Paradoxical Distribution of Augmentation Index Level in Chronic Kidney Diseases

Pulse wave velocity (PWV) and augmentation index (AI) are used as indexes of arterial stiffness and cardiovascular survival. Although PWV is known to increase as the stage of chronic kidney disease (CKD) advances, how this is related to AI and CKD stage has not yet been well defined. A sub-analysis was performed using the data from the Antihypertensive and Blood Pressure of Central Artery in Japan study. This was a cross-sectional study on hypertensive patients. All the patients with available serum creatinine levels were selected, and estimated glomerular filtration rate (eGFR) was calculated according to the modification of diet in renal disease equation for a Japanese population. Augmentation indexes at different stages of CKD were compared. Data from 1392 patients were pooled and analyzed. In addition to eGFR, there were differences in age (P<0.0001), pulse rate (P<0.0001), vasodilator antihypertensive drugs (P<0.005), systolic (P<0.005) and diastolic (P<0.01) blood pressure at 5 CKD stages. Multivariate regression showed that AI correlated to age (0.19%/year), pulse rate (-0.54%/bpm), systolic blood pressure (0.18%/mmHg) and vasodilator antihypertensive drugs (-2.42%/class). Therefore, AI was adjusted for these confounding factors. Adjusted AI in stage 5 (77±20%) was lower than that in stage 1 (84±19%, P<0.05). These data indicate that AI varies according to CKD stage, and suggest that a cut-off value of AI should be set for each stage of CKD to detect cardiovascular disease.

Download Full-text

Unawareness of hypertension and its determinants among 'quilombolas' (inhabitants of 'quilombos' - hinterland settlements founded by people of African origin) living in Southwest Bahia, Brazil

Ciência & Saúde Coletiva ◽

10.1590/1413-81232015203.14342014 ◽

2015 ◽

Vol 20 (3) ◽

pp. 797-807 ◽

Cited By ~ 1

Author(s):

Vanessa Moraes Bezerra ◽

Amanda Cristina de Souza Andrade ◽

Cibele Comini César ◽

Waleska Teixeira Caiaffa

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Antihypertensive Drugs ◽

Cross Sectional Study ◽

Public Health Issue ◽

Cross Sectional ◽

Pharmacological Management ◽

Medical Visits ◽

Stage 1 ◽

And Control

This study sought to evaluate the prevalence of unawareness of arterial hypertension (AH) and associated factors among the quilombola population and to describe aspects of the non-pharmacological management of AH. It involved a cross-sectional study with a sample of 358 people with AH aged 18 years or more. AH was considered systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg and/or reported use of antihypertensive drugs. Unawareness of AH was classified as persons answering negatively when asked if they suffered from AH. Poisson regression was then used. The prevalence of unawareness of AH was 44.1% (95% CI: 38.9-49.3). Among those who already knew the diagnosis and had drug treatment only 24.8% had controlled BP. The unawareness of AH was positively associated with the male sex and Stage 1 of AH and negatively with increasing age, overweight, negative self-perception of health and medical visits. For non-pharmacological management, low percentages of quilombola reported appropriate standard recommendations of care. Arterial hypertension is a serious public health issue among the quilombola population, revealing great vulnerability in health due to poor levels of awareness, treatment and control.

Download Full-text

FGF-23 and Phosphate in Children with Chronic Kidney Disease: A Cross-Sectional Study in Kazakhstan

Medicina ◽

10.3390/medicina57010015 ◽

2020 ◽

Vol 57 (1) ◽

pp. 15

Author(s):

Altynay Balmukhanova ◽

Kairat Kabulbayev ◽

Harika Alpay ◽

Assiya Kanatbayeva ◽

Aigul Balmukhanova

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Fibroblast Growth Factor 23 ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Ckd Stage ◽

