scholarly journals Arterial hypertension and cerebrovascular accidents. epidemiological profile of patients attended between 2013 and 2019 in Joinville, Santa Catarina, Brazil.

2021 ◽  
Author(s):  
Pedro Eugênio Deboni Daudt ◽  
Alexandre Grunfeld Starling Jardim ◽  
Felipe Ibiapina dos Reis
Keyword(s):  
Physical Activity ◽  
Arterial Hypertension ◽  
Recurrent Events ◽  
Antihypertensive Drugs ◽  
Demographic Data ◽  
Recurrent Event ◽  
Cerebrovascular Accidents ◽  
Low Levels ◽  
Epidemiological Profile ◽  
Neurologic Event

Introduction: Cerebrovascular accident (CVA) is the second cause of death in the world, and arterial hypertension (AH) is the main risk factor. Objetives: To evaluate the prevalence of AH and the epidemiological profile of patients who suffered CVA, first and recurrent events, registered at JOINVASC, between 2013 and 2019. Methodology: An observational, descriptive, retrospective study, analyzing demographic data and risk factors, in patients that suffered CVA, first or recurrent event, was done. Results: In the study period, 6057 CVA events were registered, 4402(72.6%) patients were classified as hypertensive, (122 were excluded due to incomplete data), 4387 registers were analyzed. In this group, 2149 (51.2%) were male, mean age was 68.4±14.7(18 a 102 years), BMI was 27.5±5.1(14 a 59), 4330(39.9%) with Diabetes, 2559(58.8%) were smokers or ex-smokers, 3174(7.42%) were sedentary, and 504(11.5%) had controlled AH. In the group with recurrent event (1392-31.7%) (52.3%, p<0.001) were females, mean age was (69.4± 11.5) (p<0.002); BMI was lower (p=0.02). There was more cardiopathy (47.6%) (p<0,001) ,smokers or ex-smokers (66.2)(p<.005), diabetes (46.7%) (p<0.001) and deaths (32.3%)(p<0.001), less physical activity (22.0%)(p<0.001), use of antihypertensive drugs was greater (1.52±0,93)(p<0.001),. Logistic regression showed that female sex, BMI, DM, cardiopathy, physical activity, and more anti- hypertension drugs, were significant predictors for recurrence of neurologic event. Discussion: Despite advances in primary health care and prevention campaigns, the prevalence of AH in patients with CVA is high, and still has low levels of control, even in patients with recurrent CVA.

scholarly journals Arterial hypertension and cerebrovascular accidents. epidemiological profile of patients attended between 2013 and 2019 in Joinville, Santa Catarina, Brazil

2021 ◽  
Author(s):  
Pedro Eugênio Deboni Daudt ◽  
Alexandre Grunfeld Starling Jardim ◽  
Felipe Ibiapina dos Reis
Keyword(s):  
Physical Activity ◽  
Arterial Hypertension ◽  
Recurrent Events ◽  
Antihypertensive Drugs ◽  
Demographic Data ◽  
Recurrent Event ◽  
Cerebrovascular Accidents ◽  
Primary Health ◽  
Epidemiological Profile ◽  
Neurologic Event

Introduction: Cerebrovascular accident (CVA) is the second cause of death in the world, and arterial hypertension (AH) is the main risk factor. Objectives: To evaluate the prevalence of AH and the epidemiological profile of patients who suffered CVA, first and recurrent events, registered at JOINVASC, between 2013 and 2019. Methodology: An observational, descriptive, retrospective study, analyzing demographic data and risk factors, in patients that suffered CVA, first or recurrent event, was done. Results: In the study period, 6057 CVA events were registered, 4402(72.6%) patients were classified as hypertensive, (122 were excluded due to incomplete data), 4387 registers were analyzed. In this group, 2149 (51.2%) were male, mean age was 68.4±14.7(18 a 102 years), BMI was 27.5±5.1(14 a 59), 4330(39.9%) with Diabetes, 2559(58.8%) were smokers or ex-smokers, 3174(7.42%) were sedentary, and 504(11.5%) had controlled AH. In the group with recurrent event (1392-31.7%) (52.3%, p<0.001) were females, mean age was (69.4± 11.5) (p<0.002); BMI was lower (p=0.02). There was more cardiopathy (47.6%) (p<0,001) ,smokers or ex-smokers (66.2)(p<.005), diabetes (46.7%) (p<0.001) and deaths (32.3%)(p<0.001), less physical activity (22.0%)(p<0.001), use of antihypertensive drugs was greater (1.52±0,93)(p<0.001),. Logistic regression showed that female sex, BMI, DM, cardiopathy, physical activity, and more anti- hypertension drugs, were significant predictors for recurrence of neurologic event. Discussion: Despite advances in primary health care and prevention campaigns, the prevalence of AH in patients with CVA is high, and still has lowlevels of control, even in patients with recurrent CVA.

