Journal of Clinical Hypertension最新文献_第2页

Assessing Associations of Nurse-Managed Hypertension Care on Pharmacotherapy, Lifestyle Counseling, and Prevalence of Comorbid Cardiometabolic Diseases in All Patients With Hypertension That Are Treated in Primary Care in Stockholm, Sweden. 评估瑞典斯德哥尔摩所有接受初级保健治疗的高血压患者中，由护士管理的高血压护理与药物治疗、生活方式咨询以及合并心脏代谢疾病患病率之间的关系。

IF 2.7 3区医学

Journal of Clinical Hypertension Pub Date : 2024-11-16 DOI: 10.1111/jch.14940

Charlotte Ivarsson, Monica Bergqvist, Per Wändell, Sebastian Lindblom, Anders Norrman, Julia Eriksson, Jan Hasselström, Christina Sandlund, Axel C Carlsson

{"title":"Assessing Associations of Nurse-Managed Hypertension Care on Pharmacotherapy, Lifestyle Counseling, and Prevalence of Comorbid Cardiometabolic Diseases in All Patients With Hypertension That Are Treated in Primary Care in Stockholm, Sweden.","authors":"Charlotte Ivarsson, Monica Bergqvist, Per Wändell, Sebastian Lindblom, Anders Norrman, Julia Eriksson, Jan Hasselström, Christina Sandlund, Axel C Carlsson","doi":"10.1111/jch.14940","DOIUrl":"https://doi.org/10.1111/jch.14940","url":null,"abstract":"The aim was to study if nurse-managed hypertension care was associated with differences in pharmacotherapy, lifestyle counseling, and prevalence of comorbid cardiometabolic diseases among patients receiving care at primary health care centers. To assess the extent of nurses' involvement in the hypertension care, a questionnaire was distributed to all primary health care centers in Region Stockholm. Age-adjusted logistic regression models were used to analyze the results, odds ratios with 99% confidence intervals. Data was acquired from VAL, the administrative databases of Region Stockholm in Sweden, encompassing all individuals 30 years or older with a registered hypertension diagnosis who attended to the primary health care center they were registered at. Our analysis comprised 119 267 patients diagnosed with hypertension registered in one of the 224 included primary health care centers. Of the 81 primary health care centers that responded to the questionnaire, 54 reported having nurse-managed hypertension care. Nurse-managed hypertension care was not significantly associated with differences in pharmacotherapy or patients' comorbidity, except for diabetes. Primary health care centers with nurse-managed hypertension care had a 10% greater adherence to national guidelines for lifestyle counseling (33.5%) compared to those without nurse-managed hypertension care (22.5%). Regardless of the organizational form of hypertension care management, more men received lifestyle counseling according to guidelines compared to women. In-house routines for hypertension care, with designated nurses, and booking systems were associated with more lifestyle counseling, which has been associated with signs of better hypertension care.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Alcohol Consumption in Adolescence on Early-Adulthood Hypertension or Prehypertension. 青春期饮酒对成年早期高血压或高血压前期的影响。

IF 2.7 3区医学

Journal of Clinical Hypertension Pub Date : 2024-11-15 DOI: 10.1111/jch.14928

Lisa Hayibor, Jianrong Zhang

引用次数: 0

Correlations of the Circadian Rhythmicity of Blood Pressure With Erectile Dysfunction. 血压昼夜节律与勃起功能障碍的相关性

