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Background: Despite a recent European Society of Cardiology (ESC) consensus statement about RH, no study has properly investigated the epidemiology of RH in our conditions. We armed to evaluate in hypertension patients prevalence, predictors and prognosis of resistant hypertension (RH). Methods: This retrospective cohort study included 850 patients...

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... Definitions of elevated blood pressure and hypertension in children and adults[19,20] Abbreviations: BP Blood Pressure Adults and children ≥ 13 years of ageElevated blood pressureSystolic BP ≥ 120 and diastolic BP ˂ 80 mm HgFig. 1 BP measurement algorithm. Adapted from Flynn et al. 22 Abbreviations: BP, blood pressure ...
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Cardiovascular diseases are the main causes of death and health costs in developed countries. Although cardiovascular diseases are thought to affect only adulthood, the underlying process of atherosclerosis begins in the first decade of life. Epidemiological studies show that severity of atherosclerosis depends both on the number and intensity of risk factors. Early detection of cardiovascular risk in childhood is the most powerful tool to prevent cardiovascular accidents in adulthood and possibly reduce its consequent burden for the future. A large amount of cardiovascular risk factors is already detectable in childhood and include non-modifiable elements, among which genetic factors and congenital heart diseases, and modifiable elements, which depend on environmental effects (e.g. lifestyle and nutrition). Regardless of the possibility to intervene on these factors, an early diagnosis is fundamental to ensure an optimal life expectancy in adulthood. The most important cardiovascular risk factors in the paediatric age and adolescence are excess weight, arterial hypertension, glucose metabolism and lipid metabolism alterations. In this review we will discuss the main risk factors strictly correlated with cardiac and vessels diseases, focusing on their pathogenesis, diagnosis, and treatments.
... 18 Hypertension was diagnosed as systolic blood pressure ≥ 130 mmHg, diastolic blood pressure ≥ 80 mmHg, or treatment with antihypertensive medications. 19 ...
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Purpose: Guidelines have not recommended routine transthoracic echocardiography (TTE) for elderly patients prior to noncardiac surgery. We aimed to evaluate the significance of preoperative TTE to predict perioperative cardiac complications (PCCs) for elderly patients with coronary artery disease (CAD) undergoing noncardiac surgery. Patients and methods: We retrospectively reviewed 2204 patients over 65 years of age with CAD who underwent TTE before intermediate- or high-risk noncardiac surgery in a teaching hospital in China between September 2013 and August 2019. The revised cardiac risk index (RCRI) was assessed. PCCs comprised acute coronary syndrome, heart failure, new-onset severe arrhythmia, nonfatal cardiac arrest, and cardiac death. Logistic regression was used to build the prediction model for PCCs. Discrimination was evaluated using receiver operating characteristic curves, and a nomogram of the predictive model was constructed. Results: PCCs occurred in 189 (8.6%) patients. Multivariable analysis showed that eight clinical risk factors (age, history of myocardial infarction, insulin therapy for diabetes, New York Heart Association classification, preoperative serum creatinine, preoperative electrocardiogram ST-T abnormality and pathological Q wave, and American Society of Anesthesiologists classification) and five TTE parameters (left atrial anteroposterior dimension, left ventricular ejection fraction, left ventricular diastolic dysfunction, pulmonary hypertension, and regional ventricular wall motion abnormality) were associated with PCCs. The receiver operating characteristic curve for the clinical plus TTE model provided better discrimination for PCCs compared with the RCRI model (area under the curve: 0.731 vs 0.564; P < 0.001) and the clinical model (area under the curve: 0.731 vs 0.697, P = 0.001), respectively. The clinical plus TTE model was presented as a prognostic nomogram. Conclusion: Preoperative TTE may help predict PCCs in elderly patients with CAD undergoing noncardiac surgery, and the prognostic nomogram from this study appeared to be useful for the assessment of perioperative cardiac risk.
... When compared to other racial/ethnic groups, Black adults are disproportionately affected by the overwhelming rates of HTN and HTN-related diseases. 3 The reason for the high prevalence of HTN among Black adults is multifaceted and extends from the social determinates of health to societal-level disparities influenced by the effects of systemic and structural racism. 4,5 In older adult rural populations, the social and systemic inequities that influence health disparities are accentuated by higher poverty rates, multiple chronic health conditions, limited access to health care, and less health promoting behaviors that Patient Preference and Adherence 2022:16 2135-2148 2135 ...
