Hanieh Mohammadi, Florent Besnier, Thomas Vincent, Sarah Fraser, Anil Nigam, Frédéric Lesage, Louis Bherer
{"title":"The pulsatile brain, pulse pressure, cognition, and antihypertensive treatments in older adults: a functional NIRS study.","authors":"Hanieh Mohammadi, Florent Besnier, Thomas Vincent, Sarah Fraser, Anil Nigam, Frédéric Lesage, Louis Bherer","doi":"10.1038/s41371-024-00985-4","DOIUrl":"https://doi.org/10.1038/s41371-024-00985-4","url":null,"abstract":"<p><p>Age-related arterial stiffness increases pulsatility that reaches the cerebral microcirculation, compromises cerebrovascular health and lead to cognitive decline. The presence of cardiovascular risk factors (CVRFs) such as high blood pressure can exacerbate this effect. Despite extensive research on the impact of antihypertensive treatments on reducing arterial stiffness, little is known about the impact of antihypertensive treatments on pulsatility in cerebral microcirculation. This study investigated the impact of antihypertensive treatments on cerebral pulsatility and cognition in older adults with CVRFs. Participants were 42 older adults with diverse CVRFs in two groups of untreated (n = 21, mean 67.2 ± 5.9 years old, 57.1% female) and treated with antihypertensive medications (n = 21, mean 67.2 ± 5.5 years old, 61.1% female). Cognitive scores of processing speed and executive functions were evaluated behaviorally using the four subsets of the Stroop test. A near-infrared spectroscopy (NIRS) device recorded hemodynamics data from the frontal and motor cortex subregions. The data were then used to extract an optical index of cerebral pulsatility. Results indicated that after controlling for CVRFs, the antihypertensive treatment was associated with lower cerebral pulsatility (untreated 33.99 ± 6.68 vs. treated 28.88 ± 5.39 beats/min, p = 0.009). In both groups cerebral pulsatility was associated with pulse pressure (p < 0.05). Also, treated group had significantly higher cognitive scores in executive functions compared with the untreated group (p < 0.05). These results suggest that beyond its known effect on blood pressure, antihypertensive treatments might also favor cerebrovascular health by reducing pulsatility in the cerebral microcirculation.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olayinka Rasheed Ibrahim, Kojo Awotwi Hutton-Mensah, Funmi Temidayo Adeniyi, George Bediako Nketiah, Adaku M Nwankwo, Abukari Yakubu Natogmah, James Ayodele Ogunmodede, Dike Ojji, Adesola Olumide, Biodun Sulyman Alabi, Daniel F Sarpong, Olugbenga Ayodeji Mokuolu
{"title":"Red cell distribution width as a cardiovascular risk predictor in adults with hypertension in sub-Saharan Africa.","authors":"Olayinka Rasheed Ibrahim, Kojo Awotwi Hutton-Mensah, Funmi Temidayo Adeniyi, George Bediako Nketiah, Adaku M Nwankwo, Abukari Yakubu Natogmah, James Ayodele Ogunmodede, Dike Ojji, Adesola Olumide, Biodun Sulyman Alabi, Daniel F Sarpong, Olugbenga Ayodeji Mokuolu","doi":"10.1038/s41371-025-00987-w","DOIUrl":"https://doi.org/10.1038/s41371-025-00987-w","url":null,"abstract":"<p><p>Red cell distribution width (RDW) quantifies the degree of variation in erythrocyte size, is identified as a potential marker of adverse cardiovascular events, and may be a surrogate marker for assessing cardiovascular disease (CVD) risk in low-resource settings. We evaluated RDW as a predictor of CVD risk compared to the World Health Organization (WHO) CVD risk score among adults with hypertension attending primary healthcare centers (PHCs) in Ghana and Nigeria. Adults with hypertension attending selected PHCs in Ghana and Nigeria participated in a cross-sectional study. Each participant underwent blood pressure (BP) measurement and laboratory evaluation (RDW, total cholesterol, and fasting blood sugar) following standard methods. We recruited 319 adults aged 40-74 years from the study sites. The mean (standard deviation) RDW was 13.96 (1.1%). The median CVD risk score was 8.11% [interquartile range (IQR) 4.00 to 11.00]. For participants with hemoglobin (Hb) levels ≥ 12 g/dL, RDW showed positive correlations with age (r = 0.136; p = 0.042); systolic BP (r = 0.183; p = 0.006), diastolic BP (r = 0.206, p = 0.002) and WHO CVD risk scores (r = 0.166, p = 0.013). Multiple linear regression showed an independent association between RDW and WHO CVD risk scores with an upward gradient, and was most significant at 3rd quartiles. Using receiver operating characteristic curve, the C-statistic was 0.673 (95% confidence interval: 0.618 to 0.724), p = 0.031. With a cut-off of >14, the RDW demonstrated a sensitivity of 81.82% and specificity of 55.84%. This study shows that at Hb levels ≥ 12 g/dL, RDW modestly predicted CVD risk in adults with hypertension in sub-Saharan Africa.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hong Fang, Omer Cavdar, Zhiping Yao, Xuewei Zhu, Yi Shen, Chi Liu
