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Central vs. Brachial Blood Pressure and Pulse Pressure Amplification for Mortality Risk Prediction in Patients Undergoing Coronary Angiography.
IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-19 DOI: 10.1093/ajh/hpae156
Clara Daschner, Marcus E Kleber, Niklas Ayasse, Ksenija Stach, Gökhan Yücel, Faeq Husain-Syed, Alexander Niessner, Bernd Krüger, Winfried März, Bernhard K Krämer, Babak Yazdani

Background: Arterial hypertension is a significant risk factor for cardiovascular (CV) morbidity and mortality. Although central blood pressure (BP) evaluation is considered the gold standard, the reliability of non-invasive measurements remains unclear. Therefore, we compared the predictive value of invasively measured central BP with non-invasively measured brachial BP and analyzed pulse pressure (PP) amplification (delta-PP; difference between central and peripheral PP) as an independent predictor of mortality.

Methods: We analyzed systolic (SBP), diastolic (DBP), mean arterial BP (MAP), PP and delta-PP as predictors of CV and all-cause mortality in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, involving 3316 patients referred for coronary angiography.

Results: All brachial BP parameters, except DBP, were significantly linked to all-cause and CV mortality in a univariate analysis. A 10 mmHg increase in SBP, MAP, and PP corresponded to increased risks of all-cause (11%, 10%, and 19%) and CV mortality (11%, 11%, and 18%). Central SBP and PP showed similar, but numerically weaker, associations with increased risks of all-cause (5% and 10%) and CV mortality (4% and 8%).After adjusting for age, sex, BMI, diabetes mellitus, and eGFR, only delta-PP independently predicted mortality with a 10 mmHg increase linked to a 4% reduction in all-cause and 6% reduction in CV mortality.

Conclusions: Neither brachial nor centrally measured BP parameters were independent mortality predictors in contrast to PP amplification, which remained an independent predictor of mortality in multivariate analysis, in a cohort with a medium to high CV risk profile. As PP amplification decreased, mortality increased.

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引用次数: 0
Current Status and Future Perspective of Onco-Hypertension. 肿瘤性高血压的现状与未来展望
IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-16 DOI: 10.1093/ajh/hpae099
Tatsuhiko Azegami, Hidehiro Kaneko, Shintaro Minegishi, Yuta Suzuki, Hiroyuki Morita, Katsuhito Fujiu, Norihiko Takeda, Takashi Yokoo, Yuichiro Yano, Kaori Hayashi, Akira Nishiyama, Koichi Node

Background: Hypertension and cancer are both increasing with age. Recently, the new concept of "Onco-Hypertension" has been proposed to address the mutual risks posed by hypertension and cancer and to provide comprehensive care for patients with these two conditions in an aging society.

Methods: In this review, we provide an overview of the current status and future perspective of the "Onco-Hypertension," including our research findings.

Results: Hypertension and cancer share common risk factors and may be interrelated in pathogenesis: Hypertension is involved in the development of certain cancers, and cancer survivors have a higher incidence of hypertension. With recent advances in cancer therapy, the number of cancer survivors has increased. Cancer survivors not only have a higher risk of incident hypertension but also an increased risk of future cardiovascular events, highlighting the growing importance of comprehensive care.

Conclusions: There exists a diverse array of epidemiological and pathophysiological relationships between hypertension and cancer. It is imperative to move the emerging scientific field of "Onco-Hypertension" forward through relentless research efforts.

高血压和癌症都会随着年龄的增长而增加。最近,人们提出了 "肿瘤高血压 "的新概念,以应对高血压和癌症带来的共同风险,并在老龄化社会中为患有这两种疾病的患者提供全面护理。高血压和癌症具有共同的风险因素,在发病机制上可能相互关联:高血压与某些癌症的发病有关,癌症幸存者的高血压发病率较高。随着近年来癌症治疗的进步,癌症幸存者的人数也在增加。癌症幸存者不仅发生高血压的风险较高,而且未来发生心血管事件的风险也较高,这凸显了全面护理的日益重要性。在这篇综述中,我们将概述 "肿瘤高血压 "的现状和未来前景,包括我们的研究成果。
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引用次数: 0
Dialysate Sodium Levels, Ambulatory Aortic Blood Pressure, and Arterial Stiffness in Hemodialysis Patients. 血液透析患者的透析液钠含量、流动主动脉血压和动脉僵硬度。
IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-16 DOI: 10.1093/ajh/hpae113
Thomas Weber, Martin Windpessl
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引用次数: 0
Association Between Cardiorespiratory Fitness and Trend of Age-Related Rise in Arterial Stiffness in Individuals With and Without Hypertension or Diabetes. 患有和未患有高血压或糖尿病的人的心肺功能与动脉僵化随年龄增长的趋势之间的关系。
IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-16 DOI: 10.1093/ajh/hpae124
Sae Young Jae, Kyung Hyun Lee, Hyun Jeong Kim, Setor K Kunutsor, Gary L Pierce, Stanley Sai-Chuen Hui, Mira Kang

