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Abstract 16828: Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-based Studies From 90 Countries
Abstract
Introduction: Hypertension is the leading preventable cause of premature death worldwide. We aimed to examine the global disparities of hypertension prevalence, awareness, treatment, and control in 2010 and compare secular changes in these disparities from 2000 to 2010.
Methods: We searched MEDLINE from January 1995 to December 2014 and supplemented with manual searches of references from retrieved articles. A total of 135 population-based studies with 968,419 individuals aged ≥20 years from 90 countries were included. Sex-age-specific prevalences of hypertension from each country were applied to population data to calculate the number of hypertensive adults in each region and globally. Proportions of awareness, treatment, and control from each country were applied to hypertensive populations to obtain regional and global estimates.
Results: An estimated 30.2% (95% confidence interval, 30.1-30.4%) of the world’s adult population in 2010 had hypertension; 28.6% (28.3-28.9%) in high-income countries and 30.3% (30.1-30.5%) in low- and middle-income countries. An estimated 1.35 billion (1.34-1.36 billion) people had hypertension in 2010; 349 million (339-359 million) in high-income and 1.00 billion (0.99-1.01 billion) in low- and middle-income countries. From 2000 to 2010, age-standardized prevalence of hypertension decreased by 2.3% in high-income countries but increased by 6.1% in low- and middle-income countries. During the same period, the proportions of awareness (56.6% vs 68.8%), treatment (42.9% vs 56.1%), and control (16.6% vs. 28.9%) increased substantially in high-income countries, whereas awareness (34.7% vs 35.1%), treatment (23.4% vs 26.4%), and control (7.0% vs 7.8%) increased only slightly in low- and middle-income countries.
Conclusions: Global disparities in hypertension prevalence, awareness, treatment, and control are large and increasing. Collaborative efforts from national and international stakeholders are urgently needed to combat the emerging hypertension burden in low- and middle-income countries.
... According to the 2023 World Health Organization (WHO) report, 1 in 3 persons had hypertension (silent disease) [1], defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg [2]. Globally, for example, the prevalence of hypertension among adults was higher in low-and middle-income countries (LMIC) (31.5%, 1.04 billion people) than in high-income countries (28.5%, 349 million people). ...
... Primary care should offer improved hypertension treatment programs because the economic benefits outweigh the costs by an 18 to 1 ratio. Combining antihypertensive medication with additional nutrients and dietary supplements(DSs), such as the Dietary Approaches to Stop Hypertension (DASH) I and II diets, can have additive or synergistic benefits [2,13,14]. DSs, such as calcium (Ca ++ ), magnesium (Mg ++ ), and vitamin D, are a subgroup of complementary and alternative medicine (CAM), which the public commonly uses and touts as natural ways to affect blood pressure [14][15][16]. ...
... Hypertension is characterized by blood vessel damage due to vascular inflammation, structural remodeling, stiffer arteries, less flexibility, and loss of elasticity [2]. ...
Background
Hypertension, the first global modifiable risk factor for cardiovascular disease (CVD) morbidity and mortality, is a consequential and remediable threat to the health of individuals and society. Therefore, we conducted this study to explore the role of calcium (Ca⁺⁺), magnesium (Mg⁺⁺), and vitamin D (Vit-D) supplementation as complementary therapies for hypertension, focusing on their effects on systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate.
Methods
This systematic review and meta-analysis examined relevant 6509 articles in PubMed, Scopus, Web of Science, and Cochrane CENTRAL up to October 2024. The primary outcome was the difference in blood pressure measurements (systolic and diastolic) and the pulse rate. The extracted data were analyzed using Open Meta Analyst software.
Results
This systematic review and meta-analysis included 40 studies; of them, 24 studies were analyzed. Ca⁺⁺ was associated with a significant drop in the DBP (MD: -2.04, 95% CI [-3.39, -0.69], P = 0.01), but not in the SBP (P = 0.34) or pulse rate (P = 0.84). Mg⁺⁺ significantly reduced DBP (MD: -1.64, 95% CI [-3.19, -0.09], P = 0.04), but had no significant effect on the SBP (P = 0.16) or pulse rate (P = 0.81). The estimated effect of Vit-D showed a significant reduction in SBP (MD: -2.83, 95% CI [-5.47, -0.199], P = 0.04) and DBP (MD: -1.64, 95% CI [-2.97, -0.3], P = 0.01).
Conclusion
Ca⁺⁺ and Mg⁺⁺ significantly reduced DBP but had no significant effect on SBP or the pulse rate. Whereas, vitamin D significantly reduced SBP and DBP.
... This is largely due to low hypertension awareness and health services accessibility, particularly in low-and middle-income countries (LMICs), where two-thirds of the 1.3 billion adults with hypertension live. Additional barriers include a lack of sufficient health system resources and competing communicable disease management priorities [3,4]. Furthermore, approximately onethird of hypertensive adults in LMICs also have type 2 diabetes, a comorbidity that increases the risk of severe disease complications and mortality compared to either condition alone [5,6]. ...
... Schedule of enrollment, intervention, and follow-up assessments. 1 Screening will be conducted at the health facilities and health fairs; 2 ANDES study team will conduct all study outcome assessments, including the baseline outcome assessment and the follow-up assessments (represented by diamond shapes). 3 CHW workers will conduct all participant home visits facility personnel identify hypertensive patients from their records on a weekly basis. During routine phone scheduling for follow-up care, they conduct an initial screening and invite interested patients to the ANDES screening fairs. ...
... Adapting a task-shifting model, the multicomponent ANDES hypertension control program aims to train and deploy CHWs to share the burden of hypertension education and medication adherence counseling, thereby potentially saving the existing health system and providers time and money. Furthermore, as members of the community, CHWs share many cultural, educational, and language characteristics with local participants, potentially reducing communication and trust barriers that can contribute to a lack of medication adherence [3,4]. In the ANDES trial, CHWs are financially incentivized as paid, full-time staff, whereas most CHW work in Peru has been traditionally unpaid or minimally paid. ...
Background
Hypertension is the most common cardiovascular disease in Peru despite the availability of cost-effective, evidence-based treatment. Here we describe the rationale and study design for a hybrid type 2 randomized controlled trial to test the implementation and effectiveness of a community health worker (CHW)-led hypertension control program within the national primary care system in Puno, Peru.
Methods
We will recruit 1068 adult participants with hypertension aged ≥ 18 years in Puno, Peru, via facility-based enrollment and community health fairs. Participants will be individually randomized (1:1) to either continue with usual care or participate in a 12-month CHW-led home-based hypertension control program consisting of blood pressure monitoring, medication adherence support, and healthy lifestyle counseling. Outcome development and reporting are guided by the Consolidated Framework for Implementation Research (CFIR), the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, and the Proctor et al. framework. Clinical effectiveness outcomes include mean change in systolic blood pressure (primary outcome), diastolic blood pressure, and HbA1C. Implementation outcomes include fidelity (i.e., CHW protocol adherence and dose), reach, adoption, sustainability, acceptability, and cost-effectiveness.
Discussion
The ANDES trial is testing the first CHW-led multicomponent strategy for hypertension and type 2 diabetes management in Peru. This type 2 hybrid trial will provide critical insights into the individual, community, and system-level factors necessary for successful implementation and effectiveness. These data can inform the future adaptation and scaling of the ANDES strategy in Peru and other LMICs, as well as influence policies at the system level to support this transition. Furthermore, by addressing both hypertension and diabetes, the ANDES strategy supports integrated care approaches advocated by the WHO HEARTS technical package, ultimately enhancing health outcomes and reducing morbidity and mortality in the region.
Trial registration
ClinicalTrials.gov, ID: NCT05524987, Addressing Hypertension and Diabetes through Community-Engaged Systems in Puno, Peru (ANDES study), prospectively registered on September 1, 2021.
... Hypertension is the most common chronic disease, with a prevalence of 31.1% among adults globally. 1 Its main complications, including stroke, myocardial infarction, heart failure, and chronic kidney disease, are not only disabling but also associated with high mortality rates, placing a significant burden on families and society. 2,3 The annual worldwide economic cost of hypertension is estimated at US $370 billion. ...
... 5 Hypertension affects 31.1% of adults in the world, with 28% achieving control in high-income countries and 8% in low-and middle-income countries. 1 Effective BP control depends on the patient's good self-management. 6 Self-management was defined as the capability of individuals to manage their health conditions, with or without the support of a health care provider. ...
Objective
To systematically evaluate the effectiveness of mobile health (mHealth) interventions on self-management and blood pressure (BP) control in patients with hypertension and to provide recommendations for the clinic and future research.
Methods
Databases including Embase, Cochrane Library, CINAHL, CNKI, SinoMed, Wanfang, and Weipu were searched to collect systematic reviews (SRs) and meta-analyses on mHealth interventions for hypertension management. Two researchers independently screened the articles and extracted data, and the Assessment of Multiple Systematic Reviews (AMSTAR 2) was used to evaluate the methodological quality of the included reviews.
Results
A total of 11 SRs were included: 1 review was rated as high quality, 3 as low quality, and 7 as critically low quality. The mobile phone was the most common intervention type, followed by the internet. Seven reviews performed meta-analyses and showed that mHealth was associated with a significant reduction in systolic blood pressure (SBP), from 2.28 mmHg (95%CI –3.90 to –0.66; I ² = 40%) to 14.77 mmHg (95%CI 11.76–17.77; I ² = 89.7%), and diastolic blood pressure (DBP), from 1.50 mmHg (95%CI –2.20 to –0.08; I ² = 62%) to 8.17 mmHg (95%CI 5.67–10.67; I ² = 86%). Self-management behaviors included medication adherence (MA), diet, smoking, alcohol drinking, physical activity, and BP monitoring. There were inconsistent results on the effectiveness of mHealth interventions.
Conclusions
mHealth interventions can improve BP control, MA, diet, and smoking in patients with hypertension, but the evidence for the efficacy of mHealth on physical activity and alcohol drinking improvement is limited. The methodological quality of existing SRs on the management of BP in patients with hypertension was relatively low, and more well-designed SRs or meta-analyses were needed to provide more evidence. mHealth interventions are useful for improving BP control of patients with hypertension.
