Hidenori Onishi, O. Yamamura, Hiromasa Tsubouchi, Takeshi Hirobe, S. Enomoto, Tami Yamamoto, Satoshi Daitoku, Yasutaka Mizukami, Takahiro Kishimoto, Yutaka Kai, Youichirou Hashimoto, T. Hamano, B. Kaku, Hidekazu Terasawa
Background: We aimed to investigate and report the relationship between hypertension treatment status and cardiac functions among temporary housing residents after the Kumamoto earthquake. Material and methods: Ultrasonic cardiography examinations were conducted for 56 residents at temporary housing complexes in Minami Aso village in Kumamoto Prefecture in December 2016. The subjects were divided into the following three groups according to the incidence of hypertension and the antihypertensive treatment status: normal (without hypertension), treated, and untreated. Subsequently, their cardiac functions were compared. Results: Age and BMI were found to be positive predictors for hypertension. Moreover, age, LAVI, and LVMI tended to be higher in the untreated group than in the treated group. Moderate or severe mitral regurgitation was significantly more common in the untreated group than in the treated group. Conclusions: Controlling blood pressure may help to prevent new cardiac diseases (e.g., valve regurgitation) among survivors after a major disaster. In addition, for survivors who are severely affected by psychological stress, improving the mental stress support system may be an effective measure to reduce health problems.
{"title":"Hypertension treatment status and ultrasonic cardiography findings in temporary housing residents after the Kumamoto earthquake: a cross-sectional study","authors":"Hidenori Onishi, O. Yamamura, Hiromasa Tsubouchi, Takeshi Hirobe, S. Enomoto, Tami Yamamoto, Satoshi Daitoku, Yasutaka Mizukami, Takahiro Kishimoto, Yutaka Kai, Youichirou Hashimoto, T. Hamano, B. Kaku, Hidekazu Terasawa","doi":"10.5603/ah.a2021.0010","DOIUrl":"https://doi.org/10.5603/ah.a2021.0010","url":null,"abstract":"Background: We aimed to investigate and report the relationship between hypertension treatment status and cardiac functions among temporary housing residents after the Kumamoto earthquake. Material and methods: Ultrasonic cardiography examinations were conducted for 56 residents at temporary housing complexes in Minami Aso village in Kumamoto Prefecture in December 2016. The subjects were divided into the following three groups according to the incidence of hypertension and the antihypertensive treatment status: normal (without hypertension), treated, and untreated. Subsequently, their cardiac functions were compared. Results: Age and BMI were found to be positive predictors for hypertension. Moreover, age, LAVI, and LVMI tended to be higher in the untreated group than in the treated group. Moderate or severe mitral regurgitation was significantly more common in the untreated group than in the treated group. Conclusions: Controlling blood pressure may help to prevent new cardiac diseases (e.g., valve regurgitation) among survivors after a major disaster. In addition, for survivors who are severely affected by psychological stress, improving the mental stress support system may be an effective measure to reduce health problems.","PeriodicalId":42110,"journal":{"name":"Arterial Hypertension","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74924782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Małgorzata Placek, M. Sołtysiak, J. Drozdowski, J. Wolf
We report a history of a patient with difficult-to-control high blood pressure, central nervous system mass and several comorbidities which altogether made the blood-lowering medication particularly challenging. Patient was diagnosed with glioblastoma, renovascular stenosis to a single kidney, and cerebral edema resulting from both cerebral tissue mass and exceedingly high systemic blood pressure. In the presented case we faced several contraindications to the guideline-recommended treatment with RAAS blockers, beta-blockers, and several diuretic classes which were determined by (1) the only remaining kidney’s renal artery stenosis, (2) decreased creatinine clearance and (3) reflex bradycardia secondary to cerebral edema. Evidence-based recommendations do not clarify all clinical aspects related to emergent high blood pressure because the evidence is sparse; therefore, we found it interesting to share our experience.