Background: This study aimed to investigate whether higher cardiorespiratory fitness (CRF) can modify the trend of age-related rise in arterial stiffness in individuals with and without hypertension (HTN) or diabetes.

Methods: The study included 4,935 participants who underwent maximal cardiopulmonary exercise testing with respiratory gas analysis in a health screening program. CRF was directly measured using peak oxygen uptake during the cardiopulmonary exercise test, while arterial stiffness was evaluated using brachial-ankle pulse wave velocity (baPWV).

Results: Participants with high CRF levels had significantly lower baPWV compared with those with low CRF levels, regardless of HTN or diabetes status (P < 0.05). The trend of baPWV increased with age, but the rate of age-related increase in baPWV was lower in individuals with moderate-to-high CRF levels compared with those with low CRF levels, regardless of HTN or diabetes status. Joint association analysis indicated that the trend of age-related increase in baPWV was the lowest in fit individuals without HTN or diabetes compared with unfit individuals with HTN or diabetes (P < 0.01). However, the trend of age-related increase in baPWV was not attenuated in fit with HTN or diabetes compared with unfit with HTN or diabetes.

Conclusions: These findings suggest that higher CRF levels may mitigate the trend of age-related rise in arterial stiffness in individuals with and without HTN or diabetes. However, this attenuating trend appears more pronounced in individuals without HTN or diabetes.

背景:本研究旨在探讨较高的心肺功能(CRF)是否能改变高血压(HTN)或糖尿病患者与年龄相关的动脉僵化上升趋势:本研究旨在探讨较高的心肺功能(CRF)是否能改变患有或不患有高血压(HTN)或糖尿病的人的动脉僵化与年龄相关的上升趋势:该研究纳入了 4935 名参加健康筛查项目、接受最大心肺运动测试和呼吸气体分析的参与者。CRF通过心肺运动测试期间的峰值摄氧量直接测量,而动脉僵化则通过肱踝关节脉搏波速度(baPWV)进行评估:结果:与 CRF 水平低的参与者相比,无论是否患有高血压或糖尿病,CRF 水平高的参与者的 baPWV 都明显较低(p 结论:这些研究结果表明,CRF 水平高的参与者的 baPWV 明显低于 CRF 水平低的参与者:这些研究结果表明,无论是否患有高血压或糖尿病,较高的 CRF 水平都能缓解动脉僵化与年龄相关的上升趋势。不过,这种缓解趋势在无高血压和糖尿病的人群中更为明显。
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引用次数: 0
Blood Pressure Trajectories During Young Adulthood and Cardiovascular Events in Later Life. 青壮年时期的血压轨迹与晚年的心血管事件
IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-16 DOI: 10.1093/ajh/hpae126
Mengying Xia, Jaejin An, Heidi Fischer, Norrina B Allen, Vanessa Xanthakis, Yiyi Zhang

Background: Studying the association between blood pressure (BP) trajectories during young adulthood and subsequent cardiovascular disease (CVD) risk can provide insights into how long-term BP patterns in early-life influence the development of CVD later in life.

Methods: We pooled data from 2 US cohorts (Coronary Artery Risk Development in Young Adults, Framingham Heart Study). We used latent growth curve models to identify distinct BP trajectory groups between ages 18 and 39 years. We then used Cox proportional hazards models to assess the associations between BP trajectories and CVD events (composite of coronary heart disease [CHD], stroke, and heart failure [HF]) after age 40 years.

