scholarly journals Risk factors for postpartum readmission with severe hypertension within the first 21 days after delivery

2022 ◽  
Vol 226 (1) ◽  
pp. S411
Author(s):  
Jennifer E. Powel ◽  
Alexandra M. Edwards ◽  
Samantha J. Mullan ◽  
Madeline M. L'Ecuyer ◽  
Tracy M. Tomlinson
Keyword(s):  
Risk Factors ◽  
Severe Hypertension

P6369Prevalence of severe hypertension in a sub-Saharan African community

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Gaye ◽  
A L Janeczek ◽  
X Jouven ◽  
D Luu ◽  
E Marijon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Rural Areas ◽  
Severe Hypertension ◽  
Blood Pressure Measurement ◽  
Target Organ Damage ◽  
Sub Saharan Africa ◽  
Global Health Initiative ◽  
Increased Risk ◽  
Sub Saharan

Abstract Background Individuals with SH have high 10-year risk of cardiovascular disease, especially when additional risk factors or target organ damage are present. Though some data from in-hospital or selected populations are available, there are no studies reporting community-level prevalence of Severe Hypertension (SH) in sub-Saharan Africa. Purpose Using a cross-sectional design in Abidjan (Ivory Coast), we assessed prevalence of Severe Hypertension among adults. Methods Study participants were recruited within the framework of The Heart Fund's global health initiative. Data were collected in August 2016 from 6 randomly selected sites, ensuring representativeness of both urban and rural areas. Blood pressure (BP) was measured twice, 10 minutes apart, after optimal resting time. Blood pressure measurement were standardized between sites and SH was defined as systolic blood pressure ≥180 and/or diastolic blood pressure ≥110 mmHg at both readings. Demographics and data on cardiovascular history/risk factors were collected in the field. Ethics approval for the study was obtained from the National Ethical Committee of Côte d'Ivoire and written informed consent was obtained from all adult patients. Results Among 1,785 subjects examined, 1,182 aged between 18 and 75 years were included in this analysis. The prevalence of SH was 14.1% (12.5% females vs 17.0% males; P=0.03) (Figure). Among participants with severe hypertension, 28.9% were either undiagnosed or untreated. Alarmingly, subjects at high cardiovascular risk (age ≥60 years and/or obese) had even higher prevalence of overall SH (29.6% and 24.9%, respectively) as well as undiagnosed/untreated SH (29.4% and 24.6%). SH prevalence was almost double in urban compared to rural areas (17.0% vs. 9.2%, P=0.02); however, conversely, undiagnosed/untreated SH was significantly higher in rural areas (50.4% vs 21.9%). Compared to normal bodyweight, those who were overweight and obese had a 1.95-fold (95% CI, 1.30–2.93; P<0.001)and 4.24-fold (95% CI, 2.68–6.74; P<0.001)increased odds of SH (adjusting for age and sex), respectively. Similarly, participants ≥60 years had a 6.04-fold (95% CI, 3.93–9.36; P<0.001)increased risk of undiagnosed SH compared to under 50 years. Finally, men had higher odds of SH compared to women (OR 1.71, 95% CI, 1.19–2.47; P=0.004). Figure 1 Conclusion(s) Our community-based study revealed very high prevalence of SH among adults in Abidjan area, with almost one out of every seven having SH. This underscores SH as a growing public health problemin sub-Saharan Africa.More concerning, a significant (almost one third) proportion of them were either undiagnosed or untreated.

scholarly journals 989: Prevalence and risk factors for new onset severe hypertension during labor

2017 ◽  
Vol 216 (1) ◽  
pp. S556-S557
Author(s):  
Nana-Ama E. Ankumah ◽  
Mesk Alrais ◽  
Farah H. Amro ◽  
Rachel Landgren ◽  
Baha M. Sibai
Keyword(s):  
Risk Factors ◽  
Severe Hypertension ◽  
New Onset

Prevalence and Risk Factors for New-Onset Hypertension in Labor

2019 ◽  
Vol 37 (05) ◽  
pp. 543-547
Author(s):  
Nana-Ama E. Ankumah ◽  
Mesk A. Alrais ◽  
Farah H. Amro ◽  
Rachel L. Wiley ◽  
Baha M. Sibai
Keyword(s):  
Risk Factors ◽  
Mild Hypertension ◽  
Severe Hypertension ◽  
Adverse Outcomes ◽  
Chi Square ◽  
Elevated Pressures ◽  
Chi Square Test ◽  
History Of ◽  
Blood Pressures ◽  
New Onset

Abstract Objective Little is known about prevalence, risk factors, rate of treatment, or adverse outcomes associated with intrapartum hypertension. Thus, our objective was to describe these findings. Study Design This was a retrospective study of laboring term gestations with no history of hypertensive disorders. Intrapartum blood pressures were reviewed, and women were subdivided based on blood pressures: normal (<140 mm Hg systolic and <90 mm Hg diastolic), mild hypertension (140–159 or 90–109), and severe hypertension (≥ 160 or ≥ 110). Groups were compared using chi-square test and analysis of variance. Results A total of 724 women were studied during 4 months: 248 (34%) had mild and 69 (10%) had severe hypertension. Severe hypertensives were more likely to be nulliparous, obese, or have received an epidural or oxytocin. There were no cases of eclampsia, stroke, or pulmonary edema in severe hypertensives (95% confidence interval, 0–5). Despite severely elevated pressures, only 4/69 (6%) patients received intravenous antihypertensive therapy, and 3 (4%) required medications at discharge. Conclusion One in 3 women exhibits mild hypertension and 1 in 10 develop severe hypertension in labor. Only 6% of patients received treatment for severe blood pressures. This study highlights lack of treatment of hypertension in labor and further investigation into causes and outcomes of intrapartum elevations of blood pressures.