{"title":"Difficult-to-control secondary hypertension in a patient with history of glioblastoma, and cerebral edema — a case study","authors":"Małgorzata Placek, M. Sołtysiak, J. Drozdowski, J. Wolf","doi":"10.5603/ah.a2021.0008","DOIUrl":"https://doi.org/10.5603/ah.a2021.0008","url":null,"abstract":"We report a history of a patient with difficult-to-control high blood pressure, central nervous system mass and several comorbidities which altogether made the blood-lowering medication particularly challenging. Patient was diagnosed with glioblastoma, renovascular stenosis to a single kidney, and cerebral edema resulting from both cerebral tissue mass and exceedingly high systemic blood pressure. In the presented case we faced several contraindications to the guideline-recommended treatment with RAAS blockers, beta-blockers, and several diuretic classes which were determined by (1) the only remaining kidney’s renal artery stenosis, (2) decreased creatinine clearance and (3) reflex bradycardia secondary to cerebral edema. Evidence-based recommendations do not clarify all clinical aspects related to emergent high blood pressure because the evidence is sparse; therefore, we found it interesting to share our experience.","PeriodicalId":42110,"journal":{"name":"Arterial Hypertension","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74899819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Nguyen, P. N. Truong, L. Tran, N. Bui, Khanh Truong Lieu, Gai Thi Le, Tram Thi Thu Nguyen
Background: The present study determined blood pressure percentiles in children aged between 6 and 15 years in Southern Vietnam. Material and methods: Blood pressure was measured in a random sample of 1080 students aged 6–15 years who was studying at primary and secondary high schools in My Tho city, Vietnam. A descriptive cross-sectional study was conducted from November 2019 to June 2020. To diagnose children systemic hypertension, the blood pressure must be above the 95 th percentile. Data were analyzed by IBM SPSS statistics software version 20.0. The Chi-squared test was employed to evaluate the relationship between systemic hypertension and child demographic characteristics including gender and obesity. Results: The results showed that the 95 th percentiles of systolic and diastolic blood pressure of the children was 110/70 mm Hg in the 6-year-old group, 120/75 mm Hg in the 7 to12-year-old group and 125/80 mm Hg in the 13 to 15-year-old group, respectively. The rate of systemic hypertension in the children was 10% whereas boys had a 1.2 time higher risk of systemic hypertension than girls (p > 0.05). Obese children had an 8.6 time higher risk of systemic hypertension than non-obese ones (p < 0.001). Conclusion: The blood pressure percentile chart of school children aged 6–15 years were reported here for the first time in Vietnam. The results provided useful information in early diagnosis and timely treatment of systemic hypertension in children.
背景:本研究确定了越南南部6至15岁儿童的血压百分位数。材料和方法:在越南美苴市随机抽取1080名6-15岁的中小学生进行血压测量。一项描述性横断面研究于2019年11月至2020年6月进行。要诊断儿童全身性高血压，血压必须高于第95百分位。数据采用IBM SPSS统计软件20.0进行分析。采用卡方检验评价全身性高血压与儿童人口统计学特征(包括性别和肥胖)的关系。结果:6岁组儿童收缩压和舒张压第95百分位分别为110/70 mm Hg, 7 ~ 12岁组为120/75 mm Hg, 13 ~ 15岁组为125/80 mm Hg。儿童发生全身性高血压的风险为10%，而男孩发生全身性高血压的风险是女孩的1.2倍(p > 0.05)。肥胖儿童发生全身性高血压的风险是非肥胖儿童的8.6倍(p < 0.001)。结论:本文首次报道了越南6 ~ 15岁学龄儿童血压百分位图。结果为儿童全身性高血压的早期诊断和及时治疗提供了有益的信息。
{"title":"Blood pressure percentiles and systemic hypertension-associated factors among children aged between 6 and 15 years in Southern Vietnam","authors":"L. Nguyen, P. N. Truong, L. Tran, N. Bui, Khanh Truong Lieu, Gai Thi Le, Tram Thi Thu Nguyen","doi":"10.5603/ah.a2021.0011","DOIUrl":"https://doi.org/10.5603/ah.a2021.0011","url":null,"abstract":"Background: The present study determined blood pressure percentiles in children aged between 6 and 15 years in Southern Vietnam. Material and methods: Blood pressure was measured in a random sample of 1080 students aged 6–15 years who was studying at primary and secondary high schools in My Tho city, Vietnam. A descriptive cross-sectional study was conducted from November 2019 to June 2020. To diagnose children systemic hypertension, the blood pressure must be above the 95 th percentile. Data were analyzed by IBM SPSS statistics software version 20.0. The Chi-squared test was employed to evaluate the relationship between systemic hypertension and child demographic characteristics including gender and obesity. Results: The results showed that the 95 th percentiles of systolic and diastolic blood pressure of the children was 110/70 mm Hg in the 6-year-old group, 120/75 mm Hg in the 7 to12-year-old group and 125/80 mm Hg in the 13 to 15-year-old group, respectively. The rate of systemic hypertension in the children was 10% whereas boys had a 1.2 time higher risk of systemic hypertension than girls (p > 0.05). Obese children had an 8.6 time higher risk of systemic hypertension than non-obese ones (p < 0.001). Conclusion: The blood pressure percentile chart of school children aged 6–15 years were reported here for the first time in Vietnam. The results provided useful information in early diagnosis and timely treatment of systemic hypertension in children.","PeriodicalId":42110,"journal":{"name":"Arterial Hypertension","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87225254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. S. Kusuma, Nandeesh N S, Shivaprasad Shetty, P. Shetty