IF 2.7 3区医学

Journal of Clinical Hypertension Pub Date : 2024-11-15 DOI: 10.1111/jch.14935

Ajar Koçak, Cem Şenol, Onur Yıldırım, Bilgesu Arıkan Ergün

{"title":"Correlations of the Circadian Rhythmicity of Blood Pressure With Erectile Dysfunction.","authors":"Ajar Koçak, Cem Şenol, Onur Yıldırım, Bilgesu Arıkan Ergün","doi":"10.1111/jch.14935","DOIUrl":"https://doi.org/10.1111/jch.14935","url":null,"abstract":"Erectile dysfunction (ED) and cardiovascular diseases (CVD) share common pathophysiological mechanisms. This study aimed to assess the relationship between ED and its severity with the risk of developing CVD by analyzing changes in the circadian blood pressure (BP) rhythm. In the study, 24-h BP levels of 192 (94 with ED and 98 controls) participants with no history of CVD were evaluated using an ambulatory blood pressure monitoring (ABPM) device. The International Index of Erectile Function (IIEF) questionnaire was used to assess the ED severity in the study group. ABPM measurements revealed higher BP values among the ED group. The nondipper pattern was significantly more frequent in the ED group compared to the controls (56.2% vs. 77.1%, p < 0.01). Blood pressure variability parameters, including systolic standard deviation (SD) and average real variability (ARV), were notably higher in the ED group (16.3 ± 3.9 vs. 14.6 ± 4.3, p < 0.01 and 13.39 ± 7.24 vs. 11.5 ± 2.1, p < 0.01, respectively). Furthermore, parameters reflecting arterial stiffness including pulse pressure index (PPI) and ambulatory arterial stiffness index (AASI) were higher in the ED group (0.81 ± 0.33 vs. 0.73 ± 0.18, p = 0.03 and 0.71 ± 0.09 vs. 0.59 ± 0.17, p = 0.014, respectively). Both AASI and ARV were significantly correlated with the severity of ED. This study suggests a significant association between ED severity and altered blood pressure patterns which in part explains the increased risk of CVD among individuals with ED.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypertension in Adults With Diabetes in Southeast Asia: A Systematic Review. 东南亚成人糖尿病患者中的高血压：系统回顾。

IF 2.7 3区医学

Journal of Clinical Hypertension Pub Date : 2024-11-15 DOI: 10.1111/jch.14936

Wei Jin Wong, Tan Van Nguyen, Fahed Ahmad, Huyen Thi Thanh Vu, Angela S Koh, Kit Mun Tan, Ying Zhang, Christopher Harrison, Mark Woodward, Tu Ngoc Nguyen

{"title":"Hypertension in Adults With Diabetes in Southeast Asia: A Systematic Review.","authors":"Wei Jin Wong, Tan Van Nguyen, Fahed Ahmad, Huyen Thi Thanh Vu, Angela S Koh, Kit Mun Tan, Ying Zhang, Christopher Harrison, Mark Woodward, Tu Ngoc Nguyen","doi":"10.1111/jch.14936","DOIUrl":"https://doi.org/10.1111/jch.14936","url":null,"abstract":"Diabetes is one of the most pressing health issues in the Southeast Asian region, and hypertension has been commonly reported as a comorbidity in adults with diabetes. This systematic review aimed to synthesize evidence on the prevalence and management of hypertension in adults with diabetes in Southeast Asian countries. A literature search was conducted in Ovid MEDLINE and Embase Classic + Embase from database inception until March 15, 2024. Studies were included if (1) they were conducted in Southeast Asian countries, (2) the study populations were adults with diabetes, and (3) there was information related to hypertension or blood pressure (BP) in the study results. Of the 7486 abstracts found, 90 studies qualified for this review. Most studies reported a hypertension prevalence of 70% or higher (ranging from 29.4% to 93.4%). Despite this high prevalence, a substantial proportion of these populations did not receive adequate BP control, with most studies indicating a control rate of less than 40%. There was limited evidence on the prescription of antihypertensive therapies and medication adherence. There was a lack of studies from 4 of the 11 countries in the region. This review highlights that BP control in adults with diabetes remains a significant challenge in Southeast Asia. Given the ongoing epidemiological transition, and the increasing older population in this region who are likely to accumulate multiple chronic conditions complicating medication strategies, this review highlights the urgent need to improve BP management in those with diabetes.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rheumatoid Arthritis, Circulating Inflammatory Proteins, and Hypertension: A Mendelian Randomization Study. 类风湿性关节炎、循环炎症蛋白和高血压：孟德尔随机研究》。