... Tăng huyết áp là một bệnh lý mạn tính, đặc trưng bởi áp lực máu lên thành động mạch tăng cao [1]. Tình trạng này được xác định khi huyết áp tâm thu lúc nghỉ từ 130 mmHg trở lên hoặc huyết áp tâm trương lúc nghỉ từ 80 mmHg trở lên, hoặc cả hai giá trị đều vượt ngưỡng [2]. ...
... Dựa trên các tương tác giữa thụ thể AT 1 Hình 2. Mô hình 3D-pharmacophore. ...
... Hypertension is one of the most common chronic diseases and a major contributor to the global burden of disease, affecting approximately 1.39 billion people worldwide and causing 10.4 million premature deaths annually [1]. The prevalence of hypertension in adults aged 30-79 was reported as 32% in 2019. ...
... The prevalence of hypertension in adults aged 30-79 was reported as 32% in 2019. The same report found that the prevalence of hypertension decreased significantly in high-income countries but increased in middleand low-income countries [1]. Studies conducted in our country have reported that the prevalence of hypertension varies between 29% and 31.8% ...
Individuals' knowledge and attitudes about hypertension are important in controlling blood pressure (BP) and reducing hypertension‐related mortality and morbidity. The current study aimed to investigate the effect of hypertension knowledge level on treatment adherence, BP control, and physical activity of hypertensive individuals. This prospective and cross‐sectional study was conducted in the Family Medicine clinic of a tertiary healthcare institution between October 2023 and April 2024. The study included 218 patients with essential hypertension. The BP of all patients was measured with a calibrated mercury sphygmomanometer, and the patients were divided into two groups: uncontrolled BP and controlled BP. The Hypertension Knowledge Level Scale (HK‐LS), General Practice Physical Activity Questionnaire (GPPAQ), and Modified Morisky Medication Adherence Scale (MMMAS‐6) were administered to all participants. Although 40.8% (n = 89) of the patients had their BP under control, 59.2% (n = 129) did not. The median weight of the participants whose BP was not under control was higher than those whose BP was under control (p < 0.05). A significant positive correlation was found between the hypertension knowledge score and the Morisky total score, Morisky motivation, and Morisky knowledge scores. There was a significant negative correlation between the GPPAQ score and both systolic and diastolic BP, as well as a significant positive correlation with hypertension knowledge levels. Assessing the knowledge level of hypertensive patients about their disease, recognizing their lifestyles, and questioning their habits is crucial for recommending individualized health interventions tailored to the needs and characteristics of this population.
... However, most persons with hypertension do not receive adequate diagnosis and treatment, with approximately 50 % of hypertensive patients undiagnosed. The PURE study also showed that in the participating South American countries (Argentina, Brazil, Colombia, and Chile), only 18.8-21.1 % of hypertensive participants had controlled BP levels (<140/90 mmHg) [3,[8][9][10][11]. ...
... HT is the leading risk factor for CVD, which is the leading cause of death and disability globally, with a higher burden of disease in low and middle-income countries [3]. While lifestyle changes and evidence-based pharmacologic treatment are effective, diagnosis, treatment, and control remain inadequate [8][9][10]. The COTRACO study aims to address barriers and limitations in HT diagnosis, treatment, management, and healthcare in low-and middle-income countries by implementing a model based on a standardized treatment algorithm administered by NPHWs. ...
Introduction
Cardiovascular diseases are the leading cause of death and morbidity worldwide, with a significantly higher burden in low- and middle-income countries. Hypertension, a major risk factor for cardiovascular morbidity and mortality, remains under-diagnosed and poorly controlled, especially in regions such as Latin America. The HOPE-4 study demonstrated that the involvement of non-physician health workers (NPHWs), the use of standardized treatment algorithms, the provision of free antihypertensive drugs and home follow-up can significantly improve hypertension control and reduce cardiovascular risk, as demonstrated in Colombia and Malaysia. On this basis, the COTRACO study aims to address the barriers to hypertension treatment in low- and middle-income countries by implementing a similar standardized treatment approach delivered by non-specialist health workers.
Methodology
The COTRACO study is a quasi-experimental, parallel-group, non-randomized, before-and-after study. A community-based model will be implemented in 600 patients in Colombia and the Dominican Republic, involving NPHWs to: 1) apply standardized treatment algorithms, 2) promote adherence to healthy lifestyles, and 3) provide standardized pharmacological treatment. Propensity Score Matching will be used to select 300 patients in Chile and 1200 in Spain for comparison with standard care in these populations.
Expected outcomes
The primary outcome at 12 months of follow-up is the percentage of patients achieving controlled hypertension (defined as systolic BP < 140 mmHg and diastolic BP < 90 mmHg, or < 130 mmHg, and diastolic BP < 80 mmHg for diabetic patients), ensuring it is not inferior to that achieved in the control countries. Secondary outcomes include changes in BP levels, cholesterol levels, BMI, handgrip strength, waist-to-hip ratio, smoking status, Interheart risk score, diet, and physical activity at 6 and 12 months.
Recommendations
If this model demonstrates superior outcomes compared to usual care, it is recommended that health authorities in low- and middle-income regions adopt and implement this approach. Using non-medical health professionals, standardized treatment algorithms and free access to antihypertensive medications, these regions can significantly improve awareness, diagnosis and management of hypertension. This strategy has the potential to reduce cardiovascular morbidity and mortality, thereby improving overall public health outcomes.
... Hypertension (HTN), often referred to as the "silent killer," is one of the most significant risk factors contributing to cardiovascular diseases. Notably, it plays a pivotal role in driving atherosclerosis, which is the primary cause of heart failure and stroke [1,2]. Unfortunately, it also holds a prominent position as the leading factor behind kidney failure in various nations [3]. ...
... Unfortunately, it also holds a prominent position as the leading factor behind kidney failure in various nations [3]. This health concern casts a substantial shadow over public health, posing a severe threat to the well-being of society and emerging as a major driver of disability and mortality [2,4]. Rooted in the intricate interplay of genetic, environmental, and lifestyle factors, hypertension is recognized as a complex condition [5,6]. ...
Background
Hypertension (HTN) is a major global public health concern. This study aims to identify gender differences to inform more effective prevention strategies and targeted management approaches.
Methods
This prospective cohort study included 7,710 participants aged 40 to 70 years, with a mean follow-up duration of 5.2 years. HTN was defined using European hypertension management guidelines. A Cox regression model was employed to determine factors associated with HTN, adjusting for confounding variables effects.
Results
During the mean follow-up period of 5.2 years, the incidence rate of hypertension was 21.54 per 1,000 person-years, with females exhibiting a higher incidence than males. Several significant predictors of HTN were identified. In men, key risk factors included age (60–70 years, 2.83-fold increase, 95% CI 2.05–3.92), high waist-to-height ratio (5.63-fold increase, 95% CI 2.42–13.07), smoking (2.68-fold increase, 95% CI 1.04–6.91), and opium use (1.93-fold increase, 95% CI 1.06–3.49). In women, significant predictors included age (60–70 years, 3.65-fold increase, 95% CI 2.59–5.15), contraceptive drug use (1.24-fold increase, 95% CI 1.01–1.52), high waist-to-height ratio (1.87-fold increase, 95% CI 1.19–2.92), pre-HTN (3.64-fold increase, 95% CI 3.01–4.40), and kidney stones (1.32-fold increase, 95% CI 1.06–1.65).
Conclusion
This study identified key predictors of hypertension (HTN) with notable gender differences. For men, significant risk factors included age, high waist-to-height ratio, smoking, and opium use; for women, the prominent predictors were age, contraceptive use, pre-HTN, and kidney stones. These findings highlight the need for gender-specific strategies in HTN prevention and management, focusing on modifiable risk factors by gender.
... The prevalence of hypertension was 28.5% in high-income countries and 31.5% in low-and middleincome countries in 2010, according to Mills et al. [13], who conducted a comprehensive review of population-based studies comprising 968,419 individuals spanning 135 populations in 90 countries. The prevalence of hypertension rose 7.7% in low-and middle-income nations between 2000 and 2010, while it fell 2.6% in high-income countries. ...
... Compared to high-income countries, low-and middle-income countries had much lower rates of hypertension awareness, treatment, and control. While progress in low-and middle-income nations has been slower, high-income countries have witnessed significant gains in hypertension awareness, treatment, and management over the past few decades [13]. The prevalence, awareness, treatment, and control of hypertension in rural and urban settings across high-, middle-, and low-income countries were investigated in the Prospective Urban Rural Epidemiology (PURE) study [14], which found that the treatment rate was 31.7% in low-income countries and 46.7% in highincome countries. ...
... The increasing burden of hypertension in the young population can cause an increased disease burden now and in the future; however, direct evidence of an elevated BP and hypertension in children and adolescents remains limited. Therefore, understanding the potential impact of an early elevated BP and its associated risk factors is crucial for reducing individual risks and preventing future public health burdens (17)(18)(19)(20). This review aimed to examine the existing body of evidence linking elevated BP in childhood, primarily primary BP elevation or hypertension, with progression to adult hypertension and CVD as well as identify the risk factors contributing to early-life BP elevation. ...
... Although hypertension is traditionally defined by arbitrary cut-off values such as ≥140/90 mmHg based on the magnitude of the risk of CVD, evidence of the continuous relationship between BP and CV risk has prompted efforts to address the risk for individuals below this cut-off. For instance, the 2017 American College of Cardiology/American Heart Association guideline lowered the threshold to ≥130/80 mmHg (17). ...
Elevated blood pressure (BP) during childhood and adolescence is increasingly being recognized as a precursor to adult hypertension and cardiovascular disease (CVD). This review examines the existing evidence of the relationship between early BP elevations and long-term cardiovascular (CV) outcomes. Previous studies demonstrated a moderate association between childhood BP and adult hypertension, with early BP elevations contributing to subclinical CV changes such as left ventricular hypertrophy and increased carotid intima-media thickness as well as major premature CVD events in adulthood. However, evidence also indicates that BP normalization before adulthood may mitigate these risks, suggesting a critical interventional window before irreversible CV changes occur. Multiple modifiable and nonmodifiable factors contribute to early-life BP elevations, including genetic predisposition, a high sodium intake, obesity, sedentary behavior, and sleep disturbances. Although establishing a direct causal association between childhood BP and adult hypertension or CVD remains challenging owing to the need for long-term follow-up and large sample sizes, further research is essential to addressing the existing knowledge gaps in pediatric hypertension prevention, detection, impact, and treatment. This review highlights the importance of preventing BP elevations early in life to reduce the long-term burden of hypertension and CVD. Promoting healthy behaviors, such as maintaining a healthy weight, reducing one's sodium intake, engaging in physical activity, and ensuring adequate sleep, is essential for managing BP at an early age. These efforts reduce individual CV risk and help alleviate the broader future public health burden of hypertension and CVD.
