International Journal of Hypertension最新文献

This study investigated hypertension management in young adults in Korea using data from the 2023 Korean Community Health Survey. We examined treatment patterns and identified factors associated with untreated cases among adults aged 20-39 years diagnosed with hypertension. Among young adults, 21.2% were receiving both drug treatment and lifestyle modification, while 28.6% were neither receiving drug treatment nor lifestyle modification. In addition, 35.5% were receiving only drug treatment, and 14.8% were practicing only lifestyle modification. The percentage of young adults who were not practicing both drug treatment and lifestyle modification was higher than that of adults aged 40 or older. These were associated with male sex (OR: 1.427, 95% CI: 1.12-1.82), BMI (OR: 0.932, 95% CI: 0.91-0.95), current smoking (OR: 1.366, 95% CI: 1.06-1.77), alcohol consumption (≤ once/week, OR: 1.654, 95% CI: 1.14-2.39; ≥ twice/week, OR: 2.484, 95% CI: 1.59-3.87), awareness of one's own blood pressure (OR: 0.194, 95% CI: 0.15-0.26), knowledge of myocardial infarction symptoms (OR: 0.779, 95% CI: 0.71-0.86), education about hypertension management (OR: 0.648, 95% CI: 0.52-0.80), and social network level (OR: 0.934, 95% CI: 0.91-0.96). These findings highlight the need for tailored interventions to improve hypertension awareness and management in young adults.

Background: Whether constipation serves as a risk factor for mortality in hypertensive patients remains an open question. The purpose of the study was to investigate the association of constipation in hypertensive patients with the prognosis for mortality. Methods: The study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in 2009-2010 involving hypertensive individuals. Constipation was self-reported over the past 12 months. Cox regression analyses, adjusted for age, sex, and race/ethnicity, were employed to assess the association between constipation and all-cause mortality, as well as cardiovascular mortality. Subgroup and sensitivity analyses were conducted to explore variations in the relationship across different demographic and comorbidity groups. Results: Of the 5199 individuals, 1285 had constipation. Hypertensive patients with constipation exhibited an increased risk of all-cause mortality (HR, 1.40, 95% CI, 0.99 to 1.97, p=0.06) and cardiovascular mortality (HR, 1.83, 95% CI, 1.09 to 3.07, p=0.02) compared to nonconstipated patients. The Kaplan-Meier survival curves also reflected higher rates of all-cause mortality (92.71% vs. 89.18%, p < 0.001) and cardiovascular mortality (97.87% vs. 96.44%, p=0.004) in the constipation group. Among hypertensive patients with a PIR ≤ 100, those with constipation exhibited significantly higher all-cause mortality risk than those without (HR 1.95; 95% CI 1.14-2.67; p < 0.001). These patients also demonstrated increased cardiovascular mortality risk (HR 1.93; 95% CI 1.12-3.40; p=0.019). Conclusion: Constipation shows a significant association with increased cardiovascular mortality risk in hypertensive patients.

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is an internationally recognized anti-hypertensive dietary model. This systematic scoping review examines the effectiveness of digital-based interventions utilizing the DASH dietary pattern. Methods: A search was conducted using 14 databases to include relevant studies from 1997 to January 2025 using PRISMA guidelines for scoping reviews. Results: The review included 24 studies with almost 7000 participants, including randomized controlled trials and cohort studies conducted in several countries. Interventions using the DASH dietary pattern positively affected blood pressure (BP), nutrition behavior, and weight. Some studies also reported secondary outcomes such as reduced healthcare cost savings. Conclusion: Technology-based DASH diet interventions yielded favorable health outcomes, particularly in reducing BP and dietary salt intake, as well as improved diet quality. This systematic scoping review supports the potential of digital-based interventions utilizing the DASH dietary pattern to improve nutrition and health outcomes, particularly those related to hypertension management. The findings emphasize the importance of using evidence-based approaches, which are grounded in theoretical frameworks and models to develop effective interventions, and thoughtful program design to maximize group effectiveness. Other factors that influenced the effectiveness of the intervention included the type of technology used, as well as participant comfort with using technology. Further research and development are needed to optimize these interventions for widespread impact and long-term sustainability.

