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Validation of combiomed hipermax-BF model A7101 automatic oscillometric upper-arm sphygmomanometer in general population: AAMI/ESH/ISO universal standard (ISO 81060-2:2018/Amd 1:2020) 康美药业 hipermax-BF A7101 型自动示波上臂式血压计在普通人群中的验证:AAMI/ESH/ISO通用标准(ISO 81060-2:2018/Amd 1:2020)。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-24 DOI: 10.1038/s41371-024-00948-9
Damaris Hernández Véliz, Yamilé Valdés González, Nurys Bárbara Armas Rojas, Reinaldo De la Noval García, Jennifer Ringrose, Raj Padwal
This study evaluates the accuracy of the Hipermax-BF model A7101 (Combiomed, Havana, Cuba) automatic oscillometric upper-arm sphygmomanometer for office and home use in general population as part of the HEARTS in the Americas initiative. The research was developed according to the Universal Standard AAMI/ESH/ISO ISO 81060-2:2018/Amd 1:2020. The subjects were recruited according to the requirements of age, gender, blood pressure values and upper-arm circumference. The same upper-arm sequential blood pressure measurement method was used. For measurements with the device under test, the 2-piece cuff from 22–44 cm limb circumference range was used. 92 subjects were recruited and 85 were analyzed. Mean age was 44.8 ± 14.7 years, mean upper-arm circumference was 32.3 ± 6.2, and 56.5% were female. For Validation Criterion 1, the mean value ± standard deviation of the differences in readings between the device under test and the reference device was 1.2 ± 4.9/0.8 ± 4.9 mmHg (systolic/diastolic). For both pressures, in criterion 1 the standard requires a mean value of the differences ≤ ± 5 mmHg and a standard deviation ≤ ± 8 mmHg. For Validation Criterion 2, the standard deviation of the mean blood pressure differences per subject was 4.2/4.2 mmHg (systolic/diastolic). According to Table 1 of criterion 2, for the mean values of 1.2/0.8 mmHg (systolic/diastolic), the maximum allowable standard deviation had to be < 6.84 for systolic and < 6.89 for diastolic pressure. The Combiomed Hipermax-BF A7101 automatic sphygmomanometer meets the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2:2018/Amd 1:2020) in the general population.
作为美洲 HEARTS 计划的一部分,本研究评估了 Hipermax-BF A7101 型(Combiomed,古巴哈瓦那)自动示波上臂血压计在普通人群中用于办公室和家庭的准确性。这项研究是根据通用标准 AAMI/ESH/ISO ISO 81060-2:2018/Amd 1:2020 制定的。受试者是根据年龄、性别、血压值和上臂围度等要求招募的。采用相同的上臂顺序血压测量方法。在使用测试设备进行测量时,使用的是 22-44 厘米肢围范围内的两件式袖带。共招募了 92 名受试者,对 85 名受试者进行了分析。平均年龄为 44.8 ± 14.7 岁,平均上臂周长为 32.3 ± 6.2,56.5% 为女性。对于验证标准 1,被测设备与参照设备之间读数差异的平均值(± 标准差)为 1.2 ± 4.9/0.8 ± 4.9 mmHg(收缩压/舒张压)。对于这两种压力,标准 1 要求差异的平均值≤ ± 5 mmHg,标准偏差≤ ± 8 mmHg。对于验证标准 2,每个受试者的平均血压差异标准偏差为 4.2/4.2 mmHg(收缩压/舒张压)。根据标准 2 的表 1,对于 1.2/0.8 mmHg(收缩压/舒张压)的平均值,收缩压的最大允许标准偏差必须小于 6.84,舒张压的最大允许标准偏差必须小于 6.89。Combiomed Hipermax-BF A7101 自动血压计符合 AAMI/ESH/ISO 通用标准(ISO 81060-2:2018/Amd 1:2020)对普通人群的要求。
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引用次数: 0
Text messaging to improve retention in hypertension care in Bangladesh 通过短信提高孟加拉国高血压患者的就医率。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-24 DOI: 10.1038/s41371-024-00942-1
Shamim Jubayer, Jubaida Akhtar, Ahmad Khairul Abrar, Md. Noor Nabi Sayem, Shahinul Islam, Khondoker Ehsanul Amin, Muhtamim Fuwad Nahid, Mahfuzur Rahman Bhuiyan, Mohammad Abdullah Al Mamun, Abdul Alim, Mohammad Robed Amin, Daniel Burka, Prabhanshu Gupta, Di Zhao, Kunihiro Matsushita, Andrew E. Moran, Sohel Reza Choudhury, Reena Gupta