... In 2010, approximately 1.4 billion people worldwide had hypertension (elevated blood pressure [BP]), representing 31.1% of the global population [1]. In wealthy countries, the prevalence, management, and control rates of hypertension were 67%, 55.6%, and 28.4%, respectively, while in low-and middle-income countries, these rates were 37.9%, 29%, and 7.7% [1]. ...
... In 2010, approximately 1.4 billion people worldwide had hypertension (elevated blood pressure [BP]), representing 31.1% of the global population [1]. In wealthy countries, the prevalence, management, and control rates of hypertension were 67%, 55.6%, and 28.4%, respectively, while in low-and middle-income countries, these rates were 37.9%, 29%, and 7.7% [1]. Hypertension remains the primary cause of death globally, accounting for over 10 million annually deaths [2]. ...
Background
Salt substitution (SS) has been found to reduce blood pressure (BP). However, the impact of SS on cardiac structure, as assessed through ultrasonic cardiogram (UCG) and electrocardiograms (ECG), remains poorly understood. This study aims to evaluate the effects of SS on cardiac structure and ECG parameters.
Methods
This 12-month prospective, multi-center, randomized, double-blind study involved hypertensive patients aged 50 to 70 years with office systolic BP (SBP) ranging from 140 to 180 mmHg and diastolic BP (DBP) ranging from 90 to 110 mmHg. A total of 352 patients were enrolled and equally randomized to either the normal salt (NS) group or SS group. Office BP measurements (OBPM) were obtained at baseline and at 3, 6, and 12 months, while home BP measurements (HBPM) were recorded at baseline, 3, 6, 9, and 12 months. Fasting blood, UCG, and ECG parameters were obtained at baseline and at the end of the study.
Results
Of the 352 enrolled patients, 322 completed the study. In the SS group, the reductions in systolic OBPM, HBPM, and diastolic HBPM were significantly greater than those in the NS group. Notable cardiac parameter changes included a reduction in QT dispersion (QTd) by –5 ms (–10, 5) in the NS group and –5 ms (–15, 0) in the SS group (p = 0.001); the T wave peak-to-end (Tp-e) value was 0 ms (–5, 10) and –5 ms (–10, 0) (p < 0.001), respectively; and Tp-e/QT was 0 (–0.01, 0.02) and –0.02 (–0.04, 0) (p < 0.001), respectively. Additionally, left atrial diameter (LAD) was 0 mm (–1, 1) and –1 mm (–2, 1) (p < 0.001), and the change in left ventricular mass (LVM) was –2 g (–17.75, 11) and –7 g (–18, 6) (p = 0.035), respectively.
Conclusions
This study demonstrates that SS not only significantly decreased LAD and LVM, indicating a significant effect on cardiac structure, but also improves UCG parameters, including reductions in QTd, Tp-e, and Tp-e/QT. These findings highlight the potential of SS as a beneficial intervention in managing cardiac risks in hypertensive patients.
Clinical Trial Registration
ChiCTR1800019727. (https://www.chictr.org.cn/showproj.html?proj=31036).
... The pattern and occurrence of ailment exhibit considerable variation both among and within countries, with the highest infection rates often associated with densely populated areas and lower socioeconomic status. While global efforts to implement safety measures have contributed to a decline in disease incidence [22], its prevalence remains substantial, estimated at up to 50% in developed countries [23]. However, the occurrence is even higher in underdeveloping countries, accounting for approximately 90% [24]. ...
Effective therapy against Helicobacter pylori hinges on a timely and accurate diagnosis. The objective is to assess H. pylori infection in dyspeptic patients and compare various indicative tests. After approval, gastrointestinal biopsies and blood samples of 96 subjects exhibiting gastroduodenal symptoms were collected; both invasive and non‐invasive tests were employed to analyse the samples. Results revealed 40 cases (41.67%) positive for H. pylori via histopathology and rapid urease testing, while 46 subjects tested positive for IgA and IgG antibodies via ELISA. Eighteen biopsies showed positivity in the culture test, corroborated by endoscopic examination and biochemical assessments (urease, catalase and oxidase). The isolates showed various degrees of resistance to antibiotics, while polymyxin B showed the highest (100%) followed by amoxicillin (88.90%) and kanamycin (77.78%). Additionally, the CagA gene presence was detected in 18 individuals through molecular methods. Sensitivity and specificity percentages (%) varied among diagnostic methods: histopathology (95/77), rapid urease (100/83.5), gram staining (85.7/90), IgG serology (100/66.6), IgA serology (100/79.5), PCR (100/75), RUT and IgG serology combination (100/79.04), and RUT, Gram staining and IgG serology combination (100/92.4), respectively. PCR emerged as the most reliable test. In the current investigation, other tests also exhibited high sensitivity and specificity values. Thus, employing comparative detection methods rather than relying solely on one methodology is advisable for accurate detection.
... We focused on hypertension given it is prevalent among older adults (Mills et al., 2016), can have widespread damaging effects on multiple organs, and significantly increases the risk of conditions including cardiovascular disease and stroke (Libby et al., 2019). Our finding of an interactive effect between hypertension and PTSD symptom severity after adjusting for potentially confounding comorbid vascular risk factors and excluding individuals with history of stroke, suggests that hypertension itself may have synergistic effects with PTSD symptom severity. ...
Objective
Post-traumatic stress disorder (PTSD) and hypertension are highly prevalent among Veterans. Cognitive dispersion, indicating within-person variability across neuropsychological measures at one time point, is associated with increased risk of dementia. We examined interactive effects of PTSD symptom severity and hypertension on cognitive dispersion among older Veterans.
Methods
We included 128 Vietnam-era Veterans from the Department of Defense-Alzheimer’s Disease Neuroimaging Initiative (DoD-ADNI) with a history of PTSD. Regression models examined interactions between PTSD symptom severity and hypertension on cognitive dispersion (defined as the intraindividual standard deviation across eight cognitive measures) adjusting for demographics and comorbid vascular risk factors.
Results
There was an interaction between PTSD symptom severity and hypertension on cognitive dispersion ( p = .026) but not on mean cognitive performance ( p = .543). Greater PTSD symptom severity was associated with higher cognitive dispersion among those with hypertension ( p = .002), but not among those without hypertension ( p = .531). Results remained similar after adjusting for mean cognitive performance.
Conclusions
Findings suggest, among older Veterans with PTSD, those with both hypertension and more severe PTSD symptoms may be at greater risk for cognitive difficulties. Further, cognitive dispersion may be a useful marker of subtle cognitive difficulties. Future research should examine these associations longitudinally and in a diverse sample.
... Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg and/or use of antihypertensive medication [29]. ...
Objective
To determine the prevalence of fatty pancreas disease (FPD) diagnosed by transabdominal ultrasound in Chinese elderly aged 65 years and above to explore the correlation between triglyceride glucose index (TyG index) and FPD and its severity, and to evaluate the ability of TyG index to identify FPD and its severity.
Methods
The study population was derived from the Thyroid Diseases in Older Population: Screening, Surveillance, and Intervention (TOPS) study conducted in the iodine-adapted areas of Jiangsu Province from May to July 2021. A total of 567 participants aged 65 years and above in rural areas were included in the final analysis. TyG index was calculated by the established formula: Ln [TG (mg/dL) × FBG (mg/dL)/2]. FPD and the degree of intra-pancreatic fat deposition (IPFD) were diagnosed by abdominal ultrasound. The logistic regression model was performed to determine the correlation between clinical parameters, including TyG index, and FPD and its severity. The diagnostic power of TyG index was assessed by receiver operating characteristic curve (ROC).
Results
Overall, 72.66% (412/567) of subjects had FPD, of which over half had moderate to severe FPD. The proportions of overweight, obesity, NAFLD, and dyslipidemia were significantly higher in the moderate-to-severe FPD group than in the mild FPD group. Multivariate logistic regression showed that TyG index was independently associated with FPD in the elderly population, but was not significantly associated with the severity of IPFD. As the level of TyG index increased, the metabolic disorders in the population worsened and the prevalence of FPD increased significantly. TyG index had a good diagnostic performance for FPD. The combination of BMI or NAFLD and TyG index improved the diagnostic ability for FPD.
Conclusion
The prevalence of FPD diagnosed by abdominal ultrasound is high in the elderly aged 65 years and above in rural areas in China. TyG index has good identification of FPD but poor recognition of the severity of IPFD. TyG index, when combined with other clinical parameters, may have more diagnostic advantages.
... Hypertension (HTN) is a major cause of the increasing economic burden of disease and mortality globally, with approximately 30% of adults worldwide currently suffering from HTN and 50-60% of adults in prehypertension 1,2 . The existence of a large number of pre-hypertension individuals indicates that the incidence of HTN will continue to increase in the future 3 . ...
Triglyceride glucose-body mass index (TyG-BMI), as a new surrogate index for evaluating insulin resistance (IR), has rarely been studied with the incidence rate of hypertension (HTN). This study aims to explore the correlation between TyG-BMI and HTN in American adults, to find a cost-effective and convenient marker to guide early prevention of HTN. We performed this cross-sectional study based on the NHANES database from 2017 to 2020. A multivariate logistic regression model was used to analyze the correlation between TyG-BMI and the prevalence of HTN. Additionally, stratified analysis was performed to test the robustness of the results. 3,069 eligible participants were included in our study (48.8% male, mean age 50.0 ± 17.2 years), and multivariate logistic regression analysis showed that TyG-BMI was maintained positively correlated with HTN after fully adjusting covariates. For every 10-unit increase in the TyG-BMI, the risk of HTN increases by 4.3% (95% CI: 1.007–1.08, P = 0.018). When TyG-BMI was represented as a Quartile, the relationship between TyG-BMI and increased risk of HTN remained significant, which were statistically significant for each model. Stratified analyses suggested that the correlation between TyG-BMI and HTN was more pronounced in those aged 60 years or older (P < 0.05). The correlation between TyG-BMI and HTN remained stable in all strata except the age subgroup (P > 0.05). TyG-BMI is significantly associated with HTN among American adults. Early monitoring of TyG-BMI may help to monitor early the risk of hypertension.