Results: We included 6,579 participants and identified 4 distinct systolic BP (SBP) trajectory groups during young adulthood. During a median follow-up of 18.2 years after age 40 years, 213 CHD, 139 stroke, 120 HF, and 400 composite CVD events occurred. Individuals in an elevated-increasing vs. low-stable SBP trajectory during young adulthood were associated with a higher risk of CVD after adjusting for traditional CVD risk factors, with hazard ratios (95% confidence interval) of 3.25 (1.63, 6.46) for CHD, 3.92 (1.63, 9.43) for stroke, 8.30 (2.97, 23.17) for HF, and 3.91 (2.38, 6.41) for composite CVD outcomes. Adding BP trajectory to BP at baseline improved model discrimination for all outcomes (changes in Harrell's C-index 0.0084-0.0192).

Conclusions: An elevated-increasing BP trajectory during young adulthood is associated with a higher risk of CVD later in life, highlighting the importance of maintaining a low-stable BP trajectory throughout the young adulthood period for prevention of CVD in later life.

背景:研究青壮年时期的血压(BP)变化轨迹与随后的心血管疾病(CVD)风险之间的关系,可以帮助我们了解生命早期的长期血压模式如何影响日后心血管疾病的发展:我们汇集了两个美国队列(CARDIA、FHS)的数据。我们使用潜在增长曲线模型来识别 18-39 岁期间不同的血压轨迹组。然后,我们使用 Cox 比例危险模型来评估 40 岁以后血压轨迹与心血管疾病事件(冠心病、中风和心力衰竭的综合征)之间的关系:我们纳入了 6,579 名参与者,并确定了青壮年时期四个不同的收缩压轨迹组。在 40 岁后 18.2 年的中位随访期间,共发生了 213 起冠心病、139 起中风、120 起心力衰竭和 400 起综合心血管疾病事件。在对传统心血管疾病风险因素进行调整后,青壮年时期收缩压升高轨迹与收缩压低稳定轨迹的个体发生心血管疾病的风险较高,发生冠心病的危险比(95% CI)为 3.25 (1.63, 6.46),发生中风的危险比为 3.92 (1.63, 9.43),发生高血压的危险比为 8.30 (2.97, 23.17),发生综合心血管疾病的危险比为 3.91 (2.38, 6.41)。在基线血压的基础上增加血压轨迹可提高模型对所有结果的判别能力(Harrell's C指数从0.0084变为0.0192):结论:青壮年时期的血压升高轨迹与日后心血管疾病的高风险相关,突出了在整个青壮年时期保持低稳定血压轨迹对预防日后心血管疾病的重要性。
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引用次数: 0
Dialysate Sodium Levels, Ambulatory Aortic Blood Pressure, and Arterial Stiffness in Hemodialysis Patients. 血液透析患者的透析液钠含量、流动主动脉血压和动脉僵硬度。
IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-16 DOI: 10.1093/ajh/hpae094
Adamantia Bratsiakou, Marieta Theodorakopoulou, Fotini Iatridi, Pantelis Sarafidis, Christos Davoulos, Dimitrios S Goumenos, Evangelos Papachristou, Marios Papasotiriou

Background: Increased aortic blood pressure (BP) and arterial stiffness are associated with higher cardiovascular risk in hemodialysis. Previous works showed that lower dialysate sodium is associated with lower brachial-BP; data on aortic-BP and arterial stiffness are limited. This study aimed to investigate the effects of different dialysate sodium concentrations on 72-hour aortic-BP and arterial stiffness parameters in hemodialysis patients.

Methods: This analysis is part of a prospective, non-randomized interventional study. Twenty-five hemodialysis patients underwent a set of 3 periods of different dialysate sodium concentrations; 6 sessions with dialysate sodium of 137 mEq/l, followed consecutively by 6 sessions with 139 mEq/l and, finally, 6 sessions with 141 mEq/l. At the start of the sixth hemodialysis session on each sodium concentration, 72-hour ABPM (Mobil-O-Graph) was performed to evaluate aortic-BP and arterial stiffness indices during the overall 72-hour, different 24-hour, daytime, and nighttime periods.