P6370Epidemiology of arterial hypertension in one of the regions of Russia

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E A Smirnova ◽  
S S Yakushin ◽  
Y V Terekhovskaya ◽  
A N Vorobyev
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Representative Sample ◽  
Antihypertensive Drugs ◽  
Men And Women ◽  
The Past ◽  
Number Of Patients ◽  
Increased Risk

Abstract Aim To study the dynamics of the prevalence, awareness, risk factors (RF) and treatment of arterial hypertension (AH) among men and women according to a survey of a representative sample of the population of the Ryazan region (RR) in 2007–2016. Materials and methods In 2002, as a part of the Russian epidemiological “EPOCH” study, a representative sample of the RR population (2098 people, average age 44.8±18.6 years) was formed and surveyed using step-by-step randomization of medical institutions, medical districts and apartments. A repeated survey of the sample was conducted in 2007 (1,760 people, response 83.9%) and in 2016 (1,497 people, response 85.1%). The AH group included persons with blood pressure ≥140/90 mmHg detected during the double measurement and with normal blood pressure while receiving antihypertensive therapy. In individuals with AH the risk factors were assessed: smoking, alcohol abuse, salt abuse, obesity, burdened family history, low physical activity. Results The prevalence of AH over the past 9 years has increased from 39.3% to 43.9%, p<0.001. The age-standardized prevalence of AH among women is higher than among men as in 2007 (42.1% versus 34.8%, p<0.001) and in 2016 (46.9% vs. 41.8%, p<0.05). Women's awareness about having AH increased from 83.9% to 88.9%, p<0.05, in men it decreased (84.0% against 77.4% in 2007, p>0.05). In the group of persons with AH, the more common risk factors are older age (56.8%), hereditary predisposition (58.9%), low physical activity (96.0%) and obesity (34.3%) compared with persons without AH (12.9%, 48.2%, 84.5% and 9.2%, respectively), they smoke less often (10.7% versus 23.2%) and use extra salt less often (29.5% against 38.4%), p<0.001. The number of patients taking antihypertensive drugs reached 91.2% against 84.0% in 2007, p<0.001. There was a decrease in the number of AH patients who: are treated intermittently (from 12.3% to 3.6%, p<0.001), who take drugs only when blood pressure is high (from 16.2% to 6.2%, p<0.001). The most frequently used antihypertensive drugs are still ACE inhibitors (64.8%), beta-blockers (48.9%), diuretics (42.5%), ARBs (29.2%) and calcium channel blockers (21.3%). The ratio of effectively treated AH patients increased in men from 14.6% to 27.8%, p<0.001, in women from 25.0% to 39.5%, p<0.001. A negative influence on the effectiveness of therapy was caused by smoking (RR 1.23; CI 1.11–1.37, p=0.005), salt abuse (RR 1.11; CI 1.06–1.23, p=0.04) and obesity (RR 1.16; CI 1.06–1.27, p=0.003). Conclusion Over the past nine years, the prevalence of hypertension in both the men and women has significantly increased in the Ryazan region. Increased treatment coverage and positive changes in drug therapy led to an increase in the number of effectively treated patients (from 21.4% to 35.5%, p<0.001). Obesity, smoking, salt abuse are associated with an increased risk of non-effectiveness of hypertension therapy.

scholarly journals Effects of a community physical activity program on the number of antihypertensive drugs used by elderly women with arterial hypertension: a cross-sectional study

2019 ◽  
Author(s):  
Claudio Andre Barbosa de Lira ◽  
Rafaela Gomes Santos ◽  
Ariádny Brandão Gomes ◽  
Douglas Assis Teles Santos ◽  
Marília Santos Andrade ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Exercise ◽  
Arterial Hypertension ◽  
Antihypertensive Drugs ◽  
Habitual Physical Activity ◽  
Physical Activity Program ◽  
Activity Levels ◽  
Systemic Arterial Hypertension ◽  
Activity Program ◽  
Physical Activity Levels