... [1] The prevalence of hypertension is increasing globally due to advancing age, unhealthy eating habits such as high sodium and low potassium intake, insufficient physical activity levels, and exposure to lifestyle risk factors. [2] Hypertension should be managed appropriately to prevent complications of hypertension and improve the patient's quality of life. [3] In addition to pharmacological treatment, lifestyle changes are recommended within the scope of nonpharmacological therapy. ...
... Despite advancements in the management of hypertension, the overall control of blood pressure in the general population remains unsatisfactory. Studies have shown that only a small percentage (approximately 15-20%) of hypertensive individuals achieve the recommended blood pressure values set by guidelines [13]. The failure to achieve adequate blood pressure control is considered a major factor contributing to hypertension-related mortality worldwide [14]. ...
Background
Hypertension presents as a modifiable risk factor for cardiovascular diseases, with approximately two-thirds of the global hypertensive population concentrated in low- and middle-income nations. Sarpagandha Mishran is an Ayurveda intervention utilized for the management of hypertension. The objective of the study is to assess the clinical efficacy and safety of Sarpgandha Mishran in the Management of Stage-I Hypertension.
Methods
This clinical trial employs a prospective design characterized by a double-dummy, double-blind, placebo-controlled methodology being conducted at Cardiology Outpatient Department of the AIIMS, New Delhi. A total of 150 participants (75 per group), diagnosed with Stage-I essential hypertension will be randomized and allocated in a 1:1 allocation ratio, to either Ayurveda group or Conventional Care group. Participants in Group I will receive Ayurvedic intervention, Sarpagandha Mishran 500 mg capsules orally twice daily, in addition to a matching placebo of Amlodipine 5 mg capsules orally once daily. Group II will receive a matching placebo of Sarpagandha Mishran 500 mg capsules along with Amlodipine 5 mg capsules orally once daily. All participants will also be administered Hydrochlorothiazide 12.5 mg tablets orally once daily for a duration of 12 weeks. The primary endpoint of this study involves evaluating changes in SBP and DBP from baseline to week 12. Secondary outcome includes assessing changes in IL-6, Serum Pro-BNP, oxidative stress markers, lipid profile, and the SF-36 Health Survey Score. Safety assessments will be done through recording of AE/ADR and assessments of liver function tests and renal function tests parameters.
Discussion
The present study is poised to furnish comprehensive insights into the clinical efficacy and safety profile of Sarpagandha Mishran in the management of Grade 1 hypertension. By adopting a rigorous scientific methodology, this investigation aims to contribute robust evidence that may significantly impact the formulation of future guidelines for integrative treatment protocols in hypertension management.
Trial Registration
The trial is prospectively registered with the Clinical Trial Registry of India [CTRI/2021/12/038589], dated 13.12.2021.
... In addition, several studies have demonstrated that older persons tend to have a widespread lack of understanding regarding HT (36,37). Therefore, it is essential to have a well-developed and culturally context-specific health education intervention on hypertension-related knowledge to increase understanding among older individuals who have hypertension as well as those who do not have hypertension. ...
Introduction
Hypertension is one of the most preventable risk factors for heart disease and a major problem around the world. It has a significant negative effect on public health and may cause unnecessary morbidities and premature mortalities. Lowering blood pressure reduces the risk of cerebrovascular accidents and acts as a reversible functional precursor of target organ damage. Hypertension is best treated with a combination of lifestyle modifications and medication to prevent strokes and other complications. Knowledge of prevention of its complications has been shown to have a favorable impact on health habits. Patients' lack of knowledge and medication adherence is one cause of ineffective secondary prevention. The objective of the study: The main objective of the study was to evaluate the impact of educational sessions on knowledge and medication adherence among hypertensive patients. Methodology: A quasi-experimental study was conducted on 64 Patients at WAPDA hospital by using consecutive sampling techniques.
The study duration was six months from (November 2021 to May 2022). Pre-test data were obtained using the hypertension knowledge level scale and Morisky Medication Adherence scale. Results: The findings of the study revealed that 32 (50%) were males and 32(50%) were females. The mean age of the participants was 48.47 + 2 years. The findings showed a significant difference between pre and post interventions data. Pre-intervention mean ± SD knowledge score was 8.187 ± 2.442 and the post-intervention means knowledge score was 11.79± 2.463. Pre intervention mean± SD adherence score was 5.296±1.4329 and Post-intervention means adherence score was 6.8906±1.1. There was a significant difference between pre and post-intervention knowledge and medication adherence score with a P value of 0.000.Conclusion:Findings of the study indicated that educational interventions were significantly effective in improving knowledge and medication adherence among hypertensive patients. The study provided evidence for the efficacy of an educational intervention in hypertensive patients’ knowledge and medication adherence.
Keywords: Education session, Hypertension, Impacts, Knowledge, Medication Adherence,
... In addition, several studies have demonstrated that older persons tend to have a widespread lack of understanding regarding HT (36,37). Therefore, it is essential to have a well-developed and culturally context-specific health education intervention on hypertension-related knowledge to increase understanding among older individuals who have hypertension as well as those who do not have hypertension. ...
Objective: The objective of this study was to determine chronic liver disease and its association with hepatitis C virus in patients with type 2 diabetes mellitus in our setup at DHQTH Bannu. Study Design: Descriptive / case series study. Place and Duration of Study: This study was conducted at the Department of Medicine, DHQ Teaching Hospital (DHDTH) Bannu, Khyber Pakhtunkhwa from Sep 2015 to Sep 2016. Materials and Methods: Data were collected from 53 patients already diagnosed as Type 2 diabetes mellitus for more than 10 years presented with symptoms and signs of CLD, from Sep 2015 to Sep 2016, through laboratory test, to note their cause of CLD. Results: Out of 53 T2DM patients, 29 patients were males (54.7%) and 24 (45.3%) were females. All of these were having increase ALT >60 IU/L and increased echogenicity of liver parenchyma. Out of these, 30 patients (56.6%) (19males,11females) were having HCV +ve, 5 patients (9.4%) (3males,2 females) HbsAg +ve, and 3 patients (5.7%) (2males,1female) were B&C-ve. While in the remaining, 3 patients (5.7%) (2males,1female) were having NASH, 2 patients (3.8%)(both females) were AIH(ANA+ve) and 10 patients (18.9%) (3males,7females) were having simple Steotosis (with only increase ALT and increased echogenicity). So overall 30 patients(56.6%) with T2DM with CLD were HCV +ve. Conclusion: In our set up, the major cause of CLD in T2DM was chronic HCV infection. Most of these patients were cirrhotic, which is an alarming situation and need proper planing by health care providers.
... High BP or hypertension is defined as a systolic BP greater or equal to 140 mmHg and/or diastolic BP greater or equal to 90 mmHg or a self-reported case under medication [2]. By 2025, the global burden of high BP is projected to reach1.56 billion; two-thirds of this burden is anticipated in low-and middle-income countries [3,4]. In the sub-Saharan Africa region, non-communicable diseases (NCDs), including high BP, are projected to emerge as the leading causes of morbidity and mortality by 2030 [5,6]. ...
Background
High blood pressure, commonly referred to as hypertension, remains a prevalent global health concern characterized by elevated arterial pressure, posing significant risks such as cardiovascular diseases, stroke, and kidney diseases. Therefore, this study aimed to assess the burden and determinants of self-reported high blood pressure among women of reproductive age in Tanzania.
Methods
We utilized population-based cross-sectional data obtained from the Tanzania Demographic and Health Survey (TDHS) 2022. The analysis involved a weighted sample of 15,254 women aged 15–49 years. Multivariable logistic regression models were employed to examine the independent variables associated with self-reported high blood pressure, and the results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI). The significance level was set at p < 0.05 for all analyses.
Results
Overall, the mean age of study participants was 29.3 ± 9.8 years, with a self-reported high blood pressure burden of 6.6% among women of reproductive age in Tanzania. Moreover, increased age correlated with higher odds of high blood pressure compared to women aged 15–19 years. Those with a secondary level of education exhibited a higher likelihood of high blood pressure in contrast to women with no education. Married and widowed individuals were more prone to high blood pressure than those who were never married. Additionally, women in higher wealth groups showed a significantly elevated risk of high blood pressure compared to those in the poorest wealth group. Conversely, self-reported poor health status and recent visits to health facilities were associated with significantly higher odds of high blood pressure.
Conclusion
This study highlights the burden of high blood pressure among reproductive-age women, urging heightened awareness and proactive screening measures. These findings prompt targeted interventions, emphasizing the need for collaborative efforts among stakeholders to effectively curb this health burden.
... In 2010, 31% of the world's adults had hypertension with respective prevalence rates of 29% and 32% in high-income countries (HIC) and low to middle-income countries (LMIC). 2 This translates globally to about 1.4 billion people, distributed as 349 million in HIC and 1.04 billion in LMIC. 2 ...
... This is proven by the number of hypertension sufferers in 2015 as many as 1.13 billion people, meaning 1 in 3 people in the world are diagnosed with hypertension with an average increase of 9.4 million people each year (WHO, 2015). In the same period of time, the incidence of hypertension was higher in people in developing countries compared to developed countries, even almost 75% of people with hypertension lived in developing countries (Mills, 2016). The results of the Basic Health Research / Riskesdas (2018) Hypertension is divided into two parts based on the cause, namely: hypertension primary (essential) And hypertension secondary (Smelter, 2013),. ...
