >140 mmHg; and now even blood pressures above 130 to 120 mmHg are labeled as 'pre-hypertension' by some expert committees. Are interest groups creating another 'pseudodisease' or is this trend scientifically justified? A recent meta-analysis published in BMC Medicine by Huang et al. clearly indicates that pre-hypertension (120 to 140/80 to 90 mmHg) is a significant marker of increased cardiovascular risk. This raises the question as to whether we now need to lower the threshold of 'hypertension' (as opposed to 'pre-hypertension') to >120/80 mmHg, redefining a significant proportion of currently healthy people as 'patients' with an established disease. These data need to be interpreted with some caution. It is controversial whether pre-hypertension is an independent risk factor or just a risk marker and even more controversial whether treatment of pre-hypertension will lower cardiovascular risk. Please see related research: http://www.biomedcentral.com/1741-7015/11/177.
Topics: Cardiovascular Diseases; Humans; Prehypertension
PubMed: 24229371
DOI: 10.1186/1741-7015-11-211 -
International Journal of Environmental... Aug 2021The purpose of this cross-sectional study was to identify risk factors in the normotensive and pre-hypertensive group based on the blood pressure results of healthy...
The purpose of this cross-sectional study was to identify risk factors in the normotensive and pre-hypertensive group based on the blood pressure results of healthy young adults from the Korean National Health and Nutrition Examination Survey 2018. The participants were 2225 healthy young adults between the ages of 19 and under 45, excluding those with a diagnosis of hypertension or taking antihypertensive medications. Of the 2225 participants, the normotensive group was 1498 (67.3%) and the pre-hypertensive group 727 (32.7%). Determinants of pre-hypertension were analyzed using multiple logistic regression based on a complex sample design. Factors related to pre-hypertension in young adults were age, smoking, waist circumference, diabetes, anemia, cholesterol levels including HDL cholesterol, and uric acid levels. Pre-hypertension is a pre-stage that can prevent the morbidity of hypertension through lifestyle control, so its management is very important. Furthermore, a young adult is a stage in the growth and development of human beings, in which lifestyles such as healthy behaviors, eating habits, and exercise are fixed. Therefore, it is very important to improve lifestyles such as diet, exercise, and smoking cessation and to control risk factors in young adults who are at the pre-hypertension stage for health promotion. Continuous health examinations should be conducted for young adults, and education that can be practiced based on clinical data through this should be implemented for community health.
Topics: Adult; Cross-Sectional Studies; Humans; Hypertension; Nutrition Surveys; Prehypertension; Republic of Korea; Young Adult
PubMed: 34501734
DOI: 10.3390/ijerph18179144 -
Journal of the American Heart... Oct 2020Background Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and... (Meta-Analysis)
Meta-Analysis
Background Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and pairwise meta-analyses. It is still unclear which intervention would be most efficacious. Methods and Results Bayesian network meta-analyses were performed to estimate the comparative effectiveness of different interventions for lowering BP. From 60 166 potentially relevant articles, 120 eligible articles (14 923 participants) with a median follow-up of 12 weeks, assessing 22 nonpharmacologic interventions, were included. According to the surface under the cumulative ranking probabilities and Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality of evidence, for adults with prehypertension to established hypertension, high-quality evidence indicated that the Dietary Approach to Stop Hypertension (DASH) was superior to usual care and all other nonpharmacologic interventions in lowering systolic BP (weighted mean difference, 6.97 mm Hg; 95% credible interval, 4.50-9.47) and diastolic BP (weighted mean difference, 3.54 mm Hg; 95% credible interval, 1.80-5.28). Compared with usual care, moderate- to high-quality evidence indicated that aerobic exercise, isometric training, low-sodium and high-potassium salt, comprehensive lifestyle modification, breathing-control, and meditation could lower systolic BP and diastolic BP. For patients with hypertension, moderate- to high-quality evidence suggested that the interventions listed (except comprehensive lifestyle modification) were associated with greater systolic BP and diastolic BP reduction than usual care; salt restriction was also effective in lowering both systolic BP and diastolic BP. Among overweight and obese participants, low-calorie diet and low-calorie diet plus exercise could lower more BP than exercise. Conclusions DASH might be the most effective intervention in lowering BP for adults with prehypertension to established hypertension. Aerobic exercise, isometric training, low-sodium and high-potassium salt, comprehensive lifestyle modification, salt restriction, breathing-control, meditation and low-calorie diet also have obvious effects on BP reduction.
