Prevalence, Characteristics and Predictive Factors of Microalbuminuria in Resistant Systemic Arterial Hypertension

2018 ◽  
Vol 69 (9) ◽  
pp. 2425-2429
Author(s):  
Carmen Gadau ◽  
Elena Ardeleanu ◽  
Roxana Folescu ◽  
Ioan Tilea ◽  
Andreea Varga ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Predictive Factors ◽  
Hdl Cholesterol ◽  
Arterial Disease ◽  
Left Ventricular ◽  
Cross Sectional ◽  
Systemic Arterial Hypertension ◽  
Peripheral Arterial ◽  
Made In

The present cross-sectional observational study was made in family medicine offices of Timi� County, Romania. The aim of the study was to investigate the prevalence of urinary microalbumin excretion (MAU) in resistant systemic arterial hypertension (RH), to analyze patients� biochemical and clinical characteristics, and the predictive factors for MAU. From a total number of 347 patients, MAU was detected in 76 cases (21.9%). The microalbuminuria positive patients were older, with significant higher office systolic blood pressure (BP) (155 � 13.50 vs 148 � 12.40 mmHg, p [ 0.0001) and diastolic blood pressure (94 � 12.20 vs 88 � 14.6 mmHg, p = 0.0013), higher prevalence of left ventricular hypertrophy, diabetes mellitus, obesity, ischemic and peripheral arterial disease. MAU positive patients presented statistical significant differences in biochemical data concerning: fasting plasma glucose (FPG) (118.80 � 32.02 vs 108.01 � 26.01 mg/dL, p = 0.003), impaired glucose tolerance (IGT) (10.52 % vs 4.94 %), glycated hemoglobin (HbA1c) (6.56 � 0.98% vs 5.96 � 0.91%, p [ 0.001), reduced estimated glomerular filtration rate (eGFR) (56.10 � 15.4 vs 69.30 � 17.5 ml/min/1.73m2, p [ 0.001) and higher potassium levels (4.71 � 0.43 vs 4.59 � 0.44 mg/dL, p = 0.0378). No significant differences were noticed regarding LDL- and HDL-cholesterol, triglycerides, uric acid and serum creatinine. In a logistic multivariate analysis independent predictors for MAU were: systolic BP (odds ratio, OR = 1.024, 95% confidence interval, CI:1.011-1.039, p [ 0.001), HbA1c (OR = 1.324, 95% CI: 1.078-1.724, p = 0.008) and eGFR (OR = 0.989, 95% CI: 0.977-0.999, p = 0.01). Our findings suggest that an important part of RH patients have microalbuminuria and highlight the importance of controlling its predictors, in order to improve patients� outcome.

scholarly journals Fatores de risco para vigilantes

2018 ◽  
Vol 12 (4) ◽  
pp. 849
Author(s):  
Maria Evani Souza Borges ◽  
Jefferson De Sousa Melo ◽  
Luiza Chayanne Da Silva Soares ◽  
Adélia Dalva Da Silva Oliveira ◽  
Adriana Sávia De Souza Araújo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Alcoholic Beverage ◽  
Predisposing Factor ◽  
Cross Sectional ◽  
Systemic Arterial Hypertension ◽  
Increased Risk ◽  
Factores De Riesgo

