Clinical Hypertension最新文献

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Effects of menopausal hormone therapy on ambulatory blood pressure and arterial stiffness in postmenopausal Korean women with grade 1 hypertension: a randomized, placebo-controlled trial. 绝经期激素治疗对绝经后韩国1级高血压妇女动态血压和动脉僵硬的影响:一项随机、安慰剂对照试验
IF 4.2
Clinical Hypertension Pub Date : 2021-09-15 DOI: 10.1186/s40885-021-00175-1
Byung-Koo Yoon, Jidong Sung, Yun-Mi Song, Soo-Min Kim, Kyung-A Son, Jun Hyun Yoo, Sung-Ji Park, Duk-Kyung Kim
{"title":"Effects of menopausal hormone therapy on ambulatory blood pressure and arterial stiffness in postmenopausal Korean women with grade 1 hypertension: a randomized, placebo-controlled trial.","authors":"Byung-Koo Yoon,&nbsp;Jidong Sung,&nbsp;Yun-Mi Song,&nbsp;Soo-Min Kim,&nbsp;Kyung-A Son,&nbsp;Jun Hyun Yoo,&nbsp;Sung-Ji Park,&nbsp;Duk-Kyung Kim","doi":"10.1186/s40885-021-00175-1","DOIUrl":"https://doi.org/10.1186/s40885-021-00175-1","url":null,"abstract":"<p><strong>Background: </strong>Estrogen therapy in early menopausal women decreases the risk of coronary heart disease and parenteral, but not oral, estrogen is reported to reduce blood pressure (BP). Progestogens are typically added to estrogens to prevent unopposed endometrial stimulation. The effects of progestogen on BP have been less well studied to date. This study was conducted to explore the impacts of micronized progesterone (MP4) combined with percutaneous estradiol gel (PEG) on hemodynamics in postmenopausal Korean women with grade 1 hypertension.</p><p><strong>Methods: </strong>Fifty-two postmenopausal women (aged 49-75 years) with systolic BP (SBP) of 140-160 mmHg or diastolic BP (DBP) of 90-100 mmHg were randomly assigned for 12 weeks to placebo (n = 16), estrogen therapy (ET) (n = 19) with PEG (0.1 %, 1 g./d), or estrogen + progestogen therapy (EPT, n = 17) with PEG and MP4 (100 mg/d). The primary endpoint was ambulatory BP and the secondary endpoints were arterial stiffness as brachial-ankle pulse-wave velocity (baPWV) and aortic parameters on applanation tonometry.</p><p><strong>Results: </strong>One woman in the ET group dropped out, so 51 participants were finally analyzed. Outcome measures for ambulatory BP and arterial stiffness were not different between groups. Within-group comparisons showed that EPT significantly decreased daytime heart rate and baPWV: the changes from baseline (mean ± standard deviation) were - 2.5 ± 5.7 bpm (P = 0.03) and - 0.6 ± 1.4 m/s (P = 0.04), respectively. After adjusting for baseline, linear regression analysis revealed a significant difference in the relationship between baseline and 12-week baPWV among groups (P = 0.02). The relationship was significantly different between placebo and ET (P = 0.03) and EPT (P = 0.01), respectively, but not between ET and EPT. Additionally, pooled results of active treatments disclosed that SBP, DBP, PWV, and augmentation index at the aorta were significantly reduced relative to baseline.</p><p><strong>Conclusions: </strong>There was no difference in ambulatory BP between ET and EPT in postmenopausal Korean women with grade 1 hypertension. Further, ET and EPT similarly decreased baPWV from baseline as compared with placebo. MP4 might not adversely influence estrogen effects on ambulatory BP and arterial stiffness.</p><p><strong>Trial registration: </strong>Clinical Research Information Registry, KCT0005405, Registered 22 September 2020 - Retrospectively registered, https://cris.nih.go.kr/cris/search/detailSearch.do?all_type=Y&search_page=L&pageSize=10&page=1&seq=17608&search_lang=E .</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"27 1","pages":"18"},"PeriodicalIF":4.2,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39415518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Prevalence, awareness, and control of hypertension among Bangladeshi adults: an analysis of demographic and health survey 2017-18. 孟加拉国成年人高血压的患病率、意识和控制:2017-18年人口和健康调查分析
IF 4.2
Clinical Hypertension Pub Date : 2021-09-01 DOI: 10.1186/s40885-021-00174-2
Gulam Muhammed Al Kibria, Rajat Das Gupta, Jannatun Nayeem