Abstract Background Physical exercise is an important tool to manage systemic arterial hypertension. However, less is known about the effect of physical exercise on the number of antihypertensive drugs used by older adults. Objectives The aim was to compare the number of antihypertensive drugs used by older female adults with a low level of physical activity with the number used by those with a high level of physical activity, and to verify how many participants used more than two antihypertensive drugs. Methods Twenty-eight physically active older women with systemic arterial hypertension who participated in a physical activity program for community-dwelling older female adults were divided into two groups: participants that presented lower habitual physical activity levels were placed in group 1 and participants that presented higher habitual physical activity levels were placed in group 2, according to the Baecke questionnaire. In addition, the number of antihypertensive drugs used by participants was collected. Results The number of ingested antihypertensive tablets was 2.0 (median) for both groups investigated. There was no significant difference between groups regarding the number of antihypertensive tablets ingested (p>0.05). Although there was no statistical difference, a higher proportion of participants from the lower physical activity group used more than two antihypertensive drugs. Conclusions The level of habitual physical activity did not affect the number of antihypertensive tablets used by hypertensive women.

Relationship Of A Community Physical Activity Program With The Number Of Antihypertensive Drugs Used By Elderly Women With Arterial Hypertension: A Cross-Sectional Study

2020 ◽  
Author(s):  
Claudio Andre Barbosa de Lira ◽  
Rafaela Gomes dos Santos ◽  
Ariádny Brandão Gomes ◽  
Douglas de Assis Teles Santos ◽  
Marilia Santos Andrade ◽  
...  
Keyword(s):  
Physical Activity ◽  
Arterial Hypertension ◽  
Elderly Women ◽  
Antihypertensive Drugs ◽  
Habitual Physical Activity ◽  
Activity Levels ◽  
Systemic Arterial Hypertension ◽  
Activity Program ◽  
Physical Activity Levels ◽  
Relationship Of

Abstract Background: Physical activity is an important tool to manage systemic arterial hypertension. However, less is known about the relationship of physical activity with the number of antihypertensive drugs used by older adults. The aim of this study was to compare the number of antihypertensive drugs used by older female adults (aged ≥ 60 years) with a low level of physical activity with the number used by those with a high level of physical activity, and to verify how many participants used more than two antihypertensive drugs. The habitual level of physical activity was evaluated by the Baecke questionnaireMethods: Twenty-eight physically active older women with systemic arterial hypertension who participated in a physical activity program for community-dwelling older female adults were divided into two groups: participants who presented lower habitual physical activity levels were placed in group 1 and participants that presented higher habitual physical activity levels were placed in group 2, according to the Baecke questionnaire. In addition, the number of antihypertensive drugs used by participants was collected.Results: The number of prescribed antihypertensive tablets was 2.0 (median) for both groups investigated. There was no significant difference between groups regarding the number of antihypertensive tablets prescribed (p>0.05). There was no statistical difference in proportion of participants from the lower physical activity group used more than two antihypertensive drugs.Conclusions: The level of habitual physical activity did not affect the number of antihypertensive tablets used by hypertensive elderly women.

Recurrent Stroke Risk in Pilots with Atrial Fibrillation

2020 ◽  
Vol 91 (4) ◽  
pp. 352-357
Author(s):  
Jessica Tedford ◽  
Valerie Skaggs ◽  
Ann Norris ◽  
Farhad Sahiar ◽  
Charles Mathers
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
Recurrent Events ◽  
Stroke Risk ◽  
Event Rate ◽  
Recurrent Stroke ◽  
Previous History ◽  
Recurrent Event ◽  
Recurrence Rates ◽  
Medical Certification

