Pub Date : 2024-06-28DOI: 10.1038/s41371-024-00922-5
Spoorthy Kulkarni, Luca Faconti, Sarah Partridge, Christian Delles, Mark Glover, Philip Lewis, Asha Gray, Emma Hodson, Iain Macintyre, Carmen Maniero, Carmel M. McEniery, Manish D. Sinha, Stephen B. Walsh, Ian B. Wilkinson
National and international hypertension guidelines recommend that adults with young-onset hypertension (aged <40 years at diagnosis) are reviewed by a hypertension specialist to exclude secondary causes of hypertension and optimise therapeutic regimens. A recent survey among UK secondary care hypertension specialist physicians highlighted variations in the investigation of such patients. In this position statement, the British and Irish Hypertension Society seek to provide clinicians with a practical approach to the investigation and management of adults with young-onset hypertension. We aim to ensure that individuals receive consistent and high-quality care across the UK and Ireland, to highlight gaps in the current evidence, and to identify important future research questions.
国家和国际高血压指南建议，患有年轻高血压的成年人（年龄为
{"title":"Investigation and management of young-onset hypertension: British and Irish hypertension society position statement","authors":"Spoorthy Kulkarni, Luca Faconti, Sarah Partridge, Christian Delles, Mark Glover, Philip Lewis, Asha Gray, Emma Hodson, Iain Macintyre, Carmen Maniero, Carmel M. McEniery, Manish D. Sinha, Stephen B. Walsh, Ian B. Wilkinson","doi":"10.1038/s41371-024-00922-5","DOIUrl":"10.1038/s41371-024-00922-5","url":null,"abstract":"National and international hypertension guidelines recommend that adults with young-onset hypertension (aged <40 years at diagnosis) are reviewed by a hypertension specialist to exclude secondary causes of hypertension and optimise therapeutic regimens. A recent survey among UK secondary care hypertension specialist physicians highlighted variations in the investigation of such patients. In this position statement, the British and Irish Hypertension Society seek to provide clinicians with a practical approach to the investigation and management of adults with young-onset hypertension. We aim to ensure that individuals receive consistent and high-quality care across the UK and Ireland, to highlight gaps in the current evidence, and to identify important future research questions.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"38 7","pages":"544-554"},"PeriodicalIF":2.7,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468614","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 : 2024-06-27DOI: 10.1038/s41371-024-00929-y
Steven K. Malin
{"title":"Exercise time of day and blood pressure: Considering chronotype for precision health","authors":"Steven K. Malin","doi":"10.1038/s41371-024-00929-y","DOIUrl":"10.1038/s41371-024-00929-y","url":null,"abstract":"","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"38 7","pages":"580-581"},"PeriodicalIF":2.7,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468613","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 : 2024-06-26DOI: 10.1038/s41371-024-00919-0
Avrum Gillespie, Rui Song, John P. Barile, Lorie Okada, Shari Brown, Kerry Traub, Julia Trout, Gina M. Simoncini, Casey D. Xavier Hall, Yin Tan, Crystal A. Gadegbeku, Grace X. Ma, Frank Y. Wong
Racial and sexual orientation discrimination may exacerbate the double epidemic of hypertension (HTN) and HIV that affects men of color who have sex with men (MSM). This was a cross-sectional analysis of African American, Asian American, Native Hawaiian, or Pacific Islander (NHPI) MSM living with HIV (PLWH) cohort in Honolulu and Philadelphia. Racial and sexual orientation discrimination, stress, anxiety, and depression were measured with computer-assisted self-interview questionnaires (CASI). We examined the associations between racial and sexual orientation discrimination with hypertension measured both in the office and by 24-h ambulatory blood pressure monitoring (ABPM) using multivariable logistic regression. Sixty participants (60% African American, 18% Asian, and 22% NHPI) completed CASIs and 24-h ABPM. African American participants (80%) reported a higher rate of daily racial discrimination than Asian American (36%) and NHPI participants (17%, p < 0.001). Many participants (51%) reported daily sexual orientation discrimination. Sixty-six percent of participants had HTN by office measurement and 59% had HTN by 24-h ABPM measurement. Participants who experienced racial discrimination had greater odds of having office-measured HTN than those who did not, even after adjustment (Odds Ratio 5.0 (95% Confidence Interval [1.2–20.8], p = 0.03)). This association was not seen with 24-h ABPM. Hypertension was not associated with sexual orientation discrimination. In this cohort, MSM of color PLWH experience significant amounts of discrimination and HTN. Those who experienced racial discrimination had higher in-office blood pressure. This difference was not observed in 24-h APBM and future research is necessary to examine the long-term cardiovascular effects.