Hypertension is one of the most dangerous health problems worldwide because hypertension is a major risk factor leading to cardiovascular disease. Management of hypertension can be done with pharmacological therapy by complying with medication and non-pharmacological in the form of hypertension education. Hypertension education using video is an effort to increase medication compliance in the elderly because video media involves two senses, namely sight and hearing, so that it can maximize the information received. The purpose of this study was to see the effect of hypertension education using video on medication compliance in the elderly in Sianipar Sihailhail Village, Balige District, Toba Regency in 2024. This study used a quasi experiment with a pre-post test with a control group. The sample of this study used a simple random sampling technique with a sample size of 42 respondents. The data collection method used the Morisky Medication Adherence scale (MMAS-8) questionnaire and data analysis in this study used the paired T test. The results of the study showed that the average compliance before education in the intervention group was 2.0952 after education became 3.1429, while the average in the control group before education was 2.3810 after education became 3.3333. In the marginal homogeneity test, the Asymp.Sig value was found. (2-tailed) or p value = 0.003 ≤ 0.05. The conclusion of the results of this study is that there is an effect of hypertension education using videos on compliance with taking hypertension medication in the elderly in Sianpar Sihailhail Village, Balige District, Toba Regency, it is recommended that elderly people with hypertension in Sianpar Sihailhail Village, Balige District, Toba Regency in 2019 be given hypertension education using videos to improve compliance with taking hypertension medication.
... Hypertension is a chronic disease that is serious and highly prevalent, especially given aging populations worldwide. More than 1 billion people worldwide have been estimated to have hypertension [1,2]. In Taiwan, hypertension has a prevalence of 24.1% [3]. ...
Background
previous studies have indicated that influenza vaccination may be associated with reduced risks of certain types of cancer. However, the protective effect of influenza vaccination against primary liver cancer in individuals with hypertension remains unclear.
Methods
In this cohort study, 37,022 patients over 55 years of age who received a diagnosis of hypertension at any time between January 1, 2001, and December 31, 2012, were enrolled from the National Health Insurance Research Database. The patients were divided into a vaccinated and an unvaccinated group. Categorical and continuous variables were analyzed using the chi-square test and t test, respectively, and the correlation between influenza vaccination and liver cancer in patients with hypertension was analyzed using time-varying COX model. Propensity score method was performed to reduce selection bias.
Results
Compared with the unvaccinated group, the vaccinated group had a significantly lower incidence of liver cancer (hazard ratio = 0.56, 95% confidence interval = 0.46–0.64; p < .001). In addition, a protective effect was observed regardless of sex, age, or comorbidities. Besides, the association was dose-dependent which could be noted when patients were stratified based on the total number of vaccinations. The adjusted HRs for patients receiving 1, 2 to 3, and ≥ 4 vaccinations during the follow-up period were 0.60 (0.51–0.78), 0.48 (0.38–0.65), and 0.39(0.30–0.51), respectively.
Conclusions
In summary, influenza vaccination is linked to a decreased risk of liver cancer in individuals with hypertension. However, unmeasurable confounders may have been present in the analysis.
... Due to its high prevalence and severe complications, hypertension has led to a considerable clinical and economic burden worldwide. However, the proportions of awareness, treatment, and control of hypertension are low, especially in low-and middle-income countries [5]. It is noteworthy that hypertension is preventable. ...
This study investigated the association between fat-to-muscle ratio (FMR) and hypertension. A total of 1592 participants aged ≥ 40 years were included. Participants were divided into four groups by quartiles of FMR. Odds ratio (OR) and 95% confidence interval (CI) was calculated using logistic regression models. Restricted cubic spline was applied to examine the correlation of FMR and hypertension. Of 1592 participants, 943 (59.2%) participants had hypertension. Hypertension risk rose with FMR quartiles. Compared to FMR quartile 1, ORs were 1.496 (95% CI: 1.115–2.006), 2.445 (95% CI: 1.840–3.249), and 5.415 (95% CI: 3.993–7.344) for quartiles 2, 3, and 4, respectively (P for trend < 0.001). Adjusted OR in quartile 4 was 3.015 (95% CI: 2.083–4.365). Restricted cubic spline showed a linear relationship between FMR and hypertension. Adding FMR improved hypertension risk model performance (P = 0.006). Subgroup analysis revealed FMR interactions with sex (P = 0.010) and BMI (P < 0.016), with a higher hypertension risk in females and non-obese individuals. Additionally, versus FMR quartile 1, hypertensive individuals in quartiles 2 (OR: 1.370, 95% CI: 0.900–2.085), 3 (OR: 2.055, 95% CI: 1.374–3.073) and 4 (OR: 3.102, 95% CI: 2.055–4.682) exhibited a significantly elevated risk of atherosclerotic cardiovascular disease (ASCVD). In summary, Elevated FMR independently correlated with hypertension risk, especially in women, or even in non-obese individuals. FMR is a valuable tool for identifying populations with higher hypertension risk and assessing ASCVD risk in hypertensive individuals. Body composition warrants consideration in future hypertension risk studies.
... With an aging population and the increasing prevalence of unhealthy lifestyles, the incidence of hypertension is rising, particularly in low-and middle-income countries [5,6]. Estimates indicate that 31.5% of adults (1.04 billion people) in low-and middle-income countries and 28.5% of adults (349 million people) in high-income countries have hypertension [7]. Preventing complications from hypertension remains a critical public health priority. ...
Background
Preventing cardiovascular disease (CVD) in adults with hypertension is essential, but it remains uncertain whether optimizing modifiable factors can eliminate the excess CVD risk associated with new-onset hypertension.
Methods
In this prospective cohort study, 29,597 adults with new-onset hypertension and no prior CVD (from 2006–2016 surveys) were each matched by age and sex to a normotensive control. Eight modifiable factors were assessed using the American Heart Association’s Life’s Essential 8 algorithm. We followed participants for incident CVD until December 2020, estimating 10-year and lifetime (age 25–95) CVD risks using the Fine-Gray competing risks model.
Results
Over a median follow-up of 9.81 years, adults with new-onset hypertension had higher 10-year (8.97% vs. 6.31%) and lifetime CVD risks (45.55% vs. 34.98%) compared to normotensive controls. After adjusting for age, sex, and other unmodifiable factors, each additional favorable factor was associated with a stepwise reduction in CVD risk (P-trend < 0.05). Hypertensive participants with four or more favorable factors had a 17% lower 10-year CVD risk (HR 0.83; 95% CI 0.72–0.97) and a similar lifetime CVD risk (HR 0.90; 95% CI 0.78–1.05) compared to normotensive controls. Notably, the protective effect was weaker among those with early-onset (before age 45) hypertension than those with later-onset (age ≥ 60) hypertension (P-interaction < 0.05).
Conclusions
In adults with new-onset hypertension, maintaining four or more modifiable factors at favorable levels was associated with a CVD risk comparable to that of normotensive individuals. However, young hypertensive adults may require more aggressive interventions to mitigate CVD risk.
... This study found that hypertension combined with depressive symptom was associated with an increased risk of all-cause mortality. Globally, hypertension was a significant cause of premature death, with an estimated 8.5 million deaths worldwide in 2015 due to systolic blood pressure > 115 mmHg, 88% of these occurred in low-and middle-income countries [2,24,25]. Previous studies had consistently demonstrated the association between depression and mortality risk [26,27]. The 2016 Global Burden of Disease Study reported more than 34 million disability-adjusted life years associated with depression [18]. ...
Background
China is currently grappling with the escalating burden of hypertension and depression. This study aimed to assess the prevalence and number of hypertensive patients with depressive symptom, and to evaluate their risk of all-cause mortality.
Methods
Data from the China Health and Retirement Longitudinal Study (CHARLS) were utilized to estimate the prevalence of individuals with both hypertension and depressive symptom, the recommendation rate for antihypertensive medications, the blood pressure control rate, and the corresponding population size. The Cox proportional hazard model was employed to estimate the risk of all-cause mortality associated with hypertension combined with depressive symptom.
Results
Overall, 15.01% (95% CI: 13.80, 16.31) of adults, corresponding to 72.06 million (95% CI: 66.91, 77.23) individuals, were identified as having both hypertension and depressive symptom. Among these, 28.49 million (95% CI: 27.07, 29.92) were recommended to initiate blood pressure medications but did not comply. Furthermore, 19.53 million (95% CI: 18.01, 21.06) hypertensive patients with depressive symptom who were taking antihypertensive medications did not achieve their blood pressure control goals. Hypertension combined with depressive symptom was associated with an increased risk of all-cause mortality (hazard ratio = 2.21, 95% CI: 1.48, 3.31).
Conclusions
Our findings indicated a significant population of individuals with both hypertension and depressive symptom in China, with low treatment and control rates. The coexistence of hypertension and depression was linked to a heightened risk of all-cause mortality. Strategies for hypertension prevention and treatment should be integrated with considerations for depression.
Clinical trial number
Not applicable.
... [30,31] Hence, aside from the individuallevel factors discussed earlier, the overall income of nations and its GDP per capita are important factors for adequate control and management of HTN. [29,32] Gendered factors, including greater household size, higher level of education, marital status, and high income, had significant effects on blood pressure in European and Canadian populations. Those living in larger households who typically have lower economic development are at increased risk of developing HTN. ...
While gendered psycho-socio-cultural factors are recognized as major determinants of cardiovascular health, their contribution to our understanding of their effect on hypertension (HTN) in each country is poorly understood. Therefore, we investigated the role of these factors in HTN prevalence, focusing on sex- and gender-specific differences across countries. Data from the Canadian Community Health Survey (2015–2016, N = 109,659, women: 56.6%) and the European Health Interview Survey (2013–2015, N = 316,333, women: 51.3%) were analyzed. Primary endpoint was defined as HTN prevalence within 1-year. Relationship and interaction between sex, gender, and country with HTN prevalence were assessed using multivariate models. Federated analysis was conducted using DataShield. Prevalence of HTN was higher in Canada compared to Europe (30.1% vs 22.4%, P < .001). Amongst European countries, living in the Central-East region was associated with a greater risk of developing HTN. Women in the southern and central-east regions had higher prevalence of HTN. There was a significant interaction between socioeconomic status and sex in country-stratified analysis. This was more evident in central-east and southern countries compared to northern, western nations and Canada, where women with lower socioeconomic status, income, and education had a greater risk of developing HTN. Similar trends were observed regardless of country in women who were divorced or widowed. While immigrants were at higher risk of HTN, those in northern and southern Europe were at lower risk compared to central-east region. Sex- and gender-related factors and country should be considered in the prevention and control of HTN.