Incidence and Risk Factors for Postpartum Severe Hypertension in Women with Underlying Chronic Hypertension

2018 ◽  
Vol 36 (07) ◽  
pp. 737-741
Author(s):  
Angelica V. Glover ◽  
Alan Tita ◽  
Joseph R. Biggio ◽  
Sarah B. Anderson ◽  
Lorie M. Harper
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Severe Hypertension ◽  
Care Center ◽  
Tertiary Care ◽  
Blood Pressure Level ◽  
Chronic Hypertension ◽  
Antihypertensive Medications ◽  
Time To Diagnosis ◽  
Blood Pressures

Objective To determine risk factors and time to diagnosis of postpartum severe hypertension (PHTN) in women with chronic hypertension (CHTN). Study Design Retrospective cohort of singleton pregnancies with CHTN at a tertiary care center. The primary outcome was PHTN, defined as hypertension ≥160/ ≥ 110 mm Hg during an emergency room (ER) or outpatient visit, or hospitalization within 8 weeks postpartum. Multivariable logistic regression was used to assess independent risk factors for PHTN. Results Two-hundred thirty-five women had CHTN: 30 (12.8%) were diagnosed with PHTN, and 17 (7.2%) were hospitalized or seen in the ER for PHTN. Women with PHTN had more severe superimposed pre-eclampsia (p < 0.05), higher average systolic blood pressures at discharge (141 vs. 135 mm Hg, p = 0.04), and required antihypertensives after delivery (p < 0.01). The number of antihypertensive medications (adjusted odds ratio [aOR] 1.78, 95% confidence interval [CI], 1.25–2.55) and a systolic blood pressure >135 mm Hg (aOR 4.55, 95% CI, 1.64–12.61) at discharge remained independently associated with PHTN. Median time to diagnosis of PHTN was 10 days (interquartile range [IQR] 6–32 days); time to diagnosis among women requiring readmission or ER evaluation was 8 days (IQR 5–11 days). Conclusion PHTN occurred in 13% of women with CHTN, and was associated with blood pressure level and number of medications at discharge.

Elevated level of circulatory sTLT1 induces inflammation through SYK/MEK/ERK signalling in coronary artery disease

2019 ◽  
Vol 133 (22) ◽  
pp. 2283-2299
Author(s):  
Apabrita Ayan Das ◽  
Devasmita Chakravarty ◽  
Debmalya Bhunia ◽  
Surajit Ghosh ◽  
Prakash C. Mandal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Chronic Inflammation ◽  
Ex Vivo ◽  
Human Subjects ◽  
Critical Role ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tnf Α ◽  
Artery Disease

Abstract The role of inflammation in all phases of atherosclerotic process is well established and soluble TREM-like transcript 1 (sTLT1) is reported to be associated with chronic inflammation. Yet, no information is available about the involvement of sTLT1 in atherosclerotic cardiovascular disease. Present study was undertaken to determine the pathophysiological significance of sTLT1 in atherosclerosis by employing an observational study on human subjects (n=117) followed by experiments in human macrophages and atherosclerotic apolipoprotein E (apoE)−/− mice. Plasma level of sTLT1 was found to be significantly (P<0.05) higher in clinical (2342 ± 184 pg/ml) and subclinical cases (1773 ± 118 pg/ml) than healthy controls (461 ± 57 pg/ml). Moreover, statistical analyses further indicated that sTLT1 was not only associated with common risk factors for Coronary Artery Disease (CAD) in both clinical and subclinical groups but also strongly correlated with disease severity. Ex vivo studies on macrophages showed that sTLT1 interacts with Fcɣ receptor I (FcɣRI) to activate spleen tyrosine kinase (SYK)-mediated downstream MAP kinase signalling cascade to activate nuclear factor-κ B (NF-kB). Activation of NF-kB induces secretion of tumour necrosis factor-α (TNF-α) from macrophage cells that plays pivotal role in governing the persistence of chronic inflammation. Atherosclerotic apoE−/− mice also showed high levels of sTLT1 and TNF-α in nearly occluded aortic stage indicating the contribution of sTLT1 in inflammation. Our results clearly demonstrate that sTLT1 is clinically related to the risk factors of CAD. We also showed that binding of sTLT1 with macrophage membrane receptor, FcɣR1 initiates inflammatory signals in macrophages suggesting its critical role in thrombus development and atherosclerosis.

The Preschool Stuttering Screen for Health Care Professionals

2011 ◽  
Vol 21 (2) ◽  
pp. 59-62
Author(s):  
Joseph Donaher ◽  
Christina Deery ◽  
Sarah Vogel
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Differential Diagnosis ◽  
Preschool Children ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Evidence Based ◽  
Developmental Profile

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

Clinical Response to Questions Regarding Outcomes and Therapy Efficacy

2010 ◽  
Vol 20 (3) ◽  
pp. 76-83 ◽  
Author(s):  
Joseph Donaher ◽  
Tom Gurrister ◽  
Irving Wollman ◽  
Tim Mackesey ◽  
Michelle L. Burnett
Keyword(s):  
Risk Factors ◽  
Clinical Response ◽  
Speech Language Pathologists ◽  
Specific Therapy ◽  
Therapy Efficacy ◽  
Therapy Program ◽  
Adults Who Stutter ◽  
Cure Rates

Parents of children who stutter and adults who stutter frequently ask speech-language pathologists to predict whether or not therapy will work. Even though research has explored risk-factors related to persistent stuttering, there remains no way to determine how an individual will react to a specific therapy program. This paper presents various clinicians’answers to the question, “What do you tell parents or adults who stutter when they ask about cure rates, outcomes, and therapy efficacy?”

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