... 7 Effective methods to improve blood pressure (BP) control include adherence to antihypertensive medication along with lifestyle modifications (eg, increased physical activity, healthy diet, weight management, etc.). 3,8 Modest changes in lifestyle modifications can lead to clinically significant reductions in BP. 9 However, research supports that more intensive BP lowering with antihypertensive medication reduces major cardiovascular events by 11%, myocardial infarction by 13%, stroke by 24%, and end stage renal disease by 11%. 10 Thus, BP control is paramount to prevent worsening of HTNrelated diseases. ...
... These foods contain some organic substances that have some vaso-relaxing properties as well as medicinal uses for treating hypertension. Source: [19]. ...
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Hypertension can result in myocardial infarction, renal failure, strokes, and death. It is a hemodynamic condition that is accompanied by an increase in peripheral vascular resistance. One billion individuals are believed to be affected by hypertension. This work seeks to provide an exhaustive synthesis of the theoretical and experimental data presented in various publications in order to determine the role of a food scientist and nutritionist in managing hypertension using functional food. Apart from that, the use of nutraceuticals in the management of hypertension, dietary habits in relation to trends in the management of high blood pressure coupled with the use of traditional medicines and medical foods in the management of hypertension, were discussed. Functional foods have bioactive ingredients that have been associated to restricting cholesterol absorption, which is a key element in lowering blood pressure. Functional foods, nutraceuticals, the DASH diet, conventional drugs, and medicinal foods have been found to minimize the need for antihypertensive medications, improve cardiovascular health, lower rates of morbidity and mortality, and lower healthcare expenditures. In order to treat hypertension, it is advocated that people use functional foods, nutraceuticals, folk medicine, and medical foods because they are more widely available, and safe than pharmaceutical drugs. Cite this article. Egwumah O, Abraham Girgih A, Joshua V. Managing Hypertension: Managing Hypertension: The Role of a Food Scientist and Nutritionist. Alq J Med App Sci. 2022;5(2):353-367. https://doi.org/10.5281/zenodo.6812235
... The mean of the second and third measurements was used for analysis, as recommended. 27 Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or antihypertensive medication use. ...
... 34 Synchronized European data format and sleep stage files were generated using Embla RemLogic Polysomnography Software (Natus Medical, Incorporated). PSD values were calculated in C3-M2 using fast Fourier transformation and the Welch algorithm on artifact-free consecutive, nonoverlapping 6-second epochs (Hamming windows, 8 segments, 50% overlap) and used to compute absolute signal power (μV 2 ) in typical frequency bands including delta (1-4 Hz), theta (5-8 Hz), alpha (8-12 Hz), sigma (12)(13)(14)(15)(16), and beta (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). ...
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Background Poor sleep quality is associated with increased incident hypertension. However, few studies have investigated the impact of objective sleep structure parameters on hypertension. This study investigated the association between sleep macrostructural and microstructural parameters and incident hypertension in a middle‐ to older‐aged sample. Methods and Results Participants from the HypnoLaus population‐based cohort without hypertension at baseline were included. Participants had at‐home polysomnography at baseline, allowing assessment of sleep macrostructure (nonrapid eye movement sleep stages 1, 2, and 3; rapid eye movement sleep stages; and total sleep time) and microstructure including power spectral density of electroencephalogram in nonrapid eye movement sleep and spindles characteristics (density, duration, frequency, amplitude) in nonrapid eye movement sleep stage 2. Associations between sleep macrostructure and microstructure parameters at baseline and incident clinical hypertension over a mean follow‐up of 5.2 years were assessed with multiple‐adjusted logistic regression. A total of 1172 participants (42% men; age 55±10 years) were included. Of these, 198 (17%) developed hypertension. After adjustment for confounders, no sleep macrostructure features were associated with incident hypertension. However, low absolute delta and sigma power were significantly associated with incident hypertension where participants in the lowest quartile of delta and sigma had a 1.69‐fold (95% CI, 1.00–2.89) and 1.72‐fold (95% CI, 1.05–2.82) increased risk of incident hypertension, respectively, versus those in the highest quartile. Lower spindle density (odds ratio, 0.87; 95% CI, 0.76–0.99) and amplitude (odds ratio, 0.98; 95% CI, 0.95–1.00) were also associated with higher incident hypertension. Conclusions Sleep microstructure is associated with incident hypertension. Slow‐wave activity and sleep spindles, 2 hallmarks of objective sleep continuity and quality, were inversely and consistently associated with incident hypertension. This supports the protective role of sleep continuity in the development of hypertension.
