Prevalence and coincidence of hypertension and orthostatic hypotension in pre- and centenarians and their effect on mortality: preliminary results of Moscow centenarian study

Objective. To estimate the prevalence and impact on mortality of arterial hypertension (HTN) and orthostatic hypotension (OH) in centenarians (95 years and older) in Moscow.Design and methods. The study participants were 82 super-long-livers of Moscow city aged 95 years and older (minimum age of 95 years, maximum 105 years), who underwent a comprehensive geriatric assessment at home by a multidisciplinary team (geriatrician, nurse and social worker). The following prospective observation lasted for three years (36 months).Results. Past medical history of HTN was noted in 78 %. The mean systolic blood pressure (SBP) in the supine position was 151 ± 27,9 mm Hg (100–216 mm Hg), and the diastolic blood pressure (DBP) 74 ± 12,8 mm Hg (44–197 mm Hg). OH was detected in 31 % of 61 long-livers who was able to perform an orthostatic test. The presence of OH was not associated with the higher intake of antihypertensive drugs. Within three years, 44 study participants died. The level of blood pressure (BP), history of HTN, and the presence of OH did not affect mortality (p > 0,05).Conclusions. Centenarians have a wide range of SBP and DBP, high prevalence of HTN and OH. BP level, presence of HTN and OH did not affect mortality over 3 year period. Further investigation is needed to understand better the health status of long-livers and factors affecting the prognosis.

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Diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study

Nutrition Journal ◽

10.1186/s12937-021-00717-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Amir Motamedi ◽

Maryam Ekramzadeh ◽

Ehsan Bahramali ◽

Mojtaba Farjam ◽

Reza Homayounfar

Keyword(s):

Blood Pressure ◽

Cohort Study ◽

Diet Quality ◽

Dietary Diversity ◽

Antihypertensive Drugs ◽

Healthy Eating Index ◽

Cross Sectional ◽

Common Chronic Disease ◽

History Of ◽

Prevention Of Hypertension

Abstract Background Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension. Methods This study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs. Results Hypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75–0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68–0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64–0.99) and females (OR: 0.78, 95%CI = 0.66–0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension. Conclusions Adhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.

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Childhood hypertension and family history of hypertension in primary school children in Port Harcourt

Nigerian Journal of Paediatrics ◽

10.4314/njp.v40i2.16 ◽

2013 ◽

Vol 40 (2) ◽

pp. 184-188

Author(s):

BAN Okoh ◽

EAD Alikor

Keyword(s):

Blood Pressure ◽

Family History ◽

Primary School ◽

School Children ◽

Antihypertensive Drugs ◽

Sampling Technique ◽

Primary School Children ◽

History Of ◽

Family History Of Hypertension ◽

Childhood Hypertension

Objective: To determine the relationship between childhood hypertension and family history of hypertension in primary school children in Port Harcourt.Methods: A stratified multi-staged sampling technique was used torecruit pupils between 6-12 years of age, from thirteen primary schoolslocated in three school districts. Data was collected using a pretestedquestionnaire completed by parents / guardians. The average of three blood pressure measurements, weight and height were taken for each pupil, using standardized techniques. Hypertension was defined as average systolic and / or diastolic blood pressure greater than or equalto the 95th percentile for age, gender and height using the standard bloodpressure charts. Family history of hypertension was defined as eitherparent indicating on the submitted questionnaire that they were hypertensive (diagnosed by a physician and/or on antihypertensive drugs)or had a family history of hypertension.Results: A total of 1302 pupils with 717 (55.1%) females and 585(44.9%) males were studied, giving a female to male ratio of 1.2:1. Themean age of pupils studied was 8.82±1.91 years. Sixty one (4.7%)of the pupils examined had hypertension. Of the 1302 pupils, 316(24.3%) had a family history of hypertension. The mean systolic(p<0.001) and diastolic (p=0.220) blood pressures were higher in childrenwith a family history of hypertension than in those without. Ofthe pupils that had a family history of hypertension, 7.9% had hypertension, while 3.7% of those that did not have a family history, werefound to be hypertensive (p=0.001).Conclusion: A family history of hypertension was associated with a higher prevalence of childhood hypertension than was seen in children without a family history of hypertension.Key words: Childhood Hypertension, Family history.

