scholarly journals Thoracic Aortic Calcification and Pre-Clinical Hypertension by New 2017 ACC/AHA Hypertension Guidelines

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1027
Author(s):  
Ya-Ting Jan ◽  
Pei-Shan Tsai ◽  
Chris T. Longenecker ◽  
Dao-Chen Lin ◽  
Chun-Ho Yun ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Surrogate Marker ◽  
Heart Association ◽  
Aortic Calcification ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Contributing Factors ◽  
Hypertension Guidelines ◽  
Pressure Threshold ◽  
Thoracic Aortic Calcification

The recently revised 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension (HTN) guidelines employ a lower blood pressure threshold to define HTN, aiming for earlier prevention of HTN-related cardiovascular diseases (CVD). Thoracic aortic calcification (TAC), a new surrogate marker of aging and aortic medial layer degeneration, and different stages of HTN, according to the 2017 ACC/AHA HTN guidelines, remain unknown. We classified 3022 consecutive asymptomatic individuals enrolled into four HTN categories using the revised 2017 ACC/AHA guidelines: normal blood pressure (NBP), elevated blood pressure (EBP), and stage 1 (S1) and stage 2 (S2) HTN. The coronary artery calcification score and TAC metrics (total Agaston TAC score, total plaque volume (mm3), and mean density (Hounsfield units, HU)) were measured using multi-detector computed tomography. Compared to NBP, a graded and significant increase in the TAC metrics was observed starting from EBP and S1 and S2 HTN, using the new 2017 ACC/AHA guidelines (NBP as reference; all trends: p < 0.001). These differences remained consistent after being fully adjusted. Older age (>50 years), S1 and S2 HTN, prevalent diabetes, and chronic kidney disease (<60 mL/min/1.73 m2) are all independently contributing factors to higher TAC risk using multivariate stepwise logistic regressions (all p ≤ 0.001). The optimal cutoff values of systolic blood pressure, diastolic blood pressure, and pulse pressure were 121, 74, and 45 mmHg, respectively, for the presence of TAC after excluding subjects with known CVD and ongoing HTN medication treatment. Our data showed that the presence of TAC starts at a stage of elevated blood pressure not categorized as HTN from the updated 2017 ACC/AHA hypertension guidelines.

scholarly journals Characteristics of US adults who would be recommended for lifestyle modification without antihypertensive medication to manage blood pressure

2020 ◽  
Author(s):  
Sandra L Jackson ◽  
Soyoun Park ◽  
Fleetwood Loustalot ◽  
Angela M Thompson-Paul ◽  
Yuling Hong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Lifestyle Modification ◽  
Sodium Intake ◽  
Heart Association ◽  
Lifestyle Changes ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Stage 1

Abstract Background The 2017 American College of Cardiology / American Heart Association Guideline for blood pressure (BP) management newly classifies millions of Americans with elevated blood pressure or stage 1 hypertension for recommended lifestyle modification alone (without pharmacotherapy). This study characterized these adults, including their CVD risk factors, barriers to lifestyle modification, and healthcare access. Methods This cross-sectional study examined nationally representative National Health and Nutrition Examination Survey data, 2013-2016, on 10,205 US adults aged ≥18, among whom 2,081 had elevated blood pressure or stage 1 hypertension and met 2017 ACC/AHA BP Guideline criteria for lifestyle modification alone. Results An estimated 22% of US adults (52 million) would be recommended for lifestyle modification alone. Among these, 58% were men, 43% had obesity, 52% had low quality diet, 95% consumed excess sodium, 43% were physically inactive, and 8% consumed excess alcohol. Many reported attempting lifestyle changes (range: 39%-60%). Those who reported receiving health professional advice to lose weight (adjusted prevalence ratio 1.21, 95% confidence interval 1.06-1.38), reduce sodium intake (2.33, 2.00-2.72), or exercise more (1.60, 1.32-1.95) were significantly more likely to report attempting changes. However, potential barriers to lifestyle modification included 28% of adults reporting disability, asthma, or arthritis. Additionally, 20% had no health insurance and 22% had no healthcare visits in the last year. Conclusions One fifth of US adults met 2017 ACC/AHA BP Guideline criteria for lifestyle modification alone, and many reported attempting behavior change. However, barriers exist such as insurance gaps, limited access to care, and physical impairment.

Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?: A Scientific Statement From the American Heart Association

Hypertension ◽  
2021 ◽  
Author(s):  
Bethany Barone Gibbs ◽  
Marie-France Hivert ◽  
Gerald J. Jerome ◽  
William E. Kraus ◽  
Sara K. Rosenkranz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Heart Association ◽  
Lifestyle Changes ◽  
Elevated Blood Pressure ◽  
Blood Cholesterol ◽  
Elevated Blood ◽  
First Line ◽  
Moderate Risk ◽  
Scientific Statement

Current guidelines published by the American Heart Association and the American College of Cardiology broadly recommend lifestyle approaches to prevent and treat elevated blood pressure and cholesterol. For patients with mildly or moderately elevated blood pressure and blood cholesterol, lifestyle-only approaches are the first line of therapy. The purpose of this scientific statement is to: (1) highlight the mild-moderate–risk patient groups indicated for lifestyle-only treatment for elevated blood pressure or cholesterol; (2) describe recommendations, average effects, and additional considerations when prescribing lifestyle treatment with physical activity; and (3) provide guidance and resources for clinicians to assess, prescribe, counsel, and refer to support increased physical activity in their patients. An estimated 21% and 28% to 37% of US adults, respectively, have mild-moderate–risk blood pressure and cholesterol and should receive lifestyle-only as first-line treatment. Of the recommended lifestyle changes, increasing physical activity has extensive benefits, including improving both blood pressure and blood cholesterol, that are comparable, superior, or complementary to other healthy lifestyle changes. Physical activity assessment and prescription are an excellent lifestyle behavior treatment option for all patients, including for the large population of mild-moderate–risk patients with elevated blood pressure and blood cholesterol.

scholarly journals Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Godfred O. Boateng ◽  
Stella T. Lartey ◽  
Philip Baiden ◽  
Lei Si ◽  
Richard Berko Biritwum ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Longitudinal Study ◽  
Fruits And Vegetables ◽  
Transition Probabilities ◽  
Transition Probability ◽  
Heart Association ◽  
Sub Saharan Africa ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Stage 1

This paper assessed the transition probabilities between the stages of hypertension severity and the length of time an individual might spend at a particular disease state using the new American College of Cardiology/American Heart Association hypertension blood pressure guidelines. Data for this study were drawn from the Ghana WHO SAGE longitudinal study, with an analytical sample of 1884 across two waves. Using a multistate Markov model, we estimated a seven-year transition probability between normal/elevated blood pressure (systolic ≤ 129 mm Hg &amp; diastolic &lt;80 mm Hg), stage 1 (systolic 130-139 mm Hg &amp; diastolic 80-89 mm Hg), and stage 2 (systolic ≥140mm Hg &amp; diastolic≥90 mm Hg) hypertension and adjusted for the individual effects of anthropometric, lifestyle, and socio-demographic factors. At baseline, 22.5% had stage 1 hypertension and 52.2% had stage 2 hypertension. The estimated seven-year transition probability for the general population was 19.0% (95% CI: 16.4, 21.8) from normal/elevated blood pressure to stage 1 hypertension, 31.6% (95% CI: 27.6, 35.4%) from stage 1 hypertension to stage 2 hypertension, and 48.5% (45.6, 52.1%) for remaining at stage 2. Other factors such as being overweight, obese, female, aged 60+ years, urban residence, low education and high income were associated with an increased probability of remaining at stage 2 hypertension. However, consumption of recommended servings of fruits and vegetables per day was associated with a delay in the onset of stage 1 hypertension and a recovery to normal/elevated blood pressure. This is the first study to show estimated transition probabilities between the stages of hypertension severity across the lifespan in sub-Saharan Africa. The results are important for understanding progression through hypertension severity and can be used in simulating cost-effective models to evaluate policies and the burden of future healthcare.

Impact of the New American Hypertension Guidelines on the Prevalence of Postpartum Hypertension

2018 ◽  
Vol 36 (04) ◽  
pp. 440-442 ◽  
Author(s):  
Jessica Pudwell ◽  
George Saade ◽  
Graeme Smith
Keyword(s):  
Blood Pressure ◽  
Lifestyle Modification ◽  
Secondary Analysis ◽  
Heart Association ◽  
Health Clinic ◽  
Hypertension Guidelines ◽  
Pressure Threshold ◽  
Blood Pressure Threshold ◽  
The Impact ◽  
Diagnosis Of Hypertension

