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Risk Factors and Comorbidities in Young Indian Patients with Hypertension: REAL YOUNG (Hypertension) Study. 印度年轻高血压患者的危险因素和合并症:REAL Young(高血压)研究
IF 2.2 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-02-26 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S272548
Nagaraj Desai, Govindan Unni, Rajeev Agarwala, Santosh Salagre, Sanjay Godbole, Ashish Dengra, Mahesh V Abhyankar, Santosh Revankar

Purpose: To analyze the risk factors and comorbidities among the young Indian adults with hypertension.

Patients and methods: This was a retrospective, multicentric real-world study which included patients diagnosed with and receiving treatment for hypertension. Data were collected from the medical records of clinics/hospitals across 623 study sites in India. Patients of either sex and aged 18-45 years were included. Demographic details (age, sex, anthropometric measurement), medical and family history, sedentary lifestyle, smoking status and alcohol consumption data were extracted. Descriptive and comparative analysis (Mann-Whitney U and chi-squared test) was done.

Results: Out of 15,006 young patients diagnosed with hypertension (men=63.6%), 65.7% belonged to the age group of >35-45 years. The median body mass index was 27.0 kg/m2. Patients diagnosed with only hypertension were 29.1% while other predominant comorbidities with hypertension were diabetes mellitus (42.4%) and dyslipidemia (7.8%). Hypertension with diabetes mellitus were prevalent in the age group of >35-45 years (43.8%). More than half of the patients with hypertension (n=7656) had a sedentary lifestyle. Overall, 35.6%, 47.3%, and 56.7% of the patients were alcoholic, smokers (present and former), and had a family history of hypertension, respectively.

Conclusion: The results showed that among the young population, hypertension was common in the age group of >35-45 years and diabetes mellitus and dyslipidemia were common comorbidities. Family history, sedentary lifestyle, smoking, alcohol consumption, and body mass index may also contribute to hypertension.

目的:分析印度青年高血压患者的危险因素及合并症。患者和方法:这是一项回顾性的、多中心的现实世界研究,包括诊断为高血压并接受治疗的患者。数据是从印度623个研究地点的诊所/医院的医疗记录中收集的。患者不分性别,年龄在18-45岁之间。提取了人口统计细节(年龄、性别、人体测量值)、病史和家族史、久坐生活方式、吸烟状况和饮酒数据。进行了描述性和比较分析(Mann-Whitney U和卡方检验)。结果:15,006例年轻高血压患者(男性占63.6%)中,65.7%的患者年龄>35-45岁。中位体重指数为27.0 kg/m2。仅诊断为高血压的患者占29.1%,而高血压的其他主要合并症是糖尿病(42.4%)和血脂异常(7.8%)。高血压合并糖尿病多见于>35 ~ 45岁年龄组(43.8%)。超过一半的高血压患者(n=7656)有久坐的生活方式。总体而言,35.6%、47.3%和56.7%的患者分别为酗酒者、吸烟者(现在和以前)和有高血压家族史。结论:青壮年人群中高血压多见于>35 ~ 45岁年龄组,糖尿病和血脂异常是常见的合并症。家族史、久坐不动的生活方式、吸烟、饮酒和体重指数也可能导致高血压。
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引用次数: 2
Are Community Health Center Patients Interested in Self-Measured Blood Pressure Monitoring (SMBP) - And Can They Do It? 社区卫生中心的病人对自我测量血压监测(SMBP)感兴趣吗?他们能做到吗?
IF 2.2 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-02-12 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S285007
Debosree Roy, Margaret Meador, Nana Sasu, Kate Whelihan, Joy H Lewis

Introduction: Self-measured blood pressure monitoring (SMBP) helps diagnose and manage hypertension from outside the clinic, which has implications for patient empowerment and outcomes, continuity of care, and resilience in care communities catering to vulnerable populations.

Methods: We instituted a protocol for SMBP among hypertensive patients at 9 community health centers in 3 states and administered questionnaires to patients before and after the protocol was instituted to assess knowledge and engagement with disease management, beliefs and attitudes towards, and experience doing SMBP. Questionnaires included 16 items designed to evaluate patient perceptions and beliefs about SMBP. These included a series of questions using a 5-point Likert scale, binary questions related to their perceived ability to comply with specific SMBP guidelines and open-ended questions to obtain descriptions of experiences with SMBP.

