Clinical Hypertension最新文献

{"title":"Withdrawal of antihypertensive medication in young to middle-aged adults: a prospective, single-group, intervention study.","authors":"Hae-Young Lee,&nbsp;Kyoung Suk Lee","doi":"10.1186/s40885-022-00225-2","DOIUrl":"https://doi.org/10.1186/s40885-022-00225-2","url":null,"abstract":"<p><strong>Background: </strong>Although antihypertensive drug therapy is commonly believed to be a life-long therapy, several recent guidelines have suggested that antihypertensive medications can be gradually reduced or discontinued for some patients whose blood pressure (BP) is well-controlled for an extended period. Thus, this pilot study aimed to describe the success rate of antihypertensive drug discontinuation over 6 months among young and middle-aged patients with hypertension.</p><p><strong>Methods: </strong>This was a prospective, single-group, intervention study. Patients were eligible for inclusion if their cardiologist judged them to be appropriate candidates for this study, their BP had been controlled both in the office (< 140/90 mmHg) and 24-h ambulatory BP monitoring (< 135/85 mmHg) for at least 6 months with a single tablet dose of antihypertensive medication. A total of 16 patients withdrew their antihypertensive medications at baseline after they received the education, and were followed up over 6 months. After the follow-ups, six patients participated in the in-depth interview.</p><p><strong>Results: </strong>The likelihood of remaining normotensive at 30, 90, 180, and 195 days was 1.00, 0.85, 0.51, and 0.28, respectively. There were also no significant differences in baseline characteristics and self-care activities over time between normotensive (n = 8) and hypertensive groups (n = 8). In the interview, most patients expressed ambivalent feelings toward stopping medications. Psychological distress (e.g., anxiety) was the primary reason for withdrawal from this study although the patients' BP was under control.</p><p><strong>Conclusions: </strong>We found that only a limited portion of antihypertensive patients could stop their medication successively over 6 months. Although we could not identify factors associated with success in maintaining BP over 6 months, we believe that careful selection of eligible patients may increase success in stopping antihypertensive medications. Also, continuous emotional support might be essential in maintaining patients' off-medication.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"29 1","pages":"1"},"PeriodicalIF":4.2,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9806446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10489474","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}

{"title":"Spousal concordance of ideal cardiovascular health metrics: findings from the 2014-2019 Korea National Health and Nutrition Examination Survey.","authors":"Manh Thang Hoang,&nbsp;Hokyou Lee,&nbsp;Hyeon Chang Kim","doi":"10.1186/s40885-022-00224-3","DOIUrl":"https://doi.org/10.1186/s40885-022-00224-3","url":null,"abstract":"<p><strong>Backgrounds: </strong>We aimed to investigate whether a spouse's cardiovascular health (CVH) metrics status affects the other spouse's ideal CVH using a Korea nationwide representative survey.</p><p><strong>Methods: </strong>We used the health data of 6,030 married couples who participated in the Korea National Health and Nutrition Examination Survey from 2014 to 2019. The CVH was defined using seven metrics: smoking status, blood pressure, body mass index, total cholesterol, fasting blood glucose, physical activity, and diet, following the American Heart Association guidelines and modifications for body mass index cutoffs and diet quality. The CVH score was calculated on a scale ranging from 0 to 7, with the ideal CVH defined as attaining ideal scores in at least five CVH metrics. Multiple logistic regression analyses were used to assess whether husband's ideal CVH was associated with his wife's odds for having ideal CVH, and vice versa.</p><p><strong>Results: </strong>The mean CVH scores were 3.2 and 4.0 for husband and wife, respectively. After fully adjusting for age and education of both partners and household income, husbands had 1.49 times (95% confidence interval [CI], 1.27-1.69) higher odds of achieving ideal CVH if their wives had also achieved ideal CVH. Meanwhile, wives whose husbands achieved ideal CVH also had 1.46 times (95% CI, 1.27-1.69) higher odds of achieving ideal CVH. Nonsmoking (57.17%), ideal fasting blood glucose level (34.93%), and ideal diet intake (24.18%) were the most concordant CVH metrics among spouses.</p><p><strong>Conclusions: </strong>Our study found a significant spousal concordance of ideal CVH in Korean married couples. This finding supports the use of a couple-based interventional strategy targeted to promote CVH.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"28 1","pages":"41"},"PeriodicalIF":4.2,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9753352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10367212","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}

