scholarly journals High Blood Pressure and Cardiovascular Disease

Hypertension ◽  
2020 ◽  
Vol 75 (2) ◽  
pp. 285-292 ◽  
Author(s):  
Flávio D. Fuchs ◽  
Paul K. Whelton
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Cohort Studies ◽  
High Blood Pressure ◽  
Population Distribution ◽  
Meta Analysis ◽  
Age Related

Fragmented investigation has masked the overall picture for causes of cardiovascular disease (CVD). Among the risk factors for CVD, high blood pressure (BP) is associated with the strongest evidence for causation and it has a high prevalence of exposure. Biologically, normal levels of BP are considerably lower than what has typically been characterized as normal in research and clinical practice. We propose that CVD is primarily caused by a right-sided shift in the population distribution of BP. Our view that BP is the predominant risk factor for CVD is based on conceptual postulates that have been tested in observational investigations and clinical trials. Large cohort studies have demonstrated that high BP is an important risk factor for heart failure, atrial fibrillation, chronic kidney disease, heart valve diseases, aortic syndromes, and dementia, in addition to coronary heart disease and stroke. In multivariate modeling, the presumed attributable risk of high BP for stroke and coronary heart disease has increased steadily with progressive use of lower values for normal BP. Meta-analysis of BP-lowering randomized controlled trials has demonstrated a benefit which is almost identical to that predicted from BP risk relationships in cohort studies. Prevention of age-related increases in BP would, in large part, reduce the vascular consequences usually attributed to aging, and together with intensive treatment of established hypertension would eliminate a large proportion of the population burden of BP-related CVD.

PREVALENCE OF HYPERTENSION AND TREATMENT OUTCOME IN TERTIARY CARE

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Dr. Rajendra Prasad Gupta ◽  
Dr. Satish Chandra Arya
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
High Blood Pressure ◽  
Resistant Hypertension ◽  
Tertiary Care ◽  
Hypertensive Crisis ◽  
Normal Weight ◽  
Age Group

INTRODUCTION: High blood pressure (BP) is ranked as the third most important risk factor for attributable burden of disease in south Asia. Raised blood pressure is a major risk factor for chronic heart disease, stroke, and coronary heart disease. WHO rates hypertension as one of the most important causes of premature death worldwide[i].  In India 57% of all stroke deaths and 24% of all coronary heart disease (CHD) deaths are due to hypertension. Other than coronary heart disease and stroke, complications include peripheral vascular disease, heart failure, renal impairment, retinal hemorrhage, and visual impairment. MATERIAL AND METHODS: Study population was adult patients who had been receiving anti-hypertensive treatment at hospital for at least 6 months. Interviews were conducted with all the participants and the questionnaires were filled. Demographic and anthropometric data were obtained for the patient who includes height and weight, BMI (Body Mass Index), personal medical history was obtained, and diagnosis of hypertension and other co-morbid conditions were recorded. RESULTS: A total of 200 patients were included in this study were observed and traced up to 6 month period of the study. 200 patients were included in the study of which 117 (58.50%) were male and 83 (41.50%) were female. Mean age of male patients was 52 ± 18.29 while in female it was 53 ± 17.88. We have divided our patients into four groups in <20 years only one male patient (0.85%) was having hypertension. In 20 – 39 years age group 16 (13.67%) male and 8 (9.63%) female were observed. In 40 to 59 age group 47 (35.04%) male and 31 (37.35%) female were observed. In >60 age group there were 53(45.30%) male and 44 (53.01%) female were observed. Maximum number of cases were observed in the >60 age group in both the sexes. 46 male (39.32%) and 35(42.17%) female had history of hypertension with Less than 5 years. while 71 (60.68%) male and 48 (57.83%) female had hypertension for more than five years. Out of 117 male 13 (11.11%) were normal weight, 85 (72.65%) were overweight and 19 (16.24%) were obese. In female 4 (4.82%) were normal weight, 69 (85.13%) were overweight and 10 (12.50%) were obese. Hypertension was most prevalent in overweight group in both the sexes. Diabetes was observed in 71 (60.68%) male and 56 (67.47%) female. 46 (39.32%) male and 27(32.53%) of female had myocardial infarction.   Before start of the study 68 (58.12%) had controlled blood pressure, 42 (35.90%) had uncontrolled BP, Hypertensive crisis was seen in 5 (4.27%) patients and Resistant hypertension was seen in 2 (1.71%) cases. After study period 58 (49.57%) had controlled blood pressure, 22 (18.80%) had uncontrolled BP, Hypertensive crisis was seen in 2 (1.71%) patients and Resistant hypertension was seen in 1 (0.85%) case. CONCLUSION:  Chronic uncontrolled high blood pressure which can be reduced by proper management, counselling and lifestyle modification. Prevalence of hypertension in males was slightly higher than female counterparts .Control of hypertension was more in female patients. Also patient assessment should be improved in order to increase the identification and management of hypertension KEYWORDS: Hypertension, Diabetes, coronary heart disease (CHD), management.