RESUMOObjetivo: identificar os fatores de risco para a hipertensão arterial sistêmica e diabetes mellitus em vigilantes. Método: estudo quantitativo, descritivo, transversal, realizado com 23 vigilantes, por meio de um questionário analisado pelo software SPSS e apresentado em tabelas. Resultados: predominou os que praticam atividade física; não fumam; não consomem bebida alcóolica; consomem vegetais, frutas, legumes ou grãos; consomem frituras, salgados ou carnes gordas; têm antecedentes pessoais e familiares de hipertensão e diabetes, com maior ocorrência de hipertensão. A maioria obteve pressão arterial ótima e risco aumentado e muito aumentado para obesidade abdominal. Conclusão: apesar da atividade exercida ser considerada fator predisponente para a hipertensão arterial sistêmica e diabetes mellitus, os pesquisados demonstraram hábitos de vida saudáveis e níveis pressóricos dentro do padrão de normalidade. Descritores: Saúde Pública; Diabetes Mellitus; Hipertensão; Trabalho em Turnos; Fatores de Risco; Enfermagem.                                                                                                                    ABSTRACT Objective: to identify the risk factors for systemic arterial hypertension and diabetes mellitus in vigilantes. Method: quantitative, descriptive, cross - sectional study with 23 vigilantes, through a questionnaire analyzed by SPSS software and presented in tables. Results: predominantly those who practice physical activity; do not smoke; do not consume alcoholic beverage; consume vegetables, fruits, vegetables or grains; eat fried foods, salty foods or fatty meats; have a personal and family history of hypertension and diabetes, with a higher occurrence of hypertension. Most had optimal blood pressure and increased and greatly increased risk for abdominal obesity. Conclusion: although the activity was considered a predisposing factor for systemic arterial hypertension and diabetes mellitus, the subjects showed healthy habits and blood pressure levels within the normal range. Descritores: Public Health; Diabetes Mellitus; Hypertension; Shift Work; Risk Factors; Nursing. RESUMEN Objetivo: identificar los factores de riesgo para la hipertensión arterial sistémica y la diabetes mellitus en vigilantes. Método: estudio cuantitativo, descriptivo, transversal, realizado con 23 vigilantes, por medio de un cuestionario analizados por el software SPSS y presentados en tablas. Resultados: predominó los que practican actividad física; no fuman; no consumen bebida alcohólica; consumen vegetales, frutas, legumbres o granos; consumen frituras, salados o carnes gordas; tiene antecedentes personales y familiares de hipertensión y diabetes, con mayor ocurrencia de hipertensión. La mayoría obtuvo una presión arterial óptima y un riesgo aumentado y muy aumentado para la obesidad abdominal.  Conclusión: a pesar de la actividad ejercida como factor predisponente para la hipertensión arterial sistémica y diabetes mellitus, los encuestados demostraron hábitos de vida saludables y niveles de presión dentro del patrón de normalidad. Descritores: Salud Pública; Diabetes Mellitus; Hipertensión; Trabajo en Turnos; Factores de Riesgo; Enfermería.

scholarly journals Hypertension Control and Cardiometabolic Risk: A Regional Perspective

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Martin Thoenes ◽  
Peter Bramlage ◽  
Sam Zhong ◽  
Shuhua Shang ◽  
Massimo Volpe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Cardiometabolic Risk ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Pressure Control ◽  
Uncontrolled Hypertension ◽  
Cross Sectional ◽  
Uncontrolled Blood Pressure ◽  
Regional Perspective

Background. We investigated the association between blood pressure control and common cardiometabolic risk factors from a global and regional perspective.Methods. In the present analysis of a large cross-sectional i-SEARCH study, 17.092 outpatients receiving antihypertensive treatment were included in 26 countries. According to clinical guidelines for the management of arterial hypertension, patients were classified based on the level of seated systolic/diastolic blood pressure (SBP/DBP). Uncontrolled hypertension was defined as SBP/DBP ≥140/90 mmHg for non-diabetics, and ≥130/80 mmHg for diabetics.Results. Overall, mean age was 63.1 years, 52.8% were male, and mean BMI was 28.9 kg/m2. Mean SBP/DBP was 148.9/87.0 mmHg, and 76.3% of patients had uncontrolled hypertension. Diabetes was present in 29.1% with mean HbA1c of 6.8%. Mean LDL-cholesterol was 3.2 mmol/L, HDL-cholesterol 1.3 mmol/L, and triglycerides 1.8 mmol/L; 49.0% had hyperlipidemia. Patients with uncontrolled hypertension had a higher BMI (29.4 versus 28.6 kg/m2), LDL-cholesterol (3.4 versus 3.0 mmol/L), triglycerides (1.9 versus 1.7 mmol/L), and HbA1c (6.8 versus 6.7%) than those with controlled blood pressure (P<0.0001for all parameters).Conclusions. Among outpatients treated for arterial hypertension, three quarters had uncontrolled blood pressure. Elevated SBP/DBP and uncontrolled hypertension were associated with increasing BMI, LDL-cholesterol, triglycerides, and HbA1c, both globally and regionally.

scholarly journals Efetividade de programa de apoio a terceira idade no controle da hipertensão arterial

2019 ◽  
Vol 9 (28) ◽  
pp. 26-36
Author(s):  
Eduardo Expedito Valeriano Batista ◽  
Bruno Almeida Rezende
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Elderly Patients ◽  
Arterial Hypertension ◽  
Blood Pressure Measurement ◽  
The Elderly ◽  
Relevant Information ◽  
Support Program ◽  
Cross Sectional ◽  
Systemic Arterial Hypertension

