scholarly journals Risk Probability and Influencing Factors of Stroke in Followed-up Hypertension Patients

2021 ◽  
Author(s):  
An-le Li ◽  
Ying Qi ◽  
Shuai Zhu ◽  
Zhi-hao Hu ◽  
Xue-jin Xu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Influencing Factors ◽  
Risk Model ◽  
Cumulative Risk ◽  
Peak Period ◽  
Risk Probability ◽  
History Of ◽  
Second Peak

Abstract Objective To explore the risk probability and influencing factors of stroke in followed-up hypertension (HP) patients through the analysis of long-term followed-up cohort data. Methods The method of followed-up observation cohort was used to collect the information of 168417 hypertension patients from 2002 to 2020 in Jiading district in Shanghai. Kaplan-Meier method was used to analyze the risk probability of stroke complications in long-term followed-up HP patients, and the influencing factors were analyzed by Cox proportional risk model. Results Among 168417 hypertension patients, 11143 cases had stroke, and the cumulative incidence rate was 6.62%, the male was 6.87% and the female was 6.37%. With the extension of the observation of patients, the cumulative risk probability of stroke in HP patients would continue to increasing, and the interval was not equidistant. The total cumulative risk probability of stroke in HP patients was 78.9%, and male was 91.0%, female was 70.7%. During the whole observation, the risk probability of stroke was not fixed, but fluctuates. There were 4 peak onset periods, which were 8 years (peak period 4.2%), 15 years (peak period 14.0%), 22 years (peak period 6.0%) and 26 years (peak period 13.9%). The highest risk probability of male patients was in 26 years (peak period 23.1%), and the second peak was in 15 years (peak period 15.6%). The highest risk probability of female patients was in 15 years (peak period 12.9%), and the second peak was in 26 years (peak period 8.7%). The risk probability of different sex, BP grad and BMI was different, male was higher than female, grade 3 HP higher than grade 1 and grad 2 HP, thin higher than normal weight. The major influencing factors of stroke complications were age (RR = 2.917, p < 0.001), body mass index (RR = 1.450, p < 0.001), family history of stroke (RR = 1.386, p < 0.001), blood pressure grad (RR = 1.148, p < 0.001), registry age (RR = 1.071, P < 0.001 and family history of hypertension (RR = 1.051, P < 0.001). Conclusion The risk probability of stroke among hypertension patients would continue to disproportionately increase during observation, and the total cumulative risk probability could finally reach 78.9%. Male was higher than female. Age, BMI, family history (stroke and HP), blood pressure grad and duration of HP were related to the occurrence of stroke complications.

scholarly journals Risk Probability and Influencing Factors of Stroke in Followed-up Hypertension Patients

2021 ◽  
Author(s):  
An-le Li ◽  
Ying Qi ◽  
Shuai Zhu ◽  
Zhi-hao Hu ◽  
Xue-jin Xu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Influencing Factors ◽  
Risk Model ◽  
Cumulative Risk ◽  
Peak Period ◽  
Risk Probability ◽  
History Of ◽  
Second Peak

