Poor blood pressure control in adults with repaired coarctation of the aorta and hypertension: a register-based study of associated factors

2017 ◽  
Vol 27 (9) ◽  
pp. 1708-1715 ◽  
Author(s):  
Daniel Rinnström ◽  
Mikael Dellborg ◽  
Ulf Thilén ◽  
Peder Sörensson ◽  
Niels-Erik Nielsen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pressure Gradient ◽  
Associated Factors ◽  
Coarctation Of The Aorta ◽  
Prescription Medication ◽  
Reference Interval ◽  
Pressure Control ◽  
Poor Blood Pressure Control ◽  
The Mean ◽  
Low Levels

AbstractBackgroundArterial hypertension is common in adults with repaired coarctation of the aorta, and is associated with several severe complications.AimsThis study aimed to investigate the prevalence of poorly controlled (⩾140/90 mmHg) blood pressure among patients with diagnosed hypertension and to identify associated factors.MethodsIn the national register for CHD, adults with repaired coarctation of the aorta and diagnosed hypertension – defined as a registry diagnosis and/or use of anti-hypertensive prescription medication – were identified. Logistic regression analysis was used to identify variables associated with poorly controlled blood pressure.ResultsOf the 243 included patients, 27.2% were female, the mean age was 45.4±15.3 years, and 52.3% had poorly controlled blood pressure at the last registration. In a multivariable model, age (years) (OR 1.03, CI 1.01–1.06, p=0.008) was independently associated with poorly controlled blood pressure and so was systolic arm–leg blood pressure gradient in the ranges [10, 20] mmHg (OR 4.92, CI 1.76–13.79, p=0.002) to >20 mmHg (OR 9.93, CI 2.99–33.02, p<0.001), in comparison with the reference interval [0, 10] mmHg. Patients with poorly controlled blood pressure had, on average, more types of anti-hypertensive medication classes prescribed (1.9 versus 1.5, p=0.003).ConclusionsPoorly controlled blood pressure is common among patients with repaired coarctation of the aorta and diagnosed hypertension, despite what seems to be more intensive treatment. A systolic arm–leg blood pressure gradient is associated with poorly controlled blood pressure, even at low levels usually not considered for intervention, and may be an indicator of hypertension that is difficult to treat.

Blood Pressure Control and Associated Factors Among Hypertensive Patients Attending Shashemene Referral Hospital, Oromia, Ethiopia

2021 ◽  
pp. 001857872110613
Author(s):  
Aliyi Anota ◽  
Teshome Nedi
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Blood Pressure Control ◽  
Associated Factors ◽  
Antihypertensive Drugs ◽  
Pressure Control ◽  
Referral Hospital ◽  
Hypertensive Patients ◽  
The Mean ◽  
Study Participants

Background: Hypertension is public health challenge worldwide. It is defined as persistently elevated arterial blood pressure (BP), systolic BP (SBP) ≥140 mmHg and/or diastolic BP (DBP) ≥90 mmHg or use of antihypertensive medication in adults older than 18 years. The aim of this study was to assess blood pressure control and associated factors among hypertensive patients attending the outpatient department of Shashemene Referral Hospital. Methods: Hospital based cross sectional study was conducted to determine level of blood pressure control and associated factors among hypertensive patients on medical follow-up. A medical chart review and interview was conducted from July 1 to October 31 2018. Result: A total of 325 participants were included in this study with response rate of 320 (98.5%). More than half of study participants were males 171 (53.4%). The mean age of the respondents was 55.10 (SD ± 12.7) years and majority of the respondents 191 (59.7%) were within age of less than 60 years old. The mean Systolic blood pressure (SBP) was 131.80 mmHg (SD ± 20.92) while the mean diastolic blood pressure (DBP) was 82.30 mmHg (SD ± 10.52). About 51.30% of study participants had a controlled SBP and 54.7% had a controlled DBP. The overall control of BP was achieved in 40.3% of the study participants. Multivariable logistic regression analysis showed that age, experience of side effects, frequency of BP measuring, number of antihypertensive drugs used, duration on antihypertensive, source of medication and physical exercise showed significant association with blood pressure control. Conclusion: Blood pressure control level among chronic hypertensive patients at outpatient department was low. Age of patients, educational level, experience of side effects, and number of antihypertensive drugs used were important determinant factors associated with blood pressure control among study participants.