Estudar o perfil do idoso portador de Hipertensão Arterial Sistêmica (HAS) inserido em um Grupo de Apoio a Terceira Idade (GATI), sua adesão ao tratamento medicamentoso e o controle dos níveis pressóricos. Estudo transversal, descritivo e comparativo em 72 idosos portadores de HAS divididos em dois grupos: participantes e não participantes de um GATI na cidade de Jequeri (MG). Os dados foram coletados por entrevistas através do questionário de adesão a medicamentos auto referido, aferição da pressão arterial e coleta de dados do prontuário. A maioria dos indivíduos era do sexo feminino, casados e praticavam atividades físicas regulares. Os participantes do GATI apresentaram maior escolaridade, maior adesão ao tratamento medicamentoso da HAS, maior proporção de praticantes de atividades físicas, menor IMC e menor proporção de fumantes e melhores índices pressóricos. A implementação de GATI pode auxiliar no controle dos níveis pressóricos em pacientes portadores de HAS.Descritores: Hipertensão Arterial Sistêmica, Idoso, Envelhecimento. Effectiveness of a support program for the elderly in the control of Systemic Arterial HypertensionAbstract: To study the profile of elderly patients with Systemic Arterial Hypertension (SAH) included in a support program for elderly people (SPEP) at Jequeri city (MG), as well as their drug treatment adherence and control of blood pressure levels. Cross-sectional, descriptive and comparative study performed in 72 elderly patients with SAH divided into two groups: participants and non-participants of a SPEP. The data were collected by interviews through a self-reported adherence questionnaire, blood pressure measurement, as well as the collection of relevant information to the patient’s medical record. Most of the individuals were female, married, and engaged in regular physical activity. SPEP participants presented higher schooling, greater adherence to the medical treatment of hypertension, greater proportion of physical activity practitioners, lower BMI, a lower proportion of smokers and better blood pressure indexes. The implementation of SPEP can help control pressure levels in patients with SAH.Descriptors: Systemic Arterial Hypertension, Elderly, Senior group, Aging. Efectividad de programa de apoyo a la tercera edad en el control de la hipertensión arterialResumen: Estudar o perfil do idoso portador de Hipertensão Arterial Sistémica (HAS) inserido em um Grupo de Apoio a Terceira Idade (GATI), sua adesão ao tratamento medicamentoso e o controle dos níveis pressóricos. Estudo transversal, descritivo e comparativo em 72 idosos portadores de HAS divididos em dois grupos: participantes e não participantes de um GATI na cidade de Jequeri (MG). Os dados foram coletados por entrevistas através do questionário de adesão a medicamentos auto referido, aferição da pressão arterial e coleta de dados do prontuário. A maioria dos indivíduos era do sexo feminino, casados e praticavam atividades físicas regulares. Os participantes do GATI apresentaram maior escolaridade, maior adesão ao tratamento medicamentoso da HAS, maior proporção de praticantes de atividades físicas, menor IMC e menor proporção de fumantes e melhores índices pressóricos. A implementação de GATI podem auxiliar no controle dos níveis pressóricos em pacientes portadores de HAS.Descriptores: Hipertensão Arterial Sistêmica, Idoso, Envelhecimento.

scholarly journals VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY IN RURAL MALES WITH ARTERIAL HYPERTENSION: ASSOCIATION WITH NON-VALVULAR ATRIAL FIBRILLATION

2020 ◽  
Vol 2 (12) ◽  
pp. 90-109 ◽  
Author(s):  
T.I. Nimtsovych ◽  
A.M. Kravchenko ◽  
O.Yu. Mishcheniuk ◽  
К.О. Mikhaliev ◽  
T.Ya. Chursina
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Complex Data ◽  
Cross Sectional ◽  
Risk Increase