{"title":"Discrimination and hypertension among a diverse sample of racial and sexual minority men living with HIV: baseline findings of a longitudinal cohort study","authors":"Avrum Gillespie, Rui Song, John P. Barile, Lorie Okada, Shari Brown, Kerry Traub, Julia Trout, Gina M. Simoncini, Casey D. Xavier Hall, Yin Tan, Crystal A. Gadegbeku, Grace X. Ma, Frank Y. Wong","doi":"10.1038/s41371-024-00919-0","DOIUrl":"10.1038/s41371-024-00919-0","url":null,"abstract":"Racial and sexual orientation discrimination may exacerbate the double epidemic of hypertension (HTN) and HIV that affects men of color who have sex with men (MSM). This was a cross-sectional analysis of African American, Asian American, Native Hawaiian, or Pacific Islander (NHPI) MSM living with HIV (PLWH) cohort in Honolulu and Philadelphia. Racial and sexual orientation discrimination, stress, anxiety, and depression were measured with computer-assisted self-interview questionnaires (CASI). We examined the associations between racial and sexual orientation discrimination with hypertension measured both in the office and by 24-h ambulatory blood pressure monitoring (ABPM) using multivariable logistic regression. Sixty participants (60% African American, 18% Asian, and 22% NHPI) completed CASIs and 24-h ABPM. African American participants (80%) reported a higher rate of daily racial discrimination than Asian American (36%) and NHPI participants (17%, p < 0.001). Many participants (51%) reported daily sexual orientation discrimination. Sixty-six percent of participants had HTN by office measurement and 59% had HTN by 24-h ABPM measurement. Participants who experienced racial discrimination had greater odds of having office-measured HTN than those who did not, even after adjustment (Odds Ratio 5.0 (95% Confidence Interval [1.2–20.8], p = 0.03)). This association was not seen with 24-h ABPM. Hypertension was not associated with sexual orientation discrimination. In this cohort, MSM of color PLWH experience significant amounts of discrimination and HTN. Those who experienced racial discrimination had higher in-office blood pressure. This difference was not observed in 24-h APBM and future research is necessary to examine the long-term cardiovascular effects.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"38 8","pages":"603-610"},"PeriodicalIF":2.7,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00919-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457338","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 : 2024-06-20DOI: 10.1038/s41371-024-00924-3
Ama Pokuaa Fenny, Evans Otieku, Samuel Owusu Achiaw, Bernard Okoe Boye, Francis Asenso-Boadi, Vivian Addo-Cobbiah, Mariam Musah
Hypertension is a leading cause of morbidity in Ghana and other sub-Saharan African countries, but management has historically suffered from the fragility of health systems in these countries. This has been exacerbated by the COVID-19 pandemic and its associated measures. Our study examines and quantifies the effect of the pandemic on the management of hypertension in Ghana by determining changes in disease severity and presentation, as well as changes in health service use patterns and expenditures. We used cross-sectional data to perform an impact evaluation of COVID-19 on hypertension management before and during the pandemic. We employed statistical tests including t-tests, z-tests, and exact Poisson tests to estimate and compare hypertension episode intensity and related claim expenditures before and during the pandemic using medical claims data from Ghana's National Health Insurance Authority database. The study duration includes a 12-month reference/pre-pandemic period (March 2019-February 2020) relative to the target/pandemic period (March 2020-February 2021). We observed that although there was a 20% reduction in the number of hypertension claimants in the pandemic year, there was an increase in hypertension severity as measured by the number of hypertension episodes per claimant. There was also an 18.64% or $22.88 (95% CI: $21-$25, p = 0.01042) increase in the average cost per hypertension claimant in the pandemic year. The increase in episodes per claimant had the largest financial impact on the average cost per claimant. The findings from our studies are relevant for future policymaking and strategy implementation for hypertension control in Ghana.