Abstract Objective：To explore the risk probability and influencing factors of stroke in followed-up hypertension (HP) patients through the analysis of long-term followed-up cohort data. Methods: The method of followed-up observation cohort was used to collect the information of 168417 hypertension patients from 2002 to 2020 in Jiading district in Shanghai. Kaplan-Meier method was used to analyze the risk probability of stroke complications in long-term followed-up HP patients, and the influencing factors were analyzed by Cox proportional risk model. Results: Among 168417 hypertension patients, 11143 cases had stroke, and the cumulative incidence rate was 6.62%, the male was 6.87% and the female was 6.37%. With the extension of the observation of patients, the cumulative risk probability of stroke in HP patients would continue to increasing, and the interval was not equidistant. The total cumulative risk probability of stroke in HP patients was 78.9%, and male was 91.0%, female was 70.7%. During the whole observation, the risk probability of stroke was not fixed, but fluctuates. There were 4 peak onset periods, which were 8 years (peak period 4.2%), 15 years (peak period 14.0%), 22 years (peak period 6.0%) and 26 years (peak period 13.9%). The highest risk probability of male patients was in 26 years (peak period 23.1%), and the second peak was in 15 years (peak period 15.6%). The highest risk probability of female patients was in 15 years (peak period 12.9%), and the second peak was in 26 years (peak period 8.7%). The risk probability of different sex, BP grad and BMI was different, male was higher than female, grade 3 HP higher than grade 1 and grad 2 HP, thin higher than normal weight. The major influencing factors of stroke complications were age (RR=2.917, p<0.001), body mass index (RR=1.450, p< 0.001), family history of stroke (RR=1.386, p<0.001), blood pressure grad (RR=1.148, p<0.001), registry age (RR=1.071, P<0.001 and family history of hypertension (RR=1.051, P<0.001). Conclusion: Hypertension patients were prone to stroke, the risk probability would continue to disproportionately increase during observation, and the total cumulative risk probability could finally reach 78.9%. Male was higher than female. Age, BMI, family history (stroke and HP), blood pressure grad and duration of HP were related to the occurrence of stroke complications.

scholarly journals Risk Occurred Probability and Influencing Factors of Stroke in Followed-Up Hypertension Patients

2021 ◽  
Author(s):  
An-le Li ◽  
Ying Qi ◽  
Shuai Zhu ◽  
Zhi-hao Hu ◽  
Xue-jin Xu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Influencing Factors ◽  
Cumulative Risk ◽  
Occurrence Rate ◽  
Risk Probability ◽  
History Of ◽  
Second Peak ◽  
Peak Value

Abstract Objective To explore the risk occurred probability and influencing factors of stroke in followed-up hypertension (HP) patients through the analysis of long-term followed-up cohort data. Methods The method of followed-up observation cohort was used to collect the information of 168417 followed-up hypertension patients from 2002 to 2020 in Jiading district in Shanghai. Kaplan-Meier method was used to analyze the risk occurred probability of stroke complications in long-term followed-up HP patients, and the influencing factors were analyzed by Cox proportional risk model. Results Among 168417 followed-up hypertension patients, 11143 cases had occurred stroke, and the cumulative occurrence rate of stroke was 6.62% (male was 6.87%, female was 6.37%). With the extension of the years of hypertension, the cumulative risk occurred probability of stroke in HP patients would continue to increasing, and the interval was not equidistant. The total cumulative risk probability of stroke in HP patients was 78.9% (male was 91.0%, female was 70.7%). During the period of hypertension, the risk occurred probability of stroke was not fixed, but fluctuates. There were 4 onset peaks, which were in 8 years (peak value 4.2%), 15 years (peak value 14.0%), 22 years (peak value 6.0%) and 26 years (peak value 13.9%). The highest risk probability of male patients was in 26 years (peak value 23.1%), and the second peak was in 15 years (peak value 15.6%). The highest risk probability of female patients was in 15 years (peak value 12.9%), and the second peak was in 26 years (peak value 8.7%). The risk probability of different sex, BP grad and BMI was different, male was higher than female, grade 3 HP higher than grade 1 and grad 2 HP, thin higher than normal weight. The major influencing factors of stroke complications were age (RR = 2.917, p < 0.001), body mass index (RR = 1.450, p < 0.001), family history of stroke (RR = 1.386, p < 0.001), blood pressure grad (RR = 1.148, p < 0.001), registry age (RR = 1.071, P < 0.001 and family history of hypertension (RR = 1.051, P < 0.001). Conclusion The risk occurred probability of stroke among hypertension would continue to increase disproportionately during period of hypertension, and the total cumulative risk probability could finally reach 78.9%. Male was higher than female. Age, BMI, family history (stroke and HP), blood pressure grad and duration of HP were related to the occurrence of stroke complications.