INTRODUCTION: Atrial fibrillation (AF) is one of the most common cardiac arrhythmias in the general population and is considered disqualifying aeromedically. This study is a unique examination of significant outcomes in aviators with previous history of both AF and stroke.METHODS: Pilots examined by the FAA between 2002 and 2012 who had had AF at some point during his or her medical history were reviewed, and those with an initial stroke or transient ischemic attack (TIA) during that time period were included in this study. All records were individually reviewed to determine stroke and AF history, medical certification history, and recurrent events. Variables collected included medical and behavior history, stroke type, gender, BMI, medication use, and any cardiovascular or neurological outcomes of interest. Major recurrent events included stroke, TIA, cerebrovascular accident, death, or other major events. These factors were used to calculate CHA2DS2-VASc scores.RESULTS: Of the 141 pilots selected for the study, 17.7% experienced a recurrent event. At 6 mo, the recurrent event rate was 5.0%; at 1 yr, 5.8%; at 3 yr 6.9%; and at 5 yr the recurrent event rate was 17.3%. No statistical difference between CHA2DS2-VASc scores was found as it pertained to number of recurrent events.DISCUSSION: We found no significant factors predicting risk of recurrent event and lower recurrence rates in pilots than the general population. This suggests CHA2DS2-VASc scores are not appropriate risk stratification tools in an aviation population and more research is necessary to determine risk of recurrent events in aviators with atrial fibrillation.Tedford J, Skaggs V, Norris A, Sahiar F, Mathers C. Recurrent stroke risk in pilots with atrial fibrillation. Aerosp Med Hum Perform. 2020; 91(4):352–357.

Fixed combination in patients with arterial hypertension: focus on antihypertensive and nephroprotective properties of fixed combination of lisinopril and amlodipine (clinical example)

2020 ◽  
pp. 19-28
Author(s):  
E. Yu. Ebzeeva ◽  
O. D. Ostroumova ◽  
N. M. Doldo ◽  
E. E. Pavleeva
Keyword(s):  
Kidney Disease ◽  
Arterial Hypertension ◽  
Fixed Combination ◽  
Enzyme Inhibitor ◽  
Antihypertensive Drugs ◽  
Adult Population ◽  
Secondary Damage ◽  
Dihydropyridine Calcium Channel Blocker ◽  
Based Medicine ◽  
Modern Population

Arterial hypertension (AH) remains one of the most significant medical and social problems in the world, its prevalence among the adult population is 30–45%. Along with this, the modern population is characterized by a high incidence of chronic kidney disease (CKD), including due to their secondary damage in the framework of hypertension. In turn, CKD is an important independent risk factor for the development and progression of cardiovascular diseases, including fatal ones. The use of existing approaches to nephroprotection in the treatment of patients with hypertension will significantly improve the prognosis both in patients with risk factors for developing renal dysfunction and in patients with pre-existing kidney disease. According to current recommendations for hypertension in such clinical situations, therapy should begin with fixed combinations of antihypertensive drugs. The combination of an angiotensin converting enzyme inhibitor (ACE) and a dihydropyridine calcium channel blocker (CCВ) demonstrated the greatest effectiveness according to evidence-based medicine in patients with high-risk hypertension, including from the standpoint of nephroprotection. In the presented clinical case, the successful use of a fixed combination of ACE and CCВ in a patient with hypertension and microalbuminuria is described.

The changes of some indicators of endothelial dysfunction in response to physical activity in individuals with arterial hypertension

2019 ◽  
Vol 25 (1) ◽  
pp. 17-22
Author(s):  
I.S. Dronyk ◽  
◽  
O.Y. Yavorsky ◽  
O.Y. Sklyarov ◽  
R.S. Pshyk ◽  
...  
Keyword(s):  
Physical Activity ◽  
Endothelial Dysfunction ◽  
Arterial Hypertension

scholarly journals Baroreflex activation therapy for resistant hypertension: results from mid-term prospective ambulatory blood pressure registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Sindt ◽  
T Madej ◽  
S Grimm ◽  
M Knaut
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Pressure Drop ◽  
Arterial Hypertension ◽  
Antihypertensive Drugs ◽  
Drug Resistant ◽  
Baroreflex Activation Therapy ◽  
Activation Therapy ◽  
Resistant Arterial Hypertension