Advanced Stages ◽

Fgf 23 ◽

Stage 1

Background and objectives: Chronic kidney disease (CKD) in children is a complex medical and social issue around the world. One of the serious complications is mineral-bone disorder (CKD-MBD) which might determine the prognosis of patients and their quality of life. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone which is involved in the pathogenesis of CKD-MBD. The purpose of the study was to determine what comes first in children with CKD: FGF-23 or phosphate. Materials and Methods: This cross-sectional study included 73 children aged 2–18 years with CKD stages 1–5. We measured FGF-23 and other bone markers in blood samples and studied their associations. Results: Early elevations of FGF-23 were identified in children with CKD stage 2 compared with stage 1 (1.6 (1.5–1.8) pmol/L versus 0.65 (0.22–1.08), p = 0.029). There were significant differences between the advanced stages of the disease. FGF-23 correlated with PTH (r = 0.807, p = 0.000) and phosphate (r = 0.473, p = 0.000). Our study revealed that the elevated level of FGF-23 went ahead hyperphosphatemia and elevated PTH. Thus, more than 50% of children with CKD stage 2 had the elevating level of serum FGF-23, and that index became increasing with the disease progression and it achieved 100% at the dialysis stage. The serum phosphate increased more slowly and only 70.6% of children with CKD stage 5 had the increased values. The PTH increase was more dynamic. Conclusions: FGF-23 is an essential biomarker, elevates long before other markers of bone metabolism (phosphate), and might represent a clinical course of disease.

Download Full-text

Methotrexate, blood pressure and markers of arterial function in patients with rheumatoid arthritis: a repeated cross-sectional study

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x17719850 ◽

2017 ◽

Vol 9 (9) ◽

pp. 213-229 ◽

Cited By ~ 15

Author(s):

Arduino A. Mangoni ◽

Leena R. Baghdadi ◽

E. Michael Shanahan ◽

Michael D. Wiese ◽

Sara Tommasi ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Blood Pressure ◽

Cardiovascular Risk ◽

Disease Activity Score ◽

Augmentation Index ◽

Cross Sectional Study ◽

Joint Disease ◽

Group Differences ◽

Cross Sectional ◽

Arterial Function

Background: Methotrexate (MTX) treatment in rheumatoid arthritis (RA) has been associated with lower cardiovascular risk compared to other disease-modifying antirheumatic drugs (DMARDs). We sought to identify whether the MTX-associated cardioprotection involves changes in blood pressure (BP) and/or arterial function. Methods: Clinic and 24-hour peripheral and central systolic and diastolic BP (SBP and DBP), augmentation index (AIx), pulse wave velocity (PWV) and plasma asymmetric dimethylarginine (ADMA) were assessed in RA patients on stable treatment with either MTX ± other DMARDs (MTX group, n = 56, age 61 ± 13 years, 70% females) or other DMARDs (non-MTX group, n = 30, age 63 ± 12 years, 76% females). Measurements were performed at baseline and after 8 months. Results: After adjusting for visit, age, gender, body mass index, folic acid use and 28-joint disease activity score, the MTX group had significantly lower clinic peripheral SBP (−7.7 mmHg, 95% CI −13.2 to −2.3, p = 0.006) and DBP (−6.1 mmHg, 95% CI −9.8 to −2.4, p = 0.001) and clinic central SBP (−7.8 mmHg, 95% CI −13.1 to −2.6, p = 0.003) and DBP (−5.4 mmHg, 95% CI −9.1 to −1.6, p = 0.005) versus the non-MTX group. Furthermore, the MTX group had significantly lower 24-hour peripheral and central SBP and DBP and PWV versus the non-MTX group ( p < 0.01 for all comparisons). By contrast, there were no significant between-group differences in AIx and ADMA. Conclusions: RA patients on MTX treatment had significantly lower clinic and 24-hour peripheral and central BP compared to those who did not take MTX. The lower BP with MTX may be related to differences in PWV, but not in AIx or ADMA concentrations. Further longitudinal studies including randomized controlled trials are warranted to confirm these findings, to identify other possible mechanisms responsible for the effects of MTX on BP and PWV, and to establish whether these effects might account for the reduced cardiovascular risk with MTX.

Download Full-text

An observational study on patient compliance and adverse drug reactions of antihypertensives drugs in a tertiary care center of Bihar

IP International Journal of Comprehensive and Advanced Pharmacology ◽

10.18231/j.ijcaap.2021.033 ◽

2021 ◽

Vol 6 (4) ◽

pp. 190-193

Author(s):

Mrityunjay Kumar Pandit ◽

Kumar Gaurav ◽

Jeetendra Kumar

Keyword(s):