Visit non-attendance is a common barrier to hypertension control in low and middle-income countries (LMICs). We aimed to evaluate the effectiveness of mobile text messaging in improving visit attendance among patients with hypertension in primary healthcare facilities in Bangladesh. A randomized A/B testing study was conducted with two patient groups: (1) patients regularly attending visits (regular patients) and (2) patients overdue for their follow-up clinic visit (overdue patients). Regular patients were randomized into three groups: a cascade of three text reminders, a single text reminder, or no text reminder. Overdue patients were randomized into two groups: a single text reminder or no text reminder. 20,072 regular patients and 12,708 overdue patients were enrolled. Among regular patients, visit attendance was significantly higher in the cascade reminder group and the single reminder group compared to the no reminder group (78.2% and 76.6% vs. 74.8%, p < 0.001 and 0.027, respectively). Among overdue patients, the single reminder group had a 5.8% higher visit attendance compared to the no reminder group (26.5% vs. 20.7%, p < 0.001). The results remained consistent in multivariable analysis; adjusted prevalence ratio (PR) was 1.04 (95% CI 1.02–1.06) for the cascade reminder group and 1.02 (95% CI 1.00–1.05) for the single reminder group among regular patients. The adjusted PR for the single reminder group vs. the no reminder group among overdue patients was 1.23 (95% CI 1.15–1.33). Text message reminders are an effective strategy for improving retention of patients in hypertension treatment in LMICs, especially for patients overdue to care.
不就诊是中低收入国家控制高血压的常见障碍。我们旨在评估手机短信在提高孟加拉国初级医疗机构高血压患者就诊率方面的效果。我们对两组患者进行了随机 A/B 测试研究:(1) 定期就诊的患者(定期患者)和 (2) 逾期复诊的患者(逾期患者)。定期就诊患者被随机分为三组:一连发送三条短信提醒、一条短信提醒或无短信提醒。逾期患者被随机分为两组:单条短信提醒或无短信提醒。共有 20,072 名定期就诊患者和 12,708 名逾期就诊患者登记在册。在定期就诊的患者中,串联提醒组和单一提醒组的就诊率明显高于无提醒组(78.2% 和 76.6% vs. 74.8%,p<0.05)。
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引用次数: 0
Adolescent obesity and short sleep duration as independent risk factors for hypertension: a population-based cohort study 青少年肥胖和睡眠时间短是高血压的独立风险因素:一项基于人群的队列研究。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-22 DOI: 10.1038/s41371-024-00946-x
Youngju Choi, Jang Soo Yook, Eun-Jeong Cho, Ilyoung Jeong, Junghoon Kim, Asako Zempo-Miyaki, Eunwook Chang, Dong-Ho Park, Hyo-Bum Kwak
Prevalence of hypertension in adolescents has increased worldwide and is considered a risk factor for hypertension and cardiovascular disease in adulthood. Although obesity and sleep deficiency increase this risk, the combined effects of these factors on hypertension remain unclear. This study aimed to examine the combined effects of obesity and sleep duration on hypertension in adolescents. This study was conducted using data from the 2016 to 2018 Korean National Health and Nutrition Examination Survey, which included a study population of 1272 adolescents. The participants were categorized into four groups based on sleep duration and body mass index (BMI) percentiles: normal sleep and normal body mass group (reference; normal), only short sleep group (short sleep), only overweight/obesity group (overweight/obesity), and short sleep and overweight/obesity group (short sleep and overweight/obesity). Short sleep duration was defined as <8 h of average sleep duration, and overweight/obesity was defined as a BMI ≥ 85th percentile. Hypertension in adolescents was defined as a systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. The prevalence of hypertension was 9.2% among Korean adolescents. Short sleep duration with overweight/obesity were associated with a significantly increased risk of hypertension (odds ratio = 6.57; 95% confidence interval: 3.27–13.20) in adolescents, and controlling for the potential confounding variables only partially attenuated this relationship (odds ratio = 5.28; 95% confidence interval: 2.28–12.26). This study demonstrated that the coexistence of short sleep duration and obesity was associated with an increased risk of hypertension in Korean adolescents.