Purpose: to study the association of blood pressure (BP) visit-to-visit variability (VVV) with non-valvular atrial fibrillation (AF) in rural dwellers with arterial hypertension (HTN). Material and methods. The cross-sectional study retrospectively analyzed complex data from consecutive 160 males with primary HTN (mean age 50 ± 6 years). Patients with major HTN complication were excluded. We analyzed the office systolic BP (SBP) and diastolic BP (DBP) levels, obtained at four consecutive doctor`s visits. As a metric of BP VVV, we used standard deviation (SD) and coefficient of variation (CV) values. The criteria for high BP VVV were Patients were ascertained to have high BP VVV in case of SD (SBP) ≥15 mm Hg and/or SD (DBP) ≥14 mm Hg. Totally, high BP VVV status was in 82 (51,3 %) patients. Paroxysmal AF was detected in 29 (18,1 %) patients. Results. HTN with AF group (vs. HTN alone) was characterized by higher average values of BB VVV metrics (median, interquartile range): SD (SBP) (16,7 (15,9-17,5) vs. 8,7 (4,6-15,2) mm Hg, respectively); SD (DBP) (11,5 (8,9-14,6) vs. 5,7 (3,9-8,9) mm Hg, respectively); CV (SBP) (10,1 (9,6-10,7) vs. 5,6 (2,9-9,2) %, respectively); and CV (DBP) (12,9 (9,3-15,5) vs. 6,3 (4,1-9,7) %, respectively) (р<0,001 in all the comparisons). Additionally, HTN with AF group associated with worse kidney filtration function (estimated glomerular filtration rate (eGFR): 57 (53-59) vs. 67 (62-77) ml/mim/1,73 m2, respectively) and more pronounced albuminuria (urine albumin/creatinine ratio (A/Cu): 36,1 (32,3-40,6) vs. 10,3 (6,5-26,9) mg/mmol, respectively) (р<0,001 in both comparisons). While integral assessment of eGFR and A/Cu values, we determined higher frequency of patients with high and very high cardiovascular and renal adverse events risk (AER) in HTN with AF group. Moreover, patients with HTN and AF presented with higher left atrial antero-posterior dimension (LAD) (4,3 (4,2-4,6) сm vs. 3,9 (3,6-4,1) cm, respectively; р<0,001), as well as with more advanced left ventricular remodeling. At multivariable analysis, SD (SBP) ≥15 mm Hg and SD (DBP) ≥14 mm Hg, along with AER and LAD, were the most significant factors independently associated with AF. Conclusion. In rural males with HTN, the presence of high BP VVV is one of the factors associated with non-valvular AF risk increase. High BP VVV could be proposed as an additional modified AF risk factor in patients with HTN.

scholarly journals Assessment of low ABSPI among arsenic exposed and non-exposed populations: A pilot study

2010 ◽  
Vol 36 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Manzurul Haque Khan ◽  
Sudipta Sarkar ◽  
Nasreen Khan ◽  
A.F.M. Sarwar ◽  
Sk. Akhtar Ahmad
Keyword(s):  
Blood Pressure ◽  
Systolic Pressure ◽  
Arterial Disease ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pressure Index ◽  
Diabetic Status ◽  
Peripheral Arterial ◽  
Brachial Systolic Pressure

This cross-sectional study was carried out to assess and compare Ankle Brachial Systolic Pressure Index (ABSPI) amongst 120 arsenic exposed and 120 non-exposed populations of Samta village in Bangladesh. Abnormal ABSPI was more prevalent in arsenic exposed (13.3%) than in non-exposed (2.5%) group. The prevalence of abnormal ABSPI for respondents when adjusted for age, sex, BMI, blood pressure status and diabetic status, the prevalence remain significantly different. The findings suggest that those exposed to arsenic have increased chance of having abnormal ABSP and hence increased chance of peripheral arterial disease in Bangladesh. Online: 18 July 2010DOI: http://dx.doi.org/10.3329/bmrcb.v36i1.5426Bangladesh Med Res Counc Bull 2010; 36: 23-26    

scholarly journals Ankle-Brachial Index: Nurses Strategy To Cardiovascular Disease Risk Factors Identification

2014 ◽  
Vol 48 (2) ◽  
pp. 223-227
Author(s):  
Daniela Luisa Maggi ◽  
Leyla Regina Dal Piva de Quadros ◽  
Karina de Oliveira Azzolin ◽  
Silvia Goldmeier
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Peripheral Arterial

Elevated risk of fatal and non-fatal cardiovascular events is associated with high prevalence of peripheral arterial disease, with assessment through the ankle-brachial index (ABI). This study aimed to demonstrate that the ABI and the Edinburgh Claudication Questionnaire are tools to be used by nurses in prevention and/or treatment of CVD (cardiovascular disease). A cross-sectional study was carried out with patients from a cardiovascular clinic. The Edinburgh Claudication Questionnaire was applied and the ABI was measured with the formula (ABI= Blood Pressure Ankle/Blood Pressure Brachial). A total of 115 patients were included, most were females (57.4%), aged 60.6 ± 12.5 years. The most prevalent risk factors were hypertension (64.3%), physical inactivity (48.7%) and family history (58.3%). The study showed that abnormal ABI was frequently found and 42.6% of the patients with abnormal ABI showed intermittent claudication. The method to evaluate the ABI associated to the Edinburg Claudication Questionnaire, can be easily used by nurses in the clinical evaluation of asymptomatic and symptomatic CVD patients.