Blood Pressure ◽

Combination Therapy ◽

Antihypertensive Drugs ◽

Care Center ◽

Adult Population ◽

Tertiary Care ◽

Cross Sectional Study ◽

High Dose ◽

Cross Sectional ◽

Institutional Ethics

Hypertension is among the most common non-communicable and lifestyle disease in our country that affects adult population of both the genders from all socio-economic backgrounds and urban and rural population. In-spite of this, early diagnosis and appropriate treatment are suboptimal. Adherence of prescribed treatment has been studied in patients of hypertension in this study. : An observational and cross-sectional study was conducted in the Department of Pharmacology, Jawahar Lal Nehru Medical College and Hospital, Bhagalpur, Bihar. Prior to the initiation of the study, clearance was obtained from the Institutional Ethics Committee. Study period was between January 2021 and June 2021.A predesigned pretested interview schedule was used to collect the data from the 247 study participants. This schedule contained information related to socio-demographic variables, comorbidity, a format to assess the compliance to antihypertensive drugs prescribed and any adverse event. : A significant improvement in maintain optimal in blood pressure was observed in patients treated with one pill per day as compared to patients prescribed with two and three pills per day. Compliance was significantly better in patients in combination therapy as compared to monotherapy. : Low dose combination therapy has been stated to be more effective than high dose monotherapy in controlling blood pressure. It shows better compliance and lesser incidence of side-effects.

Download Full-text

Relationship Between Fasting Plasma Glucagon Level and Renal Function—A Cross-Sectional Study in Individuals With Type 2 Diabetes

Journal of the Endocrine Society ◽

10.1210/js.2018-00321 ◽

2018 ◽

Vol 3 (1) ◽

pp. 273-283 ◽

Cited By ~ 2

Author(s):

Jian-Jun Liu ◽

Sylvia Liu ◽

Resham L Gurung ◽

Clara Chan ◽

Keven Ang ◽

...

Keyword(s):

Type 2 Diabetes ◽

Renal Function ◽

Cross Sectional Study ◽

Full Length ◽

Plasma Glucagon ◽

Cross Sectional ◽

Glucagon Level ◽

Ckd Stage ◽

Stage 1

Abstract Background and Aim The kidney is the main site for glucagon clearance. However, a recent study showed that hyperglucagonemia in patients with end-stage renal disease might not be caused by full-length intact glucagon. Additionally, the relationship between glucagon and renal function in early-stage chronic kidney disease (CKD) has not yet been characterized. We studied the association of fasting glucagon with renal function across a wide range of glomerular filtration rates (GFRs) in participants with type 2 diabetes. Participants and Methods 326 participants with type 2 diabetes and renal function spanning CKD stage 1 to 5 were included in the present cross-sectional study. Fasting full-length plasma glucagon was quantified using a newly developed ELISA (Mercodia AB, Uppsala, Sweden). Results The fasting plasma glucagon level was elevated linearly from CKD stage 1 to 5 [from a median of 2.5 pM (interquartile range, 1.4 to 4.7) in CKD 1 to a median of 8.3 pM (interquartile range, 5.9 to 12.8) in CKD 5; P for trend < 0.0001], from as early as CKD stage 2 compared with that in stage 1 (Bonferroni-corrected P < 0.0001). The estimated GFR and homeostatic model of assessment–insulin resistance were the main determinants of the fasting glucagon level. These explained 14.3% and 10.3% of the glucagon variance, respectively. Albuminuria was not associated with fasting glucagon after adjustment for estimated GFR. Conclusions Fasting full-length glucagon was elevated linearly with the deterioration in renal function in individuals with type 2 diabetes, even in those with early CKD. In addition to renal function, insulin sensitivity was also a main determinant of glucagon variance.

Download Full-text

Influence of postural misalignment on blood pressure fall in hypertensive individuals: an exploratory cross sectional study

Revista Pesquisa em Fisioterapia ◽

10.17267/2238-2704rpf.v8i2.1955 ◽

2018 ◽

Vol 8 (2) ◽

pp. 248-257

Author(s):

Ana Lucia Barbosa Goes ◽

Davi Mota De Jesus ◽

Tiago Bastos Silva ◽

Vinícius Cardoso Lago ◽

Luis Agnaldo Pereira De Souza ◽

...

Keyword(s):