{"title":"Impact of COVID-19 on the management of hypertension: a perspective on disease severity, service use patterns and expenditures from Ghana's health insurance claims data.","authors":"Ama Pokuaa Fenny, Evans Otieku, Samuel Owusu Achiaw, Bernard Okoe Boye, Francis Asenso-Boadi, Vivian Addo-Cobbiah, Mariam Musah","doi":"10.1038/s41371-024-00924-3","DOIUrl":"https://doi.org/10.1038/s41371-024-00924-3","url":null,"abstract":"<p><p>Hypertension is a leading cause of morbidity in Ghana and other sub-Saharan African countries, but management has historically suffered from the fragility of health systems in these countries. This has been exacerbated by the COVID-19 pandemic and its associated measures. Our study examines and quantifies the effect of the pandemic on the management of hypertension in Ghana by determining changes in disease severity and presentation, as well as changes in health service use patterns and expenditures. We used cross-sectional data to perform an impact evaluation of COVID-19 on hypertension management before and during the pandemic. We employed statistical tests including t-tests, z-tests, and exact Poisson tests to estimate and compare hypertension episode intensity and related claim expenditures before and during the pandemic using medical claims data from Ghana's National Health Insurance Authority database. The study duration includes a 12-month reference/pre-pandemic period (March 2019-February 2020) relative to the target/pandemic period (March 2020-February 2021). We observed that although there was a 20% reduction in the number of hypertension claimants in the pandemic year, there was an increase in hypertension severity as measured by the number of hypertension episodes per claimant. There was also an 18.64% or $22.88 (95% CI: $21-$25, p = 0.01042) increase in the average cost per hypertension claimant in the pandemic year. The increase in episodes per claimant had the largest financial impact on the average cost per claimant. The findings from our studies are relevant for future policymaking and strategy implementation for hypertension control in Ghana.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432133","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 : 2024-06-19DOI: 10.1038/s41371-024-00926-1
Gregory P. Veldhuizen, Rawan M. Alnazer, Abraham A. Kroon, Marc E. A. Spaanderman, Peter W. de Leeuw
The purpose of the present study is to identify the impact of the postpartum menstrual cycle on aldosterone, renin, and their ratio of women with and without a preeclamptic pregnancy in the past. To this end, we analysed the data from 59 women with a history of preeclampsia and 39 healthy parous controls. Five to seven months post-partum, we measured aldosterone, renin, and the aldosterone-to-renin ratio during both the follicular and the luteal phase of the menstrual cycle. All measurements were taken in the supine position in the morning. Patients had maintained a standardized sodium diet in the week prior to the measurements. Our results show that in both post-partum women with recent preeclampsia and controls, average levels of renin and aldosterone are significantly elevated in the luteal phase as compared to the follicular phase. The aldosterone-to-renin ratio does not differ between the two phases in either group. Compared to controls, women with recent preeclampsia have significantly lower levels of renin, aldosterone, and aldosterone-to-renin ratio in the follicular phase. This remained consistent in the luteal phase, except for renin. A close correlation existed between the luteal and follicular aldosterone-to-renin ratio in the control group but not in the preeclampsia group. We conclude that both renin and aldosterone are significantly affected by the menstrual cycle whereas the resulting aldosterone-to-renin ratio is not. Post-partum women with recent preeclampsia tend to have lower values for aldosterone and the aldosterone-to-renin ratio than controls.
