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Journal of the American College of... Jun 2012The purpose of this study is to better understand the origins and progression of pre-hypertension.
OBJECTIVES
The purpose of this study is to better understand the origins and progression of pre-hypertension.
BACKGROUND
Pre-hypertension is a risk factor for progression to hypertension, cardiovascular disease, and increased mortality. We used a cross-sectional twin study design to examine the role of heredity in likely pathophysiological events (autonomic or hemodynamic) in pre-hypertension.
METHODS
Eight hundred twelve individuals (337 normotensive, 340 pre-hypertensive, 135 hypertensive) were evaluated in a sample of twin pairs, their siblings, and other family members. They underwent noninvasive hemodynamic, autonomic, and biochemical testing, as well as estimates of trait heritability (the percentage of trait variance accounted for by heredity) and pleiotropy (the genetic covariance or shared genetic determination of traits) by variance components.
RESULTS
In the hemodynamic realm, an elevation of cardiac contractility prompted increased stroke volume, in turn increasing cardiac output, which elevated blood pressure into the pre-hypertension range. Autonomic monitoring detected an elevation of norepinephrine secretion plus a decline in cardiac parasympathetic tone. Twin pair variance components documented substantial heritability as well as joint genetic determination for blood pressure and the contributory autonomic and hemodynamic traits. Genetic variation at a pathway locus also indicated pleiotropic effects on contractility and blood pressure.
CONCLUSIONS
Elevated blood pressure in pre-hypertension results from increased cardiac output, driven by contractility as well as heart rate, which may reflect both diminished parasympathetic and increased sympathetic tone. In the face of increased cardiac output, systemic vascular resistance fails to decline homeostatically. Such traits display substantial heritability and shared genetic determination, although by loci not yet elucidated. These findings clarify the role of heredity in the origin of pre-hypertension and its autonomic and hemodynamic pathogenesis. The results also establish pathways that suggest new therapeutic targets for pre-hypertension, or approaches to its prevention.
Topics: Adult; Blood Pressure; Calcium Channels, L-Type; Cardiac Output; Cross-Sectional Studies; Disease Progression; Female; Hemodynamics; Humans; Male; Myocardial Contraction; Norepinephrine; Prehypertension; Stroke Volume; Vascular Resistance
PubMed: 22676942
DOI: 10.1016/j.jacc.2012.02.040 -
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 -
Journal of Clinical Hypertension... May 2011Hypertension is associated with increased left ventricular mass (LVM) and carotid intima-media thickness (cIMT), which predict cardiovascular (CV) events in adults....
Hypertension is associated with increased left ventricular mass (LVM) and carotid intima-media thickness (cIMT), which predict cardiovascular (CV) events in adults. Whether target organ damage is found in pre-hypertensive youth is not known. The authors measured body mass index, blood pressure, fasting glucose, insulin, lipids and C-reactive protein, LVM/height(2.7) (LVM index), diastolic function, cIMT, carotid stiffness, augmentation index, brachial artery distensibility, and pulse wave velocity (PWV) in 723 patients aged 10 to 23 years (29% with type 2 diabetes mellitus). Patients were stratified by blood pressure level (normotensive: 531, pre-hypertensive: 65, hypertensive: 127). Adiposity and CV risk factors worsened across blood pressure group. There was a graded increase in cIMT, arterial stiffness, and LVM index and decrease in diastolic function from normotension to pre-hypertension to hypertension. In multivariable models adjusted for CV risk factors, status as pre-hypertension or hypertension remained an independent determinant of target organ damage for LVM, diastolic function, internal cIMT, and carotid and arterial stiffness. Pre-hypertension is associated with cardiovascular target organ damage in adolescents and young adults.
Topics: Adolescent; Blood Flow Velocity; Blood Pressure; Carotid Arteries; Child; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Echocardiography; Elasticity; Female; Humans; Hypertrophy, Left Ventricular; Male; Obesity; Prehypertension; Tunica Intima; Tunica Media; Ultrasonography; Vascular Resistance; Young Adult
PubMed: 21545394
DOI: 10.1111/j.1751-7176.2011.00471.x -
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 -
Central European Journal of Public... Mar 2015Hypertension is one of the most common risk factors for cardiovascular diseases (CVDs), yet not much effort is being invested in early diagnosis and control of the...
BACKGROUND
Hypertension is one of the most common risk factors for cardiovascular diseases (CVDs), yet not much effort is being invested in early diagnosis and control of the condition in susceptible children. The aim of this study was to,investigate the prevalence of pre-hypertension and hypertension in peri-urban school-attending adolescents and explore the relationship between blood pressure and selected anthropometric measurements.