Topics: Comparative Effectiveness Research; Diet Therapy; Diet, Sodium-Restricted; Exercise; Humans; Hypertension; Prehypertension; Risk Reduction Behavior
PubMed: 32975166
DOI: 10.1161/JAHA.120.016804 -
Scientific Reports May 2020Endothelial dysfunction is a characteristic of systemic arterial hypertension (SAH) and an early marker of atherosclerosis. Aerobic exercise training (AT) improves... (Randomized Controlled Trial)
Randomized Controlled Trial
Different exercise training modalities produce similar endothelial function improvements in individuals with prehypertension or hypertension: a randomized clinical trial Exercise, endothelium and blood pressure.
Endothelial dysfunction is a characteristic of systemic arterial hypertension (SAH) and an early marker of atherosclerosis. Aerobic exercise training (AT) improves endothelial function. However, the effects of resistance training (RT) and combined training (CT) on endothelial function remain controversial in individuals with SAH. We determined the effects of AT, RT, and CT on endothelial function and systolic (SBP)/diastolic blood pressure (DBP) in individuals with prehypertension or hypertension. Forty-two participants (54 ± 11 y, resting SBP/DBP 137 ± 9/86 ± 6 mmHg) were randomly allocated into AT (n = 14, 40 min of cycling, 50-75% heart rate reserve), RT (n = 14, 6 resistance exercises, 4 × 12 repetitions, 60% maximum strength) and CT (n = 14, 2 × 12 repetitions of RT + 20 min of AT). All participants performed a 40-minute exercise session twice a week for 8 weeks. Endothelial function was evaluated by brachial artery flow-mediated dilation (FMD). Blood pressure was evaluated through ambulatory monitoring for 24 hours. After 8 weeks of exercise training, blood pressure was reduced in all 3 groups: -5.1 mmHg in SBP (95%CI -10.1, 0.0; p = 0.003) in AT; -4.0 mmHg in SBP (95%CI -7.8, -0.5; p = 0.027) in RT; and -3.2 mmHg in DBP (95%CI -7.9, 1.5; p = 0.001) in CT. All 3 exercise training modalities produced similar improvements in FMD: + 3.2% (95%CI 1.7, 4.6) (p < 0.001) in AT; + 4.0% (95%CI 2.1, 5.7) (p < 0.001) in RT; and +6.8% (95%CI 2.6, 11.1) (p = 0.006) in CT. In conclusion, different exercise training modalities were similarly effective in improving endothelial function but impacts on ambulatory blood pressure appear to be variable in individuals with prehypertension or hypertension.
Topics: Blood Pressure; Endothelium, Vascular; Exercise; Female; Humans; Hypertension; Male; Middle Aged; Prehypertension; Resistance Training
PubMed: 32376984
DOI: 10.1038/s41598-020-64365-x -
Journal of the American Heart... Feb 2013We conducted meta-analyses examining the effects of endurance, dynamic resistance, combined endurance and resistance training, and isometric resistance training on... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
We conducted meta-analyses examining the effects of endurance, dynamic resistance, combined endurance and resistance training, and isometric resistance training on resting blood pressure (BP) in adults. The aims were to quantify and compare BP changes for each training modality and identify patient subgroups exhibiting the largest BP changes.