Results: Mean 72-hour aortic systolic blood pressure (SBP)/diastolic blood pressure (DBP) were higher with increasing dialysate sodium concentrations (137 mEq/l: 114.2 ± 15.3/77.0 ± 11.8 mm Hg vs. 139 mEq/l: 115.4 ± 17.3/77.9 ± 14.0 mm Hg vs. 141 mEq/l: 120.5 ± 18.4/80.5 ± 14.7 mm Hg, P = 0.002/P = 0.057, respectively). Wave-reflection parameters (AIx, AIx(75), AP) were not significantly different between the 3 dialysate sodium concentrations. Ambulatory pulse wave velocity (PWV) was significantly higher with increasing dialysate sodium concentrations (137 mEq/l: 8.5 ± 1.7 m/s vs. 139 mEq/l: 8.6 ± 1.6 m/s vs. 141 mEq/l: 8.8 ± 1.6 m/s, P < 0.001). In generalized linear mixed models including 72-hour brachial SBP as a random covariate, the adjusted marginal means of 72-hour PWV were not significantly different between groups.

Conclusions: This study showed that higher dialysate sodium concentrations are associated with significant increases in ambulatory aortic BP and PWV. These findings further support the need for modification of dialysate sodium concentration in hemodialysis.

背景:主动脉血压(BP)和动脉僵化的增加与血液透析中较高的心血管风险有关。以前的研究表明,透析液钠浓度越低,肱动脉血压越低;而有关主动脉血压和动脉僵化的数据却很有限。本研究旨在调查不同透析液钠浓度对血液透析患者 72 小时主动脉血压和动脉僵化参数的影响:本分析是一项前瞻性非随机干预研究的一部分。25 名血液透析患者接受了三组不同透析液钠浓度的透析;六次透析液钠浓度为 137meq/L,之后连续六次透析液钠浓度为 139meq/L,最后六次透析液钠浓度为 141meq/L。在每种钠浓度的第六次血液透析开始时,进行 72 小时 ABPM(Mobil-O-Graph),以评估整个 72 小时、不同 24 小时、白天和夜间的主动脉血压和动脉僵化指数:结果:72小时平均主动脉SBP/DBP随着透析液钠浓度的增加而升高(137meq/L:114.2±15.3/77.0±11.8mmHg vs 139meq/L:115.4±17.3/77.9±14.0mmHg vs 141meq/L:120.5±18.4/80.5±14.7mmHg,分别为p=0.002/p=0.057)。波反射参数(AIx、AIx(75)、AP)在三种透析液钠浓度之间无明显差异。随着透析液钠浓度的增加,动态脉搏波速度明显增加(137meq/L:8.5±1.7m/s vs 139meq/L:8.6±1.6m/s vs 141meq/L:8.8±1.6m/s,p结论:本研究表明,较低的透析液钠浓度与活动主动脉血压和脉搏波速度的显著下降有关。该研究表明,透析液钠浓度越高,动态主动脉血压和脉搏波速度就越快。这些发现进一步支持了调整血液透析中透析液钠浓度的必要性。
{"title":"Dialysate Sodium Levels, Ambulatory Aortic Blood Pressure, and Arterial Stiffness in Hemodialysis Patients.","authors":"Adamantia Bratsiakou, Marieta Theodorakopoulou, Fotini Iatridi, Pantelis Sarafidis, Christos Davoulos, Dimitrios S Goumenos, Evangelos Papachristou, Marios Papasotiriou","doi":"10.1093/ajh/hpae094","DOIUrl":"10.1093/ajh/hpae094","url":null,"abstract":"<p><strong>Background: </strong>Increased aortic blood pressure (BP) and arterial stiffness are associated with higher cardiovascular risk in hemodialysis. Previous works showed that lower dialysate sodium is associated with lower brachial-BP; data on aortic-BP and arterial stiffness are limited. This study aimed to investigate the effects of different dialysate sodium concentrations on 72-hour aortic-BP and arterial stiffness parameters in hemodialysis patients.</p><p><strong>Methods: </strong>This analysis is part of a prospective, non-randomized interventional study. Twenty-five hemodialysis patients underwent a set of 3 periods of different dialysate sodium concentrations; 6 sessions with dialysate sodium of 137 mEq/l, followed consecutively by 6 sessions with 139 mEq/l and, finally, 6 sessions with 141 mEq/l. At the start of the sixth hemodialysis session on each sodium concentration, 72-hour ABPM (Mobil-O-Graph) was performed to evaluate aortic-BP and arterial stiffness indices during the overall 72-hour, different 24-hour, daytime, and nighttime periods.</p><p><strong>Results: </strong>Mean 72-hour aortic systolic blood pressure (SBP)/diastolic blood pressure (DBP) were higher with increasing dialysate sodium concentrations (137 mEq/l: 114.2 ± 15.3/77.0 ± 11.8 mm Hg vs. 139 mEq/l: 115.4 ± 17.3/77.9 ± 14.0 mm Hg vs. 141 mEq/l: 120.5 ± 18.4/80.5 ± 14.7 mm Hg, P = 0.002/P = 0.057, respectively). Wave-reflection parameters (AIx, AIx(75), AP) were not significantly different between the 3 dialysate sodium concentrations. Ambulatory pulse wave velocity (PWV) was significantly higher with increasing dialysate sodium concentrations (137 mEq/l: 8.5 ± 1.7 m/s vs. 139 mEq/l: 8.6 ± 1.6 m/s vs. 141 mEq/l: 8.8 ± 1.6 m/s, P < 0.001). In generalized linear mixed models including 72-hour brachial SBP as a random covariate, the adjusted marginal means of 72-hour PWV were not significantly different between groups.</p><p><strong>Conclusions: </strong>This study showed that higher dialysate sodium concentrations are associated with significant increases in ambulatory aortic BP and PWV. These findings further support the need for modification of dialysate sodium concentration in hemodialysis.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"18-26"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigating the Therapeutic Potential of Sacubitril/Valsartan for Mild Hypertension in Chronic Type B Aortic Dissection Patients. 研究萨库比特利/缬沙坦对慢性 B 型主动脉夹层患者轻度高血压的治疗潜力
IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-16 DOI: 10.1093/ajh/hpae130
Wei-Zhen Tang, Wei-Ze Xu, Tai-Hang Liu
{"title":"Investigating the Therapeutic Potential of Sacubitril/Valsartan for Mild Hypertension in Chronic Type B Aortic Dissection Patients.","authors":"Wei-Zhen Tang, Wei-Ze Xu, Tai-Hang Liu","doi":"10.1093/ajh/hpae130","DOIUrl":"10.1093/ajh/hpae130","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"80-81"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk Factors Associated With Exaggerated Blood Pressure Response at the Time of Exercise Treadmill Stress Test. 与运动跑步机压力测试时血压反应过高有关的风险因素。
IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-16 DOI: 10.1093/ajh/hpae132
Vasiliki Katsi, Nikolaos Ioakeimidis, Yannis Dimitroglou, Charalambos Vlachopoulos, Konstantinos Tsioufis