IF 2.7 3区医学

Journal of Clinical Hypertension Pub Date : 2024-11-15 DOI: 10.1111/jch.14932

Guobing Jia, Tao Guo, Lei Liu, Chengshi He

{"title":"Rheumatoid Arthritis, Circulating Inflammatory Proteins, and Hypertension: A Mendelian Randomization Study.","authors":"Guobing Jia, Tao Guo, Lei Liu, Chengshi He","doi":"10.1111/jch.14932","DOIUrl":"https://doi.org/10.1111/jch.14932","url":null,"abstract":"Observational studies have indicated that there is an association between rheumatoid arthritis (RA) and an elevated risk of hypertension. However, a definitive causal relationship between the two conditions has not been established. The objective of this study was to investigate the causal link between RA and hypertension, as well as the potential mediating role of circulating inflammatory proteins in this relationship. We utilized Mendelian randomization (MR) to examine the causal relationship between RA and hypertension. The study data were obtained from publicly accessible genome-wide association study (GWAS) databases and meta-aggregates of large GWAS studies. The primary statistical method for determining causal effects was the inverse variance weighted (IVW) method, which was supplemented by a variety of sensitivity analyses. The results of the IVW method suggest a causal relationship between RA and an increased risk of hypertension (OR = 1.03, 95% CI = 1.01-1.04, p = 3.32 × 10-5). This association remained statistically significant even after adjusting for multiple confounding factors. Furthermore, MR analyses also revealed causal links between 10 circulating inflammatory proteins and the risk of hypertension, with TNF-related activation-induced cytokine partially mediating RA-induced hypertension at a mediator ratio of 11.17% (0.27%-22.08%). Our study identifies causal relationships between several genetically determined inflammatory proteins and hypertension, establishing that RA increases hypertension risk, with inflammation partially mediating this effect. These findings provide new evidence supporting the inflammatory hypothesis in the mechanism of hypertension. Inflammatory factors may serve as potential targets for antihypertensive therapy.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multiple Treatment Strategies of Accessory Renal Artery Related Hypertension: Report of Two Cases and Literature Review. 附属肾动脉相关性高血压的多种治疗策略：两个病例的报告和文献综述。

IF 2.7 3区医学

Journal of Clinical Hypertension Pub Date : 2024-11-15 DOI: 10.1111/jch.14916

Lin Wang, Yiyun Xie, Deqiang Kong, Kang Li, Zhichao Lai, Jiang Shao, Rong Zeng, Xiao Di, Leng Ni, Yuehong Zheng, Bao Liu

{"title":"Multiple Treatment Strategies of Accessory Renal Artery Related Hypertension: Report of Two Cases and Literature Review.","authors":"Lin Wang, Yiyun Xie, Deqiang Kong, Kang Li, Zhichao Lai, Jiang Shao, Rong Zeng, Xiao Di, Leng Ni, Yuehong Zheng, Bao Liu","doi":"10.1111/jch.14916","DOIUrl":"https://doi.org/10.1111/jch.14916","url":null,"abstract":"Renovascular hypertension (RVH) is a primary cause of secondary hypertension, primarily driven by the activation of the renin-angiotensin-aldosterone system activation. Recently, growing studies suggested accessory renal artery (ARA) might also contribute to RVH. However, the treatment of ARA-related hypertension and whether to take interventional treatment lack consensus. Herein, we report two cases of ARA-related hypertension in our hospital. Imaging studies of both patients showed ARA stenosis. One patient had ARA occlusion well-compensated through tortuous collateral branches, achieving normal blood pressure by medical treatment alone. The other patient had ARA stenosis coexisted with main renal artery stenosis, and revascularization of both arteries led to a significant postoperative reduction in blood pressure. A literature review was conducted to summarize overall treatment strategies for ARA-related hypertension and clarify the relationship between ARA and hypertension. Recent research supported an association between ARA and hypertension. While medical therapy remains the first-line treatment for ARA-related hypertension, interventional procedures should be considered for patients whose blood pressure remains uncontrolled despite conservative management.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Age Differences in the Correlation Between the Cardiometabolic Index and Chronic Kidney Disease Risk in Adults With Hypertension. 成人高血压患者的心脏代谢指数与慢性肾脏病风险之间的相关性的年龄差异。

IF 2.7 3区医学

Journal of Clinical Hypertension Pub Date : 2024-11-08 DOI: 10.1111/jch.14917

Yu Tao, Tao Wang, Wei Zhou, Lingjuan Zhu, Chao Yu, Huihui Bao, Juxiang Li, Xiaoshu Cheng