METHODS AND RESULTS
Randomized controlled trials lasting ≥4 weeks investigating the effects of exercise on BP in healthy adults (age ≥18 years) and published in a peer-reviewed journal up to February 2012 were included. Random effects models were used for analyses, with data reported as weighted means and 95% confidence interval. We included 93 trials, involving 105 endurance, 29 dynamic resistance, 14 combined, and 5 isometric resistance groups, totaling 5223 participants (3401 exercise and 1822 control). Systolic BP (SBP) was reduced after endurance (-3.5 mm Hg [confidence limits -4.6 to -2.3]), dynamic resistance (-1.8 mm Hg [-3.7 to -0.011]), and isometric resistance (-10.9 mm Hg [-14.5 to -7.4]) but not after combined training. Reductions in diastolic BP (DBP) were observed after endurance (-2.5 mm Hg [-3.2 to -1.7]), dynamic resistance (-3.2 mm Hg [-4.5 to -2.0]), isometric resistance (-6.2 mm Hg [-10.3 to -2.0]), and combined (-2.2 mm Hg [-3.9 to -0.48]) training. BP reductions after endurance training were greater (P<0.0001) in 26 study groups of hypertensive subjects (-8.3 [-10.7 to -6.0]/-5.2 [-6.8 to -3.4] mm Hg) than in 50 groups of prehypertensive subjects (-2.1 [-3.3 to -0.83]/-1.7 [-2.7 to -0.68]) and 29 groups of subjects with normal BP levels (-0.75 [-2.2 to +0.69]/-1.1 [-2.2 to -0.068]). BP reductions after dynamic resistance training were largest for prehypertensive participants (-4.0 [-7.4 to -0.5]/-3.8 [-5.7 to -1.9] mm Hg) compared with patients with hypertension or normal BP.
CONCLUSION
Endurance, dynamic resistance, and isometric resistance training lower SBP and DBP, whereas combined training lowers only DBP. Data from a small number of isometric resistance training studies suggest this form of training has the potential for the largest reductions in SBP.
Topics: Blood Pressure; Evidence-Based Medicine; Exercise Therapy; Female; Humans; Hypertension; Male; Middle Aged; Physical Endurance; Prehypertension; Randomized Controlled Trials as Topic; Resistance Training; Time Factors; Treatment Outcome
PubMed: 23525435
DOI: 10.1161/JAHA.112.004473 -
Journal of Clinical Hypertension... Feb 2021Prevalence of pre-hypertension is higher among young adults and may increase the risk for hypertension and cardiovascular morbidity. Music therapy has been investigated... (Randomized Controlled Trial)
Randomized Controlled Trial
Prevalence of pre-hypertension is higher among young adults and may increase the risk for hypertension and cardiovascular morbidity. Music therapy has been investigated to reduce the blood pressure in the hypertensive population; however, its efficacy on blood pressure in pre-hypertensive young adults is not known. Thirty pre-hypertensive (systolic blood pressure [SBP] = 120-139 mmHg and diastolic blood pressure [DBP] = 80-89 mmHg) young adults were recruited and randomly assigned into two groups. Music group (N = 15) received music therapy by passive listening to music for 30 minutes/day, 5 days/week for 4 weeks, along with Dietary Approaches to Stop Hypertension (DASH) eating plan (a diet rich in fruits and vegetables, low-fat dairy or unsaturated fat) and limit the daily sodium intake less than 100 mmol/day. The control group (N = 15) practiced only DASH eating plan and sodium restriction. The SBP, DBP, and heart rate (HR) were measured before and after 4 weeks of intervention. There was a significant reduction in SBP (8.73 mmHg, p < .001) and HR (6.42 beats/minute, p = .002); however, the reduction in DBP (1.44 mmHg, p = .101) was not statistically significant in the music group. Control group did not exhibit any significant reduction in SBP (0.21 mmHg, p < .836), DBP (0.81 mmHg, p < .395) and HR (0.09 beats/minute, p < .935). In conclusion, music therapy reduced significantly SBP and HR suggesting that it could be a promising tool to prevent the progression of pre-hypertension toward hypertension among young adults.
Topics: Blood Pressure; Dietary Approaches To Stop Hypertension; Heart Rate; Humans; Hypertension; Music; Prehypertension; Young Adult
PubMed: 33347732
DOI: 10.1111/jch.14126 -
Medicine and Science in Sports and... Jun 2019This systematic umbrella review examines and updates the evidence on the relationship between physical activity (PA) and blood pressure (BP) presented in the 2008...
PURPOSE
This systematic umbrella review examines and updates the evidence on the relationship between physical activity (PA) and blood pressure (BP) presented in the 2008 Physical Activity Guidelines Advisory Committee Scientific Report.