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Fixed-dose combinations in the treatment of hypertension to increase adherence

Russian Journal of Cardiology ◽

10.15829/29/1560-4071-2020-4184 ◽

2020 ◽

Vol 25 (11) ◽

pp. 4184

Author(s):

T. E. Morozova ◽

E. O. Samokhina

Keyword(s):

Blood Pressure ◽

Antihypertensive Drugs ◽

Fixed Dose ◽

Optimal Solutions ◽

Comorbid Conditions ◽

Treatment Regimens ◽

Wide Range ◽

Treatment Of Hypertension ◽

Artery Disease ◽

Initiation Of Therapy

Despite a wide range of antihypertensive drugs, blood pressure (BP) control often remains unsatisfactory, and every year the number of people with uncontrolled high BP increases. One of the strategies aimed at improving medical adherence is the use of fixed-dose combinations of 2 antihypertensive drugs for starting therapy, and, if necessary, 3 drugs. Initiation of therapy with 2 drugs in one tablet is recommended for most patients. A review of algorithms for choosing combinations of antihypertensive drugs in different clinical situations, including in patients with various comorbid conditions, is presented. Simplification of treatment regimens makes it possible to choose the most optimal solutions in various clinical situations, in particular, with stage I-II hypertension, with a combination of hypertension with chronic kidney disease, as well as with a combination of hypertension with coronary artery disease and a number of other diseases.

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Sex differences in the adherence of antihypertensive drugs: a systematic review with meta-analyses

BMJ Open ◽

10.1136/bmjopen-2019-036418 ◽

2020 ◽

Vol 10 (7) ◽

pp. e036418 ◽

Cited By ~ 1

Author(s):

Annalisa Biffi ◽

Federico Rea ◽

Teresa Iannaccone ◽

Amelia Filippelli ◽

Giuseppe Mancia ◽

...

Keyword(s):

Sex Differences ◽

Regression Models ◽

Antihypertensive Drugs ◽

Pressure Control ◽

Self Report ◽

Factors Affecting ◽

Definitive Evidence ◽

Pharmacy Refill ◽

Meta Analyses ◽

Design And Methods

ObjectivesPoor worldwide rate of blood pressure control is largely due to poor adherence to antihypertensive (AHT) drug treatment. The question of whether sex affects adherence has long been debated but conflicting findings have been reported on this issue. Our objective was to evaluate sex differences in the adherence to AHT therapy.Research design and methodsStudies were identified through a systematic search of PubMed, CINAHL, PsycINFO, Web of Science and Google Scholar (through January 2020) and manual handsearching of relevant articles. Observational studies reporting adherence to AHT drugs measured by self-report or pharmacy refill prescription-based methods among men and women were included. Summarised estimates of ORs with 95% CIs were calculated using random-effects model and meta-regression models.ResultsFrom 12 849 potentially relevant publications, 82 studies (15 517 457 men and 18 537 599 women) were included. No significant between-sex differences in adherence to AHT were observed, whether all study-specific estimates were summarised (ORs 1.04, 95% CI 1.00 to 1.09, p=0.07), nor estimates were pooled according to the method for measuring adherence. Among patients aged 65 years or older, lower self-reported adherence was observed in women (ORs 0.84, 95% CI 0.72 to 0.97, p=0.02), while the main result remained unchanged according to other subgroup analyses.ConclusionsDefinitive evidence of sex differences in adherence to AHT therapy cannot be drawn. Our little knowledge about factors affecting adherence, in particular of sex effect among elderly, urgently requires high-quality studies investigating these issues.

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Plasma Catecholamine Responses to Change of Posture in Alcoholics during Withdrawal and after Continued Abstinence from Alcohol

Clinical Science ◽

10.1042/cs0680071 ◽

1985 ◽

Vol 68 (1) ◽

pp. 71-78 ◽

Cited By ~ 35

Author(s):

G. Eisenhofer ◽

E. A. Whiteside ◽

R. H. Johnson

Keyword(s):