{"title":"Association of the magnitude of the difference in blood pressure between office and ambulatory measurements with blood pressure variability in untreated individuals.","authors":"Yea Je Lee,&nbsp;Moo-Yong Rhee,&nbsp;Je Sang Kim,&nbsp;Ungjeong Do,&nbsp;Ji-Hyun Kim,&nbsp;Byong-Kyu Kim,&nbsp;Hae-Young Kim","doi":"10.1186/s40885-022-00220-7","DOIUrl":"https://doi.org/10.1186/s40885-022-00220-7","url":null,"abstract":"<p><strong>Objectives: </strong>We evaluated the association between cardiovascular risk factors and the magnitude of the difference in systolic blood pressure (SBP) between office and ambulatory measurements (masked effect) in untreated individuals without apparent hypertension-mediated organ damage (HMOD).</p><p><strong>Methods: </strong>The inclusion criteria were 1) age ≥ 20 years, 2) blood pressure ≥ 140/90 mmHg at the outpatient clinic, and 3) not receiving antihypertensive medications. The difference between office and ambulatory SBP was calculated by subtracting the ambulatory daytime SBP from the office SBP. The association between the masked effect and SBP variability was analyzed in individuals without HMOD (no electrocardiographic left ventricular hypertrophy, spot urine albumin-to-creatinine ratio < 30 mg/g, and estimated glomerular filtration rate ≥ 60 mL/min/1.73 m², n = 296).</p><p><strong>Results: </strong>Among the cardiovascular risk factors, ambulatory BP variability was significantly correlated with the SBP difference. The standard deviation (SD) and coefficient of variation (cv) of 24-h SBP exhibited a significant negative linear association with the SBP difference in univariate and multivariate analyses adjusted for age, sex, presence of diabetes, and 24-h ambulatory SBP. A significant association was observed in patients with ambulatory daytime hypertension. In the multivariate analysis, individuals with a negative SBP difference > -5 mmHg exhibited a higher SD and cv of 24-h SBP than those with a negative SBP difference ≤ -5 mmHg or a positive SBP difference.</p><p><strong>Conclusions: </strong>The results of our study suggest that the magnitude of the negative difference in office and ambulatory SBP may be a potential risk factor, even in individuals without apparent HMOD.</p><p><strong>Trial registration: </strong>This trial is registered with ClinicalTrials.gov ( NCT03855605 ).</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"28 1","pages":"36"},"PeriodicalIF":4.2,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9753313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10360730","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}

{"title":"Assessment of brain natriuretic peptide and copeptin as correlates of blood pressure in chronic hypertensive pregnant women.","authors":"Chika J Okwor, Kayode S Adedapo, Oluwasomidoyin O Bello, Ijeoma A Meka, Chukwuemeka V Okwor, Chukwuemelie Z Uche, Chiebonam E Nwajiobi, Uloaku A Nto-Ezimah, Chisom E Uchechukwu, Ekene J Arum","doi":"10.1186/s40885-022-00221-6","DOIUrl":"10.1186/s40885-022-00221-6","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive disorders of pregnancy including preexisting (or chronic) hypertension are the most common complication encountered during pregnancy that contribute significantly to maternal and perinatal morbidity and mortality. Brain natriuretic peptide (BNP) and copeptin have been investigated as biomarkers in various hypertensive disorders, but studies of their clinical value in chronic hypertensive pregnant women are sparce. This study aimed to assess the levels of BNP and copeptin in chronic hypertensive pregnant women and investigate their correlation with blood pressure (BP) in chronic hypertensive pregnant women in South Western Nigeria.</p><p><strong>Methods: </strong>One hundred and sixty consenting pregnant women in their third trimester of pregnancy, grouped into those with chronic hypertension (n = 80) and normotensive (n = 80), were recruited for this cross-sectional study. Age and clinical characteristics were obtained, and blood was aseptically drawn for BNP and copeptin measurement using enzyme-linked immunosorbent assay. Data was analyzed with IBM SPSS ver. 20.0. Data was analyzed using Student t-test, chi-square, and Pearson correlation test as appropriate. Statistical significance was set at P < 0.05.