Results: The pre-questionnaire was completed by 478 patients and the post-questionnaire was completed by 372. Seventy-seven percent of respondents knew their ideal blood pressure and their engagement with blood pressure management increased significantly (p=0.0024) after completing the protocol. Additionally, 85% of respondents said that they had a positive experience doing SMBP. Open-ended responses revealed insight regarding why patients chose to do SMBP and factors patients appreciated about SMBP.

Discussion: When trained properly and supported, community health center patients are capable of and motivated to perform accurate SMBP. Our study provides evidence that health center patients can follow detailed SMBP protocols and monitor their own blood pressure from the safety of their homes, which is critical to their care continuum, particularly in days of a pandemic.

自我测量血压监测(SMBP)有助于在诊所外诊断和管理高血压,这对患者赋权和结果、护理的连续性以及面向弱势群体的护理社区的恢复力具有重要意义。方法:我们在3个州的9个社区卫生中心对高血压患者制定了SMBP方案,并在方案制定前后对患者进行问卷调查,以评估患者对疾病管理的知识和参与程度、对SMBP的信念和态度以及实施SMBP的经验。问卷包括16个项目,旨在评估患者对SMBP的看法和信念。这些问题包括一系列使用5点李克特量表的问题,与他们遵守特定SMBP指南的感知能力相关的二元问题,以及获得SMBP经验描述的开放式问题。结果:完成问卷前调查478例,完成问卷后调查372例。77%的受访者知道自己的理想血压,完成方案后,他们对血压管理的参与度显著增加(p=0.0024)。此外,85%的受访者表示他们在SMBP中获得了积极的体验。开放式回答揭示了患者选择SMBP的原因以及患者对SMBP的欣赏因素。讨论:在适当的培训和支持下,社区卫生中心的患者有能力和动力执行准确的SMBP。我们的研究提供了证据,表明卫生中心的患者可以遵循详细的SMBP协议,并在家中安全监测自己的血压,这对他们的护理连续性至关重要,特别是在大流行的日子里。
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引用次数: 4
Evidence of Nonadherence in Cases of Pseudoresistant Hypertension. 假性顽固性高血压病例的不依从证据。
IF 2.2 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-02-11 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S264057
João Marcos de Menezes Zanatta, Luciana Neves Cosenso-Martin, Valquíria da Silva Lopes, Jéssica Rodrigues Roma Uyemura, Aleandra Marton Polegati Santos, Manoel Ildefonso Paz Landim, Juan Carlos Yugar-Toledo, José Fernando Vilela-Martin

Resistant hypertension (RH) is characterized by the use of three or more antihypertensive drugs without reaching the goal of controlling blood pressure (BP). For a definitive diagnosis of RH, it is necessary to exclude causes of pseudoresistance, including the white-coat effect, errors in BP measurement, secondary hypertension, therapeutic inertia, and poor adherence to lifestyle changes and pharmacological treatment. Herein, we report the history of a patient with long-standing uncontrolled BP, even when using seven antihypertensive drugs. Causes of secondary hypertension that justified the high BP levels were investigated, in addition to the other causes of pseudo-RH. In view of the difficult-to-control BP situation, it was decided to hospitalize the patient for better investigation. After 5 days, he had BP control with practically the same medications previously used. Finally, all factors related to the presence of pseudo-RH are discussed, especially poor adherence to treatment. Poor adherence to antihypertensive treatment is common in daily medical practice, and its investigation is of fundamental importance for better management of BP.

顽固性高血压(RH)的特点是使用三种或三种以上的降压药,但没有达到控制血压的目标。对于RH的明确诊断,有必要排除假耐药的原因,包括白大褂效应、血压测量误差、继发性高血压、治疗惰性、生活方式改变和药物治疗依从性差。在此,我们报告了一个长期不受控制的血压患者的病史,即使使用了七种抗高血压药物。除了假性rh的其他原因外,还调查了继发性高血压的原因,证明了高血压水平的合理性。鉴于血压难以控制的情况,决定住院治疗,以便更好地进行调查。5天后,他的血压得到了控制,使用的药物几乎与之前使用的相同。最后,讨论了与假性rh存在相关的所有因素,特别是治疗依从性差。降压治疗依从性差是日常医疗实践中常见的问题,其调查对更好地管理BP具有重要意义。
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引用次数: 1
Blood Pressure Control with Reference to Intensive Blood Pressure Targets Among Hypertension Patients on Chronic Follow-Up at Dessie Referral Hospital, Northeast Ethiopia. 埃塞俄比亚东北部Dessie转诊医院高血压患者慢性随访中强化血压指标的血压控制
IF 2.2 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2021-01-22 eCollection Date: 2021-01-01 DOI: 10.2147/IBPC.S268186
Kassahun Bogale, Assasu Aderaw

Background: Hypertension is a risk factor for heart, brain, kidney, and other diseases. It is also the major cause of premature death. Thus, it is important to prevent, treat, and control hypertension and to reduce the risk of cardiovascular disease.