{"title":"Prevalence, awareness, and control of hypertension among Bangladeshi adults: an analysis of demographic and health survey 2017-18.","authors":"Gulam Muhammed Al Kibria,&nbsp;Rajat Das Gupta,&nbsp;Jannatun Nayeem","doi":"10.1186/s40885-021-00174-2","DOIUrl":"https://doi.org/10.1186/s40885-021-00174-2","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of hypertension is increasing in Bangladesh, however, few recent studies investigated the proportion of people and factors associated with prevalence, awareness, and control of this condition in this country. This study investigated these among Bangladeshi adults.</p><p><strong>Methods: </strong>Using Bangladesh Demographic and Health Survey 2017-18 data, a cross-sectional study was conducted. Multilevel logistic regression analysis was employed after descriptive analysis and prevalence estimation.</p><p><strong>Results: </strong>Among 12,926 persons (mean age: 40 years, 57% women), the prevalence of hypertension was 27.4% (n = 3551), it was 28.4 and 26.2% among females and males, respectively. Among hypertensive people, about 42.4% (n = 1508) people were aware of having it, 48.7% among females and 33.5% among males. Of the 1313 people who were taking antihypertensive medication, only 33.8% (n = 443) had controlled hypertension, 34.7 and 31.7% among females and males, respectively. Among the studied factors associated with hypertension, people with older age, female gender, overweight/obesity, diabetes, richer wealth quintiles, and residence in some administrative divisions had higher odds of hypertension (p < 0.05). However, the odds of awareness was lower among younger people, males, and people without overweight/obesity, diabetes, or richer wealth quintiles. Odds of controlled hypertension was also lower among people with older age and higher among college-educated people.</p><p><strong>Conclusion: </strong>This study identified several important factors associated with prevalence, awareness, and control of hypertension. It is important to address these factors with nationwide prevention and control programs.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"27 1","pages":"17"},"PeriodicalIF":4.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8408995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39370913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 8
Morning blood pressure surge in the early stage of hypertensive patients impacts three-dimensional left ventricular speckle tracking echocardiography. 高血压患者早期晨起血压升高对三维左室斑点跟踪超声心动图的影响。
IF 4.2
Clinical Hypertension Pub Date : 2021-08-15 DOI: 10.1186/s40885-021-00173-3
Ami Kwon, Sang Hyun Ihm, Chan Seok Park
{"title":"Morning blood pressure surge in the early stage of hypertensive patients impacts three-dimensional left ventricular speckle tracking echocardiography.","authors":"Ami Kwon,&nbsp;Sang Hyun Ihm,&nbsp;Chan Seok Park","doi":"10.1186/s40885-021-00173-3","DOIUrl":"https://doi.org/10.1186/s40885-021-00173-3","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to examine left ventricular (LV) function in untreated, newly diagnosed hypertensive patients with morning blood pressure surge (MBPS) status using three-dimensional (3D) speckle tracking echocardiography (STE).</p><p><strong>Methods: </strong>In this study, 163 newly diagnosed hypertensive patients were included, and all patients underwent 24-h ambulatory blood pressure monitoring (ABPM). According to ABPM, participants were divided into a MBPS group and a non-MBPS group. The entire study population was examined by complete two-dimensional (2D) transthoracic echocardiography (TTE) and 3D STE.</p><p><strong>Result: </strong>The results of this study showed that 3D LV longitudinal strain was significantly decreased in the MBPS group compared with the non-MBPS group (- 30.1 ± 2.0 vs. -31.1 ± 2.7, p = 0.045). Similar trends were observed for 3D twist (9.6 ± 6.1 vs. 12.1 ± 4.8, p = 0.011) as well as for 3D torsion (1.23 ± 0.78 vs. 1.49 ± 0.62, p = 0.042). The LV principal strain was decreased in the MBPS group (- 33.9 ± 1.7 vs. -35.5 ± 2.8, p < 0.001). The 3D LV global longitudinal strain (GLS) and principal strain were significantly associated with quartile of MBPS as measured by systolic blood pressure (SBP).</p><p><strong>Conclusion: </strong>The 3D STE revealed that LV mechanics were more impaired in the MBPS group than in the non-surge newly diagnosed, untreated hypertensive patients; even the 2D TTE parameters showed no difference.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"27 1","pages":"16"},"PeriodicalIF":4.2,"publicationDate":"2021-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8364689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39310419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Clinical Impact of after-consult clinic blood pressure: comparison with automated office blood pressure. 会诊后门诊血压的临床影响:与办公室自动血压的比较。