BACKGROUND AND OBJECTIVES: Hypertension control remains a major global challenge. The behavioral approaches recommended for blood pressure reduction are stress reduction, increased exercise and healthy dietary habits. Some study findings suggest that yoga has a beneficial effect in reducing blood pressure. This study was done to assess the effect of trataka a yogic cleansing technique on heart rate variables in patients with hypertension and thereby substantiate the clinical understanding of its effect on blood pressure. MATERIALS AND METHODS: Subjects with primary hypertension within the age group of 25-45 years who fulfilled inclusion and exclusion criteria were recruited for the study were randomized into Control and yoga group after obtaining their written informed consent. The yoga group practiced trataka for 30 minute with guided instructions and the control group was asked to sit calmly for 30 min minute. The participant’s blood pressure and heart rate variability were recorded before and after the practice. RESULTS: The individuals who practiced trataka showed significant reduction in SBP (p<0.05), MEAN HR (p<0.05), and MEAN RR (p<0.05) after the practice. There was no significant changes observed in control as compared to yoga group. CONCLUSION: The practice of trataka leads to significant reduction in blood pressure and heart rate in primary hypertensive patients. Though trataka is considered as a cleansing technique, it induces calm state of mind, which is similar to a mental state reached by the practice of meditation, which can reduce stress and henceforth blood pressure.
{"title":"Immediate effect of trataka on blood pressure indices in individuals with primary hypertension — a randomized controlled trial","authors":"A. S. Kusuma, Nandeesh N S, Shivaprasad Shetty, P. Shetty","doi":"10.5603/AH.A2021.0013","DOIUrl":"https://doi.org/10.5603/AH.A2021.0013","url":null,"abstract":"BACKGROUND AND OBJECTIVES: \u0000 \u0000Hypertension control remains a major global challenge. The behavioral approaches recommended for blood pressure reduction are stress reduction, increased exercise and healthy dietary habits. Some study findings suggest that yoga has a beneficial effect in reducing blood pressure. This study was done to assess the effect of trataka a yogic cleansing technique on heart rate variables in patients with hypertension and thereby substantiate the clinical understanding of its effect on blood pressure. \u0000 \u0000MATERIALS AND METHODS: \u0000 \u0000Subjects with primary hypertension within the age group of 25-45 years who fulfilled inclusion and exclusion criteria were recruited for the study were randomized into Control and yoga group after obtaining their written informed consent. The yoga group practiced trataka for 30 minute with guided instructions and the control group was asked to sit calmly for 30 min minute. The participant’s blood pressure and heart rate variability were recorded before and after the practice. \u0000 \u0000 \u0000RESULTS: \u0000The individuals who practiced trataka showed significant reduction in SBP (p<0.05), MEAN HR (p<0.05), and MEAN RR (p<0.05) after the practice. There was no significant changes observed in control as compared to yoga group. \u0000 \u0000CONCLUSION: \u0000The practice of trataka leads to significant reduction in blood pressure and heart rate in primary hypertensive patients. Though trataka is considered as a cleansing technique, it induces calm state of mind, which is similar to a mental state reached by the practice of meditation, which can reduce stress and henceforth blood pressure.","PeriodicalId":42110,"journal":{"name":"Arterial Hypertension","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77275508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Buller, Szymon Rosiak, Wojciech Rosiak, Maciej Tyczyński, R. Gil, J. Bil
ABSTRACT Myocardial infarction with non-obstructive coronary arteries (MINOCA) as a relatively new disease entity distinguished from the group of acute coronary syndromes (ACS) is not a rare clinical problem that requires in-depth diagnostics. MINOCA accounts for 5-10% of all ACS cases. MINOCA is most common between the ages of 50-60 and predominates in females. Coronary microvascular dysfunction and coronary vasospasm are one of the potential mechanisms. The latest guidelines for the treatment of ACS in patients presenting without persistent ST-segment elevation emphasize the importance of searching for the causes of angina in patients with insignificant lesions in the coronary arteries by extending invasive diagnostics (e.g., acetylcholine provocation test) and using noninvasive diagnostics (e.g., CMR or SPECT). In the context of MINOCA, among the typical risk factors for coronary artery disease, arterial hypertension (HTN) seems to be the most important by inducing coronary microcirculation remodeling (mostly hypertrophy) and hence the narrowing of the lumen. Studies comparing patients with MINOCA and obstructive coronary artery disease (MI-CAD) in the context of risk factors, in particular, HTN, were analyzed. In five out of nine analyzed studies, HTN occurred significantly more often in patients with MINOCA compared to patients with MI-CAD. The current pharmacotherapy recommendations focus on slowing the progression of coronary microvascular dysfunction (CMD), i.e., adequate treatment of risk factors and comorbidities, such as HTN. Therefore, it seems reasonable to conduct studies directly analyzing the relationship between HTN and MINOCA in order to improve diagnostics and establish appropriate pharmacotherapy that will improve prognosis.