Background: Hypertension or elevated blood pressure is a serious medical condition that significantly increases the risk of diseases of the heart, brain, kidneys, and other organs. Antihypertensive drug adherence is key to controlling blood pressure. This study aimed to assess factors associated with antihypertensive drug adherence and blood pressure control among hypertensive patients in selected public hospitals under the Addis Ababa City Administration. Method: A hospital-based cross-sectional study was conducted among hypertensive patients on follow-up in randomly selected public hospitals under the Addis Ababa City Administration from November 1, 2022, to February 28, 2023. The study population included 393 patients who fulfilled the eligibility criteria and were selected by systematic random sampling. Data collection was conducted from the electronic medical records and by interviewing patients with a structured questionnaire. The data were entered into Epi-Info 7.2.1 and exported to SPSS version 25 software for analysis. Logistic regression analysis was performed to determine the associations between the dependent and independent variables. Results: The rates of antihypertensive drug adherence and blood pressure control were 72.5% and 23.4%, respectively. Participants with uncontrolled blood pressure were 41.7% less adherent than those with controlled blood pressure (AOR = 0.59; 95% CI, 0.36-0.97). Nonadherence to dietary restriction (AOR, 3.31; 95% CI, 1.84-5.96) and chronic kidney disease (AOR = 3.85; 95% CI, 1.41-10.52) were associated with good adherence, whereas the use of a single antihypertensive drug (AOR = 0.53; 95% CI, 0.30-0.94) and nonadherence to moderate physical exercise (AOR = 0.30; 95% CI, 0.20-0.65) were associated with poor adherence to antihypertensive medications. Male sex (AOR = 1.95; 95% CI, 1.04-3.28) and blood pressure measured at home (AOR = 0.59; 95% CI, 0.36-0.99) were found to be independent predictors of controlled blood pressure. Drinking alcohol (AOR = 1.92; 95% CI, 1.05-3.49) was inversely associated with blood pressure control. Conclusion: Although adherence to antihypertensive medications was relatively good, blood pressure control remained low, indicating that medication adherence alone is insufficient. Public health policies should focus on strengthening primary care systems to deliver integrated hypertension management, including lifestyle counseling, dietary support, and improved access to medications and monitoring tools.

Background: As frontline healthcare workers, emergency department nurses face high levels of urgency in their work and are exposed to a high risk of contingencies. Their blood pressure status and influencing factors require close attention. Methods: This study employed a census method and conducted a cross-sectional survey in 11 cities in Hebei Province from November 2016 to July 2018, measuring blood pressure and collecting questionnaires on influencing factors. Binary logistic regression and multiple linear regression were used to analyze the factors influencing blood pressure. Multivariate analysis of variance was used to examine the interaction effects between monthly night shift frequency and other influencing factors on the blood pressure of emergency department nurses. Results: A total of 7218 emergency department nurses in Hebei Province were included (median [IQR] age, 29 [8] years; 6038 [83.65%] women). The prevalence of hypertension was 9.43%. The median SBP (M [IQR]) was 112.0 (13) mmHg, and the median DBP was 70.0 (14) mmHg. Analysis showed that gender, age, BMI, marital status, hospital location, monthly night shift frequency, hyperlipidemia, and antihypertensive medication were influencing factors for the blood pressure (p < 0.05). Significant interactions existed between monthly night shift frequency and marital status, monthly night shift frequency and hospital grade, and monthly night shift frequency and hyperlipidemia (p < 0.05). The systolic blood pressure of emergency department nurses who were divorced or widowed or in Class I hospitals or hyperlipidemia increased to a high degree with the increase of night shifts. The diastolic blood pressure of those combined with hyperlipidemia increased higher with the rise of night shifts. Conclusion: The blood pressure of emergency department nurses requires attention. Nursing managers should pay particular attention to nurses in the emergency department who are prone to hypertension and take proactive measures to prevent and manage hypertension.

Background: In the modern age, the problem of heart disease is increasing day by day which cause even more deaths than cancer. The study was designed to evaluate the polymorphism and expressional analysis of genes CDKN2B and ADIPOQ in cardiovascular patients. Methodology: Blood samples of 300 cardiovascular patients and 300 controls were collected from Gannan and other hospitals of Pakistan. For polymorphism analysis, DNA was extracted followed, by conventional PCR to amplify the variants rs4977574, rs2383206, and rs2241766 of genes CDKN2B and ADIPOQ, respectively. For expressional analysis, mRNA was extracted from whole blood and converted into cDNA, followed by qPCR. Results: The results show that heterozygous (AG) of rs4977574 of the CDKN2B gene showed highly significant association with 2-folds increased risk of cardiovascular disease (CVD) (OR = 2.03; 95% Cl = 1.26-3.25; p < 0.0033) while heterozygous (AG) of rs2383206 of the gene CDKN2B exhibited significant association but with decreased risk of CVD (OR = 0.47; 95% Cl = 0.29-0.75; p < 0.0017). The results of ADIPOQ polymorphism rs2241766 show that the heterozygous genotype (TG) showed a significant association with a decreased risk of CVD (OR = 0.63; 95% CI = 0.39-1.01; p < 0.05) while the homozygous mutant genotype (GG) of rs2241766 again showed a highly significant association with CVD which increased the risk of CVD by 2-folds (OR = 1.77; 95% CI = 1.11-2.80; p < 0.0150). The results of expressional analysis show that CDKN2B is significantly overexpressed in cardiovascular patients, while the gene ADIPOQ showed significant downregulation. Conclusion: The findings show that the CDKN2B and ADIPOQ gene polymorphisms significantly raise the risk for CVD, while their expression shows a significant correlation with CVD.