IF 4.2
Clinical Hypertension Pub Date : 2021-08-01 DOI: 10.1186/s40885-021-00171-5
Cheol Ho Lee, Ji Hun Ahn, Joon Ha Ryu, Woong Gil Choi
{"title":"Clinical Impact of after-consult clinic blood pressure: comparison with automated office blood pressure.","authors":"Cheol Ho Lee,&nbsp;Ji Hun Ahn,&nbsp;Joon Ha Ryu,&nbsp;Woong Gil Choi","doi":"10.1186/s40885-021-00171-5","DOIUrl":"https://doi.org/10.1186/s40885-021-00171-5","url":null,"abstract":"<p><strong>Background: </strong>It is most important to measure blood pressure (BP) exactly in treating hypertension. Recent recommendations for diagnosing hypertension clearly acknowledge that an increase in BP attributable to the \"whitecoat response\" is frequently associated with manual BP recordings performed in community-based practice. However, there was no data about after-consult (AC) BP that could reduce whitecoat effect. So we evaluated before-consult (BC) and AC routine clinic BP and research based automated office blood pressure (AOBP) measured.</p><p><strong>Methods: </strong>The study population consisted of 82 consecutive patients with hypertension between April 2019 and December 2019. We measured routine clinic BP and AOBP before and after see a doctor, respectively. Seated blood pressure and pulse are measured at each time after a rest period using an automated device as it offers reduced potential for observer biases. AOBP was measured and measuring BP 3 times un-observed. We compared each BP parameter for identifying exact resting BP state.</p><p><strong>Results: </strong>There was significant difference between BC and AC systolic BP (135.37 ± 16.90 vs. 131.95 ± 16.40 mmHg, p = 0.015). However there was no difference in the BC and AC diastolic blood pressure (73.75 ± 11.85 vs. 74.42 ± 11.71 mmHg, p = 0.415). In the AOBP comparison, there was also significant difference (BC systolic AOBP vs. AC systolic AOBP, 125.17 ± 14.41 vs. 122.98 ± 14.09 mmHg, p = 0.006; BC diastolic ABOB vs. AC diastolic AOBP, 71.99 ± 10.49 vs. 70.99 ± 9.83, p = 0.038).</p><p><strong>Conclusions: </strong>In our study, AC AOBP was most lowest representing resting state. Although AC BP was higher than BC AOBP, it might be used as alternative measurement for reducing whitecoat effect in the routine clinical practice.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"27 1","pages":"15"},"PeriodicalIF":4.2,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40885-021-00171-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39262838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hypertension and coronary artery ectasia: a systematic review and meta-analysis study. 高血压和冠状动脉扩张:一项系统回顾和荟萃分析研究。
IF 4.2
Clinical Hypertension Pub Date : 2021-07-15 DOI: 10.1186/s40885-021-00170-6
Mostafa Bahremand, Ehsan Zereshki, Behzad Karami Matin, Mansour Rezaei, Hamidreza Omrani
{"title":"Hypertension and coronary artery ectasia: a systematic review and meta-analysis study.","authors":"Mostafa Bahremand,&nbsp;Ehsan Zereshki,&nbsp;Behzad Karami Matin,&nbsp;Mansour Rezaei,&nbsp;Hamidreza Omrani","doi":"10.1186/s40885-021-00170-6","DOIUrl":"https://doi.org/10.1186/s40885-021-00170-6","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery ectasia (CAE) is characterized by the enlargement of a coronary artery to 1.5 times or more than other non-ectasia parts of the vessel. It is important to investigate the association of different factors and CAE because there are controversial results between available studies. We perform this systematic review and meta-analysis to evaluate the effects of hypertension (HTN) on CAE.</p><p><strong>Methods: </strong>To find the potentially relevant records, the electronic databases, including Scopus, PubMed, and Science Direct were searched on 25 July 2019 by two of the authors independently. In the present study, the pooled odds ratio (OR) accompanied by 95 % confidence intervals (CIs) were calculated by a random-effects model. Heterogeneity presented with the I<sup>2</sup> index. Subgroup analysis and sensitivity analysis by the Jackknife approach was performed.