AbstractCardiovascular disease (CVD) is the leading cause of death and disability among women, with more than half occurring in individuals with hypertension. New blood pressure criteria for the diagnosis of hypertension from the American College of Cardiology/American Heart Association recognize that there is no specific blood pressure threshold that is associated with vascular disease. We performed a secondary analysis of two published postpartum databases (the Pre-Eclampsia New Emerging Team [PE-NET] cohort and the Maternal Health Clinic [MHC] cohort) to determine the impact of the change in blood pressure criteria on the diagnosis of hypertension. The prevalence of hypertension in women with uncomplicated pregnancies (PE-NET control) was 22% compared with 56.4% in those who have had a pregnancy complicated by preeclampsia (PE, PE-NET patient) and 67.2% in those referred to the MHC due to a pregnancy complicated by any of the hypertensive disorders of pregnancy. It is well established that certain complications in pregnancy can reliably identify women with risk factors for future CVD. Thus, pregnancy and the postpartum afford a new opportunity for cardiovascular risk screening that could lead to lifestyle modification and therapeutic intervention. Applying the new guideline criteria at least doubles the prevalence of women with hypertension postpartum.

scholarly journals Nutritional status as a risk factor of elevated blood pressure in preschool children

2021 ◽  
Vol 7 (3) ◽  
pp. 097-103
Author(s):  
Ni Putu Indah Kusumadewi Riandra ◽  
Gusti Ayu Putu Nilawati ◽  
Ketut Suarta
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Preschool Children ◽  
Nutritional Status ◽  
Heart Association ◽  
Cross Sectional Study ◽  
Elevated Blood Pressure ◽  
Bivariate Analysis ◽  
Elevated Blood ◽  
Cross Sectional

Background: High blood pressure is a risk factor for cardiovascular disease and neurological disease among children and adults. The American Heart Association recommended blood pressure evaluation among children aged more than 3 years for early detection of complications. Nutritional status was considered to have association with elevated blood pressure in children. Objective: To assess the association between nutritional status and the blood pressure of preschool children in Denpasar, Bali. Methods: This was a descriptive analytic cross-sectional study. Four hundred and fifty-six children aged 3-6 years who attended Kindergarten 2019 in Denpasar were enrolled by the cluster random sampling design. Results: From 456 samples obtained ratio between boys and girls was 1,1: 1. Median age of the sample was 5 years (3-5 years old). The majority of nutritional status was well nourished (52.2%) and obesity was found 11.8%. majority children had normotension (64%), and followed by pre-hypertension (25.4%), hypertension stage 1 (8.6%) and hypertension stage 2 (2%). Bivariate analysis showed that obesity and sex were risk factor for toddler having higher level of blood pressure with. Multivariate analysis showed children with obesity and boys are 2.8- and 1.8-times more likely to have hypertension (CI 95% 1.72-4.81; CI 95% 1.24-2.76, respectively). Low birth weight and prematurity were not found to be significantly related to level of blood pressure. Conclusion: Children with obesity were found to be significantly related to elevated blood pressure (hypertension).

ROLE OF THE THYROID GLAND IN DEVELOPMENT AND MAINTENANCE OF RENAL HYPERTENSION IN RATS

1960 ◽  
Vol XXXIV (III) ◽  
pp. 411-429 ◽  
Author(s):  
Melvin J. Fregly ◽  
Kenneth M. Cook
Keyword(s):  
Blood Pressure ◽  
Rate Increase ◽  
Renal Hypertension ◽  
The Other ◽  
Elevated Blood Pressure ◽  
Unit Weight ◽  
Elevated Blood ◽  
Inhibition Of Growth ◽  
Testicular Size

ABSTRACT The anti-thyroid drugs, thiouracil, propylthiouracil, and methimazole, prevented both development of elevated blood pressure and cardiac hypertrophy usually accompanying kidney encapsulation with latex envelopes. These drugs also reduced elevated blood pressure of rats with hypertension of 13 to 40 weeks' duration prior to drug administration. Addition of desiccated thyroid powder to diet containing an anti-thyroid drug overcame the anti-hypertensive effect of the latter. Withdrawal of thyroid powder only was followed by return of blood pressure to previous low level within 3 weeks. The results suggest that the anti-hypertensive effect of these drugs is related directly to the hypothyroidism produced rather than to extrathyroidal effects of the drugs. Comparison of potencies of the 3 drugs in terms of anti-hypertensive effect, inhibition of growth rate, increase in testicular size, and increase in thyroid size suggests that propylthiouracil and methimazole are equally potent per unit weight of drug. Thiouracil has approximately half the potency of the other two.

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