Pub Date : 2024-05-02DOI: 10.1038/s41371-024-00913-6
Lebo F. Gafane-Matemane, Ashleigh Craig, Ruan Kruger, Omotayo S. Alaofin, Lisa J. Ware, Erika S. W. Jones, Andre Pascal Kengne
Recent global and regional reports consistently confirm the high and increasing prevalence of hypertension in sub-Saharan Africa (SSA), with poor detection, treatment, and control rates. This narrative review summarises the burden of hypertension in SSA and recent findings from community-based hypertension management strategies. We further outline prominent risk factors according to recent data and associated underlying mechanisms for hypertension development. An extensive review of literature showed that most countries have reported on the prevalence of hypertension during 2017–2023, despite limitations linked to the lack of nationally representative studies, heterogeneity of sampling and data collection methods. Task-shifting approaches that assign roles to model patients and community health workers reported improved linkage to healthcare services and adherence to medication, with inconsistent findings on blood pressure (BP)-lowering effects over time. The regularly reported risk factors include unhealthy diet, sedentary lifestyle, increased adiposity and underweight, ageing, level of education, and/or income as well as psychosocial factors. Newer data on the pathophysiological mechanisms leading to hypertension and potential areas of intervention are reported from children and adults and include, among others, salt-handling and volume overload, endothelial function, BP dipping patterns and the role of human immunodeficiency virus . To conclude, significant strides have been made in data reporting from SSA on the burden of hypertension in the region as well as biomarker research to improve understanding and identification of areas of intervention. However, gaps remain on linkage between knowledge generation, translation, and implementation research. Coordinated studies addressing both discovery science and public health are crucial to curb hypertension development and improve management in SSA.
{"title":"Hypertension in sub-Saharan Africa: the current profile, recent advances, gaps, and priorities","authors":"Lebo F. Gafane-Matemane, Ashleigh Craig, Ruan Kruger, Omotayo S. Alaofin, Lisa J. Ware, Erika S. W. Jones, Andre Pascal Kengne","doi":"10.1038/s41371-024-00913-6","DOIUrl":"https://doi.org/10.1038/s41371-024-00913-6","url":null,"abstract":"<p>Recent global and regional reports consistently confirm the high and increasing prevalence of hypertension in sub-Saharan Africa (SSA), with poor detection, treatment, and control rates. This narrative review summarises the burden of hypertension in SSA and recent findings from community-based hypertension management strategies. We further outline prominent risk factors according to recent data and associated underlying mechanisms for hypertension development. An extensive review of literature showed that most countries have reported on the prevalence of hypertension during 2017–2023, despite limitations linked to the lack of nationally representative studies, heterogeneity of sampling and data collection methods. Task-shifting approaches that assign roles to model patients and community health workers reported improved linkage to healthcare services and adherence to medication, with inconsistent findings on blood pressure (BP)-lowering effects over time. The regularly reported risk factors include unhealthy diet, sedentary lifestyle, increased adiposity and underweight, ageing, level of education, and/or income as well as psychosocial factors. Newer data on the pathophysiological mechanisms leading to hypertension and potential areas of intervention are reported from children and adults and include, among others, salt-handling and volume overload, endothelial function, BP dipping patterns and the role of human immunodeficiency virus . To conclude, significant strides have been made in data reporting from SSA on the burden of hypertension in the region as well as biomarker research to improve understanding and identification of areas of intervention. However, gaps remain on linkage between knowledge generation, translation, and implementation research. Coordinated studies addressing both discovery science and public health are crucial to curb hypertension development and improve management in SSA.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140834595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-29DOI: 10.1038/s41371-024-00914-5
Ahmad Neyazi, Abdul Qadim Mohammadi, Mehrab Neyazi, Shashank Timilsina, Bijaya Kumar Padhi, Mark D. Griffiths
In recent decades, hypertension has become the foremost risk factor for disability-adjusted life years (DALYs). The present study investigated the relationship between quality of life, depression, and hypertension among hospitalized patients in Afghanistan. A cross-sectional survey was administered from September 3, 2022, to February 2, 2023, in the Herat and Mazar-e-Sharif provinces of Afghanistan (N = 2059). The prevalence of depression symptoms was 65.8%, and hypertension was 20.9%. Multiple regression analysis indicated that moderate physical functioning, poor role-physical, higher bodily pain, poor general health, poor social functioning, lower role-emotional, and poor mental health significantly predicted depression. Multiple regression analysis indicated that moderate quality of life, poor physical functioning, higher bodily pain, lower energy/fatigue, and depression significantly predicted hypertension. The findings of the present study offer valuable insights for healthcare providers, policymakers, and researchers in developing targeted interventions and policies to enhance the well-being of individuals facing the challenges of depression and hypertension. The prevalence of hypertension and depression was high among patients in the Herat and Mazar-e-Sharif provinces of Afghanistan. Patients with hypertension had poor mental and physical quality of life. Hospitals should therefore implement regular screening for depression and offer psychological counseling for vulnerable patients with hypertension.
