Journal of Hypertension最新文献

A recent call-to-action highlighted that Australia is lagging behind high-income countries regarding hypertension control rates. We performed a systematic literature search of reports on prevalence, awareness, treatment and control rates since 2010. We also undertook an individual participant data meta-analysis of six population-based studies in the general population from 1980 to 2018 to understand the size of the problem and trajectories over time. The aggregated data showed that after 2010, hypertension prevalence was 31% [95% confidence interval (CI) 27-34%], and awareness, treatment, and control rates among people with hypertension were 56% (41-71%), 54% (46-62%) and 34% (22-47%), respectively. Since 1980, these figures have shown slight improvement. However, we noted a low availability of quality nationwide databases for Australia. We require critical action to improve the prevention, detection and treatment of hypertension, and highlight the need for large-scale investment in tracking population health in order to produce vital health statistics for the nation.

Background: Early menarche has been associated with an increased risk of arterial hypertension. Whether the association between early menarche and hypertension is independent of menopausal status is unknown. This study aimed to investigate the association between early menarche and hypertension in pre and postmenopausal women.

Methods: This cross-sectional study analyzed data from 1406 women aged 18-100. Age at menarche, menopause status, hemodynamic, anthropometric, and biochemical data were collected by using standard protocols. Menarche <12 years was defined as early menarche. Systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg and/or intake of antihypertensive medication, were used as criteria for hypertension.

Results: In total, 21.3% of women had early menarche (<12 years), and the frequency of hypertension was 38.7%. Premenopausal women with early menarche had a 58% higher chance of developing hypertension, even after adjusting for age, obesity, and smoking [odds ratio (OR) 1.58; (95% confidence interval, CI 1.016-2.461)]. In postmenopausal women, age, obesity, and diabetes mellitus were predictors of hypertension, while early menarche was not.

Conclusion: The odds of hypertension were higher with early menarche, but only in women of reproductive age. In postmenopausal women, the physiological changes inherent to aging and the presence of more comorbidities, such as diabetes, might overlap the influence of early menarche on hypertension.

Background: This study explored the prospective associations of genetic susceptibility to high blood pressure (BP) and muscle strength with cardiovascular disease (CVD) mortality, incident coronary heart disease (CHD) and incident stroke.

Methods: This study included 349 085 white British individuals from the UK Biobank study. Genetic risk of high BP was estimated using a weighted polygenic risk score that incorporated 136 and 135 nonoverlapping single-nucleotide polymorphisms for systolic BP and diastolic BP, respectively. Muscle strength was assessed using a hand dynamometer and expressed relative to fat-free mass. Sex- and age-specific tertiles were used to classify muscle strength into three categories. Cox regressions with age as the underlying timescale were fit for CVD mortality ( n  = 8275), incident CHD ( n  = 14 503), and stroke ( n  = 7518).

Results: Compared with the lowest genetic risk of high BP (bottom 20%), the highest (top 20%) had greater hazards of each outcome. Low muscle strength was associated with higher hazards of CVD mortality [hazard ratio (HR): 1.51, 95% confidence interval (CI): 1.43-1.59], incident CHD (HR: 1.16, 95% CI: 1.11-1.21), and stroke (HR: 1.20, 95% CI: 1.14-1.27), independently of confounders and genetic predisposition to high BP, compared with high muscle strength. Joint analyses revealed that the estimated 10-year absolute risks of each outcome were lower for high muscle strength combined with high genetic risk, compared with low muscle strength combined with low or medium genetic risk.

Conclusion: Individuals who are genetically predisposed to high BP but have high muscle strength could have lower risk of major CVD events, compared with those who have low or medium genetic risk but low muscle strength.