</p><p><strong>Results: </strong>The mean systolic BP (SBP) and diastolic BP (DBP) were significantly higher in pregnant women with chronic hypertension (158.30 ± 3.51 and 105.08 ± 2.47 mmHg, respectively) compared with normotensive pregnant women (100.72 ± 3.02 and 70.29 ± 1.96 mmHg, respectively). The mean levels of BNP and copeptin were higher in pregnant women with chronic hypertension (57.26 ± 3.65 pg/mL and 12.44 ± 1.02 pmol/L, respectively) compared with normotensive pregnant women (49.85 ± 2.44 pg/mL and 10.25 ± 1.50 pmol/L, respectively) though not statistically significant. Correlations observed between SBP and DBP with levels of BNP (r = 0.204, P = 0.200; r = 0.142, P = 0.478) and copeptin (r = - 0.058, P = 0.288; r = 0.045, P = 0.907) were not statistically significant.</p><p><strong>Conclusions: </strong>There was no association between BP and the levels of BNP and copeptin in pregnant women with chronic hypertension who were already on antihypertensive treatment, with the implication that antihypertensive treatment may modulate BNP and copeptin release despite significantly elevated BP levels.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"28 1","pages":"37"},"PeriodicalIF":2.6,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9753280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10712250","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}

{"title":"Immediate pressor response to oral salt and its assessment in the clinic: a time series clinical trial.","authors":"Sepiso K Masenga,&nbsp;Leta Pilic,&nbsp;Benson M Hamooya,&nbsp;Selestine Nzala,&nbsp;Douglas C Heimburger,&nbsp;Wilbroad Mutale,&nbsp;John R Koethe,&nbsp;Annet Kirabo,&nbsp;Sody M Munsaka,&nbsp;Fernando Elijovich","doi":"10.1186/s40885-022-00209-2","DOIUrl":"https://doi.org/10.1186/s40885-022-00209-2","url":null,"abstract":"<p><strong>Background: </strong>High blood pressure (BP) is associated with high-salt consumption especially in sub-Saharan Africa. Although the pressor effect of salt is viewed as a chronic effect, some studies suggest that a salty meal may increase BP immediately in some individuals, and that this effect may cause endothelial dysfunction. Therefore, the aim of our research was to study the immediate pressor response to oral salt (IPROS) and its determinants, with the expectation that a simple methodology may be devised to diagnose it in the clinic or in low-resource environments.</p><p><strong>Methods: </strong>We conducted a time series trial at Livingstone Central Hospital. We present data in 127 normotensive participants who ingested 2 g of sodium chloride; their BP was monitored for 120 minutes in intervals of 10 minutes. Sociodemographic and clinical data were collected. Descriptive and inferential statistics were used for analyses of data.</p><p><strong>Results: </strong>Median age was 30 years (interquartile range, 22-46 years) and 52% were female patients. An increase of ≥10 mmHg in mean arterial pressure (MAP), considered a clinically significant IPROS, was present in 62% of participants. Systolic BP 30 minutes after the salt load was a significant predictor of IPROS, avoiding the need to calculate MAP in the clinic setting.</p><p><strong>Conclusions: </strong>We confirm the presence of an IPROS in a high proportion (62%) of otherwise normotensive participants. The average time course for this response was 30 minutes and its duration was sustained for the 120-minutes period of study in most of the participants. Prediction of IPROS by ∆SBP (change in systolic blood pressure) at 30 minutes allows for easy assessment of possible responder status in the clinic. Our data indicate that the IPROS to oral salt-loads in the range currently consumed by the Western world and African populations in single meals may increase the 24-hour BP load, which is a risk factor for hypertension and target organ damage. The relevance of our findings indicates the need to include dietary sodium assessment in the diagnosis, prevention, and management of high BP.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"28 1","pages":"25"},"PeriodicalIF":4.2,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10603974","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}