{"title":"Angiotensin type 1 and type 2 receptors-induced mitochondrial dysfunction promotes ferroptosis in cardiomyocytes.","authors":"Hong Fang, Omer Cavdar, Zhiping Yao, Xuewei Zhu, Yi Shen, Chi Liu","doi":"10.1038/s41371-024-00982-7","DOIUrl":"https://doi.org/10.1038/s41371-024-00982-7","url":null,"abstract":"<p><p>Previous studies suggest that ferroptosis is involved in cardiovascular diseases. The aim of the present study is to investigate the causal relationship between angiotensin II type 1 and type 2 receptors (AT<sub>1/2</sub>R) activities and mitochondrial dysfunction in induction of cardiomyocyte ferroptosis. Human AC16 cardiomyocytes were first pre-treated with an AT<sub>1/2</sub>R blockers, before stimulated with angiotensin II (Ang II) for 24 h. The redox status of the cardiomyocytes were assessed by measuring the cellular malondialdehyde (MDA), superoxide dismutase (SOD), and Nicotinamide-adenine dinucleotide phosphate, (NADPH) levels using biochemical methods. Mitochondrial reactive oxygen specifics (mitROS), mitochondrial memebrane potential, and Fe<sup>2+</sup> levels were determined using flow cytometry. The signaling pathways, including the glutathione peroxidase 4 (GPX4), heme oxygenase-1 (HO-1), sirtuin1, and ferroptosis suppressor protein 1 (FSP1)-coenzyme Q10 (CoQ10) pathways, were evaluated using western blotting. Our results demonstrated that Ang II significantly elevated the levels of MDA, Fe<sup>2+</sup>, mitoROS, and FtMt and markedly reduced SOD, NADPH, mitochondrial membrane potential, GPX4, HO-1, Sirt1, SFXN1, Nrf2, and FSP1 levels in cardiomyocyte, which were reversed by blockade of AT<sub>1/2</sub>R. Our results suggest that AT<sub>1/2</sub>R signaling can induce myocardial ferroptosis by impairing mitochondrial function via multiple signaling pathways, including the cyst (e)ine /GSH/GPX4 axis and FSP1/coenzyme Q10 (CoQ10) axis.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cemalettin Yılmaz, Büşra Güvendi Şengör, Ahmet Karaduman, Muhammet Mücahit Tiryaki, Barkın Kültürsay, Tuba Unkun, Regayip Zehir
{"title":"Association of wide pulse pressure with coronary collateral flow in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention.","authors":"Cemalettin Yılmaz, Büşra Güvendi Şengör, Ahmet Karaduman, Muhammet Mücahit Tiryaki, Barkın Kültürsay, Tuba Unkun, Regayip Zehir","doi":"10.1038/s41371-024-00986-3","DOIUrl":"https://doi.org/10.1038/s41371-024-00986-3","url":null,"abstract":"<p><p>Coronary collateral flow (CCF) is crucial for myocardial viability in patients with obstructive coronary artery disease, specifically ST-elevation myocardial infarction (STEMI). However, hypertension can contribute to vascular dysfunction and hinder the formation of CCF. Wide pulse pressure (WPP), defined as ≥65 mmHg, may better reflect impaired cardiovascular health compared to classic blood pressure indices. The effect of WPP on CCF remains unclear. Therefore, we aimed to evaluate the impact of WPP on CCF. This retrospective study included 1180 STEMI patients that underwent primary percutaneous coronary intervention (PCI) between 2021 and 2023 at a tertiary healthcare center. Patients were classified into good and poor CCF groups based on the Rentrop classification. Out of these patients, 272 (23.1%) had good CCF, while 908 (76.9%) had poor CCF. Two distinct models were constructed using multivariable logistic regression analysis to identify independent predictors of good CCF, including pulse pressure (Model 1) and WPP (Model 2). Covariates such as age, gender, diabetes mellitus, smoking, pre-infarction angina, Killip Class 3/4, multivessel disease, peak troponin, pre-thrombolysis in myocardial infarction (TIMI) flow 0, and previous PCI were added to both models. WPP was identified as an independent predictor that negatively influences good CCF (OR: 0.511, 95% CI: 0.334-0.783, p = 0.002). Moreover, diabetes, pre-infarction angina, Killip class III/IV, multivessel disease, and pre-TIMI flow 0 were also found to be independent predictors of CCF. WPP, derived from blood pressure measurements, has been associated with poor CCF in STEMI patients undergoing primary PCI and may serve as a predictor of poor CCF.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luca Faconti, Jacob George, Sarah Partridge, Carmen Maniero, Abilash Sathyanarayanan, Spoorthy Kulkarni, Vikas Kapil, Alfredo Petrosino, Philip Lewis, Terry McCormack, Neil R. Poulter, Anthony Heagerty, Ian B. Wilkinson