scholarly journals Poor blood pressure control and its associated factors among peoples living with Diabetes Mellitus in sub-Saharan Africa: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Yonas Akalu ◽  
Yigizie Yeshaw ◽  
Getayeneh Antehunegn Tesema ◽  
Sofonyas Abebaw Tiruneh ◽  
Achamyeleh Birhanu Teshale ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Associated Factors ◽  
Meta Analysis ◽  
Pressure Control ◽  
Sub Saharan Africa ◽  
Random Effects Model ◽  
Pooled Prevalence ◽  
Poor Blood Pressure Control ◽  
Sub Saharan

Abstract Background Poor blood pressure control among people living with diabetes mellitus (DM) is one of the primary causes of cardiovascular complications and death in sub-Saharan Africa (SSA). However, there is paucity of evidence on the prevalence and associated factors of poor blood pressure control in SSA. Therefore, this review aimed to estimate the prevalence and its associated factors among people living with DM in SSA. Methods We systematically searched PubMed, African Journals online, Hinari, Google scholar and direct Google to access observational studies conducted in SSA. Microsoft excel spreadsheet was used to extract the data and then exported into STATA/MP version 16.0 for further analysis. Heterogeneity across studies was checked using Cochrane Q test statistic and I2 test and small study effect were checked using Funnel plot symmetry and Egger’s statistical test at 5% significant level. A random-effects model was used to estimates the pooled prevalence of poor blood pressure control with a 95% confidence interval (CI). Results Of the 1,043 articles retrieved, 21 articles with an overall sample size of 6308 were eligible for the meta-analysis. After performing random-effects model, the pooled prevalence of poor blood pressure control was 69.8% (95% CI: 63.43, 76.25%). Poor adherence to antihypertensive treatment (OR = 1.7; 95% CI: 1.03–2.80, I2 = 0.0%, p = 0.531) and overweight (OR = 2.4, 95% CI: 1.57–3.68, I2 = 0.00%, p = 0.47) were significantly associated with poor blood pressure control. Conclusions Only one third of diabetic patients in SSA had achieved target blood pressure. Hence, there is an urgent need for initiatives to improve and control hypertension, and preventive measures should concentrate on modifiable risk factors. Systematic Review registrations: The review protocol has been registered in PROSPERO with protocol number of CRD42020187901.

scholarly journals Comparing the Apelin Level in Hypertensive Patients Who Received Hypertension Drugs

2021 ◽  
Vol 17 (4) ◽  
Author(s):  
Mina Hemmati ◽  
Fatemeh Abharzanjani ◽  
Tooba Kazemi ◽  
Fateme Estanesti
Keyword(s):  
Blood Pressure ◽  
Case Control Study ◽  
Pressure Control ◽  
Control Group ◽  
Serum Samples ◽  
Hypertensive Patients ◽  
Amlodipine Group ◽  
The Mean ◽  
Plasma Apelin ◽  
Control Study

Background: Apelin, an adipokine secreted from adipose tissue, plays an important role in regulating blood pressure and hypertension. Objectives: The current study aimed to compare the plasma Apelin level in hypertensive patients under treatment with amlodipine, losartan, and amlodipine + losartan. Methods: In this case-control study, the serum level of Apelin was compared in four groups of (A) Healthy subjects (n = 31); (B) Hypertensive patients, received amlodipine (n = 31); Hypertensive patients, received losartan (n = 45); and patients (n = 33) that received amlodipine and losartan. Apelin level in serum samples was measured using Human Apelin ELISA Kit according to the manufacturers’ instructions. Data were analyzed using SPSS version 19 (Chicago: SPSS Inc.), at the significant level of α = 0.05. Results: The mean blood level of Apelin in the control group and groups receiving amlodipine, losartan, and amlodipine + losartan was 366.16 ± 36.04, 247.19 ± 27.77, 282.93 ± 47.08, and 289.84 ± 32.20 g/dl, respectively. Losartan + amlodipine group had a higher level of Apelin compared with amlodipine alone (P < 0.05). Conclusions: This study demonstrated that Apelin has a definite protective effect in preventing hypertension. Also, according to the results, the renin-angiotensin-aldosterone system inhibitors, such as losartan, caused a higher increase in the Apelin, resulting in better blood pressure control.

