Association between self-reported snoring and hypertension among Chinese Han population aged 30–79 in Chongqing, China

Abstract Background We aim to explore the association between self-reported snoring and hypertension among adults aged 30–79 in Chongqing, China. Methods A total of 23,342 individuals aged 30–79 were included at baseline from August 2018 to January 2019, and the final sample size for the analysis was 22,423. Face-to-face interviews and physical examinations were conducted by trained investigators. Logistic regression was performed to study age-specific and gender-specific associations between snoring and hypertension. Results Frequent snoring was associated with the risk of hypertension for each age and gender group, and the frequency of snoring was positively correlated with the risk for hypertension. For the three age groups (< 45, 45–59, ≥ 60), compared with the non-snoring group, those who snore often had a 64.5%, 53.3%, and 24.5% increased risk of hypertension (< 45: OR = 1.65, 95%CI 1.34–2.02; 45–59: OR = 1.53, 95%CI 1.37–1.72; ≥ 60: OR = 1.25, 95%CI 1.09–1.42), respectively. For men and women, those who snore often had a 46.8% and 97.2% increased risk of hypertension, respectively, than the non-snoring group (men: OR = 1.47, 95%CI 1.33–1.63; women: OR = 1.97, 95%CI 1.75–2.23). Conclusions People who snore frequently should pay close attention to their blood pressure levels in order to achieve early prevention of hypertension, particularly for snorers who are female and aged under 45; importance should be attached to their blood pressure control.

Download Full-text

Hypertension in the United States Fire Service

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105432 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5432

Author(s):

Saeed U. Khaja ◽

Kevin C. Mathias ◽

Emilie D. Bode ◽

Donald F. Stewart ◽

Kepra Jack ◽

...

Keyword(s):

Blood Pressure ◽

General Population ◽

Age Groups ◽

Total Sample ◽

The United States ◽

Fire Service ◽

Atherosclerotic Cardiovascular Disease ◽

Cardiac Events ◽

Antihypertensive Medications ◽

Increased Risk

Hypertension is a major risk factor for atherosclerotic cardiovascular disease and cardiac remodeling and is associated with an increased risk of sudden cardiac events, the leading cause of duty-related death in the fire service. We assessed systemic blood pressures and prevalence of hypertension among US firefighters by decade of life. Medical records of career firefighters (5063 males and 274 females) from four geographically diverse occupational health clinics were assessed. Hypertension was defined as systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg, or taking antihypertensive medication. Results from the firefighter sample were compared to the US general population (2015–2016 and 2017–2018 National Health and Nutrition Examination Surveys). Among the total sample, 69% of firefighters met the criteria for hypertension and 17% were taking antihypertensive medications. Percentages of hypertensive male and female firefighters were 45% and 11% among 20–29 years old, respectively, and increased to 78% and 79% among 50–59 years old, respectively. Compared to the general population, male firefighters had a higher prevalence of hypertension (p < 0.05) across all age groups (11–16% higher). In order to improve firefighter health and protect against sudden incapacitation in this public safety occupational group, increased efforts are necessary to screen for and manage high blood pressure.

Download Full-text

Abstract P497: Re-analysis of the Systolic Blood Pressure Intervention Trial (SPRINT): The Renal Consequences of Intensive versus Standard Blood Pressure Lowering

Hypertension ◽

10.1161/hyp.70.suppl_1.p497 ◽

2017 ◽

Vol 70 (suppl_1) ◽

Author(s):

Leora Branfield Day ◽

David M Naimark

Keyword(s):