Background: Exaggerated blood pressure response (EBPR) to exercise stress testing (EST) may be a marker of future hypertension and carry valuable information for the prediction of cardiovascular events. We sought to evaluate the clinical and resting EST parameters associated with an increased likelihood of EBPR.

Methods: The records of 14,073 patients (mean age: 55 ± 11 years) without known cardiovascular disease who underwent a treadmill EST were analyzed.

Results: The overall prevalence of arterial hypertension was 44%. A considerable proportion (24%) of patients exhibited EBPR. Multivariate analysis of the entire study population showed that middle-aged individuals (40-60 years old), resting systolic BP > 130 mmHg and/or diastolic BP > 80 mmHg, known arterial hypertension, current cigarette smoking, and family history of premature coronary artery disease are all independent risk factors for EBPR (all P < 0.001). Although the presence of arterial hypertension increased the likelihood of EBPR in the analysis of the entire population, the relevant association in subjects above 60 years old is statistically nonsignificant (P = 0.120). Notably, the pre-test systolic BP > 130 mmHg and/or diastolic BP > 80 mmHg level increased significantly the likelihood of manifesting EBPR in all age categories (<40, 40-60, and >60 years old) independent of hypertension presence and in all hypertensive patients independently of antihypertensive treatment intake (all P < 0.001).

Conclusions: Considering the diagnostic and prognostic utility of EBPR during treadmill EST the clinical and resting hemodynamic parameters that increase the likelihood of EBPR are targets for interventions and preventive measures to modify lifestyle risk behaviors and reduce hypertension and cardiovascular risk factors in the early stages.