{"title":"Hypertension, depression, and health-related quality of life among hospitalized patients in Afghanistan","authors":"Ahmad Neyazi, Abdul Qadim Mohammadi, Mehrab Neyazi, Shashank Timilsina, Bijaya Kumar Padhi, Mark D. Griffiths","doi":"10.1038/s41371-024-00914-5","DOIUrl":"10.1038/s41371-024-00914-5","url":null,"abstract":"In recent decades, hypertension has become the foremost risk factor for disability-adjusted life years (DALYs). The present study investigated the relationship between quality of life, depression, and hypertension among hospitalized patients in Afghanistan. A cross-sectional survey was administered from September 3, 2022, to February 2, 2023, in the Herat and Mazar-e-Sharif provinces of Afghanistan (N = 2059). The prevalence of depression symptoms was 65.8%, and hypertension was 20.9%. Multiple regression analysis indicated that moderate physical functioning, poor role-physical, higher bodily pain, poor general health, poor social functioning, lower role-emotional, and poor mental health significantly predicted depression. Multiple regression analysis indicated that moderate quality of life, poor physical functioning, higher bodily pain, lower energy/fatigue, and depression significantly predicted hypertension. The findings of the present study offer valuable insights for healthcare providers, policymakers, and researchers in developing targeted interventions and policies to enhance the well-being of individuals facing the challenges of depression and hypertension. The prevalence of hypertension and depression was high among patients in the Herat and Mazar-e-Sharif provinces of Afghanistan. Patients with hypertension had poor mental and physical quality of life. Hospitals should therefore implement regular screening for depression and offer psychological counseling for vulnerable patients with hypertension.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140812642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-24DOI: 10.1038/s41371-024-00912-7
Isabella Hunjan, Alice Umulisa, G. Parati, M. Bianchetti, Gregorio P Milani, Bienvenu Muvunyi, Evariste Ntaganda, D. Radovanović, Clara Stroppa, P. Suter, Franco Muggli
{"title":"Blood pressure screening in Mata Sector, a rural area of Rwanda.","authors":"Isabella Hunjan, Alice Umulisa, G. Parati, M. Bianchetti, Gregorio P Milani, Bienvenu Muvunyi, Evariste Ntaganda, D. Radovanović, Clara Stroppa, P. Suter, Franco Muggli","doi":"10.1038/s41371-024-00912-7","DOIUrl":"https://doi.org/10.1038/s41371-024-00912-7","url":null,"abstract":"","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140662105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-16DOI: 10.1038/s41371-024-00911-8
Katerina Massengale, Yanyan Xu, Harold Snieder, Shaoyong Su, Xiaoling Wang
Altered blood pressure (BP) circadian rhythmicity has been increasingly linked with cardiovascular risk. However, little is known about BP circadian rhythm change with age and its possible sociodemographic, anthropometric, and genetic moderators. Twenty-four-hour ambulatory BP was measured up to 16 times over a 23-year period in 339 European Americans (EAs) and 293 African Americans (AAs), with an average age of 15 years at the initial visit. BP circadian rhythms were indexed by amplitude and percent rhythm (a measure of rhythm integrity) and calculated using Fourier analysis. BP amplitude and percent rhythm increased with age and average BP (BP mesor). AAs were more likely to have lower BP amplitude and percent rhythm than their EA counterparts. BP amplitude and percent rhythm also decreased with adiposity (BMI and waist circumference). The summer season was associated with lower BP amplitude in AAs and lower percent rhythm in both AAs and EAs. Sex, height, socioeconomic status, physical activity, and family history of essential hypertension did not have an independent impact on BP amplitude or percent rhythm. The results of the present study suggest that BP circadian rhythm increases with age and BP mesor from childhood to young adulthood, decreases with adiposity, and that AAs are more likely to have lower circadian rhythm than EAs. Furthermore, we demonstrated that the summer season is associated with lower BP rhythmicity.