Blood Pressure ◽

Lifetime Cost ◽

Intensive Therapy ◽

Cost Savings ◽

Cost Effective ◽

Pressure Control ◽

Average Lifetime ◽

Ckd Progression ◽

Lifetime Horizon ◽

Increased Risk

Background: BP management guidelines suggest that persons with CKD should be treated to a SBP ≤ 140 mmHg. SPRINT compared this target to intensive SBP lowering (≤ 120 mmHg) in persons with and without CKD and found a reduced rate of CV events and all-cause mortality (ACM). However intensive therapy was associated with an increased risk of AKI. We extrapolated the results of SPRINT over a lifetime horizon to determine whether in the long-term, the benefit in terms of the primary outcome would be less economically attractive when the risks of more frequent AKI and subsequent CKD progression were considered. Methods: We re-configured the CKD Simulator, a Markov model of CKD progression, AKI events, fatal and non-fatal CV events, and ESRD. We recalibrated the model to be representative of the SPRINT cohort and compared intensive vs. standard blood pressure control among 10 million simulated persons with and without CKD over their lifetimes. Marginal treatment costs were calculated and hazard ratios for AKI, CV events and ACM observed in SPRINT were applied to the monthly probabilities of these events in the intensive SBP arm. Results: Lifetime average, discounted, costs per person associated with intensive vs. standard SBP lowering were predicted to be $35,811 and $30,584, respectively. Quality-adjusted, discounted average lifespans were 196.05 and 190.47 months, respectively. The cost of each quality-adjusted life-year gained by adopting intensive over standard BP lowering would be $11,220, significantly below the accepted cost-effectiveness threshold of $50,000. Intensive SBP control would reduce the lifetime incidence of at least one CV event by 5.5%, but increase the incidence of at least one AKI episode and ESRD by 1.7% and 0.7%, respectively. These differences were associated with average lifetime cost savings per person of $459 for CV events, but losses of $161 and $2,889 for AKI and ESRD. Discussion: Intensive SBP management would be cost-effective and associated with a significant lifetime reduction in CV events. However, there would be an increase in the lifetime risk of AKI and ESRD, contributing to 58% of the total increase in cost of intensive relative to usual SBP control. Intensive SBP lowering should be adopted judiciously in persons at high risk of ESRD.

Download Full-text

Nondipping Blood Pressure: Predictive or Reactive Failure of Renal Sodium Handling?

Physiology ◽

10.1152/physiol.00024.2020 ◽

2021 ◽

Vol 36 (1) ◽

pp. 21-34 ◽

Cited By ~ 1

Author(s):

Jessica R. Ivy ◽

Matthew A. Bailey

Keyword(s):

Blood Pressure ◽

Pressure Control ◽

Sodium Reabsorption ◽

Nocturnal Sleep ◽

Sodium Homeostasis ◽

Increased Risk ◽

Health And Disease ◽

Renal Sodium Handling ◽

Sodium Handling

Blood pressure follows a daily rhythm, dipping during nocturnal sleep in humans. Attenuation of this dip (nondipping) is associated with increased risk of cardiovascular disease. Renal control of sodium homeostasis is essential for long-term blood pressure control. Sodium reabsorption and excretion have rhythms that rely on predictive/circadian as well as reactive adaptations. We explore how these rhythms might contribute to blood pressure rhythm in health and disease.

Download Full-text

Management of Presumed Acute Kidney Injury during Hypertensive Therapy: Stay Calm and Carry on?

American Journal of Nephrology ◽

10.1159/000505447 ◽

2020 ◽

Vol 51 (2) ◽

pp. 108-115

Author(s):

Teresa K. Chen ◽

Chirag R. Parikh

Keyword(s):

Blood Pressure ◽

Acute Kidney Injury ◽

Serum Creatinine ◽

Blood Pressure Control ◽

Kidney Injury ◽

Pressure Control ◽

Intensive Treatment ◽

Urinary Biomarkers ◽

Increased Risk ◽

Intensive Blood Pressure

Background: Recent studies have demonstrated that intensive blood pressure control is associated with improved cardiovascular outcomes. Acute kidney injury (AKI), however, was more common in the intensive treatment group prompting concern in the nephrology community. Summary: Clinical trials on hypertension control have traditionally defined AKI by changes in serum creatinine. However, serum creatinine has several inherent limitations as a marker of kidney injury, with various factors influencing its production, secretion, and elimination. Urinary biomarkers of kidney injury and repair have the potential to provide insight on the presence and phenotype of kidney injury. In both the Systolic Blood Pressure Intervention Trial and the Action to Control Cardiovascular Risk in Diabetes study, urinary biomarkers have suggested that the increased risk of AKI associated with intensive treatment was due to hemodynamic changes rather than structural kidney injury. As such, clinicians who encounter rises in serum creatinine during intensification of hypertension therapy should “stay calm and carry on.” Alternative explanations for serum creatinine elevation should be considered and addressed if appropriate. When the rise in serum creatinine is limited, particularly if albuminuria is stable or improving, intensive blood pressure control should be continued for its potential long-term benefits. Key Messages: Increases in serum creatinine during intensification of blood pressure control may not necessarily reflect kidney injury. Clinicians should evaluate for other contributing factors before stopping therapy. Urinary biomarkers may address limitations of serum creatinine as a marker of kidney injury.