{"title":"Variable effect of the post-partum menstrual cycle on aldosterone and renin in women with recent preeclampsia","authors":"Gregory P. Veldhuizen, Rawan M. Alnazer, Abraham A. Kroon, Marc E. A. Spaanderman, Peter W. de Leeuw","doi":"10.1038/s41371-024-00926-1","DOIUrl":"10.1038/s41371-024-00926-1","url":null,"abstract":"The purpose of the present study is to identify the impact of the postpartum menstrual cycle on aldosterone, renin, and their ratio of women with and without a preeclamptic pregnancy in the past. To this end, we analysed the data from 59 women with a history of preeclampsia and 39 healthy parous controls. Five to seven months post-partum, we measured aldosterone, renin, and the aldosterone-to-renin ratio during both the follicular and the luteal phase of the menstrual cycle. All measurements were taken in the supine position in the morning. Patients had maintained a standardized sodium diet in the week prior to the measurements. Our results show that in both post-partum women with recent preeclampsia and controls, average levels of renin and aldosterone are significantly elevated in the luteal phase as compared to the follicular phase. The aldosterone-to-renin ratio does not differ between the two phases in either group. Compared to controls, women with recent preeclampsia have significantly lower levels of renin, aldosterone, and aldosterone-to-renin ratio in the follicular phase. This remained consistent in the luteal phase, except for renin. A close correlation existed between the luteal and follicular aldosterone-to-renin ratio in the control group but not in the preeclampsia group. We conclude that both renin and aldosterone are significantly affected by the menstrual cycle whereas the resulting aldosterone-to-renin ratio is not. Post-partum women with recent preeclampsia tend to have lower values for aldosterone and the aldosterone-to-renin ratio than controls.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"38 9","pages":"649-654"},"PeriodicalIF":2.7,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00926-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427033","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 : 2024-06-18DOI: 10.1038/s41371-024-00925-2
Antonio H. Germano-Soares, Breno Q. Farah, José F. Da Silva, Mauro V. G. Barros, Rafael M. Tassitano
Physical activity (PA), sedentary behavior (SB), and sleep duration are known to have an individual effect on clinic blood pressure (BP) of older adults. However, whether different patterns of these so-called movement behaviors over the 24h-cycle on BP remains poorly investigated. The study aimed to identify movement behavior patterns associated with clinic BP among older adults with chronic diseases. Cross-sectional study with 238 older adults (80.3% female; mean age 68.8 ± 6.6) with at least one chronic disease. PA, SB, and sleep duration were measured by a triaxial accelerometer. Clinic systolic BP (SBP) and diastolic BP (DBP) were obtained through an automated method following standard procedures. Non-hierarchical K-means cluster and linear regression modeling were employed to identify the clusters of movement behaviors and to examine the associations. Two clusters were identified [active and non-sedentary, n = 103 (i.e., sufficient sleep duration, higher LPA and MVPA, and lower SB) and sedentary and inactive, n = 135 (i.e., sufficient sleep duration, lower LPA and MVPA, and higher SB). Active and non-sedentary older adults presented lower systolic BP compared to sedentary and inactive ones, even after adjustments for sociodemographic and clinical characteristics (β = 6.356; CI 95% from 0.932 to 11.779; P = 0.022). No associations were found for diastolic BP. In conclusion, higher PA and lower SB were associated with lower systolic BP in older adults with chronic diseases. However, sleep duration did not modify this association. Therefore, interventions focusing on concomitantly increasing PA levels and reducing SB should be the priority for controlling blood pressure.
{"title":"Clustering of 24H movement behaviors associated with clinic blood pressure in older adults: a cross-sectional study","authors":"Antonio H. Germano-Soares, Breno Q. Farah, José F. Da Silva, Mauro V. G. Barros, Rafael M. Tassitano","doi":"10.1038/s41371-024-00925-2","DOIUrl":"10.1038/s41371-024-00925-2","url":null,"abstract":"Physical activity (PA), sedentary behavior (SB), and sleep duration are known to have an individual effect on clinic blood pressure (BP) of older adults. However, whether different patterns of these so-called movement behaviors over the 24h-cycle on BP remains poorly investigated. The study aimed to identify movement behavior patterns associated with clinic BP among older adults with chronic diseases. Cross-sectional study with 238 older adults (80.3% female; mean age 68.8 ± 6.6) with at least one chronic disease. PA, SB, and sleep duration were measured by a triaxial accelerometer. Clinic