血压昼夜节律的改变与心血管风险的关系越来越密切。然而，人们对血压昼夜节律随年龄的变化及其可能的社会人口、人体测量和遗传调节因素知之甚少。在 23 年的时间里，对 339 名欧洲裔美国人（EAs）和 293 名非洲裔美国人（AAs）进行了多达 16 次的 24 小时动态血压测量，首次测量时的平均年龄为 15 岁。血压昼夜节律以振幅和节律百分比（节律完整性的衡量标准）为指标，并使用傅立叶分析法进行计算。血压振幅和节律百分比随年龄和平均血压（BP mesor）的增加而增加。与 EA 患者相比，AA 患者的血压振幅和节律百分比更低。血压振幅和节律百分比也随脂肪含量（体重指数和腰围）的增加而降低。在夏季，AA 族人的血压振幅较低，而 AA 族人和 EA 族人的血压节律百分比较低。性别、身高、社会经济地位、体力活动和家族性高血压病史对血压振幅或节律率没有独立影响。本研究的结果表明，血压昼夜节律随年龄和儿童至青年期血压中位数的增加而增加，随脂肪含量的增加而减少，而 AAs 比 EAs 更有可能具有较低的昼夜节律。此外，我们还证明夏季与较低的血压昼夜节律性有关。
{"title":"A longitudinal study of blood pressure circadian rhythm from childhood to early adulthood","authors":"Katerina Massengale, Yanyan Xu, Harold Snieder, Shaoyong Su, Xiaoling Wang","doi":"10.1038/s41371-024-00911-8","DOIUrl":"10.1038/s41371-024-00911-8","url":null,"abstract":"Altered blood pressure (BP) circadian rhythmicity has been increasingly linked with cardiovascular risk. However, little is known about BP circadian rhythm change with age and its possible sociodemographic, anthropometric, and genetic moderators. Twenty-four-hour ambulatory BP was measured up to 16 times over a 23-year period in 339 European Americans (EAs) and 293 African Americans (AAs), with an average age of 15 years at the initial visit. BP circadian rhythms were indexed by amplitude and percent rhythm (a measure of rhythm integrity) and calculated using Fourier analysis. BP amplitude and percent rhythm increased with age and average BP (BP mesor). AAs were more likely to have lower BP amplitude and percent rhythm than their EA counterparts. BP amplitude and percent rhythm also decreased with adiposity (BMI and waist circumference). The summer season was associated with lower BP amplitude in AAs and lower percent rhythm in both AAs and EAs. Sex, height, socioeconomic status, physical activity, and family history of essential hypertension did not have an independent impact on BP amplitude or percent rhythm. The results of the present study suggest that BP circadian rhythm increases with age and BP mesor from childhood to young adulthood, decreases with adiposity, and that AAs are more likely to have lower circadian rhythm than EAs. Furthermore, we demonstrated that the summer season is associated with lower BP rhythmicity.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1038/s41371-024-00910-9
Yang Zhao, Xueru Fu, Yamin Ke, Yuying Wu, Pei Qin, Fulan Hu, Ming Zhang, Dongsheng Hu
Our aim was to examine the independent and joint associations of estimated cardiorespiratory fitness (CRF) and its changes and obesity with risk of hypertension in a rural Chinese population. A prospective cohort including 9848 adults without hypertension at baseline was enrolled. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression models. Restricted cubic splines were used to model the dose–response relationship. During 6 years follow-up, 2,019 individuals developed hypertension. A negative association between estimated CRF and hypertension incidence was observed, with the risk being 0.87 (0.84–0.90) per MET increment. For estimated CRF change, the risks of hypertension were 1.50 (1.27–1.77) and 0.75 (0.59–0.97) for decreasers and increasers, respectively, compared to maintainers. Joint analyses showed individuals in the overweight/obesity-fourth quartile of estimated CRF had a 2.08 times higher risk of hypertension than those in the normal weight-first quartile (Pinteraction < 0.05). Those overweight/obesity-decreasers had the highest risk (OR: 2.19, 95%CI: 1.71–2.81; Pinteraction < 0.05) compared to the normal-maintainers. Similar results for abdominal obesity were also observed. Estimated CRF and its dynamic changes showed a negative association with hypertension incidence in the rural Chinese population.