Objective: To determine the level of blood pressure control and associated factors based on the new intensive blood pressure goals (<130/80 mmHg).

Methods: A cross-sectional study design was used to assess the level of blood pressure control and associated factors from February 15 to April 15, 2019. Two hundred and sixteen patients were selected through a systematic sampling technique.

Results: From 203 hypertension patients incorporated in the study, 102 (50.2%) were females. The mean age of patients documented during the last date of follow-up was 55.2 (SD=±14.47). About 51.2% of patients were less than 5 years from the day of diagnosis of hypertension. The majority of the study participants (111, 54.7%) were using two antihypertensives. The most common anti-hypertensive medication was hydrochlorothiazide (HCT), at 25 (12.3%). The most common combination drug therapy used was the combination of HCT and calcium channel blockers, at 62 (30.5%). Heart failure (22, 20.8%), stroke (18, 16.98%), and dyslipidemia (17, 16.04%) were the top three comorbidities. Based on the new intensive targets of blood pressure control (<130/80 mmHg), the blood pressure was controlled for only 25 (12%) patients.

Conclusion: The level of blood pressure control for hypertensive patients on chronic follow-up at Dessie Referral Hospital was very poor.

背景:高血压是心、脑、肾和其他疾病的危险因素。它也是过早死亡的主要原因。因此,预防、治疗和控制高血压以及降低心血管疾病的风险是非常重要的。目的:根据新的强化血压目标确定患者的血压控制水平及相关因素(方法:采用横断面研究设计,评估2019年2月15日至4月15日患者的血压控制水平及相关因素。通过系统抽样技术选取216例患者。结果:203例高血压患者中,女性102例(50.2%)。最后一次随访时记录的患者平均年龄为55.2岁(SD=±14.47)。约51.2%的患者自诊断为高血压之日起不到5年。大多数研究参与者(111人,54.7%)同时使用两种抗高血压药物。最常见的降压药物是氢氯噻嗪(HCT),占25%(12.3%)。最常见的联合药物治疗是HCT和钙通道阻滞剂的联合治疗,占62%(30.5%)。心衰(22,20.8%)、中风(18,16.98%)和血脂异常(17,16.04%)是前三大合并症。结论:德西转诊医院慢性随访高血压患者血压控制水平较差。
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引用次数: 0
Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania. 坦桑尼亚390名大学员工动态血压特征及其与心血管危险因素的相关性
IF 2.2 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-12-23 eCollection Date: 2020-01-01 DOI: 10.2147/IBPC.S280763
Godfrey Chuwa, Pilly Chillo

Background: Hypertension is a major risk factor for cardiovascular morbidity and mortality. Increasingly, evidence suggests that 24-hour ambulatory blood pressure (BP) monitoring (ABPM) is more accurate than clinic BP in predicting cardiovascular risk. However, this association has not been widely studied in subSaharan Africa, especially in Tanzania.

Aim: To explore the relationship between 24-hour ABPM profiles and cardiovascular risk factors in comparison with clinic BP among Muhimbili University of Health and Allied Sciences (MUHAS) employees.

Methods: A descriptive cross-sectional study was conducted from October 2018 to February 2019. Socio-demographic and cardiovascular risk information was gathered. We used an automated ABPM device to record 24-hour ambulatory BP. Correlation between BP profiles and cardiovascular risk factors was done using Pearson's correlation coefficient, and independent factors for hypertension were determined using logistic regression analysis. P-value of <0.05 was considered statistically significant.

Results: In total, 390 employees participated. Their mean age was 40.5 ± 8.9 years, and 53.6% were men. The mean office systolic and diastolic BP were 126±12 mmHg and 78±13 mmHg, respectively, while the corresponding values for mean 24-hour ABPM were 122±14 and 75±10 mmHg. The prevalence of hypertension was 23.1%. The prevalence of white coat hypertension was 16.2%, while masked hypertension and nocturnal non-dipping were present in 11.5 and 66.7%, respectively. Overall, the mean 24-hour systolic BP showed the strongest correlations with cardiovascular risk factors while mean office systolic BP showed least. Independent associated factors of hypertension were male gender, age ≥40 years, family history of hypertension, central obesity, raised cholesterol and uric acid levels, all p<0.01.

