Journal of Clinical Hypertension最新文献

{"title":"A rapid review of telehealth in women with recent de novo hypertensive disease of pregnancy","authors":"Toluwalase Awoyemi MD, PhD,&nbsp;Samira Teeri MD,&nbsp;Emmanuel Daniel MD,&nbsp;Isaac Ogunmola MD,&nbsp;Ujunwa Ebili MD,&nbsp;Eloho Olojakpoke MD,&nbsp;Rocio Barriga Guzman MD,&nbsp;Francis Ezekwueme MD,&nbsp;Denise Nunes MS, RN, MSLIS","doi":"10.1111/jch.14886","DOIUrl":"10.1111/jch.14886","url":null,"abstract":"<p>Hypertensive disorders of pregnancy pose significant risks to both maternal and fetal health. Postpartum hypertension, a common complication, often leads to emergency room (ER) visits or hospital readmissions. Despite the prevalence of these complications, there is a paucity of studies that focus on blood pressure monitoring in postpartum patients with de novo hypertensive disorders of pregnancy. This review aimed to address the gap by evaluating available evidence to compare telehealth monitoring with in-person visits in preventing ER visits and hospital readmissions among postpartum patients with de novo hypertensive disorders of pregnancy. The study identified relevant studies by conducting a rigorous search strategy (Medline/OVID, the Cochrane Library, Scopus, and research registries such as the International Clinical Trials Registry Platform [ICTRP] and clinical trials) directed by the clinical information specialist. Two reviewers independently screened titles and abstracts, resolving discrepancies with the assistance of a third reviewer. Data extraction followed standardized protocols, and risk of bias assessments were conducted using appropriate tools. This rapid review synthesized evidence from 11 studies on telehealth for women with recent de novo hypertensive disorders of pregnancy. Findings highlighted that telemonitoring led to earlier blood pressure documentation and intervention, reduced disparities in blood pressure measurement, decreased hypertension-related readmissions, higher rates of postpartum antihypertensive treatment initiation, and increased patient satisfaction. Telehealth emerges as a promising tool for managing postpartum hypertension among women with recent de novo hypertensive disorders of pregnancy</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 9","pages":"1015-1023"},"PeriodicalIF":2.7,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes of coagulation function and platelet parameters in preeclampsia and their correlation with pregnancy outcomes","authors":"Juan Peng MM,&nbsp;Quxi Zhao MM,&nbsp;Wei Pang MM,&nbsp;Yanjuan Li MM,&nbsp;Xudong Dong PhD","doi":"10.1111/jch.14893","DOIUrl":"10.1111/jch.14893","url":null,"abstract":"<p>Preeclampsia (PE) is a severe pregnancy complication characterized by significant alterations in coagulation function. This study aims to analyze the correlation between coagulation function, platelet parameters, and pregnancy outcomes in PE patients. Clinical data, along with blood and urine samples, were collected from 168 PE patients and 128 healthy pregnant women. General demographic and laboratory testing data were recorded, and maternal and fetal outcomes were followed up. Data were analyzed using Kaplan–Meier and logistic regression analyses. In mild PE patients, thrombin time (<i>p</i> = .000), platelet distribution width (PDW) (<i>p</i> = .000), and clot formation time (<i>p</i> = .000) were increased, while prothrombin time (<i>p</i> = .000) and fibrinogen (<i>p</i> = .045) were reduced. With increasing PE severity, prothrombin time (<i>p</i> = .000), platelet count (PLT) (<i>p</i> = .000), mean platelet volume (MPV) (<i>p</i> = .000), plateletcrit (<i>p</i> = .000), maximum amplitude (MA) (<i>p</i> = .000), and coagulation index (<i>p</i> = .001) decreased, whereas activated partial thromboplastin time (APTT) (<i>p</i> = .000), thrombin time (<i>p</i> = .002), D-dimer (<i>p</i> = .026), and PDW (<i>p</i> = .000) increased. Lower prothrombin time (<i>p</i> = .048), PLT (<i>p</i> = .004), and coagulation index (<i>p</i> = .026) or higher APTT (<i>p</i> = .032), thrombin time (<i>p</i> = .044), D-dimer (<i>p</i> = .023), and PDW (<i>p</i> = .016) were associated with a higher risk of poor pregnancy outcomes. Thrombin time was identified as an independent risk factor (<i>p</i> = .025, OR = 2.918, 95% CI: 1.145–7.436), whereas gestational age was an independent protective factor (<i>p</i> = .000, OR = 0.244, 95% CI: 0.151–0.395). This study demonstrates that specific coagulation and platelet parameters are significantly associated with PE severity and adverse pregnancy outcomes. These findings highlight the importance of monitoring coagulation function in PE patients to improve clinical management and outcomes.