{"title":"Independent and joint associations of estimated cardiorespiratory fitness and its dynamic changes and obesity with the risk of hypertension: A prospective cohort","authors":"Yang Zhao, Xueru Fu, Yamin Ke, Yuying Wu, Pei Qin, Fulan Hu, Ming Zhang, Dongsheng Hu","doi":"10.1038/s41371-024-00910-9","DOIUrl":"10.1038/s41371-024-00910-9","url":null,"abstract":"Our aim was to examine the independent and joint associations of estimated cardiorespiratory fitness (CRF) and its changes and obesity with risk of hypertension in a rural Chinese population. A prospective cohort including 9848 adults without hypertension at baseline was enrolled. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression models. Restricted cubic splines were used to model the dose–response relationship. During 6 years follow-up, 2,019 individuals developed hypertension. A negative association between estimated CRF and hypertension incidence was observed, with the risk being 0.87 (0.84–0.90) per MET increment. For estimated CRF change, the risks of hypertension were 1.50 (1.27–1.77) and 0.75 (0.59–0.97) for decreasers and increasers, respectively, compared to maintainers. Joint analyses showed individuals in the overweight/obesity-fourth quartile of estimated CRF had a 2.08 times higher risk of hypertension than those in the normal weight-first quartile (Pinteraction < 0.05). Those overweight/obesity-decreasers had the highest risk (OR: 2.19, 95%CI: 1.71–2.81; Pinteraction < 0.05) compared to the normal-maintainers. Similar results for abdominal obesity were also observed. Estimated CRF and its dynamic changes showed a negative association with hypertension incidence in the rural Chinese population.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-03DOI: 10.1038/s41371-024-00909-2
Päivi A. Lempiäinen, Antti Ylitalo, Heikki Huikuri, Y. Antero Kesäniemi, Olavi H. Ukkola
Non-dipping blood pressure (BP) pattern is a predictor for cardiovascular (CV) events and mortality. We evaluated dipping status change and its association with incidence of non-fatal CV events in middle-aged subjects. The OPERA study was carried out during the years 1991–1993, with a follow-up study 21.7 years later. In this study, we included 452 participants with 24-h ambulatory BP measurements (ABPM) available in both surveys. The study population was divided into four groups according to the dipping pattern change: dipping–dipping (n = 152/33.6%), dipping–non-dipping (n = 198/43.8%), non-dipping–dipping (n = 20/4.4%), and non-dipping–non-dipping (n = 82/18.1%). Sixty-five participants experienced a CV event (14.4%) during the 21.7 (SD 0.8) years of follow-up. The incidence of events was highest (28%) in the non-dipping–non-dipping group, and lowest (6.6%) in the dipping–dipping group (p < 0.001). In Cox regression analyses the covariates were age, sex, total cholesterol, hypertension and use of antihypertensive medication, systolic office BP and ambulatory mean or nighttime systolic BP, as well as the change in the variables during the follow-up period. After adjustments, the association of the non-dipping–non-dipping pattern with CV events compared with the dipping–dipping pattern remained significant (HR 4.01; 95% CI 1.89–8.67, p < 0.001). In summary, non-dipping–non-dipping pattern was associated with non-fatal CV events in the long term, and the effect was independent of the conventional risk factors including office and ambulatory BP levels.