... Hypertension was defined as systolic BP ≥140mmHg, diastolic BP ≥90 mm Hg, self-reported use of antihypertensive medications, or self-reported history of physician-diagnosed hypertension. 33,34 Body mass index (BMI) was calculated as weight in kilograms divided by height in meters squared (Wt [kg]/Ht [m] 2 ). BMI was categorized as underweight (<18.5), ...
... Hypertension, also known as high blood pressure (BP), and its related complications stand as prominent contributors to both morbidity and mortality. (Mills et al., 2017). Among the major problems in managing hypertensive patients include suboptimal blood pressure control and poor treatment adherence. ...
Introduction: Hypertension and its complications are massive global health issues. Major limitations in hypertensive patients' treatment include suboptimal blood pressure control and nonadherence to medication. The popularity of telemedicine has risen in recent years. Mobile phone applications intervention in particular, provides features including medication-taking, refilling reminders, and biometric results tracker resulting in better health outcomes and improved medication adherence. This review aims to assess the effectiveness of mobile application in improving adherence in hypertensive patients. Methods: PubMed, Scopus, and Cochrane Library were searched with filters applied for studies published between 2013 and 2023 and content published in English with the keywords; telemedicine, mobile apps, medication adherence, and hypertension. These keywords were joined using Boolean operators for an effective search. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement was followed for this systematic review. The Mixed Method Appraisal Tool was used to assess the quality of the included studies. The data was extracted by the authors and validated by another for accuracy and completeness. Results: Twelve studies ranging from moderate to high quality were included in this review. A total of 10 studies showed a statistically significant improvement (p < 0.001) in medication adherence with mobile apps intervention. The combined apps features from the mobile apps empower patients to be more adherent, involved and informed about their treatment progress. Conclusion: Hypertensive patients' medication adherence improved with mobile apps intervention. However, the heterogeneity of adherence measurement methods and apps functionality in the included studies calls for further studies to determine the effectiveness of specific mobile apps feature as well as the standardisation of the adherence measurement method used.
... Hypertension is a condition which is one of the most important risk factors for the development of cardiovascular diseases and mortality [3]. Studies suggest that, three-fourths of the world's hypertensive population reside in low-and middleincome countries and the prevalence of hypertension is higher in low-and middle-income countries (31.5%) than in high-income countries (28.5%) [4]. Furthermore, Bangladesh is one of those low-and middle-income countries which is undergoing an epidemiological transition from communicable to non-communicable diseases [3]. ...
Background: Hypertension is a significant non-communicable disease across the world which contributes to the worldwide disease burden. With the trend of graying population, this is a global pandemic. Objective: This study was aimed to assess the associated risk factors of hypertension in the elderly population in urban community of Dhaka city. Method: A total of 256 elderly people aged above 60 years with either pre-hypertension or hypertension were enrolled in this community-based cross-sectional study. The study period was January to July 2024. Results: It was found that, age, gender, being overweight, stress levels, red meat consumption and family history of hypertension were statistically significant with development of hypertension in the elderly. There was 3.5 times greater risk of development of hypertension in the elderly those who were overweight and had higher stress levels. It was also found that, those who not currently smoking, took normal amount of salt and consumed sufficient fruits and vegetables, were also vulnerable to hypertension. Diabetes mellitus was the commonest comorbidity in hypertensive elderly. Conclusion: Hypertension should be addressed with importance by the stakeholders, policy makers and the government in order to promote health awareness in the communities. Risk factors should be evaluated and prospective, larger-scale studies are recommended.
... The SVM algorithm predicts the high accuracy. 6) Jyoti Soni [6] did study on prediction of heart disease with the help of Naive Bayes, KNN, Decision list algorithm. With these three algorithms , the Naive Bayes has highest accuracy because there is no dependency of attributes. ...
... [2] The prevalence of hypertension is higher in lower-and middle-income countries (LMIC), which translates to a much larger patient load considering the huge population in these regions, however, disease knowledge, treatment, and management remain suboptimal. [3] Rigorous blood pressure (BP) lowering offers significant health benefits that outweigh the risks of adverse events [4] as receiving antihypertensive therapy translates to a longer lifespan and higher adjusted quality of life. [5] Various studies have detected that a significant number of hypertensive patients do not achieve the target levels for control of hypertension. ...
______________________________________________________________________________________________________ Background. Blood pressure control in hypertension reduces cardiovascular disease morbidity and mortality. A significant factor that may contribute to blood pressure control is medication adherence. This study aimed to determine the sociodemographic and clinical factors that influence adherence to antihypertensive medication in hypertensive patients in Port Harcourt, Nigeria. Methods. This descriptive cross-sectional study was conducted in the cardiology clinics of Rivers State University Teaching Hospital and the University of Port Harcourt Teaching Hospital. A total of 426 previously diagnosed hypertensive subjects on follow-up for at least 6 months were assessed. Medication adherence was assessed using Morisky's Medication Adherence Scale-8 with a score ≥3 indicative of nonadherence to medication. Data was analysed using statistical software package SPSS version 22. Bivariate logistic regression analysis was used to identify factors influencing adherence to anti-hypertensive medications. Results. The mean age of the respondents was 57.9±12.2years and 237(55.6%) were women. A total of 262(61.5%) respondents were not adherent to their medication while 164 (38.5%) reported good medication adherence and the most frequent self-reported reason for poor adherence was "I only take them when I have symptoms I attribute to hypertension" in 148(34.8%) persons. Significant predictors of medication nonadherence were older age group (p<0.001), divorced marital status (p<0.001), higher educational levels (p<0.001), absence of comorbidities (p<0.001) and absence of complications of hypertension (p=0.001). Conclusion. Adherence to antihypertensive medication in this study was poor, therefore, continuous adherence counselling should be encouraged in hypertensive patients with these identified factors to improve adherence, blood pressure control and ultimately, cardiovascular outcomes. Abstract Cite as: Oyan B,
... In Africa, hypertension is high with global highest prevalence rate among adults at approximately 46% (Bosu et al., 2019;Mills et al., 2017;Okello et al., 2020). In Uganda, hypertension is a major mortality hazard factor among adults responsible for 20% deaths (WHO, 2018) with a high prevalence among adults 18 years and older estimated between 26.5% (Guwatudde et al., 2015) and 31.5% (Lunyera et al., 2018). ...
... Although the widespread use of antihypertensive medications has lowered the global average blood pressure over the last few decades, the aging population and a rise in unhealthy lifestyles choices have led to an increasing prevalence of hypertension. 4 The management of hypertension has encountered bottlenecks, including suboptimal adherence to treatment, resistance to therapy, and various unresolved issues. 5,6 Although currently available drugs are effective at reducing blood pressure, they can lead to adverse side effects after prolonged use. ...
Gut dysbiosis serves as an underlying factor for the development of hypertension. The restoration of this dysbiosis has emerged as a promising strategy in improving hypertension. Food-derived bioactive protein peptides...
... Hypertension is a significant global public health challenge, with varying prevalence rates among different populations. Hypertension is defined by the European Society of Cardiology as >140/90 mm Hg, to achieve a level of <140/90 mm Hg for all and <130/80 mm Hg for those at high cardiovascular risk, while taking into account individual tolerability [3] . Hypertension causes morbidity and mortality worldwide, resulting in cardiovascular and kidney diseases such as myocardial infarctions, strokes, and renal failure [4] . ...
... Hypertension, usually defined as persistent systolic blood pressure (SBP) at least 140 mm Hg or diastolic blood pressure (DBP) at least 90 mm Hg [1], poses a significant global health challenge, affecting over 1.3 billion individuals worldwide [2]. It is most prevalent among older adults [3,4], with nearly two-thirds of this population experiencing high blood pressure (BP) [5], and with the aging population, the number of older adults with hypertension is expected to increase substantially [6][7][8]. Hypertension is not only a major risk factor for cardiovascular diseases but is also increasingly linked to cognitive decline, a critical public health concern as the population ages [9][10][11][12][13][14]. ...
Background
An enriched understanding is necessary concerning the association between hypertension and cognitive impairment in older adults, particularly regarding the potential underlying mechanisms at a biological level. This study aimed to explore the mediating role of methylmalonic acid (MMA) in the hypertension-cognition link in the older population.
Methods
A total of 2762 adults (age > = 60 years) from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 participated. Cognitive function was assessed using a combination of the Animal Fluency Test (AFT), the Digit Symbol Substitution Test (DSST), and the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Learning Test. Self-reported hypertension diagnosis, antihypertensive medications use, and blood pressure examinations were used to identify hypertension. Serum MMA (sMMA) levels were collected. Weighted multiple linear regressions and mediation analysis were applied. A subgroup analysis by sex and age was performed.
Results
After adjusting for potential confounding factors, we observed a significant mediating effect of the sMMA level in the hypertension-cognition link, accounting for 11.14% (95% CI 4.09%-14.00%, p < 0.001) of the relationship in older adults. The proportion mediated by the sMMA level in the relationship between hypertension and cognitive function was higher in males (15.23%, 95%CI 1.32%-27.00%, p < 0.001) than in females (6.61%, 95%CI 2.12%-10.00%, p < 0.001). This mediating effect of sMMA was observed only in individuals aged 68 years and older (11.31%, 95%CI 3.80%-16.00%, p < 0.001), with no significant mediation detected in those younger than 68 years.
Conclusion
Hypertension may lead to cognitive dysfunction in older adults through MMA. Apart from its role as a biomarker reflecting vitamin B12, MMA may act as an independent neurotoxin capable of inducing brain injury and cognitive impairment. Addressing MMA accumulation, such as through Vitamin B12 supplementation, may have a potential to mitigate hypertension-induced cognitive decline in older adults. Special attention could be paid to hypertensive males with an advanced age (> = 68) to address MMA-related cognitive decline.
... For example, dietary habits and alcohol use are often associated with a greater incidence of hypertension in Eastern Europe [9]. In contrast, advances in hypertension treatment have been observed in Western Europe due to improved healthcare infrastructure and public health programs [10]. ...