Abstract P297: Comparing Blood Pressure Control in Diabetic verses Non-Diabetic Veterans following Percutaneous Coronary Intervention (PCI)

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Sloane A McGraw ◽  
Michael Scholfield ◽  
Ragu Murthy ◽  
Anupama Shivaraju ◽  
Burhan Mohamedali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Beta Blockers ◽  
Coronary Intervention ◽  
Pressure Control ◽  
Joint National Committee ◽  
National Committee ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
The Mean ◽  
Artery Disease

Background: Blood pressure (BP) control in patients with coronary artery disease (CAD) is beneficial on morbidity and mortality, however the US Joint National Committee VII (JNC-7) also recommends systolic BP (SBP) <130 and diastolic BP (DBP) <80 for diabetic patients because diabetes itself is an additional risk for a cardiac event. This can be attained using beta-blockers (BB), angiotensin agonists (ACE-I/ARB), calcium channel blockers, diuretics and nitrates. Methods: We conducted a retrospective cohort study focusing on attaining JNC-7 guidelines, comparing outcomes between 302 diabetic to the 469 non-diabetic patients; all underwent PCI between September 2004 and September 2008 at the Jesse Brown Veterans Hospital in Chicago, IL. We collected data of BP values and antihypertensive regimens on admission and at six month follow up, and correlated these into percentages of which have attained goals. Results: Among diabetics, mean SBP decreased from 134 to 130mmHg (p = 0.002) and mean DBP decreased from 72 to 70mmHg (p= 0.004); in the non-diabetics, the mean SBP decreased from 133 to 127mmHg (p<0.0001) and the mean DBP decreased from 73 to 71mmHg (p<0.0012). With regards to guidelines, the percent of diabetics at SBP goal increased from 41% to 51% (124 to 154 of 302) (p= 0.006), however the percent at DBP goal was not significant. In non-diabetics, percent at goal for SBP increased 46% to 57% (216 to 267 of 469) (p=0.0002) and for DBP increased 69% to 76% (324 to 356 of 469) (p=0.0131). At 6 months, among diabetics the medication usage increased with BB, 80% to 92% (241 to 278 of 302) (p<0.0001) and nitrates 30% to 36% (91 to 109 of 302) (p=0.035). Similarly, among non-diabetics, use of BB, 68% to 87% (319 to 408 of 469) (p<0.0001) and nitrates 19% to 24% (89 to 113 of 469) (p=0.006) increased, as well as ACE-I/ARB 52% to 71% (244 to 333 if 469) (p<0.0001). Conclusions: There were improvements in BP among both populations at six months post-PCI; both attained JNC-7 SBP goal, but only non-diabetics achieved DBP goal. Medication use increased for both groups with BB and nitrates, but also with ACE-I/ARB for non-diabetics only. This analysis suggests that tighter control needs to be obtained among diabetics, especially because they are a higher risk population than those solely with CAD.

Reduced parasympathetic control of heart rate in obese dogs

1995 ◽  
Vol 269 (2) ◽  
pp. H629-H637 ◽  
Author(s):  
B. N. Van Vliet ◽  
J. E. Hall ◽  
H. L. Mizelle ◽  
J. P. Montani ◽  
M. J. Smith
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Rate Control ◽  
Saturated Fat ◽  
Pressure Control ◽  
Resting Heart Rate ◽  
Arterial Blood ◽  
Parasympathetic Control ◽  
The Mean ◽  
Affect Heart Rate

We investigated why resting heart rate is elevated in dogs fed a high saturated fat diet for 12.7 +/- 1.8 wk. Obese dogs exhibited elevated body weight (59%), blood pressure (14%), and heart rate (25%). Differences in resting heart rate (control, 58 +/- 5 beats/min; obese, 83 +/- 7 beats/min) were abolished after hexamethonium, indicating an autonomic mechanism. Hexamethonium also reduced blood pressure in obese (20 +/- 4 mmHg) but not control (9 +/- 6 mmHg) animals. Propranolol did not affect heart rate in either group, excluding a beta-adrenergic mechanism. Subsequent administration of atropine increased heart rate more in control than in obese dogs (110 +/- 9 vs. 57 +/- 11 beats/min). The sensitivity of the cardiac limb of the baroreflex (Oxford method) was reduced by 46% in the obese group, confirming impairment of the parasympathetic control of heart rate. The standard deviation of blood pressure measurements was normal when expressed as a percentage of the mean arterial blood pressure (control, 11.2 +/- 0.4%; obese, 11.2 +/- 0.5%). Our results indicate that the development of obesity in dogs fed a high saturated fat diet is accompanied by an attenuated resting and reflex parasympathetic control of heart rate.

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