Why is salt-sensitivity of blood pressure, a known cardiovascular risk factor, not treated?

IntroductionOur increasing ability to link large population-based health administrative datasets to create ‘big data’ cohorts offers unique opportunities to conduct health and health services surveillance at lower costs than traditional methods using surveys or primary data collection. However, comparability of findings from big data with traditional methods is unknown. Objectives and ApproachIn the CArdiovascular HEalth in Ambulatory Care Research Team (CANHEART) ‘big data’ initiative, we linked 19 population-based health databases to obtain baseline and 5-year follow-up health information on a cohort of 9.8 million adult residents of Ontario, Canada as of January 2008. We compared cardiovascular risk factor prevalence with results from 3500 participants in the 2007-09 Canadian Health Measures Survey (CHMS), a traditional population health surveillance survey. Additionally, we determined cardiovascular preventative care use and clinical event rates by sex and age. Planned linkages to new data sources will enable continued cohort surveillance of population health-related and care indicators. ResultsCholesterol and glucose levels determined from the CANHEART cohort were comparable to the CHMS, whereas blood pressure values and obesity rates were substantially higher. Overall, receipt of cardiovascular preventive care in the CANHEART cohort was high, with 85.7% of males and 91.8% of females having blood pressure assessments, and 67.8% of males and 79.4% of females having weight assessments. Cholesterol and diabetes screening rates among those recommended for screening were over 75%. Incidence of myocardial infarction, stroke or cardiovascular death was 51% higher among males than females (3.8 and 2.5 events per 1000 person-years, respectively). Challenges encountered in analyzing data included treatment of repeated and time-varying measures, selection of valid diagnostic and physician billing codes, changing coding practices and handling of missing and outlying data. Conclusion/ImplicationsComparability of cardiovascular risk factor prevalence using linked administrative data with survey methods varies by indicator. Selection biases amongst survey participants and different measurement methods could explain discrepancies. The added ability to examine health care indicators longitudinally and by subgroup supports use of linked population-based data to enhance health surveillance.

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Blood pressure as a cardiovascular risk factor: prevention and treatment

JAMA ◽

10.1001/jama.275.20.1571 ◽

1996 ◽

Vol 275 (20) ◽

pp. 1571-1576 ◽

Cited By ~ 159

Author(s):

W. B. Kannel

Keyword(s):

Blood Pressure ◽

Risk Factor ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factor ◽

Prevention And Treatment ◽

Risk Factor Prevention

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May Measurement Month 2018: an analysis of blood pressure screening results from Nigeria

European Heart Journal Supplements ◽

10.1093/eurheartj/suaa038 ◽

2020 ◽

Vol 22 (Supplement_H) ◽

pp. H96-H99

Author(s):

Kolawole W Wahab ◽

Philip M Kolo ◽

Mahmoud U Sani ◽

Njide U Okubadejo ◽

Johnson O Peter ◽

...

Keyword(s):

Blood Pressure ◽

Risk Factor ◽

Cardiovascular Risk ◽

General Population ◽

International Society ◽

Cardiovascular Risk Factor ◽

High Rate ◽

Opportunistic Screening ◽

Treatment Of Hypertension ◽

And Control

Abstract Hypertension remains the dominant cardiovascular risk factor worldwide. May Measurement Month (MMM) is an annual global programme of the International Society of Hypertension aimed at screening for undetected hypertension in the general population. We report the outcome of MMM 2018 in Nigeria. An opportunistic screening of adults aged at least 18 years was conducted in the six geopolitical zones of Nigeria in the month of May, 2018. Screening for hypertension was done by trained volunteers with the use of validated digital and mercury sphygmomanometers following the MMM protocol. Hypertension was defined as blood pressure (BP) ≥140/90 mmHg or the use of BP-lowering medication. There were 6398 participants (53.0% female) with a mean (SD) age of 41.7 (15.0) years. Hypertension was present in 36.4% of the participants with 51.1% of the hypertensives aware of their status, 41.8% on medication, of whom 43.1% were controlled. Overall, only 18.0% of all hypertensive participants had their BP under control. The proportion with hypertension is high, and awareness, treatment, and control rates are low. Concerted efforts are needed to improve awareness and treatment of hypertension in Nigeria in order to reduce the high rate of complications associated with uncontrolled BP.

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Relationship between morning blood pressure surge and cardiovascular risk factor in primary hypertensive patients

Heart ◽

10.1136/heartjnl-2011-300867.577 ◽

2011 ◽

Vol 97 (Suppl 3) ◽

pp. A198-A198

Author(s):

H. Xiao-Liang ◽

L. Fang-Hong ◽

L. Zhen-Dong ◽

Z. Ying-Xin ◽

S. Shang-Wen ◽

...

Keyword(s):

Blood Pressure ◽

Risk Factor ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factor ◽

Hypertensive Patients ◽

Morning Blood Pressure Surge ◽

Morning Blood Pressure ◽

Pressure Surge

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Abstract P611: Vascular-mediated Preterm Birth is Associated with Cardiovascular Risk after Pregnancy

Hypertension ◽

10.1161/hyp.66.suppl_1.p611 ◽

2015 ◽

Vol 66 (suppl_1) ◽

Author(s):

Janet M Catov ◽

Steven E Reis ◽

Matthew F Muldoon ◽

Roberta B Ness ◽

Lananh Nguyen ◽

...

Keyword(s):

Blood Pressure ◽

Risk Factor ◽

Cardiovascular Risk ◽

Preterm Birth ◽

Chronic Inflammation ◽

Cardiovascular Risk Factor ◽

Subclinical Atherosclerosis ◽

Carotid Imt ◽

Term Births ◽

Risk Factor Burden

Objective: To investigate whether preterm birth and placental evidence of malperfusion is associated with subclinical atherosclerosis and a higher cardiovascular risk factor burden 4 to 12 years after pregnancy. Methods: A cohort of women with preterm (n=119) and term births (n=242), mean age 38 years, was examined on average eight years after pregnancy for carotid artery intima-media thickness (IMT), fasting lipids, blood pressure and inflammatory markers (C-reactive protein [hsCRP] and Interleukin-6 [IL-6]). Pregnancy characteristics included placental pathology evidence of malperfusion (vasculopathy, infarct, advanced villous maturation, perivillous fibrin, fibrin deposition), infection (chorioamnionitis, funisitis, deciduitus), villitis (chronic inflammation), fetal thrombosis or chorangiosis. Vascular-mediated preterm births were those with malperfusion lesions, and by design, those with preeclampsia were excluded. Results: Women with malperfusion lesions had a higher mean carotid IMT (+0.055 cm), total cholesterol (+17.49 mg/dl), LDL-C (+11.44), triglycerides (+17%), apolipoprotein-B (+8.95) and systolic and diastolic blood pressure (+4.58/+2.62 mmHg) compared to women with term births, independent of age, race, smoking and adiposity assessed before and after pregnancy (all p<0.05). Women with preterm birth and evidence of malperfusion accompanied by other lesions related to infection or chronic inflammation had the most atherogenic profile after pregnancy, and carotid IMT differences were independent of traditional risk factors (+0.04 cm; p=0.027). Conclusions: Vascular-mediated preterm birth is associated with maternal subclinical atherosclerosis and a higher cardiovascular risk factor burden in the decade after pregnancy compared to term birth. The placenta may offer unique insight into how pregnancy complications can portend the emergence of maternal cardiovascular disease.

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