Conclusion: Compared to office BP, ABPM measurements had stronger correlations with cardiovascular risk factors in this population, and therefore likely to reflect true BP. ABPM has revealed high proportion of masked, white coat and nocturnal non-dipping, supporting use of ABPM to detect these clinically important BP profiles.

背景:高血压是心血管疾病发病和死亡的主要危险因素。越来越多的证据表明,24小时动态血压监测(ABPM)在预测心血管风险方面比临床血压更准确。然而,在撒哈拉以南非洲,特别是坦桑尼亚,这种联系尚未得到广泛研究。目的:探讨Muhimbili卫生与联合科学大学(MUHAS)员工24小时血压与心血管危险因素的关系。方法:于2018年10月至2019年2月进行描述性横断面研究。收集社会人口统计学和心血管风险信息。我们使用自动ABPM设备记录24小时动态血压。采用Pearson相关系数分析血压与心血管危险因素的相关性,采用logistic回归分析确定高血压的独立因素。结果的p值:共有390名员工参与。平均年龄40.5±8.9岁,男性53.6%。平均收缩压和舒张压分别为126±12 mmHg和78±13 mmHg,平均24小时ABPM分别为122±14和75±10 mmHg。高血压患病率为23.1%。白大褂高血压患病率为16.2%,隐匿性高血压和夜间不沾高血压患病率分别为11.5%和66.7%。总体而言,平均24小时收缩压与心血管危险因素的相关性最强,而平均办公室收缩压与心血管危险因素的相关性最小。高血压的独立相关因素有男性、年龄≥40岁、高血压家族史、中心性肥胖、胆固醇和尿酸水平升高等。结论:与办公室血压相比,ABPM测量与该人群心血管危险因素的相关性更强,因此可能反映真实的血压。ABPM显示了高比例的蒙面、白大褂和夜间不浸入,支持使用ABPM检测这些临床重要的血压特征。
{"title":"Ambulatory Blood Pressure Profiles and Correlation with Cardiovascular Risk Factors in a Sample of 390 University Employees in Tanzania.","authors":"Godfrey Chuwa,&nbsp;Pilly Chillo","doi":"10.2147/IBPC.S280763","DOIUrl":"https://doi.org/10.2147/IBPC.S280763","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major risk factor for cardiovascular morbidity and mortality. Increasingly, evidence suggests that 24-hour ambulatory blood pressure (BP) monitoring (ABPM) is more accurate than clinic BP in predicting cardiovascular risk. However, this association has not been widely studied in subSaharan Africa, especially in Tanzania.</p><p><strong>Aim: </strong>To explore the relationship between 24-hour ABPM profiles and cardiovascular risk factors in comparison with clinic BP among Muhimbili University of Health and Allied Sciences (MUHAS) employees.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted from October 2018 to February 2019. Socio-demographic and cardiovascular risk information was gathered. We used an automated ABPM device to record 24-hour ambulatory BP. Correlation between BP profiles and cardiovascular risk factors was done using Pearson's correlation coefficient, and independent factors for hypertension were determined using logistic regression analysis. <i>P</i>-value of <0.05 was considered statistically significant.</p><p><strong>Results: </strong>In total, 390 employees participated. Their mean age was 40.5 ± 8.9 years, and 53.6% were men. The mean office systolic and diastolic BP were 126±12 mmHg and 78±13 mmHg, respectively, while the corresponding values for mean 24-hour ABPM were 122±14 and 75±10 mmHg. The prevalence of hypertension was 23.1%. The prevalence of white coat hypertension was 16.2%, while masked hypertension and nocturnal non-dipping were present in 11.5 and 66.7%, respectively. Overall, the mean 24-hour systolic BP showed the strongest correlations with cardiovascular risk factors while mean office systolic BP showed least. Independent associated factors of hypertension were male gender, age ≥40 years, family history of hypertension, central obesity, raised cholesterol and uric acid levels, all p<0.01.</p><p><strong>Conclusion: </strong>Compared to office BP, ABPM measurements had stronger correlations with cardiovascular risk factors in this population, and therefore likely to reflect true BP. ABPM has revealed high proportion of masked, white coat and nocturnal non-dipping, supporting use of ABPM to detect these clinically important BP profiles.</p>","PeriodicalId":45299,"journal":{"name":"Integrated Blood Pressure Control","volume":"13 ","pages":"197-208"},"PeriodicalIF":2.2,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/d3/ibpc-13-197.PMC7767712.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38766337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Peri-Procedural Blood Pressure Changes and Their Relationship with MACE in Patients Undergoing Percutaneous Coronary Intervention: A Cross-Sectional Study. 经皮冠状动脉介入治疗患者术中血压变化及其与MACE的关系:一项横断面研究。
IF 2.2 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-12-10 eCollection Date: 2020-01-01 DOI: 10.2147/IBPC.S268848
Susan Labib, Hussein Heshmat Kassem, Hossam Kandil

