Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9

Hypertension Related Publications

9 Perception of Predictive Confounders for the Prevalence of Hypertension among Iraqi Population: A Pilot Study

Authors: Zahraa Albasry, Hadeel D. Najim, Anmar Al-Taie

Abstract:

Background: Hypertension is considered as one of the most important causes of cardiovascular complications and one of the leading causes of worldwide mortality. Identifying the potential risk factors associated with this medical health problem plays an important role in minimizing its incidence and related complications. The objective of this study is to explore the prevalence of receptor sensitivity regarding assess and understand the perception of specific predictive confounding factors on the prevalence of hypertension (HT) among a sample of Iraqi population in Baghdad, Iraq. Materials and Methods: A randomized cross sectional study was carried out on 100 adult subjects during their visit to the outpatient clinic at a certain sector of Baghdad Province, Iraq. Demographic, clinical and health records alongside specific screening and laboratory tests of the participants were collected and analyzed to detect the potential of confounding factors on the prevalence of HT. Results: 63% of the study participants suffered from HT, most of them were female patients (P < 0.005). Patients aged between 41-50 years old significantly suffered from HT than other age groups (63.5%, P < 0.001). 88.9% of the participants were obese (P < 0.001) and 47.6% had diabetes with HT. Positive family history and sedentary lifestyle were significantly higher among all hypertensive groups (P < 0.05). High salt and fatty food intake was significantly found among patients suffered from isolated systolic hypertension (ISHT) (P < 0.05). A significant positive correlation between packed cell volume (PCV) and systolic blood pressure (SBP) (r = 0.353, P = 0.048) found among normotensive participants. Among hypertensive patients, a positive significant correlation found between triglycerides (TG) and both SBP (r = 0.484, P = 0.031) and diastolic blood pressure (DBP) (r = 0.463, P = 0.040), while low density lipoprotein-cholesterol (LDL-c) showed a positive significant correlation with DBP (r = 0.443, P = 0.021). Conclusion: The prevalence of HT among Iraqi populations is of major concern. Further consideration is required to detect the impact of potential risk factors and to minimize blood pressure (BP) elevation and reduce the risk of other cardiovascular complications later in life.

Keywords: Hypertension, correlation, Risk Factors, Iraq

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8 Dietary Habit and Anthropometric Status in Hypertensive Patients Compared to Normotensive Participants in the North of Iran

Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahbobeh Gholipour

Abstract:

Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Keywords: Hypertension, weight, waist circumference, dietary intake, north of Iran

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7 Hypertensive Response to Maximal Exercise Test in Young and Middle Age Hypertensive on Blood Pressure Lowering Medication: Monotherapy vs. Combination Therapy

Authors: James Patrick A. Diaz, Raul E. Ramboyong

Abstract:

Background: Hypertensive response during maximal exercise test provides important information on the level of blood pressure control and evaluation of treatment. Method: A single center retrospective descriptive study was conducted among 117 young (aged 20 to 40) and middle age (aged 40 to 65) hypertensive patients, who underwent treadmill stress test. Currently on maintenance frontline medication either monotherapy (Angiotensin-converting enzyme inhibitor/Angiotensin receptor blocker [ACEi/ARB], Calcium channel blocker [CCB], Diuretic - Hydrochlorthiazide [HCTZ]) or combination therapy (ARB+CCB, ARB+HCTZ), who attained a maximal exercise on treadmill stress test (TMST) with hypertensive response (systolic blood pressure: male >210 mm Hg, female >190 mm Hg, diastolic blood pressure >100 mmHg, or increase of >10 mm Hg at any time during the test), on Bruce and Modified Bruce protocol. Exaggerated blood pressure response during exercise (systolic [SBP] and diastolic [DBP]), peak exercise blood pressure (SBP and DBP), recovery period (SBP and DBP) and test for ischemia and their antihypertensive medication/s were investigated. Analysis of variance and chi-square test were used for statistical analysis. Results: Hypertensive responses on maximal exercise test were seen mostly among female population (P < 0.000) and middle age (P < 0.000) patients. Exaggerated diastolic blood pressure responses were significantly lower in patients who were taking CCB (P < 0.004). A longer recovery period that showed a delayed decline in SBP was observed in patients taking ARB+HCTZ (P < 0.036). There were no significant differences in the level of exaggerated systolic blood pressure response and during peak exercise (both systolic and diastolic) in patients using either monotherapy or combination antihypertensives. Conclusion: Calcium channel blockers provided lower exaggerated diastolic BP response during maximal exercise test in hypertensive middle age patients. Patients on combination therapy using ARB+HCTZ exhibited a longer recovery period of systolic blood pressure.