Background: Obstructive sleep apnea (OSA) is a recognized risk factor for high blood pressure (BP) and chronic renal dysfunction in adults. However, it remains uncertain whether a similar association exists in children. Objectives: This study assessed the associations between childhood OSA and systemic BP and renal outcomes. Additionally, it examined the effects of OSA treatments on BP in children. Methods: A systematic literature search was conducted to identify relevant studies up to August 2024. Results: Sixty-four studies, consisting of 44 observational studies and 20 OSA interventional studies, were included. Compared with healthy control groups, children with OSA had significantly higher daytime systolic BP (3.30 mmHg; 95% CI, 2.07-4.53), daytime diastolic BP (1.27 mmHg; 95% CI, 0.69-1.84), nighttime systolic BP (4.08 mmHg; 95% CI, 2.71-5.46), nighttime diastolic BP (2.12 mmHg; 95% CI, 0.96-3.27), daytime mean arterial pressure (MAP) (2.11 mmHg; 95% CI, 1.32-2.89), and nighttime MAP (3.60 mmHg; 95% CI, 1.11-6.09). Obesity was the only other contributing factor to daytime systolic BP elevation. Meta-analysis of studies on BP change after treatment (adenotonsillectomy or positive airway pressure) for OSA did not show significant changes in BP. Research on childhood OSA and renal outcomes is very limited. Conclusion: Our results demonstrate the association between childhood OSA and higher risk of adverse systemic BP outcomes. OSA treatment alone, however, has not been demonstrated to improve BP outcomes yet. Children with OSA and systemic hypertension should be assessed for further need of BP treatment to reduce long-term cardiovascular morbidity and mortality.

Background: Neck circumference (NC) is a measure to identify upper-body adiposity and has been hypothesized to be linked with hypertension (HTN). This study endeavors to examine the association between NC and HTN among middle-aged and elderly Iranian adults. Methods: In this cross-sectional study, adults over 50 years of age were recruited through a stratified random sampling approach. Anthropometric measurements, blood biochemical indicators, blood pressure (BP) readings, and evaluations of physical activity (PA) levels were conducted. Results: In the univariable regression analyses, age, NC, body mass index, waist and hip circumference, waist-to-hip ratio, total cholesterol, presence of diabetes, PA levels, LDL-C, and HDL-C were found to be associated with HTN in both genders (p < 0.2). Notably, triglyceride levels showed a significant association solely among females. Subsequent multivariable regression analyses revealed an association between NC and HTN in both male and female participants (adjusted OR = 1.04 (95% CI: 1.008, 1.08) and 1.06 (95% CI: 1.01, 1.10), respectively). Conclusion: Individuals with higher NC demonstrated an increased likelihood of developing HTN. The strength of this association appeared to be slightly more pronounced in women. Consequently, individuals with larger NC measurements should undergo regular monitoring of BP levels to mitigate potential HTN risks.

Suboptimal medication adherence and unhealthy lifestyle behaviors are well-recognized contributing factors to poor blood pressure control in hypertension patients. We evaluated the effectiveness of comprehensive health management in improving medication adherence and promoting healthy lifestyle behaviors among hypertension patients in China. A cluster randomized trial was implemented in rural areas of three provinces of China. Participants were individuals aged ≥ 40 years with uncontrolled hypertension. The intervention group received multidimensional health management measures codeveloped by healthcare organizations, village doctors, and patients, while the control group received standard care. The coprimary outcomes included the proportion of patients demonstrating good medication adherence and adherence to ≥ 3 healthy lifestyle components. Secondary outcomes comprised the proportion achieving controlled hypertension (BP < 140/90 mm Hg). From May 8th to November 28th, 2018, 9204 participants were enrolled. At 18-month follow-up, significantly higher medication adherence was observed in the intervention group compared with the control group, with an absolute difference of 5.0% (95% confidence interval (CI): 2.8-7.2; p < 0.001). Similarly, adherence to ≥ 3 healthy lifestyles was achieved by 45.8% in the intervention group versus 33.7% in controls, yielding a 12.1% between-group difference (95% CI: 9.9-14.3; p < 0.001). Hypertension control rates differed significantly between groups (43.2% vs. 23.9%; absolute difference 19.2% and 95% CI: 17.2-21.3; p < 0.001). Hypertension patients receiving comprehensive health management in rural China demonstrated superior medication adherence and healthier lifestyle behaviors compared with those receiving standard care over 18 months. Further investigations are warranted to evaluate the cost-effectiveness and generalizability of this intervention. Trial Registration: ClinicalTrials.gov identifier: NCT03527719.

Hypertensive heart disease, a condition affecting millions worldwide, encompasses a spectrum from uncontrolled hypertension to heart failure. Despite the intricacies of its pathogenic mechanisms, recent attention has been directed toward the role of macrophages in the progression from hypertension to heart failure. Under normal circumstances, macrophages contribute to tissue homeostasis by clearing deceased cells. However, dysregulation during hypertension triggers inflammatory pathways, leading to tissue damage. Oxidative stress and mitochondrial dysfunction are implicated in this process. Exercise training, gaining popularity for its potential in regulating macrophage function, emerges as a promising intervention to improve outcomes in hypertensive heart disease. This review provides a succinct overview of previous research elucidating the involvement of macrophages in the transition from hypertension to heart failure. It underscores the current active areas of investigation and emphasizes the potential of exercise training in mediating macrophage responses, offering a glimpse into a hopeful avenue for therapeutic intervention in this challenging medical condition.