青少年高血压的发病率在全球范围内不断上升,被认为是成年后患高血压和心血管疾病的风险因素。虽然肥胖和睡眠不足会增加这一风险,但这些因素对高血压的综合影响仍不清楚。本研究旨在探讨肥胖和睡眠时间对青少年高血压的综合影响。这项研究使用了 2016 年至 2018 年韩国全国健康与营养调查的数据,研究对象包括 1272 名青少年。根据睡眠时间和体重指数(BMI)百分位数将参与者分为四组:正常睡眠和正常体重组(参考;正常)、仅短睡眠组(短睡眠)、仅超重/肥胖组(超重/肥胖)和短睡眠和超重/肥胖组(短睡眠和超重/肥胖)。短睡眠时间定义为
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引用次数: 0
Chronic hypertension diagnosed before or during pregnancy and its effects on pregnancy outcomes 孕前或孕期诊断出的慢性高血压及其对妊娠结果的影响。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-22 DOI: 10.1038/s41371-024-00944-z
Qingwen Nie, Weizhang Liang, Yuan Xue, Lijie Pan, Mindi Jiang, Fang He
Chronic hypertension (CH) during pregnancy, identified before or within the first 20 weeks, presents varying risks depending on the timing of diagnosis. This real-world study was conducted from January 2018 to June 2023 and included singleton pregnancies with CH to compare pre-pregnancy CH (Group 1) and newly diagnosed CH (Group 2). There were 565 women in the final analysis, with 307 in Group 1 with pre-pregnancy CH and 258 in Group 2 with new-onset CH. Those in Group 1 more frequently had pre-gestational diabetes and a history of hypertensive disorders in pregnancy, whereas Group 2 had a higher incidence of excessive gestational weight gain. Notably, 56.2% of Group 2 patients did not receive antihypertensive treatment before 20 weeks, while the proportion was 36.2% in Group 1, resulting in a significant difference in baseline blood pressure. The study revealed higher incidences of preterm preeclampsia (44.2% vs. 34.9%) and placental abruption (5.4% vs. 2.0%) in Group 2 compared to Group 1. After adjustment, logistic regression indicated that Group 2 had a 1.8-fold higher risk of preterm preeclampsia than Group 1. These findings suggest that pregnant women newly diagnosed with CH in the first 20 weeks face increased adverse outcomes compared to those diagnosed before pregnancy. Intense monitoring and earlier intervention may help manage women with new-onset CH.