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 10","pages":"1181-1187"},"PeriodicalIF":2.7,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive significance of cardio ankle vascular index for the assessment of cardiovascular risk in hypertensive patients: A systematic review","authors":"Chiranjeevee R. Saravanan MBBS,&nbsp;Shubhayu R. Chowdhury MBBS,&nbsp;Pugazhendi Inban MD,&nbsp;Sai Harini Chandrasekaran MBBS,&nbsp;Himani H. Pattani MBBS,&nbsp;Krupanagram Santoshi MBBS,&nbsp;Hyma Bamba MBBS,&nbsp;Gurmehar Singh MBBS,&nbsp;Priyadarshi Prajjwal MBBS,&nbsp;Raunak Ranjan MD,&nbsp;Mohammed Dheyaa Marsool Marsool MBChB,&nbsp;Omniat Amir MBBS","doi":"10.1111/jch.14878","DOIUrl":"10.1111/jch.14878","url":null,"abstract":"<p>Cardio-ankle vascular index (CAVI) is an innovative indicator of large-artery stiffness, which is evaluated by the pulse wave velocity (PWV) measurement. Mortality and morbidity due to cardiovascular diseases among the general public with high-risk conditions such as hypertension are usually associated with arterial stiffness. CAVI modelizes the hazard of future cardiovascular events with standard risk factors. Additionally, the “European Society of Hypertension and Cardiology” included the aortic PWV assessment in managing hypertension in their updated guidelines in 2007. We conducted this systematic review to collect, summarize, and evaluate the evidence from relevant reported studies. A literature search of four databases was conducted comprehensively until February 2024. Cardiovascular events are the primary outcome of interest in this study, cardiovascular events that have been defined as major adverse cardiac events include “heart failure”, “stroke”, “myocardial infarction”, “cardiovascular deaths”, “stable angina pectoris”, “coronary revascularization”, and “unstable angina pectoris”. We included five studies with a 11 698 sample size in this systematic review. All five prospective studies investigated composite cardiovascular events as an outcome. Three of them revealed a statistically significant prediction ability of CAVI to assess Cardiovascular disease (CVD) risk. Further analysis is required. Current evidence is insufficient to confirm the predictive power of CAVI in the assessment of cardiovascular risk in hypertensive patients. CAVI is modestly associated with incidents of CVD risk. It is necessary to conduct further studies to assess CAVI concerning CVD predictor measures in the masses and nations other than Asia.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 9","pages":"1005-1014"},"PeriodicalIF":2.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14878","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of morning blood pressure surge in chronic kidney disease","authors":"Zhilan Ma MM,&nbsp;Yan Wang MM,&nbsp;Xiaoyan Guo MM,&nbsp;Lan Ma MM,&nbsp;Yonghua Liu MM,&nbsp;Xiaoling Zhou MM","doi":"10.1111/jch.14885","DOIUrl":"10.1111/jch.14885","url":null,"abstract":"<p>This was a retrospective study. This study investigated the occurrence of a composite endpoints (cardiovascular and cerebrovascular events, end-stage renal disease, and death) in 153 patients (aged ≥ 18 years) with a diagnosis of in chronic kidney disease (CKD). Based on morning blood pressure surge (MBPS) defined as ≥35 mm Hg, patients were divided into two groups: with MBPS (<i>n</i> = 50) and without MBPS (<i>n</i> = 103). All patients were followed up for at least 1 year. Baseline demographic, laboratory and follow-up data were collected. The