Blood Pressure ◽

Antihypertensive Drugs ◽

Blood Pressure Monitoring ◽

Cross Sectional Study ◽

Pressure System ◽

Cross Sectional ◽

Total Load ◽

Anterior Trunk ◽

Student’S T ◽

Pressure Fall

INTRODUCTION: blood pressure System (SNS) has been considered as the ultimate integrator of the systems’ physiology on Blood Pressure (BP) control. Posture is also regulated by SNS. Systems which regulate BP also act on postural control. OBJECTIVE: To test the hypothesis of an association between postural misalignments (PM) and BP fall in hypertensive individuals. METHODS: Exploratory study using a sample of 40 hypertensive individuals, who regularly use antihypertensive drugs. All of them underwent Ambulatory Blood Pressure Monitoring (ABPM) and posture assessment, through Postural Assessment Software (PAS). To test association between posture angles and BP variables, the student’s t-test and Mann-Whitney tests were used, at a 5% level of significance. This study is registered at clinical trials, under the number NCT02401516. RESULTS: For Systolic Blood Pressure (SBP), anterior trunk shift presented smaller awake/asleep variation (14.7%vs25.3%, p=0.01), and flexing ankle for higher BP loads: 21.9%vs7.8% for total load (p=0.02), 21.8%vs9% for load during the period awake (p=0.04) and 21.9%vs7.9% for load during the period asleep (p=0.02). For Diastolic Blood Pressure (DBP), posterior trunk shift presented higher pressure load (24.0%vs16.2%, p=0.04), and anterior trunk shift presented smaller awake/asleep variation (14.4%vs25.5%, p=0.01) and flexing hip presented higher BP load (29.4%vs18.3%, p=0.02). From posture scores, the PM presented smaller awake/asleep variation for SBP (13.7%vs22.8%, p=0.03) and DBP (11.5%vs23.5%, p=0.01). CONCLUSION: PM can be associated with pressure fall. Three or more alterations in posture angles are associated with smaller awake/asleep BP variation.

Download Full-text

A comparative study on the adherence to anti-hypertensive medications in urban and rural areas of Hubballi

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20191408 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1701 ◽

Cited By ~ 1

Author(s):

Pratibha Rao Katapadi ◽

Dattatreya D. Bant

Keyword(s):

Blood Pressure ◽

Rural Areas ◽

Rural Population ◽

Antihypertensive Drugs ◽

Cross Sectional Study ◽

Uncontrolled Hypertension ◽

Public Health Issue ◽

Antihypertensive Medications ◽

Cross Sectional ◽

Hypertensive Patients

Background: Hypertension is a significant public health issue worldwide and can have deleterious effects on the health when it is not under control. Adherence to antihypertensive medications is thus necessary for better control of blood pressure and to reduce the risk of complications. There are various factors which support or hinder the patient’s adherence to anti- hypertensive treatment. Thus this study was done to reflect the factors influencing the adherence to antihypertensive drugs among urban and rural population.Methods: A community based cross sectional study was conducted in urban and rural field practice areas of Karnataka Institute of Medical Sciences, Hubballi. A semi-structured questionnaire was used for data collection among the known hypertensive patients. The data was entered in Microsoft Excel and analysed using SPSS software.Results: Most of the hypertensive patients were aged 45 and above (89.5%). A total of 73.5% of the participants were adherent to antihypertensive medications and adherence was more among urban (76%) as compared to rural population (71%). Knowledge regarding complications of uncontrolled hypertension was the major factor for adherence in both the areas. The mean systolic and diastolic blood pressure was controlled in patients who were adherent.Conclusions: There is a higher level of adherence to antihypertensive medications in urban population as compared to rural population of Hubballi. The findings suggest patient factors, clinical factors and socio-demographic factors play an important role in determining the adherence to the medication.

Download Full-text

Abstract P122: The Identification Of New Serum Uric Acid Levels Cut-off Point To Prevent Prehypertension And Hypertension Based On Jnc 7 And Acc/aha 2017 Classification: A Cross-sectional Study

Hypertension ◽

10.1161/hyp.78.suppl_1.p122 ◽

2021 ◽

Vol 78 (Suppl_1) ◽

Author(s):

Mochammad Sja'bani ◽

Lucky Aziza Bawazier ◽

Fredie Irijanto ◽

Zulaela Zulaela ◽

Agus Widiatmoko ◽

...

Keyword(s):