妊娠期慢性高血压(CH)在最初 20 周前或 20 周内发现,根据诊断时间的不同,其风险也不同。这项真实世界研究于2018年1月至2023年6月进行,纳入了患有CH的单胎妊娠,对孕前CH(第1组)和新诊断的CH(第2组)进行比较。共有 565 名妇女参与了最终分析,其中 307 人在第一组中患有孕前妊娠合并症,258 人在第二组中患有新发妊娠合并症。第一组中更多的人患有妊娠前糖尿病和妊娠高血压病史,而第二组中妊娠体重增加过多的发生率更高。值得注意的是,56.2%的第 2 组患者在 20 周前没有接受降压治疗,而第 1 组的这一比例为 36.2%,这导致了基线血压的显著差异。研究显示,与第一组相比,第二组先兆子痫(44.2% 对 34.9%)和胎盘早剥(5.4% 对 2.0%)的发病率更高。 这些研究结果表明,与孕前确诊的孕妇相比,在孕前 20 周新确诊 CH 的孕妇面临的不良后果更多。加强监测和尽早干预可能有助于控制新发CH的孕妇。
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引用次数: 0
Social determinants of health and hypertension screening among women in The Gambia: an evaluation of 2019-2020 demographic and health survey data. 冈比亚妇女健康和高血压筛查的社会决定因素:2019-2020 年人口与健康调查数据评估。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-17 DOI: 10.1038/s41371-024-00945-y
Heather F McClintock, Victoria Peacock, Rose Nkiri Asong

Hypertension is a leading modifiable risk factor for morbidity and mortality among women in Sub-Saharan Africa. Social determinants of health (SDH) are associated with sex-based differences in access to preventative screenings globally. Little research has assessed the influence of SDH on screening for hypertension among women in The Gambia. The aim of this study was to identify SDH associated with the utilization of hypertension screening among women in The Gambia. Data was examined from the 2019-2020 Gambia Demographic and Health Survey. Weighted multivariate logistic was used to identify whether SDH were associated with hypertension screening. Among 4116 women, over one-fifth (21.1%) had not been screened for hypertension in their lifetime. In fully adjusted models, older age, rural residence, higher than secondary educational attainment, employment, identification with specific ethnic groups, richer wealth status, parity (1 or more), and antenatal care visits increased the likelihood of lifetime hypertension screening. Women who indicated that others made their healthcare decisions for them (partners or someone else) were significantly less likely to have been screened for hypertension in their lifetime than women who made their healthcare decisions alone (adjusted odds ratio = 0.552, 95% confidence interval = (0.384-0.794)). SDH influence access to screening for hypertension among women in The Gambia. Initiatives may need to address the role of SDH to improve access and uptake of hypertension screening.

高血压是撒哈拉以南非洲妇女发病和死亡的主要可改变风险因素。在全球范围内,健康的社会决定因素(SDH)与获得预防性筛查的性别差异有关。有关 SDH 对冈比亚妇女高血压筛查影响的评估研究很少。本研究旨在确定与冈比亚妇女利用高血压筛查相关的 SDH。研究数据来自 2019-2020 年冈比亚人口与健康调查。采用加权多变量逻辑来确定 SDH 是否与高血压筛查相关。在 4116 名妇女中,超过五分之一(21.1%)的人一生中未接受过高血压筛查。在完全调整模型中,年龄较大、居住在农村、中等以上教育程度、就业、认同特定种族群体、财富状况较富裕、均妻数(1 或以上)以及产前检查次数增加了终生接受高血压筛查的可能性。表示由他人(伴侣或其他人)代为做出医疗保健决定的妇女,一生中接受高血压筛查的可能性明显低于独自做出医疗保健决定的妇女(调整后的几率比=0.552,95%置信区间=(0.384-0.794))。SDH 影响了冈比亚妇女接受高血压筛查的机会。可能需要采取一些措施来解决 SDH 的作用,以提高高血压筛查的可及性和接受率。
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引用次数: 0
Effectiveness of biofeedback on blood pressure in patients with hypertension: systematic review and meta-analysis 生物反馈对高血压患者血压的疗效:系统回顾和荟萃分析。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-14 DOI: 10.1038/s41371-024-00937-y
Sian Jenkins, Ainslea Cross, Hanad Osman, Farah Salim, Dan Lane, Dennis Bernieh, Kamlesh Khunti, Pankaj Gupta
Hypertension is the leading modifiable risk factor for cardiovascular disease, but less than 50% have their blood pressure controlled. A possible avenue to support hypertension management is a holistic approach, using non-pharmacological interventions. Since hypertension is mediated in part by dysregulation of the autonomic nervous system (ANS), biofeedback may help improve hypertension management by targeted self-regulation and self-awareness of parameters that regulate the ANS. This systematic review aimed to assess the effectiveness of biofeedback on blood pressure in hypertensive patients. The review was pre-registered on PROSPERO and followed the PICO strategy. A total of 1782 articles were retrieved, 20 met the inclusion criteria. Sample sizes ranged from 15 to 301 participants; with a median age of 49.3 (43.3–55.0) years and 45% were female. There was a significant effect of biofeedback on systolic (−4.52, Z = 2.31, P = 0.02, CI [−8.35, −0.69]) and diastolic blood pressure (−5.19, Z = 3.54, P = 0.0004, CI [−8.07, −2.32]). Six different biofeedback modalities were used, with biofeedback delivered by psychologists, trained therapists and research assistants. There was no publication bias, heterogeneity was rated as substantial and data quality was rated to be poor. This review demonstrated that biofeedback had a significant effect on blood pressure. However, this should be viewed in the context of included studies being limited by heterogeneity and dated literature, meaning the research does not reflect the current biofeedback technology such as wearable devices. Future research should incorporate these technologies with robust methodology to fully understand the effect of biofeedback on hypertension.