{"title":"Non-dipping blood pressure pattern is associated with cardiovascular events in a 21-year follow-up study","authors":"Päivi A. Lempiäinen, Antti Ylitalo, Heikki Huikuri, Y. Antero Kesäniemi, Olavi H. Ukkola","doi":"10.1038/s41371-024-00909-2","DOIUrl":"10.1038/s41371-024-00909-2","url":null,"abstract":"Non-dipping blood pressure (BP) pattern is a predictor for cardiovascular (CV) events and mortality. We evaluated dipping status change and its association with incidence of non-fatal CV events in middle-aged subjects. The OPERA study was carried out during the years 1991–1993, with a follow-up study 21.7 years later. In this study, we included 452 participants with 24-h ambulatory BP measurements (ABPM) available in both surveys. The study population was divided into four groups according to the dipping pattern change: dipping–dipping (n = 152/33.6%), dipping–non-dipping (n = 198/43.8%), non-dipping–dipping (n = 20/4.4%), and non-dipping–non-dipping (n = 82/18.1%). Sixty-five participants experienced a CV event (14.4%) during the 21.7 (SD 0.8) years of follow-up. The incidence of events was highest (28%) in the non-dipping–non-dipping group, and lowest (6.6%) in the dipping–dipping group (p < 0.001). In Cox regression analyses the covariates were age, sex, total cholesterol, hypertension and use of antihypertensive medication, systolic office BP and ambulatory mean or nighttime systolic BP, as well as the change in the variables during the follow-up period. After adjustments, the association of the non-dipping–non-dipping pattern with CV events compared with the dipping–dipping pattern remained significant (HR 4.01; 95% CI 1.89–8.67, p < 0.001). In summary, non-dipping–non-dipping pattern was associated with non-fatal CV events in the long term, and the effect was independent of the conventional risk factors including office and ambulatory BP levels.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00909-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140572192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-21DOI: 10.1038/s41371-024-00907-4
Nicolás Roberto Robles, Francesco Fici, Guido Grassi
New European Hypertension Society Guidelines for the Management of Hypertension recommend unattended blood pressure measurement use for hypertensive urgencies in the Emergency Wards. Available evidence shows that, in the specific situation of hypertensive urgencies, BP is reduced to less than 160/100 mmHg or even lower values in 30 min in 30% of the patients when unattended BP measurement is used. The implementation of unattended blood pressure measurement could avoid a significant number of antihypertensive treatments.
{"title":"Management of hypertensive urgencies: a new opportunity for unattended blood pressure measurement","authors":"Nicolás Roberto Robles, Francesco Fici, Guido Grassi","doi":"10.1038/s41371-024-00907-4","DOIUrl":"10.1038/s41371-024-00907-4","url":null,"abstract":"New European Hypertension Society Guidelines for the Management of Hypertension recommend unattended blood pressure measurement use for hypertensive urgencies in the Emergency Wards. Available evidence shows that, in the specific situation of hypertensive urgencies, BP is reduced to less than 160/100 mmHg or even lower values in 30 min in 30% of the patients when unattended BP measurement is used. The implementation of unattended blood pressure measurement could avoid a significant number of antihypertensive treatments.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140184624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-06DOI: 10.1038/s41371-024-00904-7
Stephen D. Persell, Lauren Anthony, Yaw A. Peprah, Ji Young Lee, Jim Li, Hironori Sato, Lucia C. Petito
This pragmatic matched cohort study using EHR data extended the follow up to 18 months for BP outcomes comparing individuals prescribed remote patient monitoring (n = 288) and temporally-matched controls (n = 1152) from six primary care practices. After 18 months, the RPM-prescribed cohort had greater BP control < 140/90 mm Hg (RPM cohort: 71.5%, control cohort: 51.9%, p < 0.001) and lower systolic BP (131.6 versus 136.0 mm Hg, p = 0.004) using office and home measurements. BP control at 18 months assessed by office measurements only was also higher in the RPM group (62.2% versus 51.9%, p = 0.004).