Download Full-text

FKBPL is associated with metabolic parameters and is a novel determinant of cardiovascular disease

Scientific Reports ◽

10.1038/s41598-020-78676-6 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Andrzej S. Januszewski ◽

Chris J. Watson ◽

Vikki O’Neill ◽

Kenneth McDonald ◽

Mark Ledwidge ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Fasting Blood Glucose ◽

Plasma Concentrations ◽

Diabetic Group ◽

Fk506 Binding Protein ◽

Increased Risk ◽

Echocardiographic Parameters ◽

And Gender

AbstractType 2 diabetes (T2D) is associated with increased risk of cardiovascular disease (CVD). As disturbed angiogenesis and endothelial dysfunction are strongly implicated in T2D and CVD, we aimed to investigate the association between a novel anti-angiogenic protein, FK506-binding protein like (FKBPL), and these diseases. Plasma FKBPL was quantified by ELISA cross-sectionally in 353 adults, consisting of 234 T2D and 119 non–diabetic subjects with/without CVD, matched for age, BMI and gender. FKBPL levels were higher in T2D (adjusted mean: 2.03 ng/ml ± 0.90 SD) vs. non-diabetic subjects (adjusted mean: 1.79 ng/ml ± 0.89 SD, p = 0.02), but only after adjustment for CVD status. In T2D, FKBPL was negatively correlated with fasting blood glucose, HbA1c and diastolic blood pressure (DBP), and positively correlated with age, known diabetes duration, waist/hip ratio, urinary albumin/creatinine ratio (ACR) and fasting C-peptide. FKBPL plasma concentrations were increased in the presence of CVD, but only in the non-diabetic group (CVD: 2.02 ng/ml ± 0.75 SD vs. no CVD: 1.68 ng/ml ± 0.79 SD, p = 0.02). In non-diabetic subjects, FKBPL was positively correlated with an established biomarker for CVD, B-type Natriuretic Peptide (BNP), and echocardiographic parameters of diastolic dysfunction. FKBPL was a determinant of CVD in the non-diabetic group in addition to age, gender, total-cholesterol and systolic blood pressure (SBP). FKBPL may be a useful anti-angiogenic biomarker in CVD in the absence of diabetes and could represent a novel CVD mechanism.

Download Full-text

Prevalence of and factors associated with self-reported high blood pressure in Brazilian adults

Revista de Saúde Pública ◽

10.1590/s1518-8787.2017051000006 ◽

2017 ◽

Vol 51 (suppl 1) ◽

Cited By ~ 19

Author(s):

Deborah Carvalho Malta ◽

Regina Tomie Ivata Bernal ◽

Silvânia Suely Caribé de Araújo Andrade ◽

Marta Maria Alves da Silva ◽

Gustavo Velasquez-Melendez

Keyword(s):

Blood Pressure ◽

High Blood Pressure ◽

Skin Color ◽

Adult Population ◽

Age Groups ◽

Federal District ◽

Noncommunicable Diseases ◽

Factors Associated ◽

Brazilian State ◽

Increased Risk

ABSTRACT OBJECTIVE To analyze factors associated with self-reported high blood pressure among adults in Brazilian state capitals. METHODS The study uses data from Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel – Surveillance System of Risk and Protection Factors of Noncommunicable Diseases by Telephone Survey) collected in 2013. Prevalence rates and their respective 95% confidence intervals by gender were estimated according to sociodemographic variables, lifestyle, reported noncommunicable diseases and self-rated health status. Multivariate logistic regression modeling was used to identify variables associated with self-reported high blood pressure with α < 0.05. RESULTS Prevalence of self-reported high blood pressure among adults living in Brazilian state capitals and the Federal District was 24.1%. The following variables were associated with self-reported high blood pressure: age group, taking 18-24 as reference (all age groups presented increased risk – from 25-34 years [OR = 2.6; 95%CI 2.0–3.4] up to 65 years or more [OR = 28.1; 95%CI 21.7–36.4]); low education level (9 to 11 years of study [OR = 0.8; 95%CI 0.7–0.9] and 12 years or more [OR = 0.6; 95%CI 0.6–0.7]); Black race or skin color (OR = 1.3; 95%CI 1.1–1.5); being a former smoker (OR = 1.2; 95%CI 1.1–1.3); obesity (OR = 2.7; 95%CI 2.4–3.0); diabetes (OR = 2.9; 95%CI 2.5–3.5%), and high cholesterol (OR = 1.9; 95%CI 1.8–2.2). CONCLUSIONS Approximately one quarter of the adult population living in Brazilian state capitals reported having high blood pressure. Information from Vigitel is useful to monitor high blood pressure and identity its associated factors, supporting public policies for health promotion, surveillance and care.