高血压是心血管疾病的主要可改变风险因素,但只有不到 50%的人血压得到控制。支持高血压管理的一个可能途径是采用非药物干预的整体方法。由于高血压部分是由自律神经系统(ANS)调节失调引起的,因此生物反馈可通过有针对性的自我调节和对自律神经系统调节参数的自我意识,帮助改善高血压管理。本系统综述旨在评估生物反馈对高血压患者血压的影响。该综述在 PROSPERO 上进行了预注册,并遵循 PICO 策略。共检索到 1782 篇文章,其中 20 篇符合纳入标准。样本量从 15 到 301 人不等,中位年龄为 49.3(43.3-55.0)岁,45% 为女性。生物反馈对收缩压(-4.52,Z = 2.31,P = 0.02,CI [-8.35,-0.69])和舒张压(-5.19,Z = 3.54,P = 0.0004,CI [-8.07,-2.32])有明显影响。使用了六种不同的生物反馈模式,由心理学家、训练有素的治疗师和研究助理提供生物反馈。没有发表偏倚,异质性被评为严重,数据质量被评为较差。该综述表明,生物反馈疗法对血压有显著效果。然而,这应结合所纳入的研究受到异质性和文献年代久远的限制,这意味着研究没有反映出当前的生物反馈技术,如可穿戴设备。未来的研究应结合这些技术和可靠的方法,以充分了解生物反馈对高血压的影响。
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引用次数: 0
Smoking cessation as a recommended action for incident hypertension 建议将戒烟作为治疗高血压的一项措施。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-13 DOI: 10.1038/s41371-024-00943-0
Tomoyuki Kawada
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引用次数: 0
Physical activity lower blood pressure and mortality in hypertensive patients with diabetes: data from National Health and Nutrition Examination Survey (NHANES) 1999–2018 体育锻炼可降低高血压糖尿病患者的血压和死亡率:1999-2018 年美国国家健康与营养调查(NHANES)数据。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-08-06 DOI: 10.1038/s41371-024-00941-2
Xin Zhong, Xiaowei Liu, Zhi Zhang, Lijiang Tang
In prior research related to physical activity, researchers have often centered their focus on only a limited number of activities, with little regard for mortality-related outcomes and insufficient focus on outcomes among diabetes patients with hypertension. The National Health and Nutrition Examination Survey was evaluated from 1999-2018 to identify individual with both diabetes and hypertension. These individuals were classified as being physically active or inactive. Comparisons among groups were performed with appropriate statistical tests. In total, this study evaluated data from 6,163 patients with a mean age of 63.18 ± 12.80 years. A total of 50.30% of the participants were male, with 39.86% being non-Hispanic white, 57.17% with a normal body mass index, and 89.20% were insured. Physical activity was significantly negatively correlated with systolic blood pressure in the overall population (p = 0.01) and when specifically focusing on individuals undergoing antihypertensive drug treatment (p = 0.0035). This negative relationship remained intact even following adjustment for age, sex, and ethnicity (p = 0.03). Physical activity was positively correlated with diastolic blood pressure in the overall population of participants (p = 0.002) and when specifically evaluating participants undergoing antihypertensive drug treatment (p = 0.02). All-cause and hypertensive mortality risk levels were significantly higher among individuals classified as being physically inactive (p < 0.0001), and this relationship remained true even with adjustment for age, sex, and ethnicity (p < 0.0001). In conclusion, physical activity is capable of lowering systolic blood pressure and decreasing the incidence of mortality among diabetes patients with hypertension.