systolic BP (SBP) and diastolic BP (DBP) were obtained through an automated method following standard procedures. Non-hierarchical K-means cluster and linear regression modeling were employed to identify the clusters of movement behaviors and to examine the associations. Two clusters were identified [active and non-sedentary, n = 103 (i.e., sufficient sleep duration, higher LPA and MVPA, and lower SB) and sedentary and inactive, n = 135 (i.e., sufficient sleep duration, lower LPA and MVPA, and higher SB). Active and non-sedentary older adults presented lower systolic BP compared to sedentary and inactive ones, even after adjustments for sociodemographic and clinical characteristics (β = 6.356; CI 95% from 0.932 to 11.779; P = 0.022). No associations were found for diastolic BP. In conclusion, higher PA and lower SB were associated with lower systolic BP in older adults with chronic diseases. However, sleep duration did not modify this association. Therefore, interventions focusing on concomitantly increasing PA levels and reducing SB should be the priority for controlling blood pressure.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"38 7","pages":"575-579"},"PeriodicalIF":2.7,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419491","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 : 2024-06-12DOI: 10.1038/s41371-024-00923-4
Mohammad R. Baneshi, Annette Dobson, Gita D. Mishra
Previous studies investigated the association of body weight and hypertension with risk of incident cardiometabolic multimorbidity. Our aim was to estimate the risk of diabetes and cardiovascular disease later in life for subjects with different progression patterns of overweight, obesity, and hypertension in mid-life. This was a prospective cohort study in which data from 12,784 participants in the Australian Longitudinal Study on Women’s Health were used. Multistate model was used to study the progression pattern of overweight, obesity, hypertension, diabetes, and cardiovascular disease over the life course. The cumulative incidence of diabetes and cardiovascular disease up to the age of 73 was estimated for women with different patterns of other conditions. The six most common paths and corresponding cumulative incidences for diabetes were overweight 5.1%, obesity 11.5%, hypertension 6.9%, progression from overweight to obesity 8.2%, overweight and hypertension 12.1%, and obesity and hypertension 36.8%. For women with diabetes and other conditions, the cumulative incidence of cardiovascular disease (heart disease or stroke) as the next immediate condition was 22.4%. The corresponding figure for women who only had a report of diabetes but did not have high body weight or hypertension was 8.3%. The higher risk of transition from healthy state to a cardiometabolic condition was associated with low education, income stress, smoking, not drinking alcohol (compared to low drinkers), physical inactivity, and high perceived stress. Women with obesity and hypertension in middle-age had a substantially higher risk of developing diabetes and cardiovascular disease than women without these potentially preventable conditions.
以往的研究调查了体重和高血压与心血管代谢多病发病风险的关系。我们的目的是估算中年时期超重、肥胖和高血压不同发展模式的受试者日后罹患糖尿病和心血管疾病的风险。这是一项前瞻性队列研究，使用了澳大利亚妇女健康纵向研究（Australian Longitudinal Study on Women's Health）中 12784 名参与者的数据。研究采用了多州模型来研究超重、肥胖、高血压、糖尿病和心血管疾病在生命过程中的发展模式。对患有其他疾病的不同模式的妇女在 73 岁之前的糖尿病和心血管疾病累积发病率进行了估算。六种最常见的糖尿病发病途径和相应的累积发病率分别是：超重 5.1%、肥胖 11.5%、高血压 6.9%、从超重发展到肥胖 8.2%、超重和高血压 12.1%、肥胖和高血压 36.8%。对于患有糖尿病和其他疾病的妇女来说，心血管疾病（心脏病或中风）的累积发病率为 22.4%。仅报告有糖尿病但没有高体重或高血压的妇女的相应数字为 8.3%。从健康状态转变为心脏代谢疾病的风险较高与教育程度低、收入压力大、吸烟、不饮酒（与低度饮酒者相比）、缺乏运动和感知压力大有关。中年肥胖和高血压妇女患糖尿病和心血管疾病的风险大大高于没有这些潜在可预防疾病的妇女。
{"title":"Transition between cardiometabolic conditions and body weight among women: which paths increase the risk of diabetes and cardiovascular diseases?","authors":"Mohammad R. Baneshi, Annette Dobson, Gita D. Mishra","doi":"10.1038/s41371-024-00923-4","DOIUrl":"10.1038/s41371-024-00923-4","url":null,"abstract":"Previous studies investigated the association of body weight and hypertension with risk of incident cardiometabolic multimorbidity. Our aim was to estimate the risk of diabetes and cardiovascular disease later in life for subjects with different progression patterns of overweight, obesity, and hypertension in mid-life. This was a prospective cohort study in which data from 12,784 participants in the Australian Longitudinal Study on Women’s Health were used. Multistate model was used to study the progression pattern of overweight, obesity, hypertension, diabetes, and cardiovascular disease over the life course. The cumulative incidence of diabetes and cardiovascular disease up to the age of 73 was estimated for women with different patterns of other conditions. The six most common paths and corresponding cumulative incidences for diabetes were overweight 5.1%, obesity 11.5%, hypertension 6.9%, progression from overweight to obesity 