clinical characteristics of the two groups were compared. The relationships between MBPS and endpoint events were analyzed using the Kaplan–Meier method and Cox regression model. In total, 153 patients (mean age 41.8 years; 56.86% males) were included in this study. During the follow-up period (mean 4.3 years), 34 endpoint events occurred. After adjustment for the covariates, the risk of cardiovascular and cerebrovascular events, end-stage renal disease and death remained significantly higher in patients with MBPS (hazard ratio [HR] and 95% confidence interval [CI] 3.124 [1.096–9.130]]) Among the other variables, systolic blood pressure, and night-time and daytime pulse pressures remained significantly associated with outcome in patients of CKD (1.789 [1.205–2.654], 1.710 [1.200–2.437], and 1.318 [1.096–1.586], respectively]. In conclusions, MBPS was identified as an independent prognostic factor for composite endpoint events (cardiovascular and cerebrovascular events, end-stage renal disease and death) patients with chronic kidney disease patients.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 10","pages":"1155-1162"},"PeriodicalIF":2.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fasting hypertriglyceridemia in relation to mortality in an elderly male Chinese population","authors":"Xin-Yu Wang MPH,&nbsp;Xiao-Fei Ye PhD,&nbsp;Wen-Yuan-Yue Wang MPH,&nbsp;Wei Zhang MD, PhD,&nbsp;Chang-Sheng Sheng MD, PhD,&nbsp;Qi-Fang Huang MD, PhD,&nbsp;Yan Li MD, PhD,&nbsp;Ji-Guang Wang MD, PhD","doi":"10.1111/jch.14887","DOIUrl":"10.1111/jch.14887","url":null,"abstract":"<p>We investigated fasting hypertriglyceridemia as predictors of all-cause, cardiovascular, and non-cardiovascular mortality in an elderly male Chinese population, while accounting for various conventional cardiovascular risk factors. Our participants were elderly men recruited from residents living in a suburban town of Shanghai (≥60 years of age, <i>n</i> = 1583). Hypertriglyceridemia was defined as a fasting serum triglycerides concentration ≥1.70 mmol/L. Subgroup analyses were performed according to current smoking (yes vs. no), alcohol intake (yes vs. no), and the presence and absence of hypertension and hyperglycemia. During a median of 7.9 years follow-up, all-cause, cardiovascular, and non-cardiovascular deaths occurred in 279, 112, and 167 participants, respectively. After adjustment for confounding factors, fasting hypertriglyceridemia was not significantly (<i>p</i> ≥ .33) associated with the risk of all-cause, cardiovascular, and non-cardiovascular mortality. However, there was significant (<i>p </i>= .03) interaction between hypertriglyceridemia and the presence and absence of hypertension in relation to all-cause mortality. In normotensive, but not hypertensive individuals, hypertriglyceridemia was significantly associated with a higher risk of all-cause mortality (hazard ratio 1.57, 95% confidence interval 1.06–2.31). In further non-parametric analyses in normotensive individuals, the age-standardized rate for all-cause mortality increased from 18.9 in quartile 1 to 20.0, to 24.7, and to 39.9 per 1000 person-years in quartiles 2, 3, and 4 of serum triglycerides concentration, respectively (<i>p</i>_trend= .0004). Similar results were observed for cardiovascular mortality. Our study in elderly male Chinese showed that fasting hypertriglyceridemia was associated with a higher risk of all-cause and cardiovascular mortality in patients with normotension but not those with hypertension.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 10","pages":"1163-1170"},"PeriodicalIF":2.