在以往与体育锻炼有关的研究中,研究人员往往只关注有限的几项活动,很少关注与死亡率有关的结果,也没有充分关注糖尿病合并高血压患者的结果。研究人员对 1999-2018 年期间的全国健康与营养调查进行了评估,以确定同时患有糖尿病和高血压的人群。这些人被分为身体活跃和不活跃两类。组间比较采用了适当的统计检验。本研究共评估了 6,163 名患者的数据,他们的平均年龄为(63.18 ± 12.80)岁。50.30%的参与者为男性,39.86%为非西班牙裔白人,57.17%体重指数正常,89.20%有保险。在总体人群中,体育锻炼与收缩压呈明显负相关(p = 0.01),而在接受降压药物治疗的人群中,体育锻炼与收缩压呈明显负相关(p = 0.0035)。即使在对年龄、性别和种族进行调整后,这种负相关关系仍然保持不变(p = 0.03)。在所有参与者中,体育锻炼与舒张压呈正相关(p = 0.002),在对接受降压药物治疗的参与者进行专门评估时,体育锻炼与舒张压呈正相关(p = 0.02)。在被归类为缺乏运动的人群中,全因死亡率和高血压死亡率风险水平明显更高(p = 0.002)。
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引用次数: 0
Hypertension care cascade and their determinants among older adolescents in India: evidence from a nationally representative cross-sectional survey 印度老年青少年的高血压护理流程及其决定因素:一项具有全国代表性的横断面调查提供的证据。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-07-31 DOI: 10.1038/s41371-024-00940-3
Shubhanjali Roy, Mansi Malik, Saurav Basu
Adolescent hypertension in India is an emergent public health concern with lack of programmatic focus on regular screening amongst both individuals and healthcare providers. This study was conducted to assess the hypertension care cascade (prevalence, awareness, treatment and control status of hypertension) from nationally representative data. We used data from the demographic and health surveillance (DHS) comprising India’s National Family Health Survey Fifth Round (2019–2021). The prevalence of hypertension among 204,054 older adolescents (15–19 years) was 5.08% (95% CI: 4.94–5.23%) wherein 42.26% (95% CI: 40.69–43.64%) were aware of their condition, 43.70% (95% CI: 41.73–45.70%) of those aware were receiving treatment, and 85.88% (95% CI: 83.83–87.71%) of those on treatment achieved blood pressure control. Overall, there were nearly 60% newly diagnosed hypertension cases detected on screening. Females had significantly lower odds, while those with diabetes and higher waist-hip ratio had significantly higher odds of having hypertension. The awareness of their hypertensive status was higher among females and rural residents, while it was lower among adolescents that were obese and tobacco smokers. Improved blood pressure control was associated with a lower waist-to-hip ratio. In conclusion, nearly five in every hundred older adolescents in India are clinically hypertensive with significantly higher odds linked with obesity and male gender. Awareness and utilization of antihypertensive treatment was lower than the classical rule of halves signifying deficiencies in hypertension screening and management strategies for older adolescents within the existing public health policy framework.