METHODS
A cross-sectional study of adolescents aged 13-17 years was performed. Data on height, weight, waist and hip circumferences as well as blood pressure were collected from all participants. Body mass index (BMI) and blood pressure percentiles were calculated. Results: The overall prevalence of obesity was 20.4% while the prevalence of hypertension and pre-hypertension was 21.2% and 12.3%, respectively. The prevalence of hypertension and pre-hypertension in males was 22.0% and 13.6% compared to 20.9% and 16.5% in females, respectively. Both conditions were associated with higher BMI in both girls and boys. While mean systolic blood pressure (SBP) was positively associated with higher BMI and waist circumference (WC) in males and females, it correlated negatively with hip circumference (HC) in males. On the other hand, mean diastolic blood pressure (DBP) correlated better with HC in males but only weakly in females.
CONCLUSION
Adolescent learners in Mthatha had a high prevalence of hypertension and pre-hypertension which were associated with overweight and obesity. Results highlight the urgent need for screening in view of early detection and implementation of intervention strategies to prevent a high incidence of CVDs in this country.
Topics: Adolescent; Cohort Studies; Cross-Sectional Studies; Female; Humans; Hypertension; Male; Overweight; Pediatric Obesity; Prehypertension; Prevalence; South Africa
PubMed: 26036100
DOI: 10.21101/cejph.a3922 -
The Australian Journal of Rural Health Aug 2012To find out the prevalence of hypertension, pre-hypertension and tachycardia among the women in rural areas of West Bengal, identify co-factors associated with the...
OBJECTIVE
To find out the prevalence of hypertension, pre-hypertension and tachycardia among the women in rural areas of West Bengal, identify co-factors associated with the prevalence and contribute to the body of evidence for future health programs to identify at-risk groups.
DESIGN
A population-based cross-sectional study was conducted.
SETTING
The study was conducted in remote villages.
PARTICIPANTS
1186 women participants, aged 18 years or more were included.
MAIN OUTCOME MEASURES
They were interviewed using standard structured questionnaire. Blood pressure and tachycardia was monitored using digital sphygmomanometer. For each participant, we made two blood pressure measurements with an interval of 48 hours. Data was analysed statistically using SPSS software.
RESULTS
Overall prevalence of hypertension in the study subjects was 24.7% and that of pre-hypertension and tachycardia was 40.8% and 6.4%, respectively. Both hypertension and pre-hypertension were seen to increase with age. Other identified significant factors were use of biomass fuel for cooking, absence of separate kitchen, higher body mass index (BMI), education and average family income.
CONCLUSION
This study suggests quite high prevalence of hypertension as well as pre-hypertension among the women of rural areas. The findings are significant from the women health perspectives. Early detection of pre-hypertensive and hypertensive subjects will help to formulate intervention strategies to allay the spread of cardiovascular diseases.
Topics: Adolescent; Adult; Age Factors; Aged; Body Mass Index; Cooking; Cross-Sectional Studies; Female; Fuel Oils; Humans; Hypertension; India; Interviews as Topic; Middle Aged; Prehypertension; Prevalence; Risk Factors; Rural Health; Socioeconomic Factors; Tachycardia; Young Adult
PubMed: 22827431
DOI: 10.1111/j.1440-1584.2012.01287.x -
Nutrients Oct 2021The Blood pressure control diet is well described; however, it has not been implemented in clinical care, possibly due to the impracticability of the diet assessment in...
The Blood pressure control diet is well described; however, it has not been implemented in clinical care, possibly due to the impracticability of the diet assessment in these contexts. In order to facilitate the dietary assessment, we developed and assessed the validity and reproducibility of two food group-based food frequency questionnaires (FG-FFQs), with a one-week (7-day FG-FFQ) and a one-month (30-day FG-FFQ) period of coverage for patients with pre-hypertension or hypertension. In 2010, 155 men and women, 30-70 years old, were invited to participate in a prospective study in two outpatient clinics in Porto Alegre, southern Brazil. The participants responded to two 30-day, two 7-day FG-FFQ, four 24-h dietary recalls, and underwent demographic, anthropometric, and blood pressure assessments. The validity and reproducibility were assessed using partial correlation coefficients adjusted for sex and age, and the internal validity was tested using the intra-class correlation coefficient. The participants were aged 61 (±10) years and 60% were women. The validity correlation coefficient was higher than r = 0.80 in the 30-day FG-FFQ for whole bread (r = 0.81) and the 7-day FG-FFQ for diet/light/zero soda and industrialized juices (r = 0.84) in comparison to the 24-h dietary recalls. The global internal validity was α = 0.59, but it increased to α = 0.76 when 19 redundant food groups were excluded. The reproducibility was higher than r = 0.80 for pasta, potatoes and manioc, bakery goods, sugar and cocoa, and beans for both versions. The 30-day had a slightly higher validity, both had good internal validity, and the 7-day FG-FFQ had a higher reproducibility.