Hypertension is a prevalent health issue in Bangladesh, impacting a significant portion of the population. This meta‐analysis explored how social status inequalities impact hypertension risk in Bangladesh. We systematically searched various electronic databases and rigorously selected 12 studies for inclusion in the analyses. The I² statistic measured between study heterogeneity, and pooled effect estimates were obtained using the DerSimonian and Laird random effects model to address this variability. Publication bias was assessed through a funnel plot and Egger's test. Sensitivity analysis was conducted to evaluate the robustness of the findings. All analyses were performed using STATA 17. The analyses indicated that females had a significantly higher risk of developing hypertension compared to males, with a pooled odds ratio (OR) of 1.15 (95% confidence interval [CI]: 1.02–1.27). Urban residents showed a pooled OR of 1.11 (95% CI: 1.03–1.19) compared to rural residents. The pooled ORs for hypertension were 1.02 (95% CI: 0.89–1.14) for primary education, 1.07 (95% CI: 0.94–1.21) for secondary education, and 1.25 (95% CI: 1.03–1.47) for higher secondary education, suggesting an increasing risk with higher education levels. Wealth status showed a pooled OR of 1.08 (95% CI: 0.87–1.29) for the poorer class, 1.13 (95% CI: 1.04–1.22) for the middle class, 1.38 (95% CI: 0.68–2.07) for the richer class, and 1.49 (95% CI: 0.97–2.00) for the richest class, indicating a greater risk of hypertension among wealthier individuals. Working individuals had a 39% lower risk of hypertension (OR = 0.61, 95% CI: 0.43–0.80) compared to nonworking individuals.
... This is higher than what was reported in China (80), Bangladesh (81), Iran (82), and Bosnia (83). A possible explanation for this difference may be the level of awareness, treatment, and control rates (84). According to research, hypertensive people are two to four times more likely to experience a stroke. ...
... Hypertension is the foremost worldwide health challenge, and it is globally predominant [1][2][3]. About one third of adults live with hypertension [4]. Hypertension control requires an interplay among many contributory factors [5]. ...
Background
Lots of interplays between many patient-related factors may influence disease progression among patients with hypertension. This study evaluated disease knowledge and attitude, as well as selected self-care and sociodemographic factors among patients with hypertension.
Methods
A cross-sectional study was carried out among outpatients with hypertension in a cross-sectional study involving three tertiary hospitals. An interviewer-administered semi-structured questionnaire was administered for data collection.
Results
Self-reported medication adherence revealed that majority, 180(60.4%), had high medication adherence out of 298 that participated. Medication discrepancy was observed among 153(51.3%) patients, while 131(44.0%) had high health literacy and blood pressure was controlled among 200 (67.1%) patients. Average hypertension knowledge assessment score was 10.89 ± 1.79 out of a maximum obtainable score of 13. Average hypertension attitude score was 52.60 ± 5.49, out of the maximum obtainable of 60. Significant associations observed with patients’ hypertension knowledge were with disease control (Beta = − 0.484, p = 0.019), educational level (Beta = 1.260, p < 0.001) and disease attitude (Beta = 0.698, p < 0.001); while significant association with disease attitude were with age (Beta = 2.360, p < 0.001) and disease knowledge (Beta = 2.637, p < 0.001). Significant differences were observed between hypertension knowledge and level of formal education (p < 0.001), health literacy (p < 0.001) and disease attitude (p < 0.001); while for disease attitude, significant differences were observed with patients’ age (p = 0.002), level of formal education (p = 0.005), and health literacy (p < 0.001). Significant differences were also observed between patients’ age and medication discrepancy (p = 0.047), medication adherence and age (p = 0.046), level of formal education and health literacy (p < 0.001).
Conclusions
Disease knowledge and attitude among the patients were satisfactory, and the majority were medication adherent. Health literacy level was average. The determinants of disease knowledge are disease control, educational level and disease attitude while for disease attitude are age and disease knowledge.
... Despite being common chronic diseases, such as hypertension (30.0-32.2%) and diabetes (22.9%-37.5%), the epidemic scale of NAFLD continues to increase (Estes et al., 2018;Guariguata et al., 2014;Mills et al., 2016). The consequences of NAFLD are not only associated with worsening liver problems but also with metabolic disease, cardiovascular disease, certain tumors, and other illnesses (Adams et al., 2017;Byrne & Targher, 2015;Cai et al., 2019;Rinella, 2015;Sporea et al., 2018). ...
Curcumin, as an antioxidant agent, has been proposed as a potential treatment for nonalcoholic fatty liver disease (NAFLD). The aim of the current systematic review and meta‐analysis was to summarize earlier findings regarding the effect of curcumin supplementation on liver enzymes and ALP in NAFLD patients. All studies published up to November 18, 2022, were searched through the PubMed, SCOPUS, and Web of Science databases to collect all randomized clinical trials (RCTs) on NAFLD patients in which curcumin was used as a treatment. A random‐effects model was used to measure pooled effect sizes. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used to report pooled effect sizes. Subgroup analysis was utilized to investigate heterogeneity. A total of 14 studies were included in this systematic review and meta‐analysis. Our pooled meta‐analysis indicated a significant decrease in alanine aminotransferase (ALT) following curcumin therapy by pooling 12 effect sizes (WMD: –8.72; 95% CI: –15.16, –2.27, I² = 94.1%) and in aspartate aminotransferase (AST) based on 13 effect sizes (WMD: –6.35; 95% CI: –9.81, –2.88, I² = 94.4%). However, the pooled analysis of five trials indicated that there was no significant association between curcumin therapy and alkaline phosphatase (ALP) in NAFLD patients (WMD: −4.71; 95% CI: −13.01, 3.58, I² = 64.2%). Nevertheless, subgroup analyses showed significant effects of curcumin on ALP with a longer duration of supplementation. The findings of this systematic review and meta‐analysis support the potential effect of curcumin on the management of NAFLD. Further randomized controlled trials should be conducted in light of our findings.
... Hypertension annually leads to a mortality rate of 7 million [8]. The global prevalence of hypertension is increasing due to the ageing population and greater exposure to lifestyle risk factors such as unhealthy diets (such as low potassium and high sodium intake) and insufficient physical activity [9]. The prevalence of hypertension among the adult population in Iran was 26.26% [10]. ...
Background
This study investigated the association between hypertension and oral health status, as measured by the Decayed, Missing, and Filled Teeth (DMFT) index, using data from the PERSIAN Guilan Cohort Study (PGCS).
Methods
A cross-sectional analysis was conducted on 10,520 participants aged 35–70 from Guilan Province, Northern Iran. Blood pressure measurements, oral examinations, and comprehensive data collection on demographic, lifestyle, and clinical factors were performed. The DMFT index was used to assess oral health status. Statistical analyses included Pearson correlation, t-tests, and multiple linear regression.
Results
The mean DMFT score was significantly higher in hypertensive participants than in non-hypertensive individuals (15.80 vs. 13.62, p < 0.001). Factors associated with increased DMFT scores in both hypertensive and non-hypertensive groups included older age, lower education levels, lower BMI, not flossing, smoking, alcohol use, and infrequent tooth brushing. In the hypertensive group, urban residency was additionally associated with higher DMFT scores. For non-hypertensive participants, hookah use, not using mouthwash, and lower socioeconomic status were also linked to increased DMFT scores. A significant negative correlation was found between blood triglyceride levels and DMFT scores in individuals with hypertension (p = 0.037).
Conclusion
This study establishes a significant association between hypertension and poor oral health, as evidenced by elevated DMFT scores. The findings highlight the importance of integrated healthcare approaches that consider cardiovascular and oral health.
... By 2025, it is estimated that the global burden of hypertension will rise by 60%, with the number of hypertensive patients rising to 1.56 billion [2]. In high-income countries, the age-standardized prevalence of hypertension has begun to decline, but in middle-and low-income countries such as China, this proportion continues to rise rapidly [3,4]. 23.2% of Chinese adults, approximately 244.5 million people, suffer from hypertension [4]. ...
Background
Air pollution is a major environmental risk factor. Hypertension is one of the most important modifiable risk factors for cardiovascular diseases. However, few studies have evaluated the impact of exposure to ambient air pollution on hypertension hospitalizations.
Objective
This study aims to explore the correlation between exposure to air pollution and hospital admissions for hypertension, to evaluate the short-term effects of air pollution on hypertension hospitalizations and its lag effects.
Methods
We collected air pollution concentration and hypertension hospitalization data from 2013 to 2020. Distributed lag non-linear models were employed to assess the impact of air pollution on hypertension hospitalizations in Lanzhou City. We also performed subgroup analyses and sensitivity analyses.
Results
A total of 47,884 cases of hypertension hospitalizations were included. Short-term exposure to NO2 and CO increased the risk of hypertension hospitalization. For each 10 µg/m³ increase in NO2 and each 1 mg/m³ increase in CO, the relative risk (RR) for hypertension hospitalization were highest at lag0-3 (RR: 1.0427; 95% CI: 1.0196, 1.0663) and lag3 (RR: 1.0986; 95% CI: 1.0350, 1.1661), respectively. SO2 at different lag structures showed opposite effects on hypertension hospitalization. O3 was significantly negatively associated with hypertension hospitalization. No correlation was observed between PM2.5 and PM10 and hypertension hospitalization. Females and individuals aged ≥ 65 were more susceptible to air pollution. The harmful effects of air pollution are greater in the cold season.
Conclusion
Short-term exposure to ambient air pollution increases risk of hypertension hospitalization.
Hypertension, a major risk factor for cardiovascular disease and global mortality, is characterized by elevated blood pressure. This study explored the therapeu c effects of ethanol extracts from Arthrospira platensis (Spirulina) and Vi s vinifera (Grape) fruit on dexamethasone-induced hypertension in Wistar rats. Fresh Spirulina and Grape samples were obtained from Maiduguri and Jos, Nigeria, and processed for extrac on and phytochemical analysis. Forty Wistar rats were divided into eight groups, with hypertension induced via dexamethasone over six days and subsequently treated for five weeks. Blood pressure, heart rate, and body weight were monitored at intervals, while liver, kidney, and blood parameters were assessed to evaluate safety and toxicity. Phytochemical screening iden fied saponins, tannins, flavonoids, carbohydrates, and cardiac glycosides in both extracts, with triterpenes present only in Grape. The extracts demonstrated low toxicity, with LD50 values above 5000 mg/kg and 2000 mg/kg. Both significantly lowered blood pressure, improved body weight, and exhibited nephroprotec ve and renoprotec ve effects. Spirulina also synergized with the an hypertensive drug Amlodipine, sugges ng its poten al as a novel therapeu c agent. Histological analyses confirmed no harm to the liver, kidney, or heart, while the extracts reversed dexamethasone-induced weight loss and hypertension. These findings highlight the poten al of Arthrospira platensis and Vi s vinifera as safe and effec ve natural remedies for hypertension and emphasize the need for further research to isolate ac ve compounds responsible for these benefits.