Download Full-text

My Hypertension Education and Reaching Target (MyHEART): Development and Dissemination of a Patient-Centered Website for Young Adults with Hypertension (Preprint)

10.2196/preprints.8025 ◽

2017 ◽

Author(s):

Heather M Johnson ◽

Jamie N LaMantia ◽

Colleen M Brown ◽

Ryan C Warner ◽

Laura M Zeller ◽

...

Keyword(s):

Blood Pressure ◽

Young Adults ◽

Healthcare Providers ◽

Age Groups ◽

Clinical Information ◽

Pressure Control ◽

Healthcare Research ◽

Evidence Based ◽

Patient Centered ◽

Adult Age

BACKGROUND Young adults (18 to 39 years old) with hypertension have the lowest rates of blood pressure control (defined as blood pressure less than 140/90 mmHg) compared to other adult age groups. Approximately 1 in 15 young adults have high blood pressure, increasing their risk of future heart attack, stroke, congestive heart failure, and/or chronic kidney disease. Many young adults reported having few resources to address their needs for health education on managing cardiovascular risk. OBJECTIVE The goal of our study was to develop and disseminate a website with evidence-based, clinical information and health behavior resources tailored to young adults with hypertension. METHODS In collaboration with young adults, health systems, and community stakeholders, the My Hypertension Education and Reaching Target (MyHEART) website was created. A toolkit was also developed for clinicians and healthcare systems to disseminate the website within their organizations. The dissemination plan was guided by the Dissemination Planning Tool of the Agency for Healthcare Research and Quality (AHRQ). RESULTS Google Analytics data were acquired for January 1, 2017 to June 29, 2017. The MyHEART website received 1090 visits with 2130 page views; 18.99% (207/1090) were returning visitors. The majority (55.96%, 610/1090) approached the website through organic searches, 34.95% (381/1090) accessed the MyHEART website directly, and 5.96% (65/1090) approached through referrals from other sites. There was a spike in site visits around times of increased efforts to disseminate the website. CONCLUSIONS The successfully implemented MyHEART website and toolkit reflect collaborative input from community and healthcare stakeholders to provide evidence-based, portable hypertension education to a hard-to-reach population. The MyHEART website and toolkit can support healthcare providers’ education and counseling with young adults and organizations’ hypertension population health goals.

Download Full-text

Office Blood Pressure Range and Cardiovascular Events in Patients With Hypertension: A Nationwide Cohort Study in South Korea

Journal of the American Heart Association ◽

10.1161/jaha.120.017890 ◽

2021 ◽

Author(s):

Chang Hee Kwon ◽

Woohyeun Kim ◽

Jeong‐Hun Shin ◽

Chan Joo Lee ◽

Hyeon‐Chang Kim ◽

...

Keyword(s):