Topics: Adult; Aged; Brazil; Diet; Diet Surveys; Dietary Approaches To Stop Hypertension; Female; Humans; Hypertension; Male; Mental Recall; Middle Aged; Prehypertension; Prospective Studies; Reproducibility of Results; Surveys and Questionnaires
PubMed: 34836136
DOI: 10.3390/nu13113881 -
Journal of Tropical Pediatrics Jun 2017Despite four decades of research, there is no systematic review and trend analysis on paediatric (pre)hypertension in Nigeria. This article reviewed data from... (Review)
Review
Despite four decades of research, there is no systematic review and trend analysis on paediatric (pre)hypertension in Nigeria. This article reviewed data from cross-sectional studies on the subject. From the initial 9334 articles identified, 30 studies that met the inclusion criteria were systematically reviewed. Data from studies that defined hypertension as blood pressure (BP) greater than the 95th percentile for age, height and sex gave a prevalence of 8.2% [95% confidence interval (CI): 3.6-28.2%] for prehypertension and 5.1% (95% CI: 2.9-8.6%) for hypertension. For studies that defined hypertension as BP greater than 2 SD points from the mean of the population, the prevalence of hypertension was found to be 4.0% (95% CI: 2.8-5.7%). A significant negative trend (Z = -0.89; α < 0.01) with small magnitude (Q = -0.019; 95% CI: -0.070 to 0.028) was found for hypertension in the reviewed population. The prevalence of (pre)hypertension in Nigerian children and adolescents is moderate but has slightly declined over time.
Topics: Adolescent; Blood Pressure; Blood Pressure Determination; Child; Female; Humans; Hypertension; Male; Nigeria; Prehypertension; Prevalence
PubMed: 28082664
DOI: 10.1093/tropej/fmw087 -
Current Hypertension Reports Dec 2012In the 2004 report from the National High Blood Pressure (BP) Education Program Working Group on BP in Children and Adolescents, the term "high normal BP" was replaced... (Review)
Review
In the 2004 report from the National High Blood Pressure (BP) Education Program Working Group on BP in Children and Adolescents, the term "high normal BP" was replaced with the designation "prehypertension". It was proposed that BP levels that were higher than normal but did not reach the level of hypertension posed an increased risk for progression to hypertension. The overall intent of this description was to help identify children who were at the greatest risk for the development of hypertension. These are children and adolescents for whom targeted prevention programs are expected to be most beneficial. Following the 2004 report, the prehypertension condition has been examined and described in adolescents as well as adults. This review summarizes the knowledge that has been gained on prehypertension including clinical characteristics, rates of progression to hypertension, and evidence of cardiovascular pathology.
Topics: Adolescent; Disease Progression; Humans; Hypertension; Prehypertension; Risk Reduction Behavior
PubMed: 22878957
DOI: 10.1007/s11906-012-0299-y -
Sleep & Breathing = Schlaf & Atmung Dec 2016The aim of this study is to investigate the relationship between sleep duration and hypertension in a middle-aged Chinese population.
PURPOSE
The aim of this study is to investigate the relationship between sleep duration and hypertension in a middle-aged Chinese population.
METHODS
Cross-sectional data of 20,505 individuals aged 35-64 years from Taizhou longitudinal study was used. Logistic regression models were used to calculate odds ratios (ORs) for the risk of pre-hypertension and hypertension in association with sleep duration.
RESULTS
Short sleep duration was associated with high systolic and diastolic blood pressure in comparison with sleep duration of 7-8 h in females. Short sleep duration was also associated with an increased risk of hypertension in females. Age-stratified analysis showed that as compared with sleep duration of 7-8 h, sleep duration <6 h increased risk of hypertension after controlling for multiple covariates with an OR of 1.766 (1.024-2.775) in early middle-aged females of 35-44 years. More importantly, sleeping less than 6 h is associated with increased risk of pre-hypertension in females of this age category, after controlling for multiple covariates with an OR of 1.769 (1.058-2.958).
CONCLUSIONS
Sleeping less than 6 h a day is associated with increased risk of pre-hypertension and hypertension in Chinese early middle-aged females. The high-risk populations require sufficient sleep, which could probably prevent the increased risk of pre-hypertension as well as hypertension.
Topics: Adult; China; Female; Humans; Hypertension; Middle Aged; Prehypertension; Risk Assessment; Sleep Wake Disorders; Statistics as Topic
PubMed: 27491292
DOI: 10.1007/s11325-016-1392-2