METHODS
We performed a systematic review to identify systematic reviews and meta-analyses involving adults with normal BP, prehypertension, and hypertension published from 2006 to February 2018.
RESULTS
In total, 17 meta-analyses and one systematic review with 594,129 adults ≥18 yr qualified. Strong evidence demonstrates: 1) an inverse dose-response relationship between PA and incident hypertension among adults with normal BP; 2) PA reduces the risk of cardiovascular disease (CVD) progression among adults with hypertension; 3) PA reduces BP among adults with normal BP, prehypertension, and hypertension; and 4) the magnitude of the BP response to PA varies by resting BP, with greater benefits among adults with prehypertension than normal BP. Moderate evidence indicates the relationship between resting BP and the magnitude of benefit does not vary by PA type among adults with normal BP, prehypertension, and hypertension. Limited evidence suggests the magnitude of the BP response to PA varies by resting BP among adults with hypertension. Insufficient evidence is available to determine if factors such as sex, age, race/ethnicity, socioeconomic status, and weight status or the frequency, intensity, time, and duration of PA influence the associations between PA and BP.
CONCLUSIONS
Future research is needed that adheres to standard BP measurement protocols and classification schemes to better understand the influence of PA on the risk of comorbid conditions, health-related quality of life, and CVD progression and mortality; the interactive effects between PA and antihypertensive medication use; and the immediate BP-lowering benefits of PA.
Topics: Biomedical Research; Blood Pressure; Cardiovascular Diseases; Disease Progression; Exercise; Exercise Therapy; Humans; Hypertension; Practice Guidelines as Topic; Prehypertension; Risk Reduction Behavior; Socioeconomic Factors
PubMed: 31095088
DOI: 10.1249/MSS.0000000000001943 -
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 -
Journal of Human Hypertension Jun 2017The present study aimed to assess the value of pre-diabetes and pre-hypertension in predicting cardiovascular events. A population-based, cross-sectional survey was...
The present study aimed to assess the value of pre-diabetes and pre-hypertension in predicting cardiovascular events. A population-based, cross-sectional survey was conducted, representing a large sample of the general Iranian population aged 35 years and older from the Isfahan Province and determined using a random, multistage cluster-sampling 10-year cohort. The five end points considered as study outcome were unstable angina (UA), acute occurrence of myocardial infarction (MI), sudden cardiac death (SCD), brain stroke and cardiovascular disease (CVD). Of the 6323 subjects scheduled for assessment of diabetes state 617 were diabetics and 712 were pre-diabetic. In addition, of these subjects, 1754 had hypertension and 2500 had pre-hypertension. Analysing only pre-hypertension, pre-diabetes and its combination and adjusted for gender and age variables, pre-hypertension and pre-diabetes status together, could only effectively predict occurrence of MI (hazard ratio (HR)=3.21, 95% confidence interval (CI): 1.06-9.76, P=0.04). In the same COX regression models, pre-hypertension status could predict UA and CVD occurrence (HR=2.94, 95% CI: 1.68-5.14, P<0.001 and HR=1.74, 95% CI: 1.23-2.47, P=0.002, respectively). However, pre-diabetes status could not predict any of these events after adjustment for gender and age. Our data provide valuable evidence of the triggering role of pre-hypertension and pre-diabetes together, on appearance and progression of MI even in healthy individuals and the significant predicting value of pre-hypertension on the occurrence of UA and CVD. In this regard, the value of pre-hypertension and pre-diabetes together, and the pre-hypertension state alone, are clearly superior to pre-diabetes state alone in predicting cardiovascular events.
Topics: Adult; Aged; Angina, Unstable; Chi-Square Distribution; Cross-Sectional Studies; Death, Sudden, Cardiac; Female; Health Surveys; Humans; Iran; Male; Middle Aged; Myocardial Infarction; Prediabetic State; Prehypertension; Prognosis; Proportional Hazards Models; Risk Assessment; Risk Factors; Stroke; Time Factors
PubMed: 27334522
DOI: 10.1038/jhh.2016.42