{"title":"Arterial hypertension as a risk factor for myocardial infarction with non-obstructive coronary arteries (MINOCA)","authors":"P. Buller, Szymon Rosiak, Wojciech Rosiak, Maciej Tyczyński, R. Gil, J. Bil","doi":"10.5603/AH.A2021.0009","DOIUrl":"https://doi.org/10.5603/AH.A2021.0009","url":null,"abstract":"ABSTRACT \u0000Myocardial infarction with non-obstructive coronary arteries (MINOCA) as a relatively new disease entity distinguished from the group of acute coronary syndromes (ACS) is not a rare clinical problem that requires in-depth diagnostics. MINOCA accounts for 5-10% of all ACS cases. MINOCA is most common between the ages of 50-60 and predominates in females. Coronary microvascular dysfunction and coronary vasospasm are one of the potential mechanisms. The latest guidelines for the treatment of ACS in patients presenting without persistent ST-segment elevation emphasize the importance of searching for the causes of angina in patients with insignificant lesions in the coronary arteries by extending invasive diagnostics (e.g., acetylcholine provocation test) and using noninvasive diagnostics (e.g., CMR or SPECT). In the context of MINOCA, among the typical risk factors for coronary artery disease, arterial hypertension (HTN) seems to be the most important by inducing coronary microcirculation remodeling (mostly hypertrophy) and hence the narrowing of the lumen. Studies comparing patients with MINOCA and obstructive coronary artery disease (MI-CAD) in the context of risk factors, in particular, HTN, were analyzed. In five out of nine analyzed studies, HTN occurred significantly more often in patients with MINOCA compared to patients with MI-CAD. The current pharmacotherapy recommendations focus on slowing the progression of coronary microvascular dysfunction (CMD), i.e., adequate treatment of risk factors and comorbidities, such as HTN. Therefore, it seems reasonable to conduct studies directly analyzing the relationship between HTN and MINOCA in order to improve diagnostics and establish appropriate pharmacotherapy that will improve prognosis.","PeriodicalId":42110,"journal":{"name":"Arterial Hypertension","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88081340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arterial hypertension is a leading preventable cardiovascular risk factor. The definition and thresholds for the diagnosis of hypertension vary between European and American guidelines. That is mainly due to the widely known SPRINT trial in which unattended automated blood pressure measurements were used. This technique of blood pressure estimation requires a patient to be left alone in an office and then a programmed device measures blood pressure automatically. The absence of a health professional during the measurement helps to reduce or eliminate the “white coat” effect, therefore, values of blood pressure may be lower than in after conventional office blood pressure measurements. There are premises that this technique can be a solid substitution for 24-hour ambulatory blood pressure measurements and that it can predict hypertension-mediated organ damage more accurately than standard techniques. However, due to the many methods in which measurement can be carried out , no universal protocol exists. More research is needed to evaluate the usefulness of unattended automated office blood pressure measurements in clinical practice.