Abstract P355: Predicting the 20-year Risk of First Coronary or Ischemic Stroke Event in Northern Italy: The CAMUNI Absolute Risk Equation

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Giovanni Veronesi ◽  
Lloyd E Chambless ◽  
Francesco Gianfagna ◽  
Giuseppe Mancia ◽  
Giancarlo Cesana ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Diastolic Blood Pressure ◽  
Cardiovascular Events ◽  
Absolute Risk ◽  
Northern Italy ◽  
Men And Women ◽  
Basic Model ◽  
History Of

Aims. Recent US guidelines advocate the introduction of lifetime or long-term absolute risk prediction for primary prevention of cardiovascular events, especially for young people and women. Therefore, long-term prediction models might be specially beneficial in population considered at low incidence. We aim to develop a 20-year absolute risk prediction equation in a Northern Italy population. Methods. Four independent population-based cohorts were enrolled between 1986 and 1994 from the Brianza population (Northern Italy), adopting standardized MONICA procedures. The study sample comprises n=2574 men and 2673 women, aged 35 to 69 years and free of CVD at baseline. Participants were followed-up for incidence of first coronary and ischemic stroke events (fatal and non-fatal; all MONICA validated) for a median time of 15 years (IQ range: 12-20) and up to the end of 2008. We compared several gender-specific Cox Proportional Hazards models: the basic one includes age, total cholesterol, HDL-cholesterol, systolic blood pressure, anti-hypertensive treatment, cigarette smoking and diabetes. Candidates to model addition were diastolic blood pressure, triglycerides, BMI, family history of CHD, and education. Model calibration was tested using the Grønnesby-Bogan goodness-of-fit statistic. The Area Under the ROC-Curve (AUC) was a measure of discrimination, corrected for over-optimism via bootstrapping. Changes in discrimination (Δ-AUC) and reclassification (Net Reclassification Improvement, NRI) defined the improvement from the basic model due to an additional risk factor. Intermediate risk was defined as 20-year risk between 10% and 40%. Results. We observed n=286 events in men (incidence rate 7.7 per 1000 person-years) and n=108 in women (2.6 per 1000 person-years). All risk factors included in the basic model were predictive of first cardiovascular event in both genders; discrimination was 0.725 and 0.802 in men and women, respectively. Average specificity in the top risk quintile (cut-off value: 23% in men and 8.5% in women) was similar in men and women (85% vs. 83%), while sensitivity was higher in women (63% vs. 46%). All the models were well-calibrated (p-values >0.05). The addition of a positive family history of CHD in men (Hazard Ratio: 1.6; 95%CI 1.2-2.1) and of diastolic blood pressure in women (HR: 1.4 for 11 mmHg increase; 1.1-1.8) significantly improved discrimination (Δ-AUC=0.01; 95%CI 0.002-0.02 [men] and Δ-AUC=0.005; 95%CI 0.0001-0.01 [women]) and reclassification of subjects at intermediate risk (NRI=8.4%;1.7%-19.1% [men]; and NRI=11.7%; -3.2%-33.5% [women]). Conclusions. Traditional risk factors are predictive of cardiovascular events after 20 years, with good discrimination. The addition of family history of CHD may contribute to model improvement, at least among men; the role of diastolic blood pressure in women should be carefully evaluated.

The Risk and Influencing Factors of Hypertension in Jinchang Cohort

2021 ◽  
Vol 34 (5) ◽  
pp. 563-563
Author(s):  
Qian Miao ◽  
Shan Zheng ◽  
Yan Luo ◽  
Ming-zhen Wang ◽  
Wen-zhi Zhu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Influencing Factors ◽  
Baseline Blood Pressure ◽  
High Salt Diet ◽  
Salt Diet ◽  
History Of ◽  
Family History Of Hypertension ◽  
Diabetes Family History ◽  
Diabetes Family