</p><p><strong>Results: </strong>Forty studies with 3,263 cases and 7,784 controls that investigated the association between HTN and CAE were included. The pooled unadjusted OR of CAE in subjects with HTN in comparison by subjects without HTN was estimated 1.44 (95 % CI, 1.24 to 1.68) with moderate heterogeneity (I<sup>2</sup> = 41 %, Cochran's Q P = 0.004). There was no evidence of publication bias in the analysis of HTN and CAE with Egger's test (P = 0.171), Begg's test (P = 0.179). Nine articles reported the adjusted effect of HTN on CAE by 624 cases and 628 controls. The findings indicated the overall adjusted OR was 1.03 (95 % CI, 0.80 to 1.25) with high heterogeneity (I<sup>2</sup> = 58.5 %, Cochran's Q P = 0.013).</p><p><strong>Conclusions: </strong>We found that when the vessel was in normal condition, HTN was not very effective in increasing the chance of CAE and only increased the CAE chance by 3 %. This is an important issue and a warning to people who have multiple risk factors together. More studies need to be performed to further establish these associations by reported adjusted effects.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"27 1","pages":"14"},"PeriodicalIF":4.2,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8281588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39183938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Utility of 24-hour ambulatory blood pressure monitoring in potential living kidney donors. 24小时动态血压监测在潜在活体肾供者中的应用。
IF 4.2
Clinical Hypertension Pub Date : 2021-07-01 DOI: 10.1186/s40885-021-00172-4
Nabeel Aslam, Sobia H Memon, Hani Wadei, Elizabeth R Lesser, Shehzad K Niazi
{"title":"Utility of 24-hour ambulatory blood pressure monitoring in potential living kidney donors.","authors":"Nabeel Aslam,&nbsp;Sobia H Memon,&nbsp;Hani Wadei,&nbsp;Elizabeth R Lesser,&nbsp;Shehzad K Niazi","doi":"10.1186/s40885-021-00172-4","DOIUrl":"https://doi.org/10.1186/s40885-021-00172-4","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension (HTN) is a risk factor for cardiovascular disease; therefore, it is imperative to risk stratify potential kidney donors during evaluation. Clinic blood pressure (CBP) measurement is inaccurate in assessing presence or absence of HTN. There is paucity of data about utility of 24-h ambulatory blood pressure monitoring (ABPM) during kidney donor evaluation.</p><p><strong>Methods: </strong>24-h ABPM is performed on all kidney donors at Mayo Clinic Florida. We conducted retrospective review of 264 consecutive potential kidney donors from 1/1/2012 to 12/31/2017. Demographic, comorbid conditions, laboratory results and 24-h ABPM data were collected. Subjects were divided into two groups: Group1: Subjects with no prior history of HTN and new diagnosis of HTN using 24-h ABPM; Group 2: Subjects with no prior history of hypertension and normal BP on 24-h ABPM.</p><p><strong>Results: </strong>Baseline demographic included mean age 46.40 years, 39% males, 78.4% Caucasians, and mean BMI was 26.94. Twenty one subjects (8.0%) had prior diagnosis of HTN. Among 243 subjects without prior HTN, 62 (25.5%) were newly diagnosed with HTN using 24-h ABPM. CBP was high only in 27 out of 62 (43.6%) of newly diagnosed HTN subjects. Thirty-five subjects (14.4%) had masked HTN and 14 subjects (5.8%) had white-coat HTN. Newly diagnosed hypertensive subjects were more likely to be males as compared to Group 2 (53.2% vs 34.3% P = 0.008). There was a trend of more non-Caucasians subjects (30.6% vs 19.9% P = 0.08) and more active smokers (17.7% vs 11.6%, P = 0.054) in Group1 as compared to Group 2. Only 17 (27.4%) out of 62 newly diagnosed hypertensive subjects were deemed suitable for kidney donation as compared to 105 (58.0%) out of 181 normotensive subjects (P < 0.001).</p><p><strong>Conclusion: </strong>In our cohort, use of ABPM resulted in new diagnosis of HTN in 1 out of 4 potential kidney donors. Newly diagnosed HTN was more common in men, those with non-Caucasian race, and in active smokers. There was a significantly reduced acceptance rate for kidney donation among newly diagnosed HTN subjects. Further studies are needed to determine the value of 24-h ABPM among these high risk groups.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"27 1","pages":"13"},"PeriodicalIF":4.2,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40885-021-00172-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39125672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Isolated systolic hypertension in young males: a scoping review. 年轻男性孤立性收缩期高血压:一项范围综述。
IF 4.2
Clinical Hypertension Pub Date : 2021-06-15 DOI: 10.1186/s40885-021-00169-z
Holly Scott, Matthew J Barton, Amy N B Johnston