Keywords: Hypertension, antihypertensive, exercise test, hypertensive response

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6 Hypertension and Its Association with Oral Health Status in Adults: A Pilot Study in Padusunan Adults Community

Authors: Murniwati, Nurul Khairiyah, Putri Ovieza Maizar

Abstract:

The association between general and oral health is clearly important, particularly in adults with medical conditions. Many of the medical systemic conditions are either caused or aggravated by poor oral hygiene and vice versa. Hypertension is one of common medical systemic problem which has been a public health concern worldwide due to its known consequences. Those consequences must be related to oral health status as well, whether it may cause or worsen the oral health conditions. The objective of this study was to find out the association between hypertension and oral health status in adults. This study was an analytical observational study by using cross-sectional method. A total of 42 adults both male and female in Padusunan Village, Pariaman, West Sumatra, Indonesia were selected as subjects by using purposive sampling. Manual sphygmomanometer was used to measure blood pressure and dental examination was performed to calculate the decayed, missing, and filled teeth (DMFT) scores in order to represent oral health status. The data obtained was analyzed statistically using One Way ANOVA to determine the association between hypertensive adults and their oral health status. The result showed that majority age of the subjects was ranging from 51-70 years (40.5%). Based on blood pressure examination, 57.1% of subjects were classified to prehypertension. Overall, the mean of DMFT score calculated in normal, prehypertension and hypertension group was not considered statistically significant. There was no significant association (p>0.05) between hypertension and oral health status in adults.

Keywords: Hypertension, Blood Pressure, DMFT, oral health status

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5 The Association between C-Reactive Protein and Hypertension of Different United States Participants Categorized by Ethnicity: Applying the National Health and Nutrition Examination Survey from 1999-2010

Authors: Ghada Abo-Zaid

Abstract:

Objectives: The main objective of this study was to examine the association between the elevated level of C-reactive protein (CRP) and incidence of hypertension before and after adjustments for age, BMI, gender, SES, smoking, diabetes, cholesterol LDL and cholesterol HDL, and to determine whether the association differs by race. Method: Cross sectional data for participants from aged 17 years to 74 years, included in The National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 were analyzed. The CRP level was classified into three categories (> 3 mg/L, between 1 mg/L and 3 mg/L, and < 3 mg/L). Blood pressure categorization was done using JNC 7 indicator. Hypertension is defined as either systolic blood pressure (SBP) of 140 mmHg or more and diastolic blood pressure (DBP) of 90 mmHg or more, otherwise a self-reported prior diagnosis by a physician. Pre-hypertension was defined as 139 ≥ SBP > 120 or 89 ≥ DBP >80. Multinominal regression model was undertaken to measure the association between CRP level and hypertension. Results: In univariable models, CRP concentrations > 3 mg/L were associated with a 73% greater risk of incident hypertension compared with CRP concentrations < 1 mg/L (Hypertension: odds ratio [OR] = 1.73; 95% confidence interval [CI], 1.50-1.99). Ethnic comparisons showed that American Mexicans had the highest risk of incident hypertension (OR = 2.39; 95% CI, 2.21-2.58). This risk was statistically insignificant after controlling by other variables (Hypertension: OR = 0.75; 95% CI, 0.52-1.08), or categorized by race [American Mexican: OR= 1.58; 95% CI, 0.58-4.26, Other Hispanic: OR = 0.87; 95% CI, 0.19-4.42, Non-Hispanic white: OR = 0.90; 95% CI, 0.50-1.59, Non-Hispanic Black: OR = 0.44; 95% CI, 0.22-0.87. The same results were found for pre-hypertension, and the Non-Hispanic black segment showed the highest significant risk for Pre-Hypertension (OR = 1.60; 95% CI, 1.26-2.03). When CRP concentrations were between 1.0 and 3.0 mg/L in unadjusted models, prehypertension was associated with higher likelihood of elevated CRP (OR = 1.37; 95% CI, 1.15-1.62). The same relationship was maintained in Non-Hispanic white, Non-Hispanic black, and other race (Non-Hispanic white: OR = 1.24; 95% CI, 1.03-1.48, Non-Hispanic black: OR = 1.60; 95% CI, 1.27-2.03, other race: OR = 2.50; 95% CI, 1.32-4.74) while the association was insignificant with American Mexican and other Hispanic. In the adjusted model, the relationship between CRP and prehypertension were no longer available. Contrary, hypertension was not independently associated with elevated CRP, and the results were the same after being grouped by race or adjustments for the possible confounder variables. The same results were obtained when SBP or DBP were on a continuous measure. Conclusions: This study confirmed the existence of an association between hypertension, prehypertension and elevated level of CRP, however this association was no longer available after adjusting by other variables. Ethic group differences were statistically significant at the univariable models, while it disappeared after controlling by other variables. 