{"title":"Investigation and management of resistant hypertension: British and Irish Hypertension Society position statement","authors":"Luca Faconti, Jacob George, Sarah Partridge, Carmen Maniero, Abilash Sathyanarayanan, Spoorthy Kulkarni, Vikas Kapil, Alfredo Petrosino, Philip Lewis, Terry McCormack, Neil R. Poulter, Anthony Heagerty, Ian B. Wilkinson","doi":"10.1038/s41371-024-00983-6","DOIUrl":"10.1038/s41371-024-00983-6","url":null,"abstract":"People living with resistant hypertension (RH) are at high risk of adverse cardiovascular events. The British and Irish Hypertension Society has identified suspected RH as a condition for which specialist guidance may improve rates of blood pressure control and help clinicians identify those individuals who may benefit from specialist review. In this position statement we provide a practical approach for the investigation and management of adults with RH. We highlight gaps in the current evidence and identify important future research questions. Our aim is to support the delivery of high-quality and consistent care to people living with RH across the UK and Ireland.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 1","pages":"1-14"},"PeriodicalIF":2.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00983-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dellaneira Setjiadi, Colin Geddes, Christian Delles
{"title":"Blood pressure measurement technique in clinical practice in the NHS Greater Glasgow and Clyde.","authors":"Dellaneira Setjiadi, Colin Geddes, Christian Delles","doi":"10.1038/s41371-024-00984-5","DOIUrl":"https://doi.org/10.1038/s41371-024-00984-5","url":null,"abstract":"<p><p>Blood pressure (BP) measurement is a common procedure conducted in various disciplines and is widely available on clinical reports. The diagnosis and management of hypertension require reliable measurement of BP in outpatient clinics. Published studies suggest the standardised method for BP measurement is difficult to apply in routine clinical practice. This study aimed to assess the current practice of BP measurement in outpatient clinics in relevant secondary care clinical specialties across the 15 separate hospital sites of the NHS Greater Glasgow and Clyde region (population 1.2 million) compared to the recommended standardised method. An online questionnaire was developed and disseminated to the supervising clinician of each of 268 regular outpatient clinics. The questionnaire focused on the standardised BP method (patient preparation, environment, and BP measurement technique). The questionnaire was returned for 110 clinics. 73 (66.4%) of the participating clinics measure BP routinely and these formed the basis for further analysis. 3 clinics (4.1%) apply all components of the standardised BP method. 5 (6.9%) clinics deliver advice to patients prior to clinic attendance on how to prepare for BP measurement. 61 (83.6%) of participating clinics have a dedicated quiet environment for BP measurement. 50 (68.5%) clinics always place the cuff on bare upper arm and 63.0% use a cuff size appropriate to upper arm circumference. In a wide range of secondary care out-patient clinic settings, we found that BP measurement rarely adheres to the recommended standards. This has important implications for the quality of treatment decisions that are based on BP measurement.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J Minetto, W Espeche, C E Leiva Sisnieguez, G Cerri, J I Perez Duhalde, D Olano, M R Salazar