Background: Peri-procedural blood-pressure (BP) changes were investigated and correlated to Major adverse cardiovascular events (MACE) as predictor of outcome for patients undergoing percutaneous coronary intervention (PCI); whether acute coronary syndrome (Unstable angina, or MI; STEMI or NSTEMI) or scheduled for elective PCI.

Methods: Resting BP in the 204 recruited patients undergoing PCI throughout 2018 was measured thrice - in the ward before transferring to the cardiac catheterization lab (cath lab), in the cath lab, and after transfer to the recovery room. Patients were categorized based on their systolic and diastolic BP peri-procedural difference as systolic (SBP): with a large difference (>20 mmHg, n=47), with a small difference (≤20 mmHg, n=157) (shock patients excluded); diastolic (DBP): with a large difference (>10 mmHg, n=65), and with a small difference (≤10 mmHg, n=139). The primary end-points were MACE including all-cause mortality, non-fatal myocardial infarction, and stroke during the hospital stay. The Mann-Whitney U and Chi-square tests were used to analyze the data accordingly (p<0.005).

Results: Within the category of MACE, cardiac mortality was the only adverse cardiac event encountered in the study sample. Cardiac mortality was significantly higher in both the large SBP-difference group versus the other group (10.6% vs 0.6%, p=0.003) and the large DBP-difference group versus the small-difference group (7.7% vs 0.7%, p=0.013).

Conclusion: Peri-procedural systolic and diastolic BP differences, greater than 20 mmHg and 10 mmHg, respectively, correlated with MACE in all patients undergoing PCI.

背景:研究了术中血压(BP)变化与主要不良心血管事件(MACE)的相关性,并将其作为经皮冠状动脉介入治疗(PCI)患者预后的预测因子;是否急性冠状动脉综合征(不稳定型心绞痛,或心肌梗死);STEMI或NSTEMI)或计划进行选择性PCI。方法:对2018年全年接受PCI治疗的204例患者的静息血压进行了三次测量,分别是在转入心导管实验室(cath lab)前、在cath实验室和转入康复室后。根据患者的收缩压和舒张压围手术期差异将患者分为收缩压(SBP):差异大(>20 mmHg, n=47),差异小(≤20 mmHg, n=157)(排除休克患者);舒张压(DBP):差异较大(> 10mmhg, n=65),差异较小(≤10mmhg, n=139)。主要终点为MACE,包括住院期间的全因死亡率、非致死性心肌梗死和卒中。使用Mann-Whitney U检验和卡方检验对数据进行相应的分析(结果:在MACE类别中,心脏死亡是研究样本中遇到的唯一不良心脏事件。舒张压差异大组的心脏死亡率显著高于其他组(10.6% vs 0.6%, p=0.003),舒张压差异大组的心脏死亡率显著高于舒张压差异小组(7.7% vs 0.7%, p=0.013)。结论:所有PCI患者术中收缩压和舒张压差异分别大于20mmhg和10mmhg与MACE相关。
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引用次数: 1
Anthropometric Indexes for Predicting High Blood Pressure in Vietnamese Adults: A Cross-Sectional Study. 预测越南成人高血压的人体测量指标:一项横断面研究。
IF 2.2 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-12-01 eCollection Date: 2020-01-01 DOI: 10.2147/IBPC.S281996
Quan Nguyen Minh, Minh Hoang Nguyen Vo

Background: The rate of hypertension and obesity is increasing in Vietnamese society. This study aimed to focus on assessing the relationship between anthropometric indexes (body mass index (BMI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR)) and high blood pressure to determine which is the best predictor for high blood pressure among adults over 18 years in Vietnam.