背景:对运动负荷试验(EST)的夸张血压反应(EBPR)可能是未来高血压的标志,并为预测心血管事件提供有价值的信息。我们试图评估与 EBPR 可能性增加相关的临床和静息 EST 参数:方法:分析了 14073 名无已知心血管疾病的患者(平均年龄:55±11 岁)接受跑步机 EST 的记录:结果:动脉高血压的总患病率为 44%。相当一部分患者(24%)表现出 EBPR。对整个研究人群进行的多变量分析表明,中年人(40-60 岁)、静息收缩压>130 毫米汞柱和/或舒张压>80 毫米汞柱、已知动脉高血压、目前吸烟和有早产家族史、在所有年龄组(60 岁)中,与是否患有高血压无关,在所有高血压患者中,与是否接受降压治疗无关(所有 PConclusions):考虑到 EBPR 在跑步机 EST 期间的诊断和预后效用,增加 EBPR 发生可能性的临床和静息血流动力学参数是干预和预防措施的目标,以在早期阶段改变生活方式风险行为并减少高血压和心血管风险因素。
{"title":"Risk Factors Associated With Exaggerated Blood Pressure Response at the Time of Exercise Treadmill Stress Test.","authors":"Vasiliki Katsi, Nikolaos Ioakeimidis, Yannis Dimitroglou, Charalambos Vlachopoulos, Konstantinos Tsioufis","doi":"10.1093/ajh/hpae132","DOIUrl":"10.1093/ajh/hpae132","url":null,"abstract":"<p><strong>Background: </strong>Exaggerated blood pressure response (EBPR) to exercise stress testing (EST) may be a marker of future hypertension and carry valuable information for the prediction of cardiovascular events. We sought to evaluate the clinical and resting EST parameters associated with an increased likelihood of EBPR.</p><p><strong>Methods: </strong>The records of 14,073 patients (mean age: 55 ± 11 years) without known cardiovascular disease who underwent a treadmill EST were analyzed.</p><p><strong>Results: </strong>The overall prevalence of arterial hypertension was 44%. A considerable proportion (24%) of patients exhibited EBPR. Multivariate analysis of the entire study population showed that middle-aged individuals (40-60 years old), resting systolic BP > 130 mmHg and/or diastolic BP > 80 mmHg, known arterial hypertension, current cigarette smoking, and family history of premature coronary artery disease are all independent risk factors for EBPR (all P < 0.001). Although the presence of arterial hypertension increased the likelihood of EBPR in the analysis of the entire population, the relevant association in subjects above 60 years old is statistically nonsignificant (P = 0.120). Notably, the pre-test systolic BP > 130 mmHg and/or diastolic BP > 80 mmHg level increased significantly the likelihood of manifesting EBPR in all age categories (<40, 40-60, and >60 years old) independent of hypertension presence and in all hypertensive patients independently of antihypertensive treatment intake (all P < 0.001).</p><p><strong>Conclusions: </strong>Considering the diagnostic and prognostic utility of EBPR during treadmill EST the clinical and resting hemodynamic parameters that increase the likelihood of EBPR are targets for interventions and preventive measures to modify lifestyle risk behaviors and reduce hypertension and cardiovascular risk factors in the early stages.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"55-62"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Blood Pressure Cuff Sizes for Pregnant Women in the United States: Findings From the National Health and Nutrition Examination Survey. 美国孕妇的血压袖带尺寸:全国健康与营养调查的结果。
IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-16 DOI: 10.1093/ajh/hpae128
Shamim Shahi, Taylor E Streeter, Hilary K Wall, Wen Zhou, Elena V Kuklina, Sandra L Jackson

Background: The use of correctly sized blood pressure (BP) cuffs is important to ensure accurate measurement and effective management of hypertension. The goals of this study were to determine the proportions of pregnant women that would require small, adult, large, and extra-large (XL) cuff sizes, and to examine the demographic characteristics associated with need for a large or XL cuff.

Methods: This cross-sectional study analyzed 1,176 pregnant women (≥18 years) included in the National Health and Nutrition Examination Survey (NHANES) 1999-2006 cycles. Recommended BP cuff sizes, based on American Heart Association recommendations, were categorized by mid-arm circumference: small adult (≤26 cm), adult (>26 to ≤34 cm), large (>34 to ≤44 cm), and extra-large (XL) (>44 cm).

Results: Among US pregnant women, recommended cuff sizes were: 17.9% small adult, 57.0% adult, and 25.1% for large or XL. About 38.5% of non-Hispanic Black, 21.6% of Mexican American and 21.0% of non-Hispanic White pregnant women required a large or XL cuff. About 81.8% of women in the highest quartile for BMI required large or XL cuffs, which was significantly higher than women in other quartiles.