8.2%, overweight and hypertension 12.1%, and obesity and hypertension 36.8%. For women with diabetes and other conditions, the cumulative incidence of cardiovascular disease (heart disease or stroke) as the next immediate condition was 22.4%. The corresponding figure for women who only had a report of diabetes but did not have high body weight or hypertension was 8.3%. The higher risk of transition from healthy state to a cardiometabolic condition was associated with low education, income stress, smoking, not drinking alcohol (compared to low drinkers), physical inactivity, and high perceived stress. Women with obesity and hypertension in middle-age had a substantially higher risk of developing diabetes and cardiovascular disease than women without these potentially preventable conditions.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"38 8","pages":"611-619"},"PeriodicalIF":2.7,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00923-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310865","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 : 2024-06-11DOI: 10.1038/s41371-024-00918-1
Matthew K. Armstrong
{"title":"JHH Young Investigator Award 2022: interview with the winner Matthew K. Armstrong","authors":"Matthew K. Armstrong","doi":"10.1038/s41371-024-00918-1","DOIUrl":"10.1038/s41371-024-00918-1","url":null,"abstract":"","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"38 7","pages":"543-543"},"PeriodicalIF":2.7,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00918-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306135","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 : 2024-06-10DOI: 10.1038/s41371-024-00921-6
Amy E. Boettcher, Hannah E. Penfold, Katharine D. Currie
Blood pressure (BP) assessment during exercise testing has the capacity to identify exaggerated exercise BP (EEBP). BP has a circadian rhythm; therefore, exercise BPs may change throughout the day complicating EEBP identification. The purpose of this study was to determine the effect of time of day on exercise BP in healthy young adults. Thirty-one participants [48% female; 23(4) years] completed a modified Bruce treadmill protocol in the morning (M), afternoon (A), and evening (E). Submaximal (stage 4) and peak (highest value) systolic BP (SBP) were determined and ΔSBP was calculated (peak SBP-pre-exercise SBP). Repeated-measures tests were used to compare SBP data. EEBP was defined as a submaximal SBP ≥ 170 mmHg. Chronotype was assessed using the Morning-Eveningness Questionnaire (MEQ) and Pearson correlations were used to determine the relationship between MEQ score and ΔSBP during all tests. Significance was set at P < 0.05. Submaximal SBP (M:159(25); A:156(16); E:162(24) mmHg; P = 0.295), peak SBP (M:177(32); A:184(25); E:185(26) mmHg; P = 0.087) and ΔSBP (M:62(29); A:67(23); 65(20) mmHg; P = 0.546) were similar across time points. Eight participants had an EEBP on at least two tests. MEQ scores were correlated with ΔSBP during the A test (r = 0.357, P = 0.049) and E test (r = 0.363, P = 0.045). In conclusion, time of day had no effect on SBP responses to exercise, but our correlational analysis suggests changes in SBP may differ between chronotypes depending on the time of day of exercise. Given the clinical value of EEBP, it is notable that 26% of our healthy young sample had EEBP.
{"title":"Exercise systolic blood pressures are unaffected by time of day in healthy young adults","authors":"Amy E. Boettcher, Hannah E. Penfold, Katharine D. Currie","doi":"10.1038/s41371-024-00921-6","DOIUrl":"10.1038/s41371-024-00921-6","url":null,"abstract":"Blood pressure (BP) assessment during exercise testing has the capacity to identify exaggerated exercise BP (EEBP). BP has a circadian rhythm; therefore, exercise BPs may change throughout the day complicating EEBP identification. The purpose of this study was to determine the effect of time of day on exercise BP in healthy young adults. Thirty-one participants [48% female; 23(4) years] completed a modified Bruce treadmill protocol in the morning (M), afternoon (A), and evening (E). Submaximal (stage 4) and peak (highest value) systolic BP (SBP) were determined and ΔSBP was calculated (peak SBP-pre-exercise SBP). Repeated-measures tests were used to compare SBP data. EEBP was defined as a submaximal SBP ≥ 170 mmHg. Chronotype was assessed using the Morning-Eveningness Questionnaire (MEQ) and Pearson correlations were used to determine the relationship between MEQ score and ΔSBP during all tests. Significance was set at P < 0.05. Submaximal SBP (M:159(25); A:156(16); E:162(24) mmHg; P = 0.295), peak SBP (M:177(32); A:184(25); E:185(26) mmHg; P = 0.087) and ΔSBP (M:62(29); A:67(23); 65(20) mmHg; P = 0.546) were similar across time points. Eight participants had an EEBP on at least two tests. MEQ scores were correlated with ΔSBP during the A test (r = 0.357, P = 0.049) and E test (r = 0.363, P = 0.045). In conclusion, time of day had no effect on SBP responses to exercise, but our correlational analysis suggests changes in SBP may differ between chronotypes depending on the time of day of exercise. Given the clinical value of EEBP, it is notable that 26% of our healthy young sample had EEBP.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"38 7","pages":"568-574"},"PeriodicalIF":2.7,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300826","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 : 2024-06-06DOI: 10.1038/s41371-024-00920-7