Methods: A cross-sectional study of 1636 people was conducted. People who were over 18 years old, healthy or had hyperlipidemia and on the treatment were recruited. Patients with cancer, heart disease, diabetes, kidney disease, and hypertension were excluded. Information on demographics, smoking and drinking habits, weight, height, waist circumference, and blood pressure was collected. Areas under receiver operating characteristic curves (AUCs) were examined to determine the predictability of anthropometric indicators for high blood pressure in men and women. Logistic regression analysis, stratified by gender, was performed to examine the association between anthropometric indexes and high blood pressure.

Results: In this study, the percentage of people with high blood pressure was 10.51%. The AUC for the WHtR was significantly greater than for the BMI for both genders. Logistic regression demonstrated that only WHtR had a significant positive association with high blood pressure among women. The optimal WHtR cut-off value for predicting high blood pressure in men and women were 0.47 and 0.50, respectively.

Conclusion: Among the indicators analyzed in this study, WHtR was the best for the predicting of the presence of high blood pressure, in both men and women. However, WHtR could only explain the changes of high blood pressure in women.

背景:越南社会高血压和肥胖率呈上升趋势。本研究旨在重点评估人体测量指数(身体质量指数(BMI)、腰高比(WHtR)、腰臀比(WHR))与高血压之间的关系,以确定哪一个是越南18岁以上成年人高血压的最佳预测指标。方法:对1636人进行横断面研究。研究人员招募了年龄在18岁以上、健康或患有高脂血症并正在接受治疗的人。排除了癌症、心脏病、糖尿病、肾病和高血压患者。收集了人口统计、吸烟和饮酒习惯、体重、身高、腰围和血压等信息。检查受试者工作特征曲线(auc)下的区域,以确定男性和女性高血压人体测量指标的可预测性。采用Logistic回归分析,按性别分层,检验人体测量指标与高血压之间的关系。结果:本研究中高血压患者的比例为10.51%。无论男女,WHtR的AUC都明显大于BMI。Logistic回归显示,女性中只有WHtR与高血压有显著正相关。预测男性和女性高血压的最佳WHtR临界值分别为0.47和0.50。结论:在本研究分析的指标中,WHtR在男性和女性中都是预测高血压存在的最佳指标。然而,WHtR只能解释女性高血压的变化。
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引用次数: 5
Prevalence of Hypertension and Its Associated Factors Among Gimbi Town Residents, Ethiopia: A Community-Based Cross-Sectional Study. 埃塞俄比亚金比镇居民的高血压患病率及其相关因素:一项基于社区的横断面研究。
IF 1.5 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-11-26 eCollection Date: 2020-01-01 DOI: 10.2147/IBPC.S277582
Birhanu Yadecha, Firew Tekle, Getahun Fetensa, Ashenafi Habte, Bisrat Zeleke

Background: Globally, sixty-two percent of cerebrovascular disease and forty-nine percent of ischemic heart disease are attributable to increased blood pressure. Half of the patients with stroke and heart disease were due to hypertension.

Objective: This study aimed to identify prevalence of hypertension and its associated factors in Gimbi town, Ethiopia.

Methods: We conducted a community-based cross-sectional study from May to June 2017 on 471 participants in Gimbi town, western Ethiopia. A systematic sampling method was used to recruit study participants. Data collectors used structured questionnaires to gather data through face to face interview. The standardized procedure followed to measure blood pressure and anthropometric measurements by trained extension health workers. We entered data into Epi-data and exported to SPSS version 20.00 for analysis. Variables having a P-value less than or equal to 0.05 were declared as statistically significant in multivariable analysis.

Results: Four hundred seventy-one participants were included with a response rate of 98.85%, and 248 (52.6%) were female. The prevalence of isolated systolic and diastolic hypertension was 9.55% and 9.3%, respectively. Of 157 (33.5%) hypertensive participants, 117 (24.8%) were newly diagnosed. Age 35-55 [AOR: 2.335 95% CI (1.360-4.009)], ≥55 [(AOR: 3.566 95% CI (1.288-9.876))], occupation, government employee [(AOR: 3.072 95% CI (1.458-6.474))], merchants [(AOR: 3.177 95% CI (1.290-7.824))], ever alcohol drinker [(AOR: 2.333 95% CI (1.320-4.122))], and family history of hypertension [(AOR: 6.642 95% CI (4.068-10.843))] were found to be predictor variables for hypertension.