Abstract Objectives First generation baroreflex activation therapy (BAT) devices showed clinical efficacy in patients with drug-resistant arterial hypertension (AHT), but the safety profile was insufficient. Data regarding efficacy of second-generation devices were generated mostly from office blood pressure (BP) measurements or short-term 24-hour ambulatory blood pressure measurements (ABPM). We present a mid-term prospective registry to evaluate the efficacy and safety of recent BAT devices. Purpose The purpose of our study was to find a method that helps patients with drug-resistant arterial hypertension to control their blood pressure. Further we sought to reduce the overall amount of antihypertensive drugs to lessen side effects, as well as the effects of polypharmacy. Methods All patients receiving Barostim neo between November 2013 and June 2019 for resistant AHT were prospectively included into this observational study. ABPM was performed at baseline, in 3-month intervals in the first year after BAT implantation and in 6-month intervals afterwards for up to 42 months. Patients were assigned into two groups of responders and non-responders. Non-responders had a mean blood pressure drop (BPD) below 5mmHg. Responders in turn were categorized into 3 sub-groups (low-BPD between 5–9 mmHg, medium-BPD between 10–19 mmHg and high-BPD ≥20 mmHg). The primary efficacy end-points were changes in systolic and diastolic BP and number of antihypertensive medications. The primary safety end point was BAT-related major adverse events (MAE). Results 64 patients (mean age 63 years, 67% males) were included. Only patients who completed a 24-hour ABPM during a follow up were counted in the statistical analysis. We had an overall responder rate of 67.8%. Out of those 15.4% had low-BPD, 38.4% medium-BPD and 46.2% had a high-BPD. Systolic BP decreased over the 3.5-years period from 168±17 mmHg to 149±19 mmHg (n=19, mean change −18.8 mmHg; 95% confidence interval [CI]: −29.32 to −8.36; p&lt;0.0007). Diastolic BP decreased from 97±16 to 85±12 mmHg (n=19, mean change −11.7 mmHg; 95% CI: −19.2 to −4.2; p&lt;0.0021). The mean number of antihypertensive drugs was reduced from 6.9±1.3 to 5.2±1.5 (n=19, mean change −1.7; 95% CI: −0.8 to −0.27; p&lt;0.0009). The time course of primary end-points is shown in Fig.1. Freedom from BAT-related MAE was 93.5%. 4 perioperative complications (1 pocket bleeding, 1 pocket infection, 1 N. hypoglossus palsy, 1 hoarseness) resolved without residual side effects. There were five non BAT related deaths (7,8%) in the follow up period. Conclusion Systolic and diastolic ABP, as well as number and dosage of antihypertensive drugs decreased significantly during 3.5-years follow-up after Barostim neo implantation in 64 consecutive patients (of whom 62 completed at least one follow-up). No MAE associated with BAT were observed after the perioperative period. However, further controlled trials are needed to confirm the long-term efficacy of BAT. Figure 1. Mean blood pressure drop Funding Acknowledgement Type of funding source: None

scholarly journals EXPRESS: Association of daily physical activity with psychosocial aspects and functional capacity in patients with Pulmonary Arterial Hypertension: a cross-sectional study

2021 ◽  
pp. 204589402199995
Author(s):  
Layse Nakazato Lima ◽  
Felipe Mendes ◽  
Ilma Paschoal ◽  
Daniela Oliveira ◽  
Marcos Mello Moreira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Functional Capacity ◽  
Daily Physical Activity ◽  
Cross Sectional ◽  
Pulmonary Arterial ◽  
The Mean

Pulmonary arterial hypertension (PAH) impairs exercise tolerance and daily physical activity (PA). Aside from the hemodynamic limitations, physical, cognitive and emotional factors may play a relevant and as yet unexplored role. We investigated whether there is an association between the PA level and psychological disorders, health-related quality of life, and daily activities. We also searched for an association of the PA level with clinical factors and functional capacity. This was an analytical, cross-sectional, observational study conducted in a Brazilian University Hospital. Twenty stable PAH subjects wore an accelerometer for a week and completed an activity diary. They answered the quality of life questionnaire (SF-36), as well as the anxiety and depression scale (HADS), and the Manchester Respiratory Activities of Daily Living questionnaire (MRADL). Transthoracic echocardiography, the 6-Minute walk test (6MWT), the 1-minute sit-to-stand test (STST), and spirometry were performed. For statistical analysis we used Chi-square tests or Fisher's test as appropriate and the Mann-Whitney test to compare numerical values between two groups. The relationship between the parameters was assessed using the Spearman correlation test. The mean age was 44.3 years, 80% were women, 80% had idiopathic PAH, and 20% had connective tissue disease . The mean daily step count was 4,280 ± 2,351, and the mean activity time was 41.6 ± 19.3 minutes. The distance covered (6MWT) was 451.5 m, and the number of movements (1-STST) was 23.8. Thirty percent scored positive for anxiety, and 15% for depression (HADS). There was a significant correlation between accelerometer data and walking distance (6MWT), number of movements (1-STST), level of daily physical activity (MRADL), and depression symptoms. Our findings support the hypothesis that other aspects beyond physical and hemodynamic ones might impact the daily physical activity of patients with PAH.

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