Yeliz Guler, Omer Genc, Abdullah Yildirim, Aslan Erdogan, Huseyin Akgun, Gamze Acar, Ahmet Guler, Cevat Kirma
The relationship between white coat hypertension (WCH) and anxiety remains not fully elucidated. This study aims to investigate the correlation between WCH and Templer’s Death Anxiety Scale (T-DAS) questionnaire. Asymptomatic individuals with a familial history of sudden cardiac death or acute myocardial infarction within the last year, who presented at our cardiology outpatient clinic, were enrolled in this prospective, single-center, cross-sectional study. Among those with elevated blood pressure in the outpatient clinic setting, participants were categorized into normotensive and WCH groups through 24-hour ambulatory blood pressure monitoring. Demographic features, laboratory parameters, and T-DAS scores were documented. Logistic regression and sensitivity analyses were conducted to ascertain WCH occurrence. Among 324 consecutive participants, 90 were diagnosed with WCH. T-DAS scores were significantly elevated in the WCH subgroup, particularly among those seeking early medical attention following bereavement. Multivariable logistic regression highlighted gender, BMI, heart rate, T-DAS, and admission time as independent correlates of WCH. Significantly, T-DAS exhibited the third most substantial contribution to the regression analysis, following admission time and heart rate. The multivariable logistic regression analysis incorporating T-DAS exhibited high robustness, discrimination, fit, and calibration, with a Brier score of 0.106, adjusted R2 of 0.576, and C-statistic of 0.905 (95% CI: 0.871–0.940, p < 0.001). T-DAS, with a threshold of >8, demonstrated 48% sensitivity and 90% specificity in detecting WCH. Additionally, decision curve analysis verified that the model including T-DAS offers a net benefit in detecting WCH. This study unveils a potential association between WCH and death anxiety.
{"title":"Templer’s death anxiety scale on the relationship between white coat hypertension and anxiety: A cross-sectional study","authors":"Yeliz Guler, Omer Genc, Abdullah Yildirim, Aslan Erdogan, Huseyin Akgun, Gamze Acar, Ahmet Guler, Cevat Kirma","doi":"10.1038/s41371-024-00920-7","DOIUrl":"10.1038/s41371-024-00920-7","url":null,"abstract":"The relationship between white coat hypertension (WCH) and anxiety remains not fully elucidated. This study aims to investigate the correlation between WCH and Templer’s Death Anxiety Scale (T-DAS) questionnaire. Asymptomatic individuals with a familial history of sudden cardiac death or acute myocardial infarction within the last year, who presented at our cardiology outpatient clinic, were enrolled in this prospective, single-center, cross-sectional study. Among those with elevated blood pressure in the outpatient clinic setting, participants were categorized into normotensive and WCH groups through 24-hour ambulatory blood pressure monitoring. Demographic features, laboratory parameters, and T-DAS scores were documented. Logistic regression and sensitivity analyses were conducted to ascertain WCH occurrence. Among 324 consecutive participants, 90 were diagnosed with WCH. T-DAS scores were significantly elevated in the WCH subgroup, particularly among those seeking early medical attention following bereavement. Multivariable logistic regression highlighted gender, BMI, heart rate, T-DAS, and admission time as independent correlates of WCH. Significantly, T-DAS exhibited the third most substantial contribution to the regression analysis, following admission time and heart rate. The multivariable logistic regression analysis incorporating T-DAS exhibited high robustness, discrimination, fit, and calibration, with a Brier score of 0.106, adjusted R2 of 0.576, and C-statistic of 0.905 (95% CI: 0.871–0.940, p < 0.001). T-DAS, with a threshold of >8, demonstrated 48% sensitivity and 90% specificity in detecting WCH. Additionally, decision curve analysis verified that the model including T-DAS offers a net benefit in detecting WCH. This study unveils a potential association between WCH and death anxiety.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"38 7","pages":"561-567"},"PeriodicalIF":2.7,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00920-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283921","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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