Blood Pressure ◽

Orthostatic Hypotension ◽

Plasma Noradrenaline ◽

Plasma Catecholamine ◽

Heart Rates ◽

Control Subjects ◽

Wide Range ◽

Blood Pressures ◽

Sympathetic Nervous ◽

Abstinence From Alcohol

1. Plasma catecholamine, blood pressure and heart rate responses to standing were measured in ten alcoholics during withdrawal, ten alcoholics after 2–7 weeks of abstinence from alcohol, six abstinent alcoholics with orthostatic hypotension and ten normal control subjects. 2. Withdrawing alcoholics had supine and standing heart rates and plasma noradrenaline and adrenaline concentrations that were higher than in abstinent alcoholics or control subjects. Supine blood pressures were also higher in withdrawing alcoholics than in abstinent alcoholics or control subjects, but on standing blood pressures in withdrawing alcoholics fell, four patients having a fall of more than 30/5 mmHg. 3. Abstinent alcoholics without orthostatic hypotension had higher basal and standing concentrations of noradrenaline than control subjects but normal heart rates and adrenaline concentrations. 4. Abstinent alcoholics with orthostatic hypotension showed a wide range of basal plasma noradrenaline concentrations and were found to have variable plasma noradrenaline responses to standing, three subjects having normal responses and three subjects having no or little increase in plasma noradrenaline on standing. 5. It is concluded that alcohol withdrawal is associated with increased sympathetic nervous activity, as reflected by raised supine and standing plasma concentrations of catecholamines, and that even after 2–7 weeks of abstinence from alcohol plasma noradrenaline concentrations may be higher than in control subjects. Despite increased sympathetic nervous responses to standing, alcoholics during withdrawal have impaired blood pressure control and some may exhibit orthostatic hypotension. Orthostatic hypotension may also be observed in alcoholics during continuing abstinence from alcohol; in some of these patients failure of reflex noradrenaline release in response to standing may contribute to orthostatic hypotension.

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Faktor Risiko yang Mempengaruhi Terjadinya Stroke Non Hemoragik pada Pasien di RS RK Charitas dan RS Myria Palembang

Jurnal Akademika Baiturrahim Jambi ◽

10.36565/jab.v9i2.234 ◽

2020 ◽

Vol 9 (2) ◽

pp. 268

Author(s):

Bangun Dwi Hardika ◽

M Yuwono ◽

HM Zulkarnain

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Multivariate Analysis ◽

Hemorrhagic Stroke ◽

Case Control ◽

Blood Cholesterol ◽

Total Blood ◽

Factors Affecting ◽

History Of ◽

Total Blood Cholesterol

Non-hemorrhagic stroke is a frequent case of stroke caused by blockage of blood vessels and the accumulation of changeable and unchangeable risk factors. The impact of stroke is a long-term physical and functional disorder that affects the life quality of the patient and the family. The aim of this study was to analyze the factors that influence the occurrence of non-hemorrhagic stroke. This study is an observational analytic epidemiological study with case control research design conducted in 2 private hospitals. The samples were selected sequentially with a ratio of 1: 2 (case: control) consisting of 50 patients with non-hemorrhagic stroke and 100 patients without non-hemorrhagic stroke. The data was analyzed by univariate, bivariate, and multivariate analysis method by using binary logistic regression. The results of risk factor analysis which were independently associated were Total Blood Cholesterol, History of Hypertension, Systolic Blood Pressure, Diastolic Blood Pressure, and Cardiac Examination. The multivariate analysis showed that the risk factors affecting non hemorrhagic stroke were History of Hypertension (OR: 6,476, p = 0.000, 95% CI: 2,338-17,935), Total Blood Cholesterol Level ≥200 mg/dl (OR: 6,139, p = 0.000, 95% CI: 2,334-16,148), Education Level (OR: 0,311, p = 0.009, 95% CI: 0,129-0,747), Gender (OR: 0.379, p = 0.022, 95% CI: 0.165-0.871 ), and Obesity (OR: 2,217, p = 0.080, 95% CI: 0.910-5.401). As a conclusion, there were 5 variables of risk factors that influence to Non Hemorrhagic Stroke. If those variables of risk factors were exist in the respondent, the risk of a non hemorrhagic Stroke reached 81.6%. It was suggested that the patients made an effort on preventions by maintaining a healthy lifestyle and controlling risk factors affecting the occurrence of non-hemorrhagic stroke.