{"title":"\"Clinical prediction model for masked hypertension diagnosed by 24-h ambulatory blood pressure measurements in a sample from specialized hospital.\"","authors":"J Minetto, W Espeche, C E Leiva Sisnieguez, G Cerri, J I Perez Duhalde, D Olano, M R Salazar","doi":"10.1038/s41371-024-00980-9","DOIUrl":"https://doi.org/10.1038/s41371-024-00980-9","url":null,"abstract":"<p><p>The conventional assessment of the relationship between arterial hypertension (AH) and cardiovascular damage has predominantly relied on office measurements. However, the diagnostic significance of ambulatory and home measurements has gained prominence, particularly in identifying distinct AH phenotypes like masked hypertension (MH), characterized by normal office values but elevated readings outside the clinical setting, carrying comparable risks to sustained AH. Current guidelines advocate for Ambulatory Blood Pressure Monitoring (ABPM) in individuals with office values exceeding 130/85 mmHg. This study aims to develop a clinical prediction model to identify masked hypertension in individuals with normal office blood pressure and to create a clinical score.A cross-sectional study was conducted in a secondary level hospital, including patients aged 18-85 years with average office blood pressure <140/90 mmHg who underwent a valid ABPM on the same day. Pregnant and postpartum women were excluded. A multivariable logistic regression model with calibration, discrimination, and stability parameters was applied to predict masked hypertension. 506 individuals with valid ABPM were analysed. The prevalence of masked hypertension was 30.8%. The selected variables were: diastolic blood pressure, pulse pressure, waist diameter and sex. The model calibrated adequately (Hosmer-Lemeshow test p = 0.35), with an AUC of 0.72 (95% CI, 0.67-0.77). Significant differences existed between the traditional and the new models (p < 0.001). A user-friendly clinical model was developed, with a clinical score achieving 90% specificity using an estimated probability of 0.4 with a 10-point score.A novel model, performed with easily collectable clinical variables, showed robust calibration, stability, and discrimination. It outperforms sole reliance on office blood pressure, exhibiting high specificity (~90%) for masked hypertension detection. Its internal validity suggests a potential for enhanced masked hypertension identification.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preventing troublesome variability in clinical blood pressure measurement","authors":"Chengyu Liu, Jian Liu, Jianqing Li, Alan Murray","doi":"10.1038/s41371-024-00978-3","DOIUrl":"10.1038/s41371-024-00978-3","url":null,"abstract":"The importance of accurate blood pressure (BP) measurement is well-established. However, there is little quantitative comparative data on the influence of different measurement conditions on BP or the stability of the oscillometric pulse waveform from which BP is calculated. This study investigates the effect of six different measurement conditions (Quiet, Reading, Speaking, Deep Breathing, Moving, and Tapping) on BP readings in 30 healthy normotensive subjects. We hypothesize that non-standard conditions will result in significant deviations in BP measurements compared to the Quiet condition. Additionally, the quality and stability of the oscillometric waveform were assessed by evaluating the smoothness of the oscillometric pulse waveform characteristics during cuff deflation. Compared with the Quiet condition, all others resulted in significantly higher blood pressures, except for the respiratory condition, which resulted in significantly lower BPs. Average subject systolic BP (SBP) rose from 117.4 ± 6.0 mmHg for the Quiet condition to 129.7 ± 7.2 mmHg for the light finger tapping condition, P < 0.00001. Overall, changes for diastolic BP (DBP) were not significant. For the quality Noise indicator, all conditions in comparison with the Quiet condition were significantly noisier, increasing from 0.144 ± 0.024 to 1.055 ± 0.308 mmHg, P < 0.00001. Changes in SBP were significantly correlated to changes in quality Noise (r = 0.965, P < 0.001). This study confirms the importance of following international BP measurement guidelines, providing quantitative data showing significant changes in BP when guidelines are not followed. A method for assessing the quality of the measurement is also demonstrated, and shows that BP changes are significantly related to changes in the quality indicator.