... Guideline recommend when the systolic blood pressure ≥165 mm Hg or diastolic blood pressure ≥100 mm Hg, antiangiogenesis therapy should be combined with antihypertensive agents and maintained until the blood pressure reaches to 140/90 mmHg (8). For the treatment of essential HT, thiazide diuretics, beta-adrenoceptor antagonists, calcium channel blockers (CCBs), angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are widely used (9,10). However, at present, appropriate antihypertensive agents for Bev-induced HT are unavailable, because patients undergoing chemotherapy and targeted therapy are excluded from clinical trials (11). ...
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Bevacizumab (Bev) is a humanized vascular endothelial growth factor monoclonal antibody that is used with chemotherapeutic drugs for the treatment of metastatic colorectal cancer (mCRC). Bev-induced hypertension (HT) is the most common adverse reaction during clinical practice. However, at present, appropriate antihypertensive agents for Bev-induced HT are unavailable. In this study, retrospective analysis of clinical data from mCRC patients who received renin-angiotensin system inhibitors (RASIs) showed significant survival benefits of overall survival (OS) and progression-free survival (PFS) over patients who received calcium channel blockers (CCBs) and patients who received no antihypertensive drug (NO: Y2020046 retrospectively registered). An experiment of HCT116 colon cancer cell xenografts in mice confirmed that combined treatment of Bev and lisinopril (Lis), a RASI, synergistically inhibited subcutaneous tumor growth and enhanced the concentration of 5-fluorouracil (5-Fu) in tumor tissues. Our results showed that the addition of Lis did not interfere with the vascular normalization effect promoted by Bev, but also inhibited collagen and hyaluronic acid (HA) deposition and significantly downregulated the expression of TGF-β1 and downstream SMAD signaling components which were enhanced by Bev, ultimately remodeling primary extracellular matrix components. In conclusion, RASIs and Bev have synergistic effect in the treatment of colorectal cancer and RASIs might be an optimal choice for the treatment of Bev-induced HT.
... 2 Cardiovascular disease (CVD) risk starts to increase even at a blood pressure (BP) lower than 130/80 mmHg, 3 which is the new cut-off for HT diagnosis. 4 This emphasizes the importance of early detection of elevated BP, especially as it is estimated that 25% to 50% of the worldwide adult population is considered as having Elevated BP or Stage 1 HT. 5 Lifestyle interventions and exercise capacity improvements can prevent and delay the progression to HT. 5 It is therefore important to develop simple screening tools for early identification of individuals susceptible to develop HT and related comorbidities in order to target those who would benefit the most from aggressive lifestyle interventions. ...
... Therefore, diagnosis of hypertensive nephropathy or identification of patients who are at high risk of developing renal damage is vital for the effective management of patients with hypertension. In this regard, guidelines for the management of hypertension recommend routine assessment of hypertension-induced renal damage by using simple renal function parameters (serum creatinine and eGFR) together with the investigation of albuminuria (dipstick or urinary albumin creatinine ratio) [10,19,20]. ...
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Proteinuria, frequently observed in hypertensive crisis, is a risk factor for cardiovascular and all-cause mortality in patients with hypertension. Here we investigated the association between proteinuria and all-cause mortality in patients with a hypertensive crisis in the emergency department (ED). This retrospective study included patients admitted to the ED of a tertiary referral center between 2016 and 2019 with hypertensive crisis (systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 110 mmHg); 3599 patients with an assay for proteinuria were included in this study. Proteinuria was defined as a trace or more protein on a urine dipstick test. Proteinuria was present in 1964 (54.6%) of 3599 patients. At 3 years, crude all-cause mortality rates were 10.8% for patients with negative proteinuria, 21.7% for those with trace proteinuria, 29.0% for those with proteinuria (1+), 32.0% for those with proteinuria (2+), and 35.4% for those with proteinuria (≥3+). After adjusting for age, sex, blood pressure, and comorbid conditions, the hazard ratio (95% confidence interval) for dipstick proteinuria was 1.91 (1.53–2.37) for those with trace proteinuria, 2.32 (1.85–2.91) for those with proteinuria (1+), 2.40 (1.86–3.10) for those with proteinuria (2+), and 2.40 (1.78–3.24) for those with proteinuria (≥3+) compared to the reference of negative proteinuria. In patients with hypertensive crisis, dipstick proteinuria was a significant predictor of all-cause mortality, and the risk of all-cause mortality increased in a dose-dependent manner according to its degree. Moreover, even trace proteinuria was associated with an increased risk of mortality. The dipstick urine test could be used as a simple and useful method for risk assessment of all-cause mortality in patients with hypertensive crisis.