Abstract Background To investigate the incidence and influencing factors of hypertension in Jinchang cohort. Methods A prospective cohort study was conducted to collect the baseline and follow-up information of 22,826 employees from 2011 to 2015 based on the Jinchang cohort platform. The incidence of hypertension in the cohort was calculated and the influencing factors were analyzed by Cox proportional risk model. Results The subjects were followed up for an average of 22 years, and the incidence density of hypertension was 56.31/1000 person-years. Multivariate Cox regression results showed that the main risk factors for hypertension in the population included age ≥40 years, alcohol consumption, high-salt diet, history of diabetes, family history of hypertension, overweight and obesity, baseline systolic blood pressure ≥110 mm Hg and diastolic blood pressure ≥75 mm Hg, and higher education levels (middle school, high school, and above) were a protective factor. The incidence of grade 1 hypertension was related to age, drinking, history of diabetes, family history of hypertension and baseline blood pressure levels, and the incidence of grades 2 and 3 hypertension was related to high-salt diet, family history of hypertension, overweight or obesity, and baseline blood pressure levels. Conclusions The Jinchang cohort has a higher risk of hypertension. Age, unhealthy lifestyle, history of diabetes, family history of hypertension, obesity, and baseline blood pressure are strongly associated with the onset of hypertension. There are differences in the risk factors for the occurrence of grades 1, 2, and 3 hypertension.

Long-term systolic blood pressure and all-cause mortality in heart failure with preserved ejection fraction: an analysis of the TOPCAT trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Huang ◽  
C Liu
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Ejection Fraction ◽  
Funding Source ◽  
Preserved Ejection Fraction ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
History Of

Abstract Background Lower systolic blood pressure (SBP) at admission or discharge was associated with poor outcomes in patients with heart failure and preserved ejection fraction (HFpEF). However, the optimal long-term SBP for HFpEF was less clear. Purpose To examine the association of long-term SBP and all-cause mortality among patients with HFpEF. Methods We analyzed participants from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) study. Participants had at least two SBP measurements of different times during the follow-up were included. Long-term SBP was defined as the average of all SBP measurements during the follow-up. We stratified participants into four groups according to long-term SBP: &lt;120mmHg, ≥120mmHg and &lt;130mmHg, ≥130mmHg and &lt;140mmHg, ≥140mmHg. Multivariable adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality associated with SBP level. To assess for nonlinearity, we fitted restricted cubic spline models of long-term SBP. Sensitivity analyses were conducted by confining participants with history of hypertension or those with left ventricular ejection fraction≥50%. Results The 3338 participants had a mean (SD) age of 68.5 (9.6) years; 51.4% were women, and 89.3% were White. The median long-term SBP was 127.3 mmHg (IQR 121–134.2, range 77–180.7). Patients in the SBP of &lt;120mmHg group were older age, less often female, less often current smoker, had higher estimated glomerular filtration rate, less often had history of hypertension, and more often had chronic obstructive pulmonary disease and atrial fibrillation. After multivariable adjustment, long-term SBP of 120–130mmHg and 130–140mmHg was associated with a lower risk of mortality during a mean follow-up of 3.3 years (HR 0.65, 95% CI: 0.49–0.85, P=0.001; HR 0.66, 95% CI 0.50–0.88, P=0.004, respectively); long-term SBP of &lt;120mmHg had similar risk of mortality (HR 1.03, 95% CI: 0.78–1.36, P=0.836), compared with long-term SBP of ≥140mmHg. Findings from restricted cubic spline analysis demonstrate that there was J-shaped association between long-term SBP and all-cause mortality (P=0.02). These association was essentially unchanged in sensitivity analysis. Conclusions Among patients with HFpEF, long-term SBP showed a J-shaped pattern with all-cause mortality and a range of 120–140 mmHg was significantly associated with better outcomes. Future randomized controlled trials need to evaluate optimal long-term SBP goal in patients with HFpEF. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): China Postdoctoral Science Foundation Grant (2019M660229 and 2019TQ0380)