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14887","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reported sleep duration and quality and cardiovascular diseases among middle-aged and older Chinese: A 7-year longitudinal cohort study","authors":"Zhe Lv MD, PhD,&nbsp;Yuqiang Ji MD, PhD,&nbsp;Chao Li MD, PhD,&nbsp;Zhao Zhao MM,&nbsp;Wanru Jia MM,&nbsp;Jingjing Hou MM,&nbsp;Hong Yan MD, PhD","doi":"10.1111/jch.14883","DOIUrl":"10.1111/jch.14883","url":null,"abstract":"<p>Cardiovascular disease (CVD) is a leading cause of death worldwide, and several studies have attempted to identify its risk factors. This study aimed to investigate the association between sleep duration and sleep quality, and the 7-year incidence of CVD among middle-aged and older Chinese individuals. A total of 6682 participants aged 45–90 years from the China Health and Retirement Longitudinal Study database were included in this study. The authors estimated sleep duration and quality based on self-reported data of night sleep hours and disturbance symptoms, and examined the associations between them and the composite outcome of CVD using logistic regression models. A total of 1692 participants (25.32%) reported new CVD events during follow-up. Short sleep duration (&lt; 6 h/night) was significantly associated with a higher risk of CVD in all three models (<i>p</i> &lt; .05). However, this was not observed for long sleep duration (&gt; 8 h/night). Additionally, participants with mild sleep disturbance in all three models, and severe sleep disturbance in Models 2 and 3 had a significantly higher risk of CVD (<i>p</i> &lt; .05). After stratification by age and daytime napping, we still found a significant association between short sleep duration and CVD in individuals aged 45–59 years, and between sleep disturbance and CVD in non-nappers (<i>p</i> &lt; .05). However, these associations were not significant in individuals aged ≥60 years or in nappers (<i>p</i> &gt; .05). In conclusion, short sleep duration and sleep disturbance are both associated with an increased risk of CVD in middle-aged and older Chinese individuals.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 10","pages":"1145-1154"},"PeriodicalIF":2.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of self-reported treated hypertension in the women's health initiative: Comparisons with medication inventories","authors":"Michael J. LaMonte PhD,&nbsp;Grace M. Milton MS,&nbsp;Connor R. Miller MS,&nbsp;Kathleen M. Hovey MS,&nbsp;Ahmed Soliman PharmD,&nbsp;Amy E. Millen PhD,&nbsp;Jean Wactawski-Wende PhD","doi":"10.1111/jch.14889","DOIUrl":"10.1111/jch.14889","url":null,"abstract":"<p>Few studies have reported on the accuracy of self-reported hypertension history among older postmenopausal women, which was this study's objective. Participants were postmenopausal women enrolled in the Osteoporosis and Periodontal Disease (OsteoPerio) study, an ancillary investigation of the Women's Health Initiative Observational Study (WHI-OS) at the Buffalo, New York, clinical site. Participants self-reported their history of physician diagnosed hypertension treated with medication at WHI-OS enrollment (1993–1998; <i>n</i> = 1342, mean age 63 years), then 3 years later at OsteoPerio enrollment (1997–2001; <i>n</i> = 1342), and again at OsteoPerio Year 5 follow-up (2002–2005; <i>n</i> = 1020). At each time point, medication inventories were recorded and served as the criterion with which self-report was compared in the present study. Physician diagnosed-treated hypertension was also self-reported annually on mailed health update questionnaires in the WHI-OS and were compared against medication inventory at the subsequent clinic exam. Of those participants who self-reported a history of hypertension at WHI enrollment, OsteoPerio enrollment, and OsteoPerio Year 5 follow-up, 41.2%, 90.3%, and 94.4%, respectively, had anti-hypertensive pills in their medication inventory. Across the three time points, sensitivity and specificity ranged from 0.72 to 0.98 and from 0.85 to 0.95, and kappa coefficients ranged from 0.52 to 0.79 when comparing self-report with medication inventory. For self-reported newly physician-diagnosed and treated hypertension on the annual health update questionnaire, 88.4% and 95.2% of those reporting hypertension had anti-hypertensive pills in the subsequent medication inventory. In general, sensitivity and kappa were lower in women aged ≥70 versus &lt; 70 years and in those with history of cardiovascular disease and diabetes compared to those without these comorbidities. In this cohort of postmenopausal women, self-reported physician diagnosed and treated hypertension demonstrated moderate to high accuracy when compared against anti-hypertensive medication use documented by pill inventory, particularly for those who were younger and managing fewer comorbidities.