Keywords: Hypertension, Ethnicity, Blood Pressure, CRP, NHANES

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4 Systolic Blood Pressure and Its Determinants: Study in a Population Attending Pharmacies in a Portuguese Coastal City

Authors: M. J. Reis Lima, J. Oliveira, M. Brito, C. Lemos, A. Mascarenhas, E. Teixeira Lemos

Abstract:

Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic Blood Pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2., and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Although this is a preliminary study, it might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

Keywords: Exercise, Gender, Obesity, Hypertension, age

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3 An ANN-Based Predictive Model for Diagnosis and Forecasting of Hypertension

Authors: V. Balanica, O. O. Obe, E. Neagoe

Abstract:

The effects of hypertension are often lethal thus its early detection and prevention is very important for everybody. In this paper, a neural network (NN) model was developed and trained based on a dataset of hypertension causative parameters in order to forecast the likelihood of occurrence of hypertension in patients. Our research goal was to analyze the potential of the presented NN to predict, for a period of time, the risk of hypertension or the risk of developing this disease for patients that are or not currently hypertensive. The results of the analysis for a given patient can support doctors in taking pro-active measures for averting the occurrence of hypertension such as recommendations regarding the patient behavior in order to lower his hypertension risk. Moreover, the paper envisages a set of three example scenarios in order to determine the age when the patient becomes hypertensive, i.e. determine the threshold for hypertensive age, to analyze what happens if the threshold hypertensive age is set to a certain age and the weight of the patient if being varied, and, to set the ideal weight for the patient and analyze what happens with the threshold of hypertensive age.

Keywords: Neural Network, Hypertension, Supervised Learning, data set, training set

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2 Serum Nitric Oxide and Sialic Acid: Possible Biochemical Markers for Progression of Diabetic Nephropathy

Authors: Syed M. Shahid, Rozeena Shaikh, Syeda N. Nawab, Shah A. Qader, Abid Azhar, Tabassum Mahboob

Abstract:

This study was designed to investigate the role of serum nitric oxide and sialic acid in the development of diabetic nephropathy as disease marker. Total 210 diabetic patients (age and sex matched) were selected followed by informed consent and divided into four groups (70 each) as I: control; II: diabetic; III: diabetic hypertensive; IV: diabetic nephropathy. The blood samples of all subjects were collected and analyzed for serum nitric oxide, sialic acid, fasting blood glucose, serum urea, creatinine, HbA1c and GFR. The BMI, systolic and diastolic blood pressures, blood glucose, HbA1c and serum sialic acid levels were high (p<0.01) in group II as compared to control subjects. The higher levels (p<0.01) of BMI, systolic and diastolic blood pressures, blood glucose, HbA1c, serum urea, creatinine and sialic acid were observed in group III and IV as compared to controls. Significantly low levels of GFR and serum nitric oxide (p<0.01) were observed in group III and IV as compared to controls. Results indicated that serum nitric oxide and sialic acid are the major biochemical indicators for micro and macrovascular complications of diabetes such as hypertension and nephropathy. These should be taken into account during screening procedures regarding identifications of the diabetic patients to get them rid of progressive renal impairment to ESRD.

Keywords: Hypertension, Diabetic Nephropathy, Nitric Oxide, sialic acid

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1 The Care Management Network as an Effective Intervention in Mitigating the Risks of Hypertension

Authors: Feng-Chuan Pan, Fang-Yue Liu

Abstract:

Hospitals in southern Hualien teamed with the Hypertension Joint Care Network. Working with the network, the team provided a special designed health education to the individual who had been identified as a hypertension patient in the outpatient department. Some metabolism improvements achieved. This is a retrospective study by purposively taking 106 patients from a hospital between 2008 and 2010. Records of before and after education intervention of the objects was collected and analyzed to see the how the intervention affected the patients- hypertension control via clinical parameter monitoring. The results showed that the clinical indicators, the LDL-C, the cholesterol and the systolic blood pressure were significantly improved. The study provides evidence for the effectiveness of the network in controlling hypertension.

Keywords: metabolic syndrome, Cardiovascular Diseases, Hypertension, joint care management network

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