Hypertension control is the crucial indicator for cardiovascular disease programs. We conducted a baseline cross-sectional survey to estimate hypertension awareness, treatment, and control in the selected districts in 2018–19, where the India Hypertension Control Initiative is being implemented. We conducted cross-sectional surveys in nine project districts for 18–69 years age group. The sample size was 624 per district. The study population was individuals with raised BP/diagnosed HT. We estimated the proportion and 95% confidence intervals (CI) for each district’s awareness, treatment, and control. We computed unadjusted and adjusted prevalence ratios (APR) with 95% CI for factors associated with BP control. Hypertension was defined as systolic blood pressure (SBP) > = 140 or diastolic blood pressure (DBP) > = 90 mmHg or treatment in the previous two weeks. Control was defined as SBP < 140 and DBP < 90 mmHg. Among 7047 who had hypertension, 52.4% were aware, 40.8% were on treatment, and 14.5% had BP control. BP control was below 5% in two districts, 5–15% in three districts, and more than 15% in four districts. Among hypertensives aware of the diagnosis, the factors (APR with 95% CI) associated with control were lack of alcohol consumption [1.28 (1.09–1.52)], recent visit to government [1.98 (1.57–2.50)] or private facility [1.99 (1.61–2.46)] and treatment with single drug [2.40 (1.98–2.90)] or multiple drugs [2.84 (2.27–3.55)]. The simple, rapid population-based surveys can document awareness, treatment, and control changes. Improving access to treatment for hypertension through the public or private sector should be a high priority for India.
Background Gene-environment interactions may enhance our understanding of hypertension. Our previous study highlighted the importance of considering psychosocial factors in gene discovery for blood pressure (BP) but was limited in statistical power and population diversity. To address these challenges, we conducted a multi-population genome-wide association study (GWAS) of BP accounting for gene-depressive symptomatology (DEPR) interactions in a larger and more diverse sample. Results Our study included 564,680 adults aged 18 years or older from 67 cohorts and 4 population backgrounds (African (5%), Asian (7%), European (85%), and Hispanic (3%)). We discovered seven novel gene-DEPR interaction loci for BP traits. These loci mapped to genes implicated in neurogenesis ( TGFA , CASP3 ), lipid metabolism ( ACSL1 ), neuronal apoptosis ( CASP3 ), and synaptic activity ( CNTN6 , DBI ). We also identified evidence for gene-DEPR interaction at nine known BP loci, further suggesting links between mood disturbance and BP regulation. Of the 16 identified loci, 11 loci were derived from African, Asian, or Hispanic populations. Post-GWAS analyses prioritized 36 genes, including genes involved in synaptic functions ( DOCK4 , MAGI2 ) and neuronal signaling ( CCK , UGDH , SLC01A2 ). Integrative druggability analyses identified 11 druggable candidate gene targets, including genes implicated in pathways linked to mood disorders as well as gene products targeted by known antihypertensive drugs. Conclusions Our findings emphasize the importance of considering gene-DEPR interactions on BP, particularly in non-European populations. Our prioritized genes and druggable targets highlight biological pathways connecting mood disorders and hypertension and suggest opportunities for BP drug repurposing and risk factor prevention, especially in individuals with DEPR.
Hypertension, a common multifactorial trait, increases the risk of myocardial
infarction, stroke, and end-stage renal disease. Most individuals are unaware of
the primary determinants of hypertension and the factors that lead to specific
morbid outcomes. The recognition that a significant portion of interindividual
variation in this trait is genetically determined drives the use of genetic methods
to identify these primary determinants. This review highlights key studies in
experimental and clinical hypertension, highlighting challenges in bridging
evidence, translating findings to human populations, and validating genome-
wide association studies.
Hipertensi adalah suatu kondisi dimana terjadinya peningkatan tekanan darah. Seseorang dinyatakan mengalami Hipertensi jika Tekanan Darah Sistolik (TDS) ≥140 mmHg dan/atau Tekanan Darah Diastolik (TDD) ≥90 mmHg. Hipertensi merupakan tantangan kesehatan global yang penting karena prevalensinya yang tinggi dan menjadi masalah medis serius karena secara signifikan meningkatkan risiko penyakit jantung, otak, ginjal, dan organ lainnya. Penelitian ini bertujuan untuk mengetahui hubungan usia dan jenis kelamin dengan kejadian Hipertensi di poliklinik penyakit dalam RSUD Meuraxa Banda Aceh. penelitian ini merupakan studi observasional analitik dengan pendekatan cross sectional menggunakan wawancara terarah dan hasil diagnosis Dokter Penanggung Jawab Pelayanan pada pasien rawat jalan Poliklinik Penyakit Dalam RSUD Meuraxa Banda Aceh. Jumlah sampel yang diambil sebanyak 98 sampel dari Pasien rawat jalan Poliklinik Penyakit Dalam RSUD Meuraxa Banda Aceh dengan pengambilan sampel purposive sampling. Analisis data yang digunakan adalah analisis univariat dan analisis bivariat dengan menggunakan uji chi square. Hasil penelitian menunjukkan bahwa terdapat hubungan antara usia dengan kejadian Hipertensi dengan nilai p = 0,014 (p<0,05), dan tidak terdapat hubungan antara jenis kelamin dengan kejadian hipertensi dengan nilai p = 0,377 (p>0,05). kesimpulan dari penelitian ini adalah Terdapat hubungan yang bermakna antara Usia dengan kejadian Hipertensi dan Tidak terdapat hubungan yang bermakna antara Jenis Kelamin dengan kejadian Hipertensi pada Pasien rawat jalan di Poliklinik Penyakit Dalam RSUD Meuraxa Banda Aceh.
Background Hypertension is a global public health problem, and as good prevention and management of hypertension can effectively reduce the risk of myocardial infarction and stroke, thereby significantly reducing the health economic burden, exploring more risk factors used to identify hypertension remains necessary. Aim To investigate whether the combination of elevated hs-CRP levels and abdominal obesity increases the risk of hypertension in middle-aged and older adults. Methods This study used data from 3439 investigators aged 45 years and older who participated in the 2015 China Health and Retirement Longitudinal Study (CHARLS). Hypertension, waist circumference, and hs-CRP were measured. logistic regression adjusted for confounding variables was used to examine the association between abdominal obesity and hs-CRP under the combination with hypertension. Results The risk of hypertension was significantly increased when participants had both abdominal obesity and high hs-CRP levels. Even after adjusting for covariates, a significant risk of hypertension was still possible (OR = 1.71, 95% CI:1.33–2.20). Sex- and age-stratified analyses showed that the association between abdominal obesity and high hs-CRP levels in combination with incident hypertension was more likely to be observed in participants under 60 years of age (OR = 1.72, 95% CI:1.15–2.59) and in women (OR = 1.72, 95% CI:1.15–2.59). Conclusions The findings suggest that elevated hs-CRP levels in combination with abdominal obesity may increase the risk of hypertensive events in the middle-aged and elderly Chinese population.
Large gaps persist in the diagnosis, awareness, treatment, and control of hypertension globally. Standardized treatment protocols (STPs) have been widely proposed to guide hypertension treatment, particularly in primary healthcare settings. However, there has been no review that quantifies the effects of hypertension STPs on blood pressure (BP) reduction and control. We conducted a systematic review of randomized clinical trials (RCTs) among adults with hypertension, comparing hypertension STPs (intervention) with usual care (comparator) for effects on BP. Relevant RCTs were identified by searching multiple electronic databases. Random‐effects meta‐analyses were conducted to evaluate between‐group differences in systolic BP reduction (primary outcome), diastolic BP reduction, BP control, and adverse events (AEs). Sixteen RCTs involving 59,945 participants (baseline mean BP: 149/91 mmHg) were included. Reductions in systolic and diastolic BP with STPs compared to usual care were 6.7 (95% CI 3.7–9.8) mmHg and 2.6 (1.2–4.1) mmHg, respectively (p < 0.001 for both). BP control achieved was 57% in the STP group compared to 24% in the usual care group (p < 0.001). The overall incidence of any AEs was 14.5% versus 13.5% (RR 1.27 [0.88–1.82]) with STPs and usual care, respectively. In summary, interventions involving hypertension STPs significantly reduce systolic and diastolic BP and improve BP control compared to usual care. STPs can, therefore, be an efficient strategy to implement evidence‐based treatments and upscale treatment coverage, given the large untreated and uncontrolled hypertension burdens globally.
Background
Hypertension is a major risk factor for cardiovascular disease (CVD), with a high prevalence in rural northeastern China. This study assesses the cardiovascular risk associated with different blood pressure patterns: systolic dominant, diastolic dominant, and parallel elevation.
Methods
We analyzed data from the Northeast Rural Cardiovascular Health Study (NCRCHS), which included 8,189 participants aged 35 and above. Baseline surveys from 2012 to 2013 and follow-ups in 2015 and 2018 provided a median follow-up of 4.66 years. Participants were categorized into ten subgroups based on systolic and diastolic blood pressure elevations. Kaplan-Meier curves and Cox regression models were used to examine CVD incidence and cardiovascular risk across these groups.
Results
The incidence of CVD varied significantly among hypertension categories. Patients with grade 1 hypertension had no significant increase in cardiovascular risk at nearly 5 years. Notably, parallel elevations in systolic and diastolic pressures posed the highest cardiovascular risk, while a predominant rise in diastolic pressure alone did not significantly increase risk. This highlights the importance of analyzing blood pressure comprehensively for cardiovascular risk stratification and suggests rethinking treatment strategies for diastolic dominant hypertension.
Conclusions
Our findings call for a nuanced approach to cardiovascular risk assessment in hypertension, taking into account distinct patterns of systolic and diastolic blood pressure. The study supports personalized treatment interventions and reinforces current hypertension treatment guidelines. We advocate for prioritizing non-pharmacological management in grade 1 hypertension and further clinical evaluation of treatment thresholds for diastolic dominant hypertension.
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