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Visit-to-visit blood pressure variability in patients after acute coronary syndrome

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2021-27-2-206-215 ◽

2021 ◽

Vol 27 (2) ◽

pp. 206-215

Author(s):

V. A. Brazhnik ◽

L. O. Minushkina ◽

A. S. Galyavich ◽

N. R. Khasanov ◽

M. A. Chichkova ◽

...

Keyword(s):

Blood Pressure ◽

Acute Coronary Syndrome ◽

Adverse Outcomes ◽

Risk Of Death ◽

Coronary Syndrome ◽

History Of ◽

Initial Severity ◽

Coronary Events ◽

Design And Methods

Objective. The aim of the study was to assess the possible association of visit-to-visit blood pressure (BP) variability and the risk of adverse outcomes in hypertensive (HTN) patients after acute coronary syndrome.Design and methods. We analyzed data of 1,456 patients (mean age 65,6 ± 12,2 years, 875 (60,1 %) men) discharged from the hospital after acute coronary syndrome and followed up for 1 year in 4 vascular centers in Moscow, Astrakhan, Kazan and Krasnodar in 2014–2017. BP, heart rate, and adverse events were recorded on the day of discharge and on days 25, 90, 180 and 360 after discharge. The visit-to-visit BP variability was assessed by the VIM coefficient (variation independent of mean).Results. The systolic BP variability was 7,81 ± 0,226 mm Hg, diastolic BP variability was 9,89 ± 0,577 mm Hg during follow-up. In total, 110 deaths from any cause, 63 coronary deaths, 130 repeated non-fatal coronary events, 33 ischemic strokes were recorded. A decrease in BP variability was associated with the dihydropyridine calcium antagonists (10,21 ± 6,45 and 7,99 ± 4,70 mm Hg, p = 0,024) and thiazide diuretics (10,34 ± 6,59 and 7,63 ± 9,63 mm Hg, p = 0,049). Multivariate analysis showed that high long-term variability of BP is a more significant factor associated with the overall mortality rate than the initial severity of HTN and even the fact of achieving target BP. The risk of ischemic stroke in patients with HTN was associated with factors such as atrial fibrillation, heart failure, a history of stroke, and high visit-to-visit BP variability.Conclusions. Visit-to-visit BP variability is an important characteristic of BP control and is associated with the risk of death from any causes and stroke in patients with coronary heart disease.

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How to Choose the Optimal Single-Pill Combination of the First-Line Antihypertensive Drugs? The Benefits of Amlodipine and Telmisartan Combination

Rational Pharmacotherapy in Cardiology ◽

10.20996/1819-6446-2020-07-01 ◽

2020 ◽

Vol 16 (4) ◽

pp. 614-622

Author(s):

O. D. Ostroumova ◽

A. I. Kochetkov ◽

V. N. Butorov ◽

I. F. Krotkova

Keyword(s):

Blood Pressure ◽

Cardiovascular Risk ◽

Antihypertensive Drugs ◽

Blood Pressure Monitoring ◽

Large Body ◽

First Line ◽

Cardiovascular Risk Reduction ◽

Smoothness Index ◽

Wide Range ◽

Single Pill

In patients with arterial hypertension (AH), an extremely important measure of the effectiveness of antihypertensive drugs (AHD) is not only a direct decrease in blood pressure (BP), but also its stable control throughout the 24 hours, preventing excessive morning surge and increased BP variability, which in turn are recognized cardiovascular risk factors. Currently, in the vast majority of hypertensive patients, the main antihypertensive therapy approach is using single-pill combinations (SPC) of AHD. Among the first-line combinations for a wide range of patients with AH and no special clinical conditions is amlodipine/telmisartan SPC. Distinctive features of these drugs, on the one hand, are unique pharmacological properties, consisting in an ultra-long antihypertensive effects, superior to other AHD in their classes; and on the other hand, there is an large body of evidence from numerous clinical trials confirming their high antihypertensive and target-organ protective potential as well as excellent capabilities in cardiovascular risk reduction. To assess the AHD effectiveness extent, several parameters have been proposed, of which the most rational and useful is the smoothness index, calculated using the ambulatory blood pressure monitoring data. Smoothness index describes both the degree of BP reduction and its distribution during the monitoring period. This index inversely associates with the changes in BP variability, and has predictive value in relation to the hypertension-mediated organ damage regression during different antihypertensive regimens. Amlodipine/telmisartan SPC has also been studied in many trials, including comparative ones with other AHD. In these works its direct powerful antihypertensive effect and a pronounced beneficial impact on the smoothness index have been proved, demonstrating stable BP control throughout the 24 hours (especially in the most dangerous morning hours), and also a decrease in BP variability. Therefore, amlodipine/telmisartan SPC can effectively reduce cardiovascular risk and improve prognosis in patients with AH.