在印度,青少年高血压是一个新出现的公共卫生问题,个人和医疗服务提供者都缺乏对定期筛查的计划关注。本研究旨在通过具有全国代表性的数据评估高血压的护理流程(高血压的患病率、认知度、治疗和控制状况)。我们使用了印度第五轮全国家庭健康调查(2019-2021 年)中的人口与健康监测(DHS)数据。在 204 054 名年龄较大的青少年(15-19 岁)中,高血压患病率为 5.08% (95% CI: 4.94-5.23%),其中 42.26% (95% CI: 40.69-43.64%)知道自己的病情,43.70% (95% CI: 41.73-45.70%)知道自己病情的人正在接受治疗,85.88% (95% CI: 83.83-87.71%)正在接受治疗的人实现了血压控制。总体而言,近 60% 的新诊断高血压病例是通过筛查发现的。女性患高血压的几率明显较低,而患有糖尿病和腰臀比较高的人患高血压的几率明显较高。女性和农村居民对自身高血压状况的知晓率较高,而肥胖和吸烟的青少年对自身高血压状况的知晓率较低。血压控制的改善与腰臀比的降低有关。总之,印度每 100 名年龄较大的青少年中就有近 5 人患有临床高血压,而肥胖和男性患高血压的几率明显更高。对降压治疗的认识和利用率低于传统的减半规则,这表明在现有的公共卫生政策框架内,针对老年青少年的高血压筛查和管理策略存在缺陷。
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引用次数: 0
Pathophysiology and pregnancy outcomes of ascites in preeclampsia—a scoping review 子痫前期腹水的病理生理学和妊娠结局--范围综述。
IF 2.7 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-07-24 DOI: 10.1038/s41371-024-00927-0
Yavana Suriya Venkatesh, Venkatesh Raju, Koustav Pal, Anish Keepanasseril
Preeclampsia is a multisystem disorder associated with defective trophoblast invasion, maternal syndrome, and capillary endothelial leak. The presence of ascites/third space fluid accumulation increases the risk of maternal morbidity and mortality. The current criteria/guidelines of preeclampsia do not establish the presence of ascites as a marker of severity or recognize the timing and need for early delivery despite associated complications. Medline and Embase databases were searched to identify relevant literature, reported up to December 2023, regarding the pathophysiology, pregnancy outcome, and management of preeclampsia complicated with ascites. A total of 5 studies on pathophysiology and eight on pregnancy outcomes met the inclusion criteria, with 41 case reports on ascites in preeclampsia. The etiopathogenesis for the development of ascites in preeclampsia includes endothelial damage, capillary hyperpermeability, release of vasoconstrictive agents, reduced intravascular oncotic pressure, and raised intraabdominal pressure. The presence of ascites represents the extreme form of microvascular damage, which also correlates with the raised sFlt-1 levels in this condition. The adverse pregnancy outcomes include increased risk of congestive heart failure, eclampsia, renal failure, disseminated intravascular coagulation, acute respiratory distress syndrome, and maternal death. The presence of ascites in preeclampsia is associated with the deterioration of the maternal condition. Hence, it is indicative of preeclampsia with severe features and requires vigilant monitoring, and prompt delivery may be considered.
子痫前期是一种多系统疾病,与滋养细胞侵袭缺陷、母体综合征和毛细血管内皮渗漏有关。腹水/三腔积液的出现会增加孕产妇发病和死亡的风险。现行的子痫前期标准/指南并未将腹水的存在作为严重程度的标志,也未认识到尽管存在相关并发症,但仍需尽早分娩的时机和必要性。我们检索了 Medline 和 Embase 数据库,以确定截至 2023 年 12 月有关子痫前期并发腹水的病理生理学、妊娠结局和管理的相关文献。符合纳入标准的病理生理学研究共有 5 项,妊娠结局研究共有 8 项,子痫前期腹水病例报告共有 41 项。子痫前期腹水的发病机制包括内皮损伤、毛细血管高渗透性、血管收缩剂的释放、血管内渗透压降低和腹内压升高。腹水的出现代表了微血管损伤的极端形式,也与这种情况下 sFlt-1 水平的升高有关。不良妊娠结局包括充血性心力衰竭、子痫、肾功能衰竭、弥散性血管内凝血、急性呼吸窘迫综合征和孕产妇死亡的风险增加。子痫前期出现腹水与产妇病情恶化有关。因此,腹水表明子痫前期症状严重,需要警惕监测,并考虑及时分娩。
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Journal of Human Hypertension
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