Risk factors for cardiovascular diseases and development of prehypertension

2018 ◽  
pp. 37-43
Author(s):  
В.В. Шерстнев ◽  
М.А. Грудень ◽  
В.П. Карлина ◽  
В.М. Рыжов ◽  
А.В. Кузнецова ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Serum Levels ◽  
Left Ventricular ◽  
Optimal Blood Pressure

Цель - исследование взаимосвязи факторов риска сердечно-сосудистых заболеваний и развития предгипертонии. Методика. Проведен сравнительный и корреляционный анализы показателей модифицируемых и немодифицируемых факторов риска сердечно-сосудистых заболеваний у обследованных лиц в возрасте 30-60 лет с «оптимальным» артериальным давлением, (n = 63, АД <120/80 мм рт.ст.) и лиц с предгипертонией (n = 52, АД = 120-139/80-89 мм рт.ст.). Результаты. Показано, что лица с предгипертонией по сравнению с группой лиц, имеющих «оптимальное» артериальное давление характеризуются статистически значимо повышенным содержанием холестерина и холестерина липопротеидов низкой плотности, интеллектуальным характером трудовой деятельности, а также значимыми сочетаниями факторов риска: повышенный уровень холестерина липопротеидов низкой плотности с интеллектуальным характером трудовой деятельности; повышенное содержание креатинина с уровнем триглициридов; наследственная отягощенность по заболеваниям почек и интеллектуальным характером трудовой деятельности; наследственная отягощенность по сахарному диабету и гипертрофия левого желудочка сердца. У лиц с предгипертонией документированы перестройки структуры взаимосвязи (количество, направленность и сила корреляций) между показателями факторов риска в сравнении с лицами, имеющими «оптимальное» артериальное давление. Заключение. Выявленные особенности взаимосвязей факторов риска сердечно-сосудистых заболеваний при предгипертонии рассматриваются как проявление начальной стадии дизрегуляционной патологии и нарушения регуляции физиологических систем поддержания оптимального уровня артериального давления. The aim of the study was to investigate the relationship between risk factors for cardiovascular disease and development of prehypertension. Methods. Comparative and correlation analyses of modifiable and non-modifiable risk factors for cardiovascular disease were performed in subjects aged 30-60 with «optimal» blood pressure (n = 63, BP <120/80 mm Hg) and prehypertension (n = 52, BP = 120-139 / 80-89 mm Hg). Results. The group with prehypertension compared with the «optimal» blood pressure group had significantly increased serum levels of low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol, sedentary/intellectual type of occupation, and significant combinations of risk factors. The risk factor combinations included an increased level of LDL cholesterol and a sedentary/intellectual occupation; increased serum levels of creatinine and triglycerides; hereditary burden of kidney disease and a sedentary/intellectual occupation; hereditary burden of diabetes mellitus and cardiac left ventricular hypotrophy. In subjects with prehypertension compared to subjects with «optimal» blood pressure, changes in correlations (correlation number, direction, and strength) between parameters of risk factors were documented. Conclusion. The features of interrelationships between risk factors for cardiovascular disease observed in prehypertension are considered a manifestation of early dysregulation pathology and disordered regulation of physiological systems, which maintain optimal blood pressure.

scholarly journals The Capabilities of Amlodipine/Lisinopril Single-Pill Combination in the Treatment of Newly Diagnosed Arterial Hypertension in a Middle-Aged Patient (Case Report)

2020 ◽  
Vol 16 (2) ◽  
pp. 221-230
Author(s):  
A. I. Kochetkov ◽  
M. V. Lopukhina ◽  
E. A. Kotaeva ◽  
A. A. Kirichenko ◽  
O. D. Ostroumova
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Left Ventricular ◽  
Favorable Effect ◽  
Newly Diagnosed ◽  
Functional Changes ◽  
Collagen Formation ◽  
Cardiovascular Morbidity And Mortality ◽  
Single Pill ◽  
Left Atrial Stiffness

Arterial hypertension (AH) is one of the most significant modifiable risk factors that increase cardiovascular morbidity and mortality worldwide, including Russia. The complex of structural and functional changes in the heart that occurs during AH consists not only in the formation of left ventricular (LV) myocardial hypertrophy, but also in the myocardial stiffness increasing due to collagen formation and cardiomyocytes apoptosis. These abnormalities are substrate for diastolic function disturbances, electrical myocardial instability and ischemia. The article provides a clinical case of amlodipine/lisinopril single-pill combination (A/L SPC) use in real clinical practice in a patient with stage II grade 2 newly diagnosed AH and its effect on blood pressure and echocardiographic myocardial fibrosis markers, including speckle tracking parameters The high antihypertensive efficacy of A/L SPC, a favorable effect on blood pressure circadian rhythm, as well as pronounced target-organ protective properties, in particular the ability to reduce LV and left atrial stiffness, were demonstrated. So, we conclude that A/L SPC improve the elastic properties of the left heart.

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