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Awareness, Treatment, and Control of Hypertension Among 10663 Adults in Kherameh: A Population-Based Study

10.21203/rs.3.rs-151499/v1 ◽

2021 ◽

Author(s):

Abbas Rezaianzadeh ◽

Fatemeh Jafari ◽

Seyed Ebrahim Sadeghi ◽

Salar Rahimikazerooni ◽

Ehsan Bahramali ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Diseases ◽

Antihypertensive Drugs ◽

Population Based ◽

Related Factors ◽

Cross Sectional ◽

Dependent Variables ◽

History Of ◽

And Control ◽

Second Degree

Abstract Background: Hypertension (HTN) is known to be a modifiable risk factor for Cardiovascular Disease (CVDs), stroke, and kidney disease. The present study aimed to determine awareness, treatment, and control of HTN and the related factors in Kherameh, Iran.Methods: This cross-sectional study was performed on 10663 individuals over 40 years of age using Kherameh cohort data. HTN was defined as either Systolic/Diastolic Blood Pressure (SBP/DBP) ≥140/90 mmHg or taking medications. Logistic regression was used to examine the relationship between awareness, treatment, and control and their related factors. Results: Awareness, treatment, and control rates were 80.3%, 78%, and 53.6%, respectively among the individuals with HTN. Age, gender, body mass index, and CVD were associated with all dependent variables in the regression model. In addition, occupation, diabetes, chronic diseases, history of CVD in the first- and second-degree relatives, and history of chronic diseases in the second-degree relatives were related to all dependent variables, except for treatment.Conclusion: The results indicated that despite the high level of awareness, the proportion of patients under treatment and control gradually decreased, such a way that about half of the patients had abnormal blood pressure. Hence, educational intervention is recommended to increase the patients’ awareness to ensure the continuous use of antihypertensive drugs in order to help control the disease more efficiently.

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Pharmacogenomics of Hypertension Treatment

International Journal of Molecular Sciences ◽

10.3390/ijms21134709 ◽

2020 ◽

Vol 21 (13) ◽

pp. 4709

Author(s):

Jacek Rysz ◽

Beata Franczyk ◽

Magdalena Rysz-Górzyńska ◽

Anna Gluba-Brzózka

Keyword(s):

Blood Pressure ◽

Complex Traits ◽

Drug Response ◽

Antihypertensive Drugs ◽

Individual Variability ◽

Metabolizing Enzymes ◽

Factors Affecting ◽

Genetic Heritability ◽

Costs Of Treatment ◽

Metabolic Reactions

Hypertension is one of the strongest modifiable cardiovascular risk factors, affecting an increasing number of people worldwide. Apart from poor medication adherence, the low efficacy of some therapies could also be related to inter-individual genetic variability. Genetic studies of families revealed that heritability accounts for 30% to 50% of inter-individual variation in blood pressure (BP). Genetic factors not only affect blood pressure (BP) elevation but also contribute to inter-individual variability in response to antihypertensive treatment. This article reviews the recent pharmacogenomics literature concerning the key classes of antihypertensive drugs currently in use (i.e., diuretics, β-blockers, ACE inhibitors, ARB, and CCB). Due to the numerous studies on this topic and the sometimes-contradictory results within them, the presented data are limited to several selected SNPs that alter drug response. Genetic polymorphisms can influence drug responses through genes engaged in the pathogenesis of hypertension that are able to modify the effects of drugs, modifications in drug–gene mechanistic interactions, polymorphisms within drug-metabolizing enzymes, genes related to drug transporters, and genes participating in complex cascades and metabolic reactions. The results of numerous studies confirm that genotype-based antihypertension therapies are the most effective and may help to avoid the occurrence of major adverse events, as well as decrease the costs of treatment. However, the genetic heritability of drug response phenotypes seems to remain hidden in multigenic and multifactorial complex traits. Therefore, further studies are required to analyze all associations and formulate final genome-based treatment recommendations.

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