{"title":"Unattended automated office blood pressure measurement — current evidence and the role in clinical practice","authors":"M. Stopa, A. Olszanecka, M. Rajzer","doi":"10.5603/AH.A2021.0012","DOIUrl":"https://doi.org/10.5603/AH.A2021.0012","url":null,"abstract":"Arterial hypertension is a leading preventable cardiovascular risk factor. The definition and thresholds for the diagnosis of hypertension vary between European and American guidelines. That is mainly due to the widely known SPRINT trial in which unattended automated blood pressure measurements were used. This technique of blood pressure estimation requires a patient to be left alone in an office and then a programmed device measures blood pressure automatically. The absence of a health professional during the measurement helps to reduce or eliminate the “white coat” effect, therefore, values of blood pressure may be lower than in after conventional office blood pressure measurements. There are premises that this technique can be a solid substitution for 24-hour ambulatory blood pressure measurements and that it can predict hypertension-mediated organ damage more accurately than standard techniques. However, due to the many methods in which measurement can be carried out , no universal protocol exists. More research is needed to evaluate the usefulness of unattended automated office blood pressure measurements in clinical practice.","PeriodicalId":42110,"journal":{"name":"Arterial Hypertension","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89796603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marziyeh Ebadi-Vanestanagh, Roghayeh Molani-Gol, Leili Faraji-Gavgani, M. Alizadeh
Background: This study set up to determine which of the neck circumference (NC), as a predictor of upper body sub-cutaneous fat, or visceral adipose tissue, as an indicator of intra-abdominal fat mass, can be the better predictor of hypertension. Material and methods: 130 overweight/obese women took part in this cross-sectional study conducted in November 2017. Blood pressure, anthropometric measurements, and body composition were determined. Pearson’s correlation coefficients, multivariate logistic regression, and the area under the curve of the receiver operator characteristic curves analyses were performed. Results: Mean age, weight, and neck circumference were 39.93 ± 8.71 years, 74.26 ± 9.86 Kg, and 35.06 ± 1.74 cm, respectively. There was a significant correlation between neck circumference and visceral adipose tissue with systolic blood pressure (r = 0.32, p = 0.001) (r = 0.57, p < 0.001) and diastolic blood pressure (r = 0.23, p = 0.008) (r = 0.45, p < 0.001), in the respective order. According to the results of the ROC curve analysis, visceral adipose tissue and neck circumference predicted hypertension with an accuracy of 81 and 65 percent, respectively. In addition, the probability of having increased blood pressure increased with higher visceral adipose tissue (OR = 1.22, p < 0.001). Conclusions: According to our findings, abdominal obesity and high NC in implication with overweight or obesity can more exactly evaluate hypertension risk.
背景:本研究旨在确定哪个颈围(NC)，作为上体皮下脂肪的预测指标，或内脏脂肪组织，作为腹腔内脂肪量的指标，可以更好地预测高血压。材料和方法:2017年11月，130名超重/肥胖女性参加了这项横断面研究。测定血压、人体测量值和身体成分。进行Pearson相关系数、多元logistic回归及接收算子特征曲线下面积分析。结果:患者平均年龄39.93±8.71岁，体重74.26±9.86 Kg，颈围35.06±1.74 cm。颈围、内脏脂肪组织与收缩压(r = 0.32, p = 0.001) (r = 0.57, p < 0.001)、舒张压(r = 0.23, p = 0.008) (r = 0.45, p < 0.001)呈显著相关。根据ROC曲线分析的结果，内脏脂肪组织和颈部围度预测高血压的准确率分别为81%和65%。此外，随着内脏脂肪组织的增加，血压升高的可能性也随之增加(OR = 1.22, p < 0.001)。结论:根据我们的研究结果，腹部肥胖和高NC与超重或肥胖相关可以更准确地评估高血压风险。
{"title":"Neck circumference, visceral adiposity, and hypertension: does upper body adiposity outperforms visceral adiposity in terms of hypertension predictions?","authors":"Marziyeh Ebadi-Vanestanagh, Roghayeh Molani-Gol, Leili Faraji-Gavgani, M. Alizadeh","doi":"10.5603/AH.A2021.0005","DOIUrl":"https://doi.org/10.5603/AH.A2021.0005","url":null,"abstract":"Background: This study set up to determine which of the neck circumference (NC), as a predictor of upper body sub-cutaneous fat, or visceral adipose tissue, as an indicator of intra-abdominal fat mass, can be the better predictor of hypertension. Material and methods: 130 overweight/obese women took part in this cross-sectional study conducted in November 2017. Blood pressure, anthropometric measurements, and body composition were determined. Pearson’s correlation coefficients, multivariate logistic regression, and the area under the curve of the receiver operator characteristic curves analyses were performed. Results: Mean age, weight, and neck circumference