Blood Pressure and Intra-Erythrocyte Sodium during Normal and High Salt Intake in Middle-Aged Men: Relationship to Family History of Hypertension, and Neurogenic and Hormonal Variables

1984 ◽  
Vol 66 (4) ◽  
pp. 427-433 ◽  
Author(s):  
Ottar Gudmundsson ◽  
Hans Herlitz ◽  
Olof Jonsson ◽  
Thomas Hedner ◽  
Ove Andersson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Family History ◽  
Salt Intake ◽  
Sodium Intake ◽  
Positive Family History ◽  
Sodium Content ◽  
High Salt Intake ◽  
History Of ◽  
Family History Of Hypertension ◽  
Erythrocyte Sodium

1. During 4 weeks 37 normotensive 50-year-old men identified by screening in a random population sample were given 12 g of NaCl daily, in addition to their usual dietary sodium intake. Blood pressure, heart rate, weight, urinary excretion of sodium, potassium and catecholamines, plasma aldosterone and noradrenaline and intra-erythrocyte sodium content were determined on normal and increased salt intake. The subjects were divided into those with a positive family history of hypertension (n = 11) and those without such a history (n = 26). 2. Systolic blood pressure and weight increased significantly irrespective of a positive family history of hypertension. 3. On normal salt intake intra-erythrocyte sodium content was significantly higher in those with a positive family history of hypertension. During high salt intake intra-erythrocyte sodium content decreased significantly in that group and the difference between the hereditary subgroups was no longer significant. 4. In the whole group urinary excretion of noradrenaline, adrenaline and dopamine increased whereas plasma aldosterone decreased during the increased salt intake. 5. Thus, in contrast to some earlier studies performed in young subjects, our results indicate that moderately increased sodium intake acts as a pressor agent in normotensive middle-aged men whether there was a positive family history of hypertension or not. We confirm that men with positive family history of hypertension have an increased intra-erythrocyte sodium content, and that an increase in salt intake seems to increase overall sympathetic activity.

scholarly journals A pilot study investigating the relationship between heart rate variability and blood pressure in young adults at risk for cardiovascular disease

2022 ◽  
Vol 28 (1) ◽  
Author(s):  
Linda P. Bolin ◽  
Amelia D. Saul ◽  
Lauren L. Bethune Scroggs ◽  
Carolyn Horne
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Pilot Study ◽  
Family History ◽  
Diastolic Blood Pressure ◽  
Biofeedback Training ◽  
Paced Breathing ◽  
History Of

Abstract Background Cardiovascular disease is one of the leading causes of death globally with hypertension being a primary cause of premature death from this disease process. Individuals with a family history of cardiovascular disease and hypertension are at a greater risk for developing the same sequela. Autonomic cardiac control is important in the level of cardiac function. One intervention that is effective in improving cardiovascular function is heart rate variability biofeedback training. The purpose of our study was to determine the effectiveness of heart rate biofeedback training on HRV and blood pressure in individuals with a family history of cardiovascular disease. Methods Thirty-four participants (76.5% female, 22.7 ± 4.3 years) completed a baseline assessment and training using an established short-term HRV protocol followed by two weeks of at-home paced breathing employing a smartphone application. The participants were then reassessed in a biofeedback clinic. Results The participants physiological measures showed a significant increase in means between pre and post intervention of SDNN (t (32) = 2.177, p =.037) and TP, (t (32) = 2.327 p = .026). Correlation noted a medium effect on diastolic blood pressure and high frequency heart rate variability, F, r = .41, n =33, p < .05. A multiple regression with all predictor variables in the model found no significance with diastolic and systolic blood pressure. Conclusions The findings from this pilot study demonstrated that a two-week paced breathing intervention may assist in reducing heart rate and diastolic blood pressure while improving heart rate variability.

Sign in / Sign up

Export Citation Format

Share Document