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 10","pages":"1171-1180"},"PeriodicalIF":2.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of baseline arterial elasticity (stiffness) on left ventricular functions in healthy subjects exposed to short-term extreme cold","authors":"Uğur Canpolat MD","doi":"10.1111/jch.14881","DOIUrl":"10.1111/jch.14881","url":null,"abstract":"&lt;p&gt;In the current issue of &lt;i&gt;The Journal of Clinical Hypertension&lt;/i&gt;, Chen et al.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; assessed the association of baseline blood pressure variability (BPV) with the changes in left heart functions after short-term extreme cold exposure. A total of 70 healthy participants were exposed to the cold outside (Mohe City, Heilongjiang Province, China, the average temperature of each month was below 0°C for 8 months, and the temperature interval during the study was −17 to −34°C) for 1 day, and were monitored by a 24-h ambulatory blood pressure monitoring (ABPM) and underwent transthoracic echocardiography before and after extreme cold exposure. All participants performed their daily activities during the daytime and rested in tents at nighttime. The forehead skin and respiratory tract alone were exposed to cold mainly because the participants wore winter clothes. Among 70 subjects in the study, 41 participants (58.6%) revealed an increase in left ventricular ejection fraction (LVEF), and the remaining 29 participants (41.4%) showed a decrease in LVEF after cold exposure. Baseline coefficients of variation (CV) in BP (particularly daytime) and average real variability (ARV) as parameters of BP variability (BPV) were lower in participants with LVEF increase compared to the LVEF decrease group. In multivariable regression analysis, CV and ARV were reported as significant predictors of LVEF change after short-term extreme cold exposure. Beyond focusing on the LVEF change alone, end-diastolic volume (EDV), end-systolic volume (ESV), E/A, E/e’, and ventricular-arterial coupling (VAC) were significantly reduced, however global longitudinal/circumferential strain (GLS/GCS), torsion, untwisting rate, effective arterial elastance (Ea), and end-systolic elastance (Ees) were significantly increased after short-term extreme cold exposure in all participants. Although the EDV was reduced in participants with both LVEF increased and decreased after an extreme cold exposure, the ESV was only reduced in participants with LVEF increase. Furthermore, the Ees was increased and the VAC was reduced in participants with LVEF increase after an extreme cold exposure. Besides changes in LV functions, there was also an increase in mean 24-h heart rate (particularly night-time heart rate) and systolic BP (particularly daytime systolic BP) in participants with LVEF increase after extreme cold exposure. As mentioned in the study, there was no data about the body temperatures and sympathetic or parasympathetic hormone levels in response to short-term extreme cold exposure.&lt;/p&gt;&lt;p&gt;The human body has adaptive mechanisms to the acute and chronic changes in the ambient temperatures.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; The central and autonomic nervous system plays a critical role in the management of those adaptive changes that directly act on cardiac and vascular functions.