Conclusion: The findings of this study indicated a hidden high prevalence of hypertension indicating the need for stakeholders' collaboration to design and implement a mobile blood pressure screening programs at the community level.

背景:全球有 62% 的脑血管疾病和 49% 的缺血性心脏病可归因于血压升高。在中风和心脏病患者中,有一半是由高血压引起的:本研究旨在确定埃塞俄比亚金比镇的高血压患病率及其相关因素:我们于 2017 年 5 月至 6 月在埃塞俄比亚西部金比镇对 471 名参与者进行了一项基于社区的横断面研究。研究采用系统抽样法招募参与者。数据收集人员使用结构化问卷,通过面对面访谈收集数据。经过培训的推广卫生工作者按照标准化程序测量血压和人体测量数据。我们将数据输入 Epi-data,并导出到 SPSS 20.00 版进行分析。在多变量分析中,P 值小于或等于 0.05 的变量被视为具有统计学意义:共纳入 471 名参与者,回复率为 98.85%,其中 248 人(52.6%)为女性。孤立的收缩期和舒张期高血压患病率分别为 9.55% 和 9.3%。在 157 名(33.5%)高血压患者中,有 117 名(24.8%)是新确诊的。年龄 35-55 [AOR: 2.335 95% CI (1.360-4.009)]、≥55 [(AOR: 3.566 95% CI (1.288-9.876))]、职业、政府雇员[(AOR: 3.072 95% CI (1.458-6.474))]、商人[(AOR: 3.177 95% CI (1.290-7.824))]、曾经酗酒[(AOR: 2.335 95% CI (1.360-4.009))]。824))]、曾经饮酒[(AOR:2.333 95% CI(1.320-4.122))]和高血压家族史[(AOR:6.642 95% CI(4.068-10.843))]被认为是高血压的预测变量:本研究的结果表明,高血压的发病率较高,这表明需要利益相关者合作,在社区层面设计和实施流动血压筛查计划。
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引用次数: 0
Matrix Metalloproteinases and Hypertension-Mediated Organ Damage: Current Insights. 基质金属蛋白酶和高血压介导的器官损伤:当前的见解。
IF 2.2 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-11-02 eCollection Date: 2020-01-01 DOI: 10.2147/IBPC.S223341
Valeria Bisogni, Alberto Cerasari, Giacomo Pucci, Gaetano Vaudo

Matrix metalloproteinases (MMPs) are important extracellular enzymes involved in many physiological and pathological processes. Changes in the activity and concentration of specific MMPs, as well as the unbalance with their inhibitors (tissue inhibitors of metalloproteinases - TIMPs), have been described as a part of the pathogenic cascade promoted by arterial hypertension. MMPs are able to degrade various protein substrates in the extracellular matrix, to influence endothelial cells function, vascular smooth muscle cells migration, proliferation and contraction, and to stimulate cardiomyocytes changes. All these processes can be activated by chronically elevated blood pressure values. Animal and human studies demonstrated the key function of MMPs in the pathogenesis of hypertension-mediated vascular, cardiac, and renal damage, besides age and blood pressure values. Thus, the role of MMPs as biomarkers of hypertension-mediated organ damage and potential pharmacological treatment targets to prevent further cardiovascular and renal complications in hypertensive population is increasingly supported. In this review, we aimed to describe the main scientific evidence about the behavior of MMPs in the development of vascular, cardiac, and renal damage in hypertensive patients.

基质金属蛋白酶(MMPs)是一种重要的细胞外酶,参与许多生理和病理过程。特异性MMPs活性和浓度的变化,以及与它们的抑制剂(组织金属蛋白酶抑制剂- TIMPs)的不平衡,已被描述为由动脉高血压促进的致病性级联反应的一部分。MMPs能够降解细胞外基质中的各种蛋白底物,影响内皮细胞功能,血管平滑肌细胞的迁移、增殖和收缩,刺激心肌细胞的变化。所有这些过程都可以被长期升高的血压值激活。动物和人体研究表明,除了年龄和血压值外,MMPs在高血压介导的血管、心脏和肾脏损害的发病机制中也起着关键作用。因此,MMPs作为高血压介导的器官损伤的生物标志物和潜在的药物治疗靶点在高血压人群中预防进一步的心血管和肾脏并发症的作用越来越得到支持。在这篇综述中,我们旨在描述MMPs在高血压患者血管、心脏和肾脏损害发展中的主要科学证据。
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引用次数: 9
Adherence to Lifestyle Modifications and Associated Factors Among Adult Hypertensive Patients Attending Chronic Follow-Up Units of Dessie Referral Hospital, North East Ethiopia, 2020. 埃塞俄比亚东北部Dessie转诊医院慢性随访单元成年高血压患者生活方式改变依从性及相关因素
IF 2.2 Q3 PERIPHERAL VASCULAR DISEASE Pub Date : 2020-10-23 eCollection Date: 2020-01-01 DOI: 10.2147/IBPC.S275575
Atsedemariam Andualem, Habtam Gelaye, Yitayish Damtie