scholarly journals Relation of Different Fruit and Vegetable Sources With Incident Cardiovascular Outcomes: A Systematic Review and Meta‐Analysis of Prospective Cohort Studies

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Andreea Zurbau ◽  
Fei Au‐Yeung ◽  
Sonia Blanco Mejia ◽  
Tauseef A. Khan ◽  
Vladimir Vuksan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Fruit And Vegetables ◽  
Fruit And Vegetable ◽  
Prospective Cohort Studies

Background Public health policies reflect concerns that certain fruit sources may not have the intended benefits and that vegetables should be preferred to fruit. We assessed the relation of fruit and vegetable sources with cardiovascular outcomes using a systematic review and meta‐analysis of prospective cohort studies. Methods and Results MEDLINE, EMBASE, and Cochrane were searched through June 3, 2019. Two independent reviewers extracted data and assessed study quality (Newcastle‐Ottawa Scale). Data were pooled (fixed effects), and heterogeneity (Cochrane‐Q and I 2 ) and certainty of the evidence (Grading of Recommendations Assessment, Development, and Evaluation) were assessed. Eighty‐one cohorts involving 4 031 896 individuals and 125 112 cardiovascular events were included. Total fruit and vegetables, fruit, and vegetables were associated with decreased cardiovascular disease (risk ratio, 0.93 [95% CI, 0.89–0.96]; 0.91 [0.88–0.95]; and 0.94 [0.90–0.97], respectively), coronary heart disease (0.88 [0.83–0.92]; 0.88 [0.84–0.92]; and 0.92 [0.87–0.96], respectively), and stroke (0.82 [0.77–0.88], 0.82 [0.79–0.85]; and 0.88 [0.83–0.93], respectively) incidence. Total fruit and vegetables, fruit, and vegetables were associated with decreased cardiovascular disease (0.89 [0.85–0.93]; 0.88 [0.86–0.91]; and 0.87 [0.85–0.90], respectively), coronary heart disease (0.81 [0.72–0.92]; 0.86 [0.82–0.90]; and 0.86 [0.83–0.89], respectively), and stroke (0.73 [0.65–0.81]; 0.87 [0.84–0.91]; and 0.94 [0.90–0.99], respectively) mortality. There were greater benefits for citrus, 100% fruit juice, and pommes among fruit sources and allium, carrots, cruciferous, and green leafy among vegetable sources. No sources showed an adverse association. The certainty of the evidence was “very low” to “moderate,” with the highest for total fruit and/or vegetables, pommes fruit, and green leafy vegetables. Conclusions Fruits and vegetables are associated with cardiovascular benefit, with some sources associated with greater benefit and none showing an adverse association. Registration URL: https://www.clini​caltr​ials.gov ; Unique identifier: NCT03394339.

scholarly journals Association of Cumulative Systolic Blood Pressure With Long-Term Risk of Cardiovascular Disease and Healthy Longevity

Hypertension ◽  
2020 ◽  
Author(s):  
Orna Reges ◽  
Hongyan Ning ◽  
John T. Wilkins ◽  
Colin O. Wu ◽  
Xin Tian ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Healthy Longevity ◽  
All Cause Mortality

Hypertension is a major risk factor for cardiovascular disease (CVD), but previous studies have mostly been limited to a single exam, a single cohort, a short follow-up period, or a limited number of outcomes. This study aimed to assess the association of 10-year cumulative systolic blood pressure (BP) in middle age with long-term risk of any CVD, coronary heart disease, stroke, heart failure, all-cause mortality, and healthy longevity. Individuals (11 502) from 5 racially/ethnically diverse US community-based cohorts were included in this study once they met all the inclusion criteria: ≥10 year of observation in the included cohort, aged 45 to 60 years, free of CVD, and had ≥3 visits with BP exams over the preceding 10 years. For each participant, systolic BP level was predicted for each year of the 10-year prior inclusion, based on the available exams (median of 4.0; spread over, 9.1 [range, 7.2–10] years). Lower 10-year cumulative systolic BP was associated with 4.1 years longer survival and 5.4 years later onset of CVD, resulting in living longer life with a shorter period with morbidity. Models adjusted for sociodemographic characteristics, cardiovascular risk factors, and index systolic BP demonstrated associations of 10-year cumulative systolic BP (per 130 mm Hg×year change, the threshold for stage-1 hypertension) with CVD (hazard ratio [HR], 1.28 [95% CI, 1.20–1.36]), coronary heart disease (HR, 1.29 [95% CI, 1.19–1.40]), stroke (HR, 1.33 [95% CI, 1.20–1.47]), heart failure (HR, 1.12 [95% CI, 1.02–1.23]), and all-cause mortality (HR, 1.21 [95% CI, 1.14–1.29]). These findings emphasize the importance of 10-year cumulative systolic BP as a risk factor to CVD, above and beyond current systolic BP.