were 39.93 ± 8.71 years, 74.26 ± 9.86 Kg, and 35.06 ± 1.74 cm, respectively. There was a significant correlation between neck circumference and visceral adipose tissue with systolic blood pressure (r = 0.32, p = 0.001) (r = 0.57, p < 0.001) and diastolic blood pressure (r = 0.23, p = 0.008) (r = 0.45, p < 0.001), in the respective order. According to the results of the ROC curve analysis, visceral adipose tissue and neck circumference predicted hypertension with an accuracy of 81 and 65 percent, respectively. In addition, the probability of having increased blood pressure increased with higher visceral adipose tissue (OR = 1.22, p < 0.001). Conclusions: According to our findings, abdominal obesity and high NC in implication with overweight or obesity can more exactly evaluate hypertension risk.","PeriodicalId":42110,"journal":{"name":"Arterial Hypertension","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82933552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Foaad Shaghee, H. Nafakhi, Karrar Al-Buthabhak, Mohammed Alareedh, Ahmed Nafakhi, S. Kasim
Background: We aimed to explore the association of clinical symptoms of COVID-19 pneumonia, blood parameters on admission, and anti-hypertensive drugs with in-hospital outcomes, including length of hospital and intensive care unit (ICU) stay, receiving mechanical ventilation, degree of lung injury, and in-hospital death among patients with hypertension. Material and methods: This retrospective study conducted in patients with newly diagnosed COVID-19 pneumonia from August 20, 2020 to September 25, 2020. Results: A total of 182 patients with COVID-19 pneumonia were included in the present study. The patients were categorized into those with hypertension (n = 82) or without hypertension (n = 100). Patients on angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) showed no significant increase in the risk for all in-hospital outcomes. Old age [0.6 (0.5–2) p < 0.00], fever [0.3 (0.2–1.8), p < 0.00] and low lymphocytes percentage [0.3 (0.2–1.2), p < 0.00] were associated with increased risk for extensive lung injury. Old age [0.4 (0.1 = 0.7) p < 0.01], high neutrophil count [0.3 (0.2–2), p = 0.02] and low lymphocyte percentage [0.3 (0.1–0.7), p = 0.01] were associated with prolonged hospital stay while low lymphocytes percentage [0.7 (0.6–0.9), p < 0.00], old age [1.2 (1–1.4), p = 0.01] and fatigue [2 (1–4), p = 0.04] showed significant association with prolonged length of ICU stay. Low lymphocytes percentage [0.7 (0.6–1), p < 0.00], old age [1.1 (1–1.2), p = 0.01] and fatigue [2 (1.7–4), p = 0.02] were associated with increased risk for receiving mechanical ventilation. Risk for in-hospital death was associated with increased neutrophil percentage [1.2 (1–1.5), p = 0.01] and old age [1.1 (1–1.2), p = 0.03]. Conclusions: ARBs and ACEIs showed no significant association with adverse in-hospital outcomes. Old age, low lymphocytes percentage and high neutrophils percentage on admission were independent predictors for increased risk of in-hospital mortality and morbidity among COVID-19 pneumonia patients with hypertension.
{"title":"Blood parameters, symptoms at presentation and adverse in-hospital outcomes of COVID-19 pneumonia in patients with hypertension","authors":"Foaad Shaghee, H. Nafakhi, Karrar Al-Buthabhak, Mohammed Alareedh, Ahmed Nafakhi, S. Kasim","doi":"10.5603/AH.A2021.0004","DOIUrl":"https://doi.org/10.5603/AH.A2021.0004","url":null,"abstract":"Background: We aimed to explore the association of clinical symptoms of COVID-19 pneumonia, blood parameters on admission, and anti-hypertensive drugs with in-hospital outcomes, including length of hospital and intensive care unit (ICU) stay, receiving mechanical ventilation, degree of lung injury, and in-hospital death among patients with hypertension. Material and methods: This retrospective study conducted in patients with newly diagnosed COVID-19 pneumonia from August 20, 2020 to September 25, 2020. Results: A total of 182 patients with COVID-19 pneumonia were included in the present study. The patients were categorized into those with hypertension (n = 82) or without hypertension (n = 100). Patients on angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) showed no significant increase in the risk for all in-hospital outcomes. Old age [0.6 (0.5–2) p < 0.00], fever [0.3 (0.2–1.8), p < 0.00] and low lymphocytes percentage [0.3 (0.2–1.2), p < 0.00] were associated with increased risk for extensive lung injury. Old age [0.4 (0.1 = 0.7) p < 0.01], high neutrophil count [0.3 (0.2–2), p = 0.02] and low lymphocyte percentage [0.3 (0.1–0.7), p = 0.01] were associated with prolonged hospital stay while low lymphocytes percentage [0.7 (0.6–0.9), p < 0.00], old age [1.2 (1–1.4), p = 0.01] and fatigue [2 (1–4), p = 0.04] showed significant association with prolonged length of ICU stay. Low lymphocytes percentage [0.7 (0.6–1), p < 0.00], old age [1.1 (1–1.2), p = 0.01] and fatigue [2 (1.7–4), p = 0.02] were associated with increased risk for receiving mechanical ventilation. Risk for in-hospital death was associated with increased neutrophil percentage [1.2 (1–1.5), p = 0.01] and old age [1.1 (1–1.2), p = 0.03]. Conclusions: ARBs and ACEIs showed no significant association with adverse in-hospital outcomes. Old age, low lymphocytes percentage and high neutrophils percentage on admission were independent predictors for increased risk of in-hospital mortality and morbidity among COVID-19 pneumonia patients with hypertension.","PeriodicalId":42110,"journal":{"name":"Arterial Hypertension","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77707917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dunja Buljubašić, I. Drenjančević, Aleksandar Kibel, L. Zibar, Vedrana Vizjak, S. Mandić, T. Bačun
Aims: Low-grade inflammation mediates the relation between overweight and the development of cardiovascular diseases. The study aimed to examine if myeloperoxidase (MPO) and hsCRP (high-sensitivity C-reactive protein) in overweight hypertensive patients can be used as biomarkers of endothelial and leukocyte activation. Methods : Seventy-five subjects were included in the study; 38 had essential arterial hypertension (AH) and 37 were normotensive controls (NC), subsequently divided into overweight (OW;BMI≥25kgm 2) and normal weight subgroups (NW;BMI<25kgm-2). Body mass index (BMI), inflammatory markers concentrations, association of MPO and hsCRP with AH and/or overweight were assessed. Results : AH patients had higher MPO (median 132.5pmol/L, IQR 53.8–691.9)(P<0.001), while hsCRP did not significantly differ compared to normotensive controls (NC). NW-AH patients had higher MPO (P=0.02) than normotensive NW patients. MPO was similar between normotensive patients OW and NW, while hsCRP concentration was significantly higher in the OW (median 1.85 mg/L, IQR 0.47–7.19)(P=0.01) compared to NW. OW-AH patients had significantly higher MPO (median 137.4pmol/L, IQR 53.80-703.4) (P=0.002) compared to normotensive NW and OW (P<0.001) patients, likely reflecting neutrophilic activation in hypertension. Additionaly, OW-AH patients had significantly higher hsCRP (median 1.71mg/L, IQR 0.22-14) (P=0.005) than normotensive NW patients. hsCRP significantly positively correlated with BMI in both AH (ρ=0.41, P=0,009) and NC groups (ρ=0.38, P=0.01), while MPO did not correlate, supporting inflammation in OW, particularly in OW with AH. Conclusions: All together, the results suggest that inflammation may mediate mutual association of AH and OW, suggesting MPO as inflammatory biomarker for AH and hsCRP for overweight.
{"title":"Myeloperoxidase (MPO) and high sensitivity C-reactive protein (hsCRP) as inflammatory biomarkers of endothelial and leukocyte activation in overweight hypertensive patients","authors":"Dunja Buljubašić, I. Drenjančević, Aleksandar Kibel, L. Zibar, Vedrana Vizjak, S. Mandić, T. Bačun","doi":"10.5603/AH.A2021.0003","DOIUrl":"https://doi.org/10.5603/AH.A2021.0003","url":null,"abstract":"Aims: Low-grade inflammation mediates the relation between overweight and the development of cardiovascular diseases. The study aimed to examine if myeloperoxidase (MPO) and hsCRP (high-sensitivity C-reactive protein) in overweight hypertensive patients can be used as biomarkers of endothelial and leukocyte activation. Methods : Seventy-five subjects were included in the study; 38 had essential arterial hypertension (AH) and 37 were normotensive controls (NC), subsequently divided into overweight (OW;BMI≥25kgm 2) and normal weight subgroups (NW;BMI<25kgm-2). Body mass index (BMI), inflammatory markers concentrations, association of MPO and hsCRP with AH and/or overweight were assessed. Results : AH patients had higher MPO (median 132.5pmol/L, IQR 53.8–691.9)(P<0.001), while hsCRP did not significantly differ compared to normotensive controls (NC). NW-AH patients had higher MPO (P=0.02) than normotensive NW patients. MPO was similar between normotensive patients OW and NW, while hsCRP concentration was significantly higher in the OW (median 1.85 mg/L, IQR 0.47–7.19)(P=0.01) compared to NW. OW-AH patients had significantly higher MPO (median 137.4pmol/L, IQR 53.80-703.4) (P=0.002) compared to normotensive NW and OW (P<0.001) patients, likely reflecting neutrophilic activation in hypertension. Additionaly, OW-AH patients had significantly higher hsCRP (median 1.71mg/L, IQR 0.22-14) (P=0.005) than normotensive NW patients. hsCRP significantly positively correlated with BMI in both AH (ρ=0.41, P=0,009) and NC groups (ρ=0.38, P=0.01), while MPO did not correlate, supporting inflammation in OW, particularly in OW with AH. Conclusions: All together, the results suggest that inflammation may mediate mutual association of AH and OW, suggesting MPO as inflammatory biomarker for AH and hsCRP for overweight.","PeriodicalId":42110,"journal":{"name":"Arterial Hypertension","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81470633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Boccardi, M. Taghizadeh, Mina Salek, S. Jafarnejad
Background: The aim of the present meta-analysis was to detect the effect of a-lipoic acid (ALA) supplementation on systolic and diastolic blood pressure (BP). Material and methods: The related records were selected from several electronic databases from the earliest date 1980 until October 2019. The heterogeneities were assessed by I 2 test (I 2 < 50%) and X 2 test on Cochrane’s Q statistic. Standardized mean difference (SMD) and their 95% confidence intervals (CIs) were considered for net change in systolic blood pressure (SBP) and diastolic blood pressure (DBP). Subgroup analyses were also conducted by baseline BP, health status, doses of supplementation, study duration and supplement utilization. Results: As a result, a total of 10 studies with 612 subjects were included in the final analysis. Alpha-lipoic acid supplementation significantly reduced SBP (SMD = –0.50, 95% CI: –0.84, –0.16, p = 0.004) and DBP (SMD = –0.40, 95% CI: –0.71, –0.09, p = 0.01), compared to the controls, with the reduction of 6.1 mm Hg and 3.6 mm Hg of the mean SBP and DBP, respectively. Heterogeneities were explored in both SBP and DBP. Moreover, a statistically significant reduction in BP was detected in elevated BP and hypertensive patients as compared with the normotensive subjects. Conclusion: ALA supplementation could be considered as a BP-lowering agent, especially in subjects with higher blood pressure.
背景:本荟萃分析的目的是检测补充a-硫辛酸(ALA)对收缩压和舒张压(BP)的影响。材料与方法:从多个电子数据库中选取1980年至2019年10月的相关记录。采用Cochrane’s Q统计量的i2检验(i2 < 50%)和x2检验评估异质性。收缩压(SBP)和舒张压(DBP)的净变化采用标准化平均差(SMD)及其95%置信区间(CIs)。亚组分析还包括基线血压、健康状况、补充剂剂量、研究持续时间和补充剂使用情况。结果:最终共纳入10项研究，612名受试者。与对照组相比，补充α -硫辛酸显著降低了收缩压(SMD = -0.50, 95% CI: -0.84， -0.16, p = 0.004)和舒张压(SMD = -0.40, 95% CI: -0.71， -0.09, p = 0.01)，平均收缩压和舒张压分别降低了6.1 mm Hg和3.6 mm Hg。探讨收缩压和舒张压的异质性。此外，与血压正常者相比，血压升高和高血压患者的血压有统计学意义的降低。结论:补充ALA可被认为是一种降血压剂，特别是在高血压患者中。
{"title":"Blood pressure lowering effects of alpha-lipoic acid supplementation: a meta-analysis of randomized controlled trials","authors":"V. Boccardi, M. Taghizadeh, Mina Salek, S. Jafarnejad","doi":"10.5603/AH.A2021.0001","DOIUrl":"https://doi.org/10.5603/AH.A2021.0001","url":null,"abstract":"Background: The aim of the present meta-analysis was to detect the effect of a-lipoic acid (ALA) supplementation on systolic and diastolic blood pressure (BP). Material and methods: The related records were selected from several electronic databases from the earliest date 1980 until October 2019. The heterogeneities were assessed by I 2 test (I 2 < 50%) and X 2 test on Cochrane’s Q statistic. Standardized mean difference (SMD) and their 95% confidence intervals (CIs) were considered for net change in systolic blood pressure (SBP) and diastolic blood pressure (DBP). Subgroup analyses were also conducted by baseline BP, health status, doses of supplementation, study duration and supplement utilization. Results: As a result, a total of 10 studies with 612 subjects were included in the final analysis. Alpha-lipoic acid supplementation significantly reduced SBP (SMD = –0.50, 95% CI: –0.84, –0.16, p = 0.004) and DBP (SMD = –0.40, 95% CI: –0.71, –0.09, p = 0.01), compared to the controls, with the reduction of 6.1 mm Hg and 3.6 mm Hg of the mean SBP and DBP, respectively. Heterogeneities were explored in both SBP and DBP. Moreover, a statistically significant reduction in BP was detected in elevated BP and hypertensive patients as compared with the normotensive subjects. Conclusion: ALA supplementation could be considered as a BP-lowering agent, especially in subjects with higher blood pressure.","PeriodicalId":42110,"journal":{"name":"Arterial Hypertension","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82446949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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