{"title":"Isolated systolic hypertension in young males: a scoping review.","authors":"Holly Scott,&nbsp;Matthew J Barton,&nbsp;Amy N B Johnston","doi":"10.1186/s40885-021-00169-z","DOIUrl":"https://doi.org/10.1186/s40885-021-00169-z","url":null,"abstract":"<p><p>Isolated systolic hypertension typically occurs in young males; however, its clinical significance is unknown. Given the prevalence of the hypertension and its contribution to global morbidity and mortality, a synthesis of the most recent available evidence around isolated systolic hypertension is warranted. This review aims firstly to review the haemodynamic and physical characteristics indicative of cardiovascular risk in young males (aged 18 to 30 years) with isolated systolic hypertension, and secondly to synthesize the associated clinical management recommendations reported in the literature. Six databases were systematically searched for all relevant peer-reviewed literature examining isolated systolic hypertension in young males. Search results were screened and examined for validity, those that did not meet the inclusion criteria were removed. A total of 20 articles were appropriate for inclusion. Key factors indicative of cardiovascular risk in isolated systolic hypertension were characterized by several distinctive haemodynamic parameters and physical characteristics. After the literature was synthesized based around these key factors, two distinct cohorts (healthy and unhealthy) were highlighted. The healthy cohort of younger males with isolated systolic hypertension was associated with a decreased cardiovascular risk and therefore no medical interventions were recommended. The second (unhealthy) cohort was, however, associated with an increased cardiovascular risk and may therefore, benefit from antihypertensive therapy.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"27 1","pages":"12"},"PeriodicalIF":4.2,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39231042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Hypertension, renin-angiotensin-aldosterone-system-blocking agents, and COVID-19. 高血压、肾素-血管紧张素-醛固酮系统阻断剂和 COVID-19。
IF 2.6
Clinical Hypertension Pub Date : 2021-06-01 DOI: 10.1186/s40885-021-00168-0
Si-Hyuck Kang, Dong-Hoon Lee, Kyung-Do Han, Jin-Hyung Jung, Sang-Hyun Park, Andrew M Dai, Henry G Wei, Chang-Hwan Yoon, Tae-Jin Youn, In-Ho Chae, Cheol-Ho Kim
{"title":"Hypertension, renin-angiotensin-aldosterone-system-blocking agents, and COVID-19.","authors":"Si-Hyuck Kang, Dong-Hoon Lee, Kyung-Do Han, Jin-Hyung Jung, Sang-Hyun Park, Andrew M Dai, Henry G Wei, Chang-Hwan Yoon, Tae-Jin Youn, In-Ho Chae, Cheol-Ho Kim","doi":"10.1186/s40885-021-00168-0","DOIUrl":"10.1186/s40885-021-00168-0","url":null,"abstract":"<p><strong>Background: </strong>There have been concerns regarding the safety of renin-angiotensin-aldosterone-system (RAAS)-blocking agents including angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) during the coronavirus disease 2019 (COVID-19) pandemic. This study sought to evaluate the impact of hypertension and the use of ACEI/ARB on clinical severity in patients with COVID-19.</p><p><strong>Methods: </strong>A total of 3,788 patients aged 30 years or older who were confirmed with COVID-19 with real time reverse transcription polymerase chain reaction were identified from a claims-based cohort in Korea. The primary study outcome was severe clinical events, a composite of intensive care unit admission, need for ventilator care, and death.</p><p><strong>Results: </strong>Patients with hypertension (n = 1,190, 31.4 %) were older and had higher prevalence of comorbidities than those without hypertension. The risk of the primary study outcome was significantly higher in the hypertension group, even after multivariable adjustment (adjusted odds ratio [aOR], 1.67; 95 % confidence interval [CI], 1.04 to 2.69). Among 1,044 patients with hypertensive medical treatment, 782 (74.9 %) were on ACEI or ARB. The ACEI/ARB subgroup had a lower risk of severe clinical outcomes compared to the no ACEI/ARB group, but this did not remain significant after multivariable adjustment (aOR, 0.68; 95 % CI, 0.41 to 1.15).</p><p><strong>Conclusions: </strong>Patients with hypertension had worse COVID-19 outcomes than those without hypertension, while the use of RAAS-blocking agents was not associated with increased risk of any adverse study outcomes. The use of ACE inhibitors or ARBs did not increase the risk of adverse COVID-19 outcomes, supporting current guidance to continue these medications when indicated.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"27 1","pages":"11"},"PeriodicalIF":2.6,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39037287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of changes of pulse wave velocity and augmentation index after isometric handgrip exercise with coronary lesion extent and revascularization. 等长握力运动后脉搏波速度和增强指数变化与冠状动脉病变程度和血运重建的关系。