Blood Pressure ◽

Cohort Study ◽

Cardiovascular Events ◽

Age Groups ◽

Cardiovascular Death ◽

Office Blood Pressure ◽

Target Range ◽

Major Cardiovascular Events ◽

Increased Risk ◽

Blood Pressure Range

Background It is unclear what office blood pressure (BP) is the optimal treatment target range in patients with hypertension. Methods and Results Using the Korean National Health Insurance Service database, we extracted the data on 479 359 patients with hypertension with available BP measurements and no history of cardiovascular events from 2002 to 2011. The study end point was major cardiovascular events (MACE), a composite of cardiovascular death, myocardial infarction, or stroke. This cohort study evaluated the association of BP levels (<120/<70, 120–129/70–79, 130–139/80–89, 140–149/90–99, and ≥150/≥100 mm Hg) with MACE. During a median follow‐up of 9 years, 55 401 MACE were documented in our cohort. The risk of MACE was the lowest (adjusted hazard ratio [HR], 0.79; 95% CI, 0.76–0.84) at BP level of <120/<70 mm Hg, and was the highest (HR, 1.32; 95% CI, 1.29–1.36) at ≥150/≥100 mm Hg in comparison with 130 to 139/80 to 89 mm Hg. These results were consistent in all age groups and both sexes. Among patients treated with antihypertensive medication (n=237 592, 49.5%), in comparison with a BP level of 130 to 139/80 to 89 mm Hg, the risk of MACE was significantly higher in patients with elevated BP (≥140/≥90 mm Hg), but not significantly lower in patients with BP of <130/<80 mm Hg. Low BP <120/70 mm Hg was associated with increased risk of all‐cause or cardiovascular death in all age groups. Conclusions BP level is significantly correlated with the risk of MACE in all Korean patients with hypertension. However, there were no additional benefits for MACE amongst those treated for hypertension with BP <120/70 mm Hg.

Download Full-text

Associations between Aquaglyceroporin Gene Polymorphisms and Risk of Type 2 Diabetes Mellitus

BioMed Research International ◽

10.1155/2018/8167538 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Yijun Wang ◽

Gang Chen ◽

Qingyun Tu ◽

Junxia Wu ◽

Yu Qin ◽

...

Keyword(s):

Type 2 Diabetes ◽

Metabolic Diseases ◽

Proteinase K ◽

Nucleotide Polymorphisms ◽

Chinese Han ◽

Single Nucleotide ◽

Increased Risk ◽

Polymerase Chain ◽

And Gender

Objectives. AQP7 and AQP9 represent glycerol channel in adipose tissue and liver and have been associated with metabolic diseases. We aimed to investigate the associations between genetic variants in AQP7 and AQP9 genes and the risk of type 2 diabetes (T2DM) in Chinese population. Methods. Blood samples were drawn from 400 T2DM patients and 400 age- and gender-matched controls. Genomic DNA was extracted by proteinase K digestion and phenol–chloroform extraction. Genotyping of 5 single nucleotide polymorphisms (SNPs) in AQP7 (rs2989924, rs3758269, and rs62542743) and AQP9 (rs57139208, rs16939881) was performed by the polymerase chain reaction assay with TaqMan probes. Results. The subjects with rs2989924 GA+AA genotypes had 1.47-fold increased risk of T2DM (odds ratio [OR] 1.47, 95% confidence interval [CI] 1.06-2.04), compared to those with GG genotype, and this association remained significant after adjustment for covariates (OR 1.66, 95% CI 1.07-2.57). When compared with rs3758269 CC genotype, the subjects with CT+TT genotypes had 45% decreased T2DM risk after multivariate adjustment (OR 0.55, 95% CI 0.35-0.85). The associations were evident in elder and overweight subjects and those with central obesity. No association was observed between AQP9 SNPs and T2DM risk. Conclusions. AQP7 SNP rs2989924 and rs3758269 were associated with T2DM risk in Chinese Han population.

Download Full-text

Atrial fibrillation and hypertension

ESC CardioMed ◽

10.1093/med/9780198784906.003.0524 ◽

2018 ◽

pp. 2227-2229

Author(s):

Hung-Fat Tse ◽

Jo-Jo Hai

Keyword(s):

Oxidative Stress ◽

Risk Factors ◽

Atrial Fibrillation ◽

Blood Pressure ◽

Pressure Control ◽

Hypertensive Patients ◽

Good Blood Pressure Control ◽

Increased Risk ◽

Independent Risk Factors ◽

Stress Activation

Hypertension is one of the most important independent risk factors for atrial fibrillation (AF). Conversely, AF is associated with an increased risk of stroke in hypertensive patients. While the pathophysiology linking the two conditions is not completely understood, it is likely attributed to interplay between mechanical stress, activation of the renin–angiotensin–aldosterone system, oxidative stress, and inflammatory response in hypertension to cause atrial electroanatomical remodelling, and thus AF. Management of hypertensive patients with AF encompasses lenient rate control, thromboprophylaxis, and good blood pressure control.

Download Full-text