{"title":"Age Differences in the Correlation Between the Cardiometabolic Index and Chronic Kidney Disease Risk in Adults With Hypertension.","authors":"Yu Tao, Tao Wang, Wei Zhou, Lingjuan Zhu, Chao Yu, Huihui Bao, Juxiang Li, Xiaoshu Cheng","doi":"10.1111/jch.14917","DOIUrl":"https://doi.org/10.1111/jch.14917","url":null,"abstract":"Literature on the association between the cardiometabolic index (CMI) and chronic kidney disease (CKD) risk is limited, especially in hypertensive populations. The objective of the present investigation was to assess the relationship between the CMI and CKD risk in a hypertensive population. The current cross-sectional study included a total of 13 717 individuals with hypertension. The calculation of the CMI was based on the waist-to-height ratio and the triglyceride-to-high-density lipoprotein cholesterol ratio. The definition of CKD was based on an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m2. The prevalence of CKD was found to be 4.24% in younger adults (aged < 65 years) and 14.93% in the elderly (aged ≥ 65 years). The results of the multivariate regression analysis indicated that in the elderly group, the CMI was positively associated with CKD risk (odd ratio [OR] 1.29; 95% confidence interval [CI]: 1.14, 1.46), while no significant relationship was observed in the younger group (OR 1.04, 95% CI: 0.85, 1.27). Furthermore, subgroup analyses did not identify any potential factors that could modify the relationship between the CMI and CKD risk (all p for interaction > 0.05). Among adults with hypertension, there was an independent and positive correlation between the CMI and CKD risk in the elderly, whereas such a correlation was not observed in younger adults. Trial Registration: ClinicalTrials.gov identifier: ChiCTR1800017274 [China Hypertension Registry Study].","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of Olmesartan/Amlodipine Single-Pill Combination on 24-h Mean Systolic Blood Pressure Measured by Ambulatory Monitoring in Non-Responders to Valsartan or Candesartan Monotherapy. 奥美沙坦/氨氯地平单药复方制剂对缬沙坦或坎地沙坦单药治疗无效者通过动态监测测量的 24 小时平均收缩压的疗效。

IF 2.7 3区医学

Journal of Clinical Hypertension Pub Date : 2024-11-06 DOI: 10.1111/jch.14929

Woo-Baek Chung, Sang-Hyun Ihm, Yun-Seok Choi, Ho-Joong Youn

{"title":"Efficacy of Olmesartan/Amlodipine Single-Pill Combination on 24-h Mean Systolic Blood Pressure Measured by Ambulatory Monitoring in Non-Responders to Valsartan or Candesartan Monotherapy.","authors":"Woo-Baek Chung, Sang-Hyun Ihm, Yun-Seok Choi, Ho-Joong Youn","doi":"10.1111/jch.14929","DOIUrl":"https://doi.org/10.1111/jch.14929","url":null,"abstract":"The aim of this study was to evaluate the efficacy of olmesartan/amlodipine (OLM/AML) single-pill combination (SPC) therapy using ambulatory blood pressure monitoring (ABPM) in non-responders to valsartan or candesartan monotherapy. Isolated systolic hypertension (ISH) is the most prevalent form of hypertension in middle-aged and elderly individuals. Patients aged over 55 years who did not achieve the target systolic blood pressure (SBP < 140 mmHg) with valsartan 80 mg or candesartan 8 mg for at least 4 weeks were included. Doses were escalated from 20/5 mg to 40/5 mg and finally to 40/10 mg of OLM/AML SPC until patients reached the target SBP. Efficacy was assessed via ABPM by comparing baseline values with those in the 12th week. Office blood pressure (OBP) and brachial-ankle pulse wave velocity (baPWV) were assessed at baseline, weeks 4, 8, and 12. Fifty-four patients (average age 64 ± 6 years; 33 males) participated. The 24-h mean BPs decreased significantly from an average of 146.2 ± 12.7/93.3 ± 9.2 mmHg to 129.7 ± 14.3/83.4 ± 10.7 mmHg (p < 0.001), and pulse pressures (PPs) from ABPM were reduced (p < 0.001). Additionally, significant reductions in night-time SBP standard deviations (SDs) (14.7 ± 4.7 vs. 12.5 ± 3.9, p = 0.029) were observed at 12 weeks compared to baseline. OBPs significantly dropped from 151.1 ± 9.7/89.3 ± 8.3 mmHg to 125.5 ± 13.8/77.8 ± 8.8 mmHg after 12 weeks of SPC therapy (p < 0.001). Reductions in PPs of OBP and baPWVs were also observed. OLM/AML SPC therapy effectively reduced the 24-h mean BP, as measured by ABPM, in hypertensive patients over 55 years old who failed to achieve a target SBP (< 140 mmHg) with angiotensin receptor blocker (ARB) monotherapy using valsartan 80 mg or candesartan 8 mg. Trial Registration: ClinicalTrials.gov identifier: NCT01713920.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cost-Effectiveness of Radiofrequency Renal Denervation for Uncontrolled Hypertension in Japan. 日本射频肾脏去神经治疗不受控制的高血压的成本效益。