Conclusion: Roughly one out of every four pregnant women required large or XL BP cuffs. The requirement for large or XL cuffs was highest among non-Hispanic Black women and women with the highest BMI. For pregnant women, measuring the arm circumference and selecting an appropriately sized cuff is important to facilitate accurate blood pressure monitoring and hypertension management.

背景:使用尺寸正确的血压袖带对于确保准确测量和有效管理高血压非常重要。本研究的目的是确定需要小号、成人号、大号和特大号(XL)袖带的孕妇比例,并研究与需要大号或 XL 袖带相关的人口统计学特征:这项横断面研究分析了全国健康与营养调查(NHANES)1999-2006 年周期中的 1176 名孕妇(≥18 岁)。根据美国心脏协会的建议,推荐的血压袖带尺寸按中臂围分为:小型成人(≤26 厘米)、成人(>26 至≤34 厘米)、大型(>34 至≤44 厘米)和特大型(XL)(>44 厘米):结果:在美国孕妇中,推荐的袖带尺寸为结果:在美国孕妇中,推荐的袖带尺寸为:17.9% 成人小号,57.0% 成人大号,25.1% 成人大号或 XL 号。大约 38.5% 的非西班牙裔黑人、21.6% 的墨西哥裔美国人和 21.0% 的非西班牙裔白人孕妇需要大号或加大号袖带。体重指数(BMI)最高四分位数中约有 81.8% 的妇女需要大号或 XL 袖带,明显高于其他四分位数的妇女:结论:大约每四名孕妇中就有一名需要大号或超大号血压袖带。非西班牙裔黑人妇女和体重指数最高的妇女对大号或超大号袖带的需求量最大。对于孕妇来说,测量臂围和选择合适大小的袖带对于准确监测血压和管理高血压非常重要。
{"title":"Blood Pressure Cuff Sizes for Pregnant Women in the United States: Findings From the National Health and Nutrition Examination Survey.","authors":"Shamim Shahi, Taylor E Streeter, Hilary K Wall, Wen Zhou, Elena V Kuklina, Sandra L Jackson","doi":"10.1093/ajh/hpae128","DOIUrl":"10.1093/ajh/hpae128","url":null,"abstract":"<p><strong>Background: </strong>The use of correctly sized blood pressure (BP) cuffs is important to ensure accurate measurement and effective management of hypertension. The goals of this study were to determine the proportions of pregnant women that would require small, adult, large, and extra-large (XL) cuff sizes, and to examine the demographic characteristics associated with need for a large or XL cuff.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 1,176 pregnant women (≥18 years) included in the National Health and Nutrition Examination Survey (NHANES) 1999-2006 cycles. Recommended BP cuff sizes, based on American Heart Association recommendations, were categorized by mid-arm circumference: small adult (≤26 cm), adult (>26 to ≤34 cm), large (>34 to ≤44 cm), and extra-large (XL) (>44 cm).</p><p><strong>Results: </strong>Among US pregnant women, recommended cuff sizes were: 17.9% small adult, 57.0% adult, and 25.1% for large or XL. About 38.5% of non-Hispanic Black, 21.6% of Mexican American and 21.0% of non-Hispanic White pregnant women required a large or XL cuff. About 81.8% of women in the highest quartile for BMI required large or XL cuffs, which was significantly higher than women in other quartiles.</p><p><strong>Conclusion: </strong>Roughly one out of every four pregnant women required large or XL BP cuffs. The requirement for large or XL cuffs was highest among non-Hispanic Black women and women with the highest BMI. For pregnant women, measuring the arm circumference and selecting an appropriately sized cuff is important to facilitate accurate blood pressure monitoring and hypertension management.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"12-17"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dialysate Sodium, Pulse Wave Velocity, and Clinical Outcomes: The Missing Link of Sodium Stores and the Need for Rigorous Trials. 透析液钠、脉搏波速度和临床结果:钠储存的缺失环节与严格试验的必要性。
IF 3.2 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-12-16 DOI: 10.1093/ajh/hpae117
Tuncay Sahutoglu
{"title":"Dialysate Sodium, Pulse Wave Velocity, and Clinical Outcomes: The Missing Link of Sodium Stores and the Need for Rigorous Trials.","authors":"Tuncay Sahutoglu","doi":"10.1093/ajh/hpae117","DOIUrl":"10.1093/ajh/hpae117","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"76-77"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
American Journal of Hypertension
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