{"title":"Blood pressure outcomes at 18 months in primary care patients prescribed remote physiological monitoring for hypertension: a prospective cohort study","authors":"Stephen D. Persell, Lauren Anthony, Yaw A. Peprah, Ji Young Lee, Jim Li, Hironori Sato, Lucia C. Petito","doi":"10.1038/s41371-024-00904-7","DOIUrl":"10.1038/s41371-024-00904-7","url":null,"abstract":"This pragmatic matched cohort study using EHR data extended the follow up to 18 months for BP outcomes comparing individuals prescribed remote patient monitoring (n = 288) and temporally-matched controls (n = 1152) from six primary care practices. After 18 months, the RPM-prescribed cohort had greater BP control < 140/90 mm Hg (RPM cohort: 71.5%, control cohort: 51.9%, p < 0.001) and lower systolic BP (131.6 versus 136.0 mm Hg, p = 0.004) using office and home measurements. BP control at 18 months assessed by office measurements only was also higher in the RPM group (62.2% versus 51.9%, p = 0.004).","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00904-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-04DOI: 10.1038/s41371-024-00906-5
Alexander S. MACDONALD, Alex MCCONNACHIE, David Alexander DICKIE, Philip M. BATH, Kirsten FORBES, Terence QUINN, Niall M. BROOMFIELD, Krishna DANI, Alex DONEY, Keith W. MUIR, Allan STRUTHERS, Matthew WALTERS, Mark BARBER, Ajay BHALLA, Alan CAMERON, Paul GUYLER, Ahamad HASSAN, Mark KEARNEY, Breffni KEEGAN, Sekaran LAKSHMANAN, Mary Joan MACLEOD, Marc RANDALL, Louise SHAW, Ganesh SUBRAMANIAN, David WERRING, Jesse DAWSON
Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it was related to neuroimaging markers of cerebral small vessel disease (CSVD) and cognition. We used data from a randomised, double-blind, placebo-controlled trial of two years allopurinol treatment after recent ischemic stroke or transient ischemic attack. Visit-to-visit BPV was assessed using brachial blood pressure (BP) recordings. Short-term BPV was assessed using ambulatory BP monitoring (ABPM) performed at 4 weeks and 2 years. Brain MRI was performed at baseline and 2 years. BPV measures were compared between the allopurinol and placebo groups, and with CSVD and cognition. 409 participants (205 allopurinol; 204 placebo) were included in the visit-to-visit BPV analyses. There were no significant differences found between placebo and allopurinol groups for any measure of visit-to-visit BPV. 196 participants were included in analyses of short-term BPV at week 4. Two measures were reduced by allopurinol: the standard deviation (SD) of systolic BP (by 1.30 mmHg (95% confidence interval (CI) 0.18–2.42, p = 0.023)); and the average real variability (ARV) of systolic BP (by 1.31 mmHg (95% CI 0.31–2.32, p = 0.011)). There were no differences in other measures at week 4 or in any measure at 2 years, and BPV was not associated with CSVD or cognition. Allopurinol treatment did not affect visit-to-visit BPV in people with recent ischemic stroke or TIA. Two BPV measures were reduced at week 4 by allopurinol but not at 2 years.
{"title":"Allopurinol and blood pressure variability following ischemic stroke and transient ischemic attack: a secondary analysis of XILO-FIST","authors":"Alexander S. MACDONALD, Alex MCCONNACHIE, David Alexander DICKIE, Philip M. BATH, Kirsten FORBES, Terence QUINN, Niall M. BROOMFIELD, Krishna DANI, Alex DONEY, Keith W. MUIR, Allan STRUTHERS, Matthew WALTERS, Mark BARBER, Ajay BHALLA, Alan CAMERON, Paul GUYLER, Ahamad HASSAN, Mark KEARNEY, Breffni KEEGAN, Sekaran LAKSHMANAN, Mary Joan MACLEOD, Marc RANDALL, Louise SHAW, Ganesh SUBRAMANIAN, David WERRING, Jesse DAWSON","doi":"10.1038/s41371-024-00906-5","DOIUrl":"10.1038/s41371-024-00906-5","url":null,"abstract":"Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it was related to neuroimaging markers of cerebral small vessel disease (CSVD) and cognition. We used data from a randomised, double-blind, placebo-controlled trial of two years allopurinol treatment after recent ischemic stroke or transient ischemic attack. Visit-to-visit BPV was assessed using brachial blood pressure (BP) recordings. Short-term BPV was assessed using ambulatory BP monitoring (ABPM) performed at 4 weeks and 2 years. Brain MRI was performed at baseline and 2 years. BPV measures were compared between the allopurinol and placebo groups, and with CSVD and cognition. 