IF 4.2
Clinical Hypertension Pub Date : 2021-05-01 DOI: 10.1186/s40885-021-00163-5
Seong Taeg Kim, Yeekyoung Ko, Jong-Wook Beom, Ki Yung Boo, Jae-Geun Lee, Joon-Hyouk Choi, Song-Yi Kim, Seung-Jae Joo
{"title":"Association of changes of pulse wave velocity and augmentation index after isometric handgrip exercise with coronary lesion extent and revascularization.","authors":"Seong Taeg Kim,&nbsp;Yeekyoung Ko,&nbsp;Jong-Wook Beom,&nbsp;Ki Yung Boo,&nbsp;Jae-Geun Lee,&nbsp;Joon-Hyouk Choi,&nbsp;Song-Yi Kim,&nbsp;Seung-Jae Joo","doi":"10.1186/s40885-021-00163-5","DOIUrl":"https://doi.org/10.1186/s40885-021-00163-5","url":null,"abstract":"<p><strong>Background: </strong>Arterial stiffness is associated with myocardial ischemia and incident coronary artery disease (CAD), and indexes of arterial stiffness are usually increased in patients with CAD. However, these indexes are often increased in elderly without CAD. Arterial stiffness in patients with CAD may become more evident after isometric handgrip exercise which increases systolic pressure and ventricular afterload. We investigated the association of the change of stiffness indexes after isometric handgrip exercise with the lesion extent of CAD and the necessity for coronary revascularization.</p><p><strong>Methods: </strong>Patients who were scheduled a routine coronary angiography via a femoral artery were enrolled. Arterial waveforms were traced at aortic root and external iliac artery using coronary catheters at baseline and 3 min after handgrip exercise. Augmentation index (AIx) was measured on the recorded aortic pressure waveform, and pulse wave velocity (PWV) was calculated using the ECG-gated time difference of the upstroke of arterial waveforms and distance between aortic root and external iliac artery.</p><p><strong>Results: </strong>Total 37 patients were evaluated. Both PWV and AIx increased after handgrip exercise. ΔPWV was significantly correlated with ΔAIx (r = 0.344, P = 0.037). Patients were divided into higher and lower ΔPWV or ΔAIx groups based on the median values of 0.4 m/sec and 3.3%, respectively. Patients with higher PWV had more 2- or 3-vessel CAD (69% vs. 27%, P = 0.034), and underwent percutaneous coronary intervention (PCI) more frequently (84% vs. 50%, P = 0.038), but higher ΔAIx was not associated with either the lesion extent or PCI. Area under curve (AUC) of ΔPWV in association with PCI by C-statistics was 0.70 (95% confidence interval [CI] 0.51-0.88; P = 0.056). In multiple logistic regression analysis, ΔPWV was significantly associated with PCI (odds ratio 7.78; 95% CI 1.26-48.02; P = 0.027).</p><p><strong>Conclusions: </strong>Higher ΔPWV after isometric handgrip exercise was associated with the lesion extent of CAD and the necessity for coronary revascularization, but higher ΔAIx was not.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"27 1","pages":"5"},"PeriodicalIF":4.2,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40885-021-00163-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38936168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to: Korea hypertension fact sheet 2020: analysis of nationwide population-based data. 更正:韩国高血压情况说明书2020:全国人口数据分析。
IF 4.2
Clinical Hypertension Pub Date : 2021-03-29 DOI: 10.1186/s40885-021-00167-1
Hyeon Chang Kim, So Mi Jemma Cho, Hokyou Lee, Hyeok-Hee Lee, Jongmin Baek, Ji Eun Heo
{"title":"Correction to: Korea hypertension fact sheet 2020: analysis of nationwide population-based data.","authors":"Hyeon Chang Kim,&nbsp;So Mi Jemma Cho,&nbsp;Hokyou Lee,&nbsp;Hyeok-Hee Lee,&nbsp;Jongmin Baek,&nbsp;Ji Eun Heo","doi":"10.1186/s40885-021-00167-1","DOIUrl":"https://doi.org/10.1186/s40885-021-00167-1","url":null,"abstract":"","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"27 1","pages":"10"},"PeriodicalIF":4.2,"publicationDate":"2021-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40885-021-00167-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25530503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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