{"title":"Association between ethnicity and hypertension in Northern Colombia in 2015","authors":"Drew H. Smith, Jaskaran Grewal, Saba Mehboob, Shiva Mohan, L. Pombo, Pura Rodriguez, J. González, J. Zevallos, N. Barengo","doi":"10.1186/s40885-022-00203-8","DOIUrl":"https://doi.org/10.1186/s40885-022-00203-8","url":null,"abstract":"","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43386615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing self-reported and measured hypertension and hypercholesterolaemia at standard and more stringent diagnostic thresholds: the cross-sectional 2010–2015 Busselton Healthy Ageing study","authors":"Angela J Burvill, K. Murray, M. Knuiman, J. Hung","doi":"10.1186/s40885-022-00199-1","DOIUrl":"https://doi.org/10.1186/s40885-022-00199-1","url":null,"abstract":"","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41991137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risks and management of hypertension in cancer patients undergoing targeted therapy: a review","authors":"Xiaolei Zhu, Shenhong Wu","doi":"10.1186/s40885-022-00197-3","DOIUrl":"https://doi.org/10.1186/s40885-022-00197-3","url":null,"abstract":"","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47391130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating 25-hydroxyvitamin D levels and hypertension risk after adjusting for publication bias","authors":"J. Bae","doi":"10.1186/s40885-022-00196-4","DOIUrl":"https://doi.org/10.1186/s40885-022-00196-4","url":null,"abstract":"","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2022-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43647936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions in hypertension: systematic review and meta-analysis of natural and quasi-experiments.","authors":"Tong Xia, Fan Zhao, Roch A Nianogo","doi":"10.1186/s40885-022-00198-2","DOIUrl":"10.1186/s40885-022-00198-2","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is an urgent public health problem. Consistent summary from natural and quasi-experiments employed to evaluate interventions that aim at preventing or controlling hypertension is lacking in the current literature. This study aims to summarize the evidence from natural and quasi-experiments that evaluated interventions used to prevent or control hypertension.</p><p><strong>Methods: </strong>We searched PubMed, Embase and Web of Science for natural and quasi-experiments evaluating interventions used to prevent hypertension, improve blood pressure control or reduce blood pressure levels from January 2008 to November 2018. Descriptions of studies and interventions were systematically summarized, and a meta-analysis was conducted.</p><p><strong>Results: </strong>Thirty studies were identified, and all used quasi-experimental designs including a difference-in-difference, a pre-post with a control group or a propensity score matching design. Education and counseling on lifestyle modifications such as promoting physical activity (PA), promoting a healthy diet and smoking cessation consultations could help prevent hypertension in healthy people. The use of computerized clinical practice guidelines by general practitioners, education and management of hypertension, the screening for cardiovascular disease (CVD) goals and referral could help improve hypertension control in patients with hypertension. The educating and counseling on PA and diet, the monitoring of patients' metabolic factors and chronic diseases, the combination of education on lifestyles with management of hypertension, the screening for economic risk factors, medical needs, and CVD risk factors and referral all could help reduce blood pressure. In the meta-analysis, the largest reduction in blood pressure was seen for interventions which combined education, counseling and management strategies: weighted mean difference in systolic blood pressure was - 5.34 mmHg (95% confidence interval [CI], - 7.35 to - 3.33) and in diastolic blood pressure was - 3.23 mmHg (95% CI, - 5.51 to - 0.96).</p><p><strong>Conclusions: </strong>Interventions that used education and counseling strategies; those that used management strategies; those that used combined education, counseling and management strategies and those that used screening and referral strategies were beneficial in preventing, controlling hypertension and reducing blood pressure levels. The combination of education, counseling and management strategies appeared to be the most beneficial intervention to reduce blood pressure levels.</p>","PeriodicalId":10480,"journal":{"name":"Clinical Hypertension","volume":"28 1","pages":"13"},"PeriodicalIF":2.6,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9057066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10240181","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}