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 1","pages":"72-77"},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"U-shaped association between blood pressure and all-cause mortality in older adults: the Shizuoka study","authors":"Aya Shoji-Asahina, Takeshi Usui, Yasuharu Tabara","doi":"10.1038/s41371-024-00979-2","DOIUrl":"10.1038/s41371-024-00979-2","url":null,"abstract":"Low blood pressure (BP) is suggested to be associated with all-cause mortality in older adults. The aim of this study is to validate the relationship in older adults and to examine the possible involvement of clinical characteristics, namely functional disability, comorbidities, antihypertensive treatment, and reverse causation, in the relationship using insurance claims data including annual health checkup data. The study participants were 337,975 individuals aged ≥65 years. The earliest day of participation in the annual health checkup from 2012 to 2020 was determined at baseline. Data on comorbidities, functional disability levels, prescribed antihypertensive medications, and incidence of stroke, myocardial infarction and all-cause mortality were obtained from the insurance claims. During a mean follow-up period of 5.3 years, there were 27,495 cases of all-cause mortality, 9000 cases of stroke and 1640 cases of myocardial infarction. A U-shaped association was observed between systolic BP and all-cause mortality in participants aged ≥75 years and the hazard ratio calculated systolic BP 120–129 mmHg as reference was 1.14 for <110 mmHg and 1.16 for ≥150 mmHg (all P < 0.001). The U-shaped association remained significant in the sub-analyses of individuals without severe comorbidities, antihypertensive treatment, or functional disability. Similar results were observed in the analysis excluding early-mortality cases. In contrast, the risk of stroke and myocardial infarction increased linearly with increasing BP. Low BP was associated with all-cause mortality in older adults. The U-shaped association may not be solely attributed to the previously suggested factors, including antihypertensive treatment, potential comorbidities, and functional disability.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 1","pages":"66-71"},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Bentzel, Karin Manhem, Ottilia Öhman, Karzan Abdulla, Georgios Mourtzinis
{"title":"High blood pressure in the emergency department as an opportunistic screening tool for detection of hypertension","authors":"Sara Bentzel, Karin Manhem, Ottilia Öhman, Karzan Abdulla, Georgios Mourtzinis","doi":"10.1038/s41371-024-00977-4","DOIUrl":"10.1038/s41371-024-00977-4","url":null,"abstract":"Hypertension is the most preventable cause of morbidity and mortality, but many individuals are underdiagnosed and lack treatment control. High blood pressure (BP) in the emergency department (ED) is commonly observed, but mostly used for short-term evaluation. We aimed to study the usefulness of high BP in the ED as a screening tool for undiagnosed hypertension. We used the electronic medical record system to identify all patients that had attended the ED at a university hospital from 2018-01-01 to 2018-03-31 and from 2018-07-01 to 2018-09-30 with an obtained systolic BP ≥ 160 and/or diastolic BP ≥ 100 mmHg measured at the ED. We excluded patients with previously diagnosed hypertension and patients on BP-lowering medication. All patients identified where contacted two years after attending the ED, with a letter of consent and a questionnaire regarding diagnosis of hypertension and current medication. 5424 patients attended the ED during the 6-months-period. 271 patients met the inclusion criteria and were asked to participate. 167 individuals (62%) agreed to participate and responded to the questionnaire. Mean age of participants were 63.1 years and 51% were women. 134 patients (80%) had measured their BP after the ED-visit, and 48 (36%) of those had been diagnosed with hypertension. 96% of patients diagnosed with hypertension were on BP-lowering medication. To follow-up BP ≥ 160/100 mmHg after an ED visit can reveal undiagnosed hypertension in one third of the patients. Given the amount of undiagnosed hypertension, an ED-measured BP might provide an important tool to detect and start treatment of hypertension.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 1","pages":"46-50"},"PeriodicalIF":2.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-024-00977-4.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}