&lt;span&gt;&lt;sup&gt;3-6&lt;/sup&gt;&lt;/span&gt; An alteration in the central and autonomic nervous system affects both ve","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 9","pages":"1113-1115"},"PeriodicalIF":2.7,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14881","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of community-based hypertension management on hypertension in the urban slums of Haiti: A mixed methods study","authors":"Reichling St Sauveur MD,&nbsp;Rodney Sufra MD,&nbsp;Marie Christine Jean Pierre MD,&nbsp;Vanessa Rouzier MD,&nbsp;Fabiola Preval RN,&nbsp;Serfine Exantus RN,&nbsp;Mirline Jean RN,&nbsp;Josette Jean PharmD,&nbsp;Guyrlaine Pierre-Louise Forestal PharmD,&nbsp;Obed Fleurijean BS,&nbsp;Nour Mourra BS,&nbsp;Anju Ogyu MPH,&nbsp;Rodolphe Malebranche MD,&nbsp;Jean Pierre Brisma MD,&nbsp;Marie M. Deschamps MD,&nbsp;Jean W. Pape MD,&nbsp;Radhika Sundararajan MD, PhD,&nbsp;Margaret L. McNairy MD, Msc,&nbsp;Lily D. Yan MD, Msc","doi":"10.1111/jch.14882","DOIUrl":"10.1111/jch.14882","url":null,"abstract":"<p>Hypertension is a leading contributor to mortality in low-middle income countries including Haiti, yet only 13% achieve blood pressure (BP) control. We evaluated the effectiveness of a community-based hypertension management program delivered by community health workers (CHWs) and physicians among 100 adults with uncontrolled hypertension from the Haiti Cardiovascular Disease Cohort. The 12-month intervention included: community follow-up visits with CHWs (1 month if BP uncontrolled ≥140/90, 3 months otherwise) for BP measurement, lifestyle counseling, medication delivery, and dose adjustments. Primary outcome was mean change in systolic BP from enrollment to 12 months. Secondary outcomes were mean change in diastolic BP, BP control, acceptability, feasibility, and adverse events. We compared outcomes to 100 age, sex, and baseline BP matched controls with standard of care: clinic follow-up visits with physicians every 3 months. We also conducted qualitative interviews with participants and providers. Among 200 adults, median age was 59 years, 59% were female. Baseline mean BP was 154/89 mmHg intervention versus 153/88 mmHg control. At 12 months, the difference in SBP change between groups was −12.8 mmHg (95%CI −6.9, −18.7) and for DBP −7.1 mmHg (95%CI −3.3, −11.0). BP control increased from 0% to 58.1% in intervention, and 28.4% in control group. Four participants reported mild adverse events. In mixed methods analysis, we found community-based delivery addressed multiple participant barriers to care, and task-shifting with strong teamwork enhanced medication adherence. Community-based hypertension management using task-shifting with CHWs and community-based care was acceptable, and effective in reducing SBP, DBP, and increasing BP control.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 10","pages":"1133-1144"},"PeriodicalIF":2.7,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11466359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary aldosteronism with postoperative elevation of aldosterone treated effectively by finerenone: A case report","authors":"Cai-Guo Yu MD,&nbsp;Bin Cao MD,&nbsp;Hao-Lin Gong MD, PhD,&nbsp;Jing Ke MD, PhD,&nbsp;Shao-Zhong Xian MD, PhD,&nbsp;Nan-Nan Wu MD, PhD,&nbsp;Dong Zhao MD, PhD","doi":"10.1111/jch.14877","DOIUrl":"10.1111/jch.14877","url":null,"abstract":"<p>The authors report a case of primary aldosteronism (PA) with postoperative elevation of aldosterone treated effectively by finerenone. The patient was a hypertensive man with a 30-year history of hypertension and sustained an acute myocardial infarction 5 years ago. Bilateral adrenal nodules with hyperplasia were detected and PA was confirmed. His blood potassium, direct renin concentration, and aldosterone level returned to normal after surgery of right adrenalectomy. However, 1 year after surgery, he experienced a decrease in blood potassium and an increase in aldosterone. A saline infusion test revealed an aldosterone level of 124.47 pg/mL. The patient consented to treatment with finerenone. His aldosterone and potassium levels and blood pressure have been controlled well during follow-up. This case highlights the need to screen for secondary hypertension as early as possible. Finerenone may be effective for patients with PA who are not candidates for surgery and those not relieved after surgery.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 9","pages":"1116-1120"},"PeriodicalIF":2.7,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14877","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}