IF 2.7 3区医学

Journal of Clinical Hypertension Pub Date : 2024-11-06 DOI: 10.1111/jch.14922

Kazuomi Kario, Khoa N Cao, Yuji Tanaka, Anne M Ryschon, Jan B Pietzsch

{"title":"Cost-Effectiveness of Radiofrequency Renal Denervation for Uncontrolled Hypertension in Japan.","authors":"Kazuomi Kario, Khoa N Cao, Yuji Tanaka, Anne M Ryschon, Jan B Pietzsch","doi":"10.1111/jch.14922","DOIUrl":"https://doi.org/10.1111/jch.14922","url":null,"abstract":"Radiofrequency renal denervation (RF RDN) is a novel therapy for uncontrolled hypertension. In the recent sham-controlled SPYRAL HTN-ON MED study, office-based systolic blood pressure (oSBP) and nighttime BP were reduced significantly. This study examined the cost-effectiveness of RF RDN in the context of the Japanese healthcare system based on this latest clinical evidence. Clinical events, costs, and quality-adjusted life-years (QALYs) were projected using a decision-analytic Markov model adjusted to Japanese incidence data. Risk reduction in clinical events from changes in oSBP was calculated based on a published meta-regression of 47 trials of intentional hypertension treatment. Demographics and results from the SPYRAL HTN-ON MED trial (oSBP effect size -4.9 mmHg vs. sham) were utilized in the base case analysis. Additional scenarios were explored including the potential added benefit of improved night-time control. Costs were sourced from claims data and published literature. The incremental cost-effectiveness ratio (ICER) was evaluated against a cost-effectiveness threshold of ¥5 000 000 per QALY gained. RF RDN was projected to reduce clinical events (10-year relative risks: 0.80 for stroke, 0.88 for myocardial infarction, and 0.75 for heart failure). Over lifetime, RF RDN added 0.36 QALYs at the incremental cost of ¥923 723, resulting in an ICER of ¥2 565 236 per QALY gained. Under the assumption of added night-time benefit, the ICER decreased to ¥2 155 895 per QALY. Cost-effectiveness findings were robust across all tested scenarios. The findings of this model-based analysis suggest that RF RDN can provide meaningful clinical event reductions and is a cost-effective treatment option in the Japanese healthcare system.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of Questionnaire-Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults. 问卷评估的跌倒风险与老年人血压失控和治疗惰性的关系

IF 2.7 3区医学

Journal of Clinical Hypertension Pub Date : 2024-11-05 DOI: 10.1111/jch.14933

Grant T Hiura, Talar W Markossian, Beatrice D Probst, Katherine Habicht, Holly J Kramer

{"title":"Association of Questionnaire-Assessed Fall Risk With Uncontrolled Blood Pressure and Therapeutic Inertia Among Older Adults.","authors":"Grant T Hiura, Talar W Markossian, Beatrice D Probst, Katherine Habicht, Holly J Kramer","doi":"10.1111/jch.14933","DOIUrl":"https://doi.org/10.1111/jch.14933","url":null,"abstract":"Therapeutic inertia (TI), or failure to escalate or initiate BP lowering medications when BP is uncontrolled, increases with advancing age and may in part be due to perceived fall risk. This study examined the association of a fall risk assessment, based on patient response to three questions administered by trained staff, with uncontrolled BP (≥140/90 mmHg) during a clinic visit and with TI during clinic visits with uncontrolled BP among 13 893 patients age ≥ 65 years corresponding to 41 122 primary care visits. Separate generalized linear mixed effects models were used to examine the association of fall risk (low, moderate, and high) with uncontrolled BP and with TI at a clinic visit after adjustment for demographics, comorbidities, and total number of visits. Baseline mean age was 73.0 years (standard deviation [SD] 5.6), 43.3% were men and questionnaire-assessed fall risk severity was low in 73.6%, moderate in 14.3%, and high in 12.2%. Compared to low fall risk, the adjusted odds of uncontrolled BP during a clinic visit were 0.97 (95% CI: 0.89, 1.06) and 0.90 (95% CI: 0.82, 0.98) with moderate and high fall risk, respectively. In contrast, adjusted odds of TI during a clinic visit with BP ≥ 140/90 mmHg was 1.16 (95% CI: 1.01, 1.34) and 1.30 (95% CI: 1.11, 1.52) with moderate and high fall risk, respectively, compared to low fall risk. These findings suggest that perceived fall risk severity may be one of several factors that influence hypertension management in older adults.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0