Background: Hypertension is a major health problem throughout the world which affects over one billion people due to severe complications and inadequate control. Even though lifestyle modification is one of the most effective ways to prevent and control hypertension, only little emphasis has been given for it compared with treating hypertension with medication. Therefore, the aim of this study was to assess adherence to lifestyle modifications and associated factors among hypertensive patients attending Dessie referral hospital.

Materials and methods: Institutional-based cross-sectional study design was conducted among 301 hypertensive patients during May and June, 2020. The study participants were selected with a convenient sampling technique due to the COVID-19 pandemic. Data were collected using pre-tested and structured face to face interviewer-administered questionnaire and checked, cleaned and entered into Epi data version 4.4 and exported to SPSS version 25.0 software for analysis. The associations between independent variables and dependent variable were analyzed using binary logistic regression models.

Results: A total of 301 respondents participated in the study yielding a response of 100%. The overall adherence in this study was only 23.6%. Independent predictors of adherence to lifestyle modifications were divorced (AOR=0.35; 95% CI (0.13-0.94)) and widowed (AOR=0.27; 95% CI (0.10-0.75)), secondary school education (AOR=4.85; 95% CI (1.54-15.22)), no regular income (AOR=0.22; 95% CI (0.08-0.65)) or monthly income of ≥3000 ETB (AOR=5.58; 95% CI (2.46-12.66)), having co-morbidities (AOR=2.37; CI (1.23-4.57)), good knowledge about the disease (AOR=1.83; CI (0.92-3.65)) and good self-efficacy (AOR=3.64; CI (1.75-7.55)).

Conclusion and recommendations: The overall adherence to recommended lifestyle modifications was very low. The independent predictors were marital status, educational level, monthly income, having co-morbidities, knowledge and self-efficacy. Therefore, multifaceted and collaborative implementation of strategies about lifestyle modifications for hypertension prevention and control are needed to address barriers at the patient, provider, system and community levels.

背景:高血压是世界范围内的一个主要健康问题,由于严重并发症和控制不足,影响了超过10亿人。尽管改变生活方式是预防和控制高血压最有效的方法之一,但与药物治疗高血压相比,人们对它的重视程度却很少。因此,本研究的目的是评估在Dessie转诊医院就诊的高血压患者对生活方式改变的依从性及其相关因素。材料与方法:采用基于机构的横断面研究设计,于2020年5 - 6月对301例高血压患者进行研究。由于COVID-19大流行,采用方便的抽样技术选择了研究参与者。数据采用预测、结构化的面对面访谈问卷收集,经检查、清理后录入Epi数据4.4版,导出至SPSS 25.0版软件进行分析。采用二元logistic回归模型分析自变量与因变量之间的关系。结果:共有301名受访者参与了这项研究,并获得了100%的回应。本研究的总体依从性仅为23.6%。生活方式改变依从性的独立预测因子为离婚(AOR=0.35;95% CI(0.13-0.94))和丧偶(AOR=0.27;95% CI(0.10-0.75))、中学教育程度(AOR=4.85;95% CI(1.54-15.22)),无固定收入(AOR=0.22;95% CI(0.08-0.65))或月收入≥3000 ETB (AOR=5.58;95% CI(2.46-12.66)),有合并症(AOR=2.37;CI(1.23-4.57)),对疾病有良好的了解(AOR=1.83;CI(0.92-3.65))和良好的自我效能(AOR=3.64;CI(1.75 - -7.55))。结论和建议:对所建议的生活方式改变的总体依从性非常低。独立预测因子为婚姻状况、受教育程度、月收入、是否有合并症、知识和自我效能感。因此,需要多方协作实施改变生活方式以预防和控制高血压的策略,以解决患者、提供者、系统和社区层面的障碍。
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引用次数: 16
期刊
Integrated Blood Pressure Control
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