scholarly journals Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports

BMJ ◽  
2018 ◽  
pp. j5855 ◽  
Author(s):  
Allan Hackshaw ◽  
Joan K Morris ◽  
Sadie Boniface ◽  
Jin-Ling Tang ◽  
Dušan Milenković
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Relative Risk ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Cigarette Consumption ◽  
Excess Relative Risk ◽  
Multiple Factors ◽  
Relative Risks

Abstract Objective To use the relation between cigarette consumption and cardiovascular disease to quantify the risk of coronary heart disease and stroke for light smoking (one to five cigarettes/day). Design Systematic review and meta-analysis. Data sources Medline 1946 to May 2015, with manual searches of references. Eligibility criteria for selecting studies Prospective cohort studies with at least 50 events, reporting hazard ratios or relative risks (both hereafter referred to as relative risk) compared with never smokers or age specific incidence in relation to risk of coronary heart disease or stroke. Data extraction/synthesis MOOSE guidelines were followed. For each study, the relative risk was estimated for smoking one, five, or 20 cigarettes per day by using regression modelling between risk and cigarette consumption. Relative risks were adjusted for at least age and often additional confounders. The main measure was the excess relative risk for smoking one cigarette per day (RR 1_per_day −1) expressed as a proportion of that for smoking 20 cigarettes per day (RR 20_per_day −1), expected to be about 5% assuming a linear relation between risk and consumption (as seen with lung cancer). The relative risks for one, five, and 20 cigarettes per day were also pooled across all studies in a random effects meta-analysis. Separate analyses were done for each combination of sex and disorder. Results The meta-analysis included 55 publications containing 141 cohort studies. Among men, the pooled relative risk for coronary heart disease was 1.48 for smoking one cigarette per day and 2.04 for 20 cigarettes per day, using all studies, but 1.74 and 2.27 among studies in which the relative risk had been adjusted for multiple confounders. Among women, the pooled relative risks were 1.57 and 2.84 for one and 20 cigarettes per day (or 2.19 and 3.95 using relative risks adjusted for multiple factors). Men who smoked one cigarette per day had 46% of the excess relative risk for smoking 20 cigarettes per day (53% using relative risks adjusted for multiple factors), and women had 31% of the excess risk (38% using relative risks adjusted for multiple factors). For stroke, the pooled relative risks for men were 1.25 and 1.64 for smoking one or 20 cigarettes per day (1.30 and 1.56 using relative risks adjusted for multiple factors). In women, the pooled relative risks were 1.31 and 2.16 for smoking one or 20 cigarettes per day (1.46 and 2.42 using relative risks adjusted for multiple factors). The excess risk for stroke associated with one cigarette per day (in relation to 20 cigarettes per day) was 41% for men and 34% for women (or 64% and 36% using relative risks adjusted for multiple factors). Relative risks were generally higher among women than men. Conclusions Smoking only about one cigarette per day carries a risk of developing coronary heart disease and stroke much greater than expected: around half that for people who smoke 20 per day. No safe level of smoking exists for cardiovascular disease. Smokers should aim to quit instead of cutting down to significantly reduce their risk of these two common major disorders.

scholarly journals Lipid profile and prognosis in patients with coronary heart disease: a meta-analysis of prospective cohort studies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiangmei Zhao ◽  
Dongying Wang ◽  
Lijie Qin
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cohort Studies ◽  
Lipid Profile ◽  
Prospective Cohort ◽  
Cardiac Death ◽  
Meta Analysis ◽  
Prospective Cohort Studies ◽  
All Cause Mortality ◽  
Reduced Risk

Abstract Background This meta-analysis based on prospective cohort studies aimed to evaluate the associations of lipid profiles with the risk of major adverse cardiovascular outcomes in patients with coronary heart disease (CHD). Methods The PubMed, Embase, and Cochrane Library electronic databases were systematically searched for prospective cohort study published through December 2019, and the pooled results were calculated using the random-effects model. Results Twenty-one studies with a total of 76,221 patients with CHD met the inclusion criteria. The per standard deviation (SD) increase in triglyceride was associated with a reduced risk of major adverse cardiovascular events (MACE). Furthermore, the per SD increase in high-density lipoprotein cholesterol (HDL-C) was associated with a reduced risk of cardiac death, whereas patients with lower HDL-C were associated with an increased risk of MACE, all-cause mortality, and cardiac death. Finally, the risk of MACE was significantly increased in patients with CHD with high lipoprotein(a) levels. Conclusions The results of this study suggested that lipid profile variables could predict major cardiovascular outcomes and all-cause mortality in patients with CHD.