409 participants (205 allopurinol; 204 placebo) were included in the visit-to-visit BPV analyses. There were no significant differences found between placebo and allopurinol groups for any measure of visit-to-visit BPV. 196 participants were included in analyses of short-term BPV at week 4. Two measures were reduced by allopurinol: the standard deviation (SD) of systolic BP (by 1.30 mmHg (95% confidence interval (CI) 0.18–2.42, p = 0.023)); and the average real variability (ARV) of systolic BP (by 1.31 mmHg (95% CI 0.31–2.32, p = 0.011)). There were no differences in other measures at week 4 or in any measure at 2 years, and BPV was not associated with CSVD or cognition. Allopurinol treatment did not affect visit-to-visit BPV in people with recent ischemic stroke or TIA. Two BPV measures were reduced at week 4 by allopurinol but not at 2 years.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00906-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140028222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-29DOI: 10.1038/s41371-024-00903-8
Paul Olowoyo, Anastase Dzudie, Akinkunmi Paul Okekunle, Reginald Obiako, Ana Mocumbi, Hind Beheiry, Gianfranco Parati, Daniel T. Lackland, Fred S. Sarfo, Augustine Odili, Abiodun M. Adeoye, Kolawole Wahab, Charles Agyemang, Norman Campbell, Andre Pascal Kengne, Paul K. Whelton, Pierpaolo Pellicori, Ad Adams Ebenezer, Oladimeji Adebayo, Oladotun Olalusi, Ayodele Jegede, Ezinne Uvere, Olayinka Adebajo, Baffour Awuah, Andrew Moran, Bryan Williams, Tomasz J. Guzik, Collins Kokuro, Fred Bukachi, Okechukwu S. Ogah, Christian Delles, Pasquale Maffia, Rufus Akinyemi, Prebo Barango, Dike Ojji, Mayowa Owolabi
The prevalence of hypertension, the commonest risk factor for preventable disability and premature deaths, is rapidly increasing in Africa. The African Control of Hypertension through Innovative Epidemiology, and a Vibrant Ecosystem [ACHIEVE] conference was convened to discuss and initiate the co-implementation of the strategic solutions to tame this burden toward achieving a target of 80% for awareness, treatment, and control by the year 2030. Experts, including the academia, policymakers, patients, the WHO, and representatives of various hypertension and cardiology societies generated a 12-item communique for implementation by the stakeholders of the ACHIEVE ecosystem at the continental, national, sub-national, and local (primary) healthcare levels.
{"title":"ACHIEVE conference proceedings: implementing action plans to reduce and control hypertension burden in Africa","authors":"Paul Olowoyo, Anastase Dzudie, Akinkunmi Paul Okekunle, Reginald Obiako, Ana Mocumbi, Hind Beheiry, Gianfranco Parati, Daniel T. Lackland, Fred S. Sarfo, Augustine Odili, Abiodun M. Adeoye, Kolawole Wahab, Charles Agyemang, Norman Campbell, Andre Pascal Kengne, Paul K. Whelton, Pierpaolo Pellicori, Ad Adams Ebenezer, Oladimeji Adebayo, Oladotun Olalusi, Ayodele Jegede, Ezinne Uvere, Olayinka Adebajo, Baffour Awuah, Andrew Moran, Bryan Williams, Tomasz J. Guzik, Collins Kokuro, Fred Bukachi, Okechukwu S. Ogah, Christian Delles, Pasquale Maffia, Rufus Akinyemi, Prebo Barango, Dike Ojji, Mayowa Owolabi","doi":"10.1038/s41371-024-00903-8","DOIUrl":"10.1038/s41371-024-00903-8","url":null,"abstract":"The prevalence of hypertension, the commonest risk factor for preventable disability and premature deaths, is rapidly increasing in Africa. The African Control of Hypertension through Innovative Epidemiology, and a Vibrant Ecosystem [ACHIEVE] conference was convened to discuss and initiate the co-implementation of the strategic solutions to tame this burden toward achieving a target of 80% for awareness, treatment, and control by the year 2030. Experts, including the academia, policymakers, patients, the WHO, and representatives of various hypertension and cardiology societies generated a 12-item communique for implementation by the stakeholders of the ACHIEVE ecosystem at the continental, national, sub-national, and local (primary) healthcare levels.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00903-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139996509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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