Blood Pressure ◽

Uric Acid ◽

Confidence Interval ◽

Serum Uric Acid ◽

Simple Random Sampling ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

History Of ◽

Stage 1

Background: Serum uric acid levels have been reported to be associated with elevated blood pressure and hypertension events. It is needed to determine the prognostic serum uric acid (SUA) cut-off point to prevent the incidents of prehypertension and hypertension. Methods: This was a cross-sectional study involving a total of 733 participants who a had history of prehypertension in 2007. These participants were selected from “Mlati Study Database” in 2007 by simple random sampling using statistical software. Participants underwent both physical and laboratorical examination. Data were analyzed based on JNC 7 and ACC/AHA 2017 guideline. Results: Based on JNC 7 classification, the analysis using ROC curve showed that the prognostic SUA cut-off point of 4.85 mg/dL was able to indicate the incidents of prehypertension or hypertension in the database (95% confidence interval, CI, 0.532-0.629, p=0.001). Additional analysis using ACC/AHA 2017 guideline as the blood pressure classification was also performed for comparison. Based on ACC/AHA 2017 classification, the ROC curved showed a slightly higher SUA cut-off points than the previous analysis using JNC 7. The prognostic SUA cut-off point of 4.95 mg/dL was able to indicate the events of hypertension stage 1 and stage 2 in the database (95% confidence interval, CI, 0.532-0.615, p=0.001). These results were parallel with the previous study which reported that SUA cut-off points of 5-7 mg/dL (high-normal SUA) and ≥7 mg/dL (high SUA) were associated with the incidents of prehypertension and hypertension. Conclusion: The new SUA cut-off points may be used as an early warning for the development of prehypertension and hypertension in the future.

Download Full-text

Health Status and Predictors of Hypertension, Blood Pressure, and Pulse Rate of Jamaicans During the Covid-19 Pandemic

10.47363/jmhc/2021(3)140 ◽

2019 ◽

pp. 1-12

Author(s):

Paul Andrew Bourne ◽

◽

Vincent M.S. Peterkin ◽

Keyword(s):

Public Health ◽

Blood Pressure ◽

Health Status ◽

Research Design ◽

Pulse Rate ◽

Cross Sectional Study ◽

Least Square ◽

Unhealthy Lifestyle ◽

Cross Sectional Survey ◽

Cross Sectional

The objectives of the current research are to examine Jamaicans’ health status, pulse rate, body mass index (BMI), hypertension, and factors influencing 1) hypertension, 2) blood pressure, and 3) pulse rate, during COVID-19. A cross-sectional survey using associational research design by way of convenience sampling was used to conduct this research. This study examined correlation of age, gender, BMI, hypertension, and blood pressure among Jamaicans age ranging from 15 to 85 and above. Cross–sectional study and associational research design were used to collect data for the period of June to August 2020. The study demonstrated that hypertension is significantly predicted by gender, age, and pulse rate one─Omnibus tests of model (χ2(4) =138.947, P < 0.0001, -2Ll=2098.67) and Wald statistic being 90.161, P < 0.0001, and the variance in model 10.8% (Nagelkerke R2). Furthermore, ordinary least square (OLS) regression can be used to model pulse rate (bpm) for Jamaicans (F [4, 1676] =17.236, P < 0.0001), with the model explaining 4.0% of the variance in pulse rate of Jamaicans. Gender, BMI and Hypertensive emerged as the factors that determine the pulse rate of Jamaicans. Diastolic & systolic blood pressure were determined by age, weight, and pulse rate, with age being the most significant predictor. The risk of hypertension was higher among population groups who were overweight and obese. Gender was found to correlate with blood pressure and hypertension; female participants were more likely to be hypertensive than the male participants. BMI measurement should be recommended as a simple and effective predictor of hypertension in public health strategies. There is empirical evidence that can be used to establish that Jamaicans health status has worsen since March 10, 2020, and that Covid-19 has brought with it unhealthy lifestyle practices, which are pending public health challenges come 2021 and beyond.

Download Full-text

PREVALENCE OF HYPERTENSION AND ITS ASSOCIATED RISK FACTORS AMONG AMONG DRIVERS IN NORTH CHENNAI– A CROSS SECTIONAL STUDY

10.36106/ijar/8409918 ◽

2020 ◽

pp. 1-3

Author(s):

Aravind Raj G V ◽

Umashankar R

Keyword(s):

Blood Pressure ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Study Population ◽

The Mean ◽

Associated Risk Factors ◽

Stage 1 ◽

Chennai City ◽

Structured Questionnaire

Background. Hypertension is a leading cause of morbidity and mortality worldwide. We aimed to estimate the prevalence of hypertension in a population of drivers in Chennai, India. Methods. The study population included drivers working in Chennai city. Blood pressure, height, and weight of subjects were measured, and relevance was obtained using a structured questionnaire. Results. Age varied from 30 to 60 years with the mean age of 43 years. Among 400 drivers studied, 33% of them were hypertensive and based on diastolic and systolic blood pressure, 15% of them were in pre-hypertensive and 28% of the were in stage -1 HTN and 31% of them were in stage-2 HTN. Obesity, Smoking, alcohol and history diabetes play a major risk factor the development of hypertension Conclusion. Prevalence of hypertension was high among drivers. Life style may play a key role in the development of hypertension along with duration of work and behavioral pattern.Prevention strategies need to be emphasized in this kind of occupational group.

Download Full-text