Soy Consumption with Risk of Coronary Heart Disease and Stroke: A Meta-Analysis of Observational Studies

2016 ◽  
Vol 46 (4) ◽  
pp. 242-252 ◽  
Author(s):  
Danfei Lou ◽  
Yuehua Li ◽  
Guoliang Yan ◽  
Jianhong Bu ◽  
Haihui Wang
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cohort Studies ◽  
Observational Studies ◽  
Meta Analysis ◽  
Case Control ◽  
Inverse Association ◽  
Case Control Studies ◽  
Relative Risks ◽  
Product Consumption

Background: The association of soy product consumption with the relative risk of cardiovascular disease remains controversial. This meta-analysis aimed at investigating whether an association exists between soy consumption and the risk of stroke and coronary heart disease (CHD) in observational studies. Methods: A systematic search of the PubMed and EMBASE databases was performed for case-control and cohort studies that assessed soy consumption and the risk of stroke and CHD. Summary relative risks (SRRs) and 95% CIs were combined by using a random-effects model. Results: Of a total of 1,266 abstracts, 5 prospective cohort and 6 case-control studies met our inclusion criteria, and comprised 4,954 stroke and 7,616 CHD events. Based on the high vs. low analyses, combining cohort studies showed no association between soy intake and risk of stroke (SRR 0.92; 95% CI 0.70-1.10; Pheterogeneity = 0.236; I2 = 29.4%) or CHD (SRR 0.97; 95% CI 0.74-1.27; Pheterogeneity = 0.020; I2 = 62.7%), although a significantly inverse association between soy intake and the risk of stroke (SRR 0.54; 95% CI 0.34-0.87; Pheterogeneity = 0.001; I2 = 79.3%) and CHD (SRR 0.66; 95% CI 0.56-0.77; Pheterogeneity = 0.421; I2 = 0) was observed in case-control studies. No association between soy isoflavone intake and the risk of stroke and CHD was identified. Conclusion: There was limited evidence to indicate that soy consumption was inversely associated with the risk of stroke and CHD, although further studies, with prospective designs that use validated questionnaires and control for important confounders, are warranted.

Abstract MP77: Projected Impact of Shifting Population Distributions of Blood Pressure on Rates of Coronary Heart Disease, Heart Failure and Stroke: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Shakia T Hardy ◽  
Laura R Loehr ◽  
Kenneth R Butler ◽  
Patricia P Chang ◽  
Aaron R Folsom ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
African American ◽  
Heart Disease ◽  
Population Distribution ◽  
The United States ◽  
Incidence Rates ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

Introduction: Rates of cerebrovascular disease, heart failure (HF), and coronary heart disease (CHD), increase progressively as blood pressure rises. Several authors have estimated the theoretical effects of shifting the population distribution of blood pressure; however few studies have examined the degree to which modest decrements in blood pressure affect HF incidence, or included a racially diverse population. Methods: Incident HF was identified by a first hospitalization with discharge diagnosis code of 428.X. Incident hospitalized (definite or probable) CHD and stroke were classified according to protocol. We used multivariable regression to estimate incidence rate differences (IRD) for HF, CHD, and stroke that could be associated with a two mm Hg reduction in systolic blood pressure (SBP) in 15,744 participants from the Atherosclerosis Risk in Communities Study. Results: Over a mean of 18.3 years of follow up, age-adjusted incidence rates for HF, CHD, and stroke were higher among African American than Caucasians (Table 1). After adjusting for antihypertensive use, gender, and age, a two mm Hg decrement in SBP across the total population was associated with an estimated 24/100,000 person-years (PY) and 39/100,000 PY fewer incident HF events in Caucasians and African Americans, respectively. The projected disease reductions were of smaller absolute magnitude for incident CHD and incident stroke. Extrapolation to the African American and Caucasian U.S. populations age greater than 45 years suggests that a two mmHg decrement in SBP could result in approximately 22,000 fewer incident HF events, 15,000 fewer incident CHD events, and 5,000 fewer incident stroke events annually. Conclusion: Our results suggest that modest shifts in SBP, consistent with what could theoretically be achieved through population level lifestyle interventions, could substantially decrease the incidence of HF, stroke, and CHD in the United States, especially among African American populations.

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