... We estimated a mean systolic and diastolic blood pressure of 122.4 mm Hg and 76.7 mm Hg, respectively, in those consuming one serving of soft drink per day for the previous ten years. The level of systolic blood pressure falls under the classification of elevated [41]. Moreover, the estimated increase of systolic and diastolic blood pressure over ten years would be 6.2 mm Hg and 5.1 mm Hg, respectively, in adults consuming one serving of soft drinks per day and moving a large proportion of the population towards hypertension. ...
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Background A few prospective studies have investigated the potential association of soft drink and non-caloric soft drink intake with high blood pressure using methods that adequately consider changes in intake over time and hypertensive status at baseline. Objective To prospectively examine the association of soft drink and non-caloric soft drink intake with systolic and diastolic blood pressure in a sample of Mexican adults, overall and by hypertension status. Methods We used data from the Health Workers Cohort Study spanning from 2004 to 2018 ( n = 1,324 adults). Soft drink and non-caloric soft drink intake were assessed with a semiquantitative food frequency questionnaire. We fit multivariable-adjusted fixed-effects models to test the association of soft drink and non-caloric soft drink intake with systolic and diastolic blood pressure. The models were adjusted for potential confounders and considering the potential modifying effect of hypertension status at baseline. Results A one-serving increase in soft drink intake was associated with a 2.08 mm Hg (95% CI: 0.21, 3.94) increase in systolic blood pressure and 2.09 mm Hg (95% CI: 0.81, 3.36) increase in diastolic blood pressure over ten years. A stronger association between soft drink intake and diastolic pressure was observed among participants with versus without hypertension at baseline. We found no association between non-caloric soft drink intake and blood pressure. Conclusions Our findings support the hypothesis that soft drink intake increases blood pressure. While further studies should be conducted to confirm our findings, food policies and recommendations to limit soft drink intake are likely to help reduce blood pressure at the population level. We probably did not find an association between non-caloric soft drink intake and blood pressure because of the low consumption of this type of beverage in the cohort. More studies will be needed to understand the potential effect of non-caloric beverages on blood pressure.
... Hypertension was defined as self-reported hypertension or measured systolic blood pressure (SBP) ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg, or physician-prescribed blood pressure-lowering medications. 16 Dyslipidaemia was defined as a self-reported history. Hypercholesterolaemia was defined as a total cholesterol ≥6.21 mmol/L. ...
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Objectives: To determine the prevalence of cardiovascular disease (CVD) risk factors and explore associations with high-sensitivity cardiac troponin I (hscTnI) and high-sensitivity C-reactive protein (hsCRP) in people living with HIV (PLHIV) in Kenya. Design: Pilot cross-sectional study. Setting: Data were collected from community HIV clinics across two sites in Nairobi, Kenya, from July 2019 to May 2020. Participants: Convenience sample of 200 PLHIV (≥30 years with no prior history of CVD). Outcome measures: Prevalence of cardiovascular risk factors and its association with hsTnI and hsCRP levels. Results: Across 200 PLHIV (median age 46 years, IQR 38-53; 61% women), the prevalence of hypercholesterolaemia (total cholesterol >6.1 mmol/L) and hypertension were 19% (n=30/199) and 30% (n=60/200), respectively. Smoking and diabetes prevalence was 3% (n=5/200) and 4% (n=7/200). HscTnI was below the limit of quantification (<2.5 ng/L) in 65% (n=109/169). High (>3 mg/L), intermediate (1-3 mg/L) and low (<1 mg/L) hsCRP levels were found in 38% (n=75/198), 33% (n=65/198) and 29% (n=58/198), respectively. Framingham laboratory-based risk scores classified 83% of PLHIV at low risk with 12% and 5% at intermediate and high risk, respectively. Older age (adjusted OR (aOR) per year increase 1.05, 95% CI 1.01 to 1.08) and systolic blood pressure (140-159 mm Hg (aOR 2.96; 95% CI 1.09 to 7.90) and >160 mm Hg (aOR 4.68, 95% CI 1.55 to 14) compared with <140 mm Hg) were associated with hscTnI levels. No associations were observed between hsCRP and CVD risk factors. Conclusion: The majority of PLHIV-using traditional risk estimation systems-have a low estimated CVD risk likely reflecting a younger aged population predominantly consisting of women. Hypertension and hypercholesterolaemia were common while smoking and diabetes rates remained low. While hscTnI values were associated with increasing age and raised blood pressure, no associations between hsCRP levels and traditional cardiovascular risk factors were observed.