Changes in the prevalence of measures associated with hypertension among Iranian adults according to classification by ACC/AHA guideline 2017.

BACKGROUND: Different definitions have been proposed to categorize hypertension. We aimed to investigate the difference in prevalence of measures associated with hypertension according to the American College of Cardiology/American Heart Association (ACC/AHA) criteria versus Joint National Committee 7 (JNC7) criteria. METHODS: We analyzed the data of 10,000 participants of Yazd Health Study (YaHS) aged 20-69 years. Blood pressure was measured three times with standard protocol defined by ACC/AHA. Prevalence of high blood pressure measure was compared in both definitions and absolute differences reported. RESULTS: The prevalence of high blood pressure in our measurement was 61.0% according to ACC/AHA, and 28.9% according to JNC 7. The prevalence of self-reported hypertension was 18.6%. Age and sex standardized prevalence rates of high blood pressure measure indicates a 2.4-fold increase in the prevalence rate (30.1% absolute difference) by the ACC/AHA guideline. While the prevalence increased in all age groups, the age group of 20-29 showed the highest relative increase by 3.6 times (10.6% vs. 38.1%). High blood pressure measure among people with diabetes increased from 45.8 to 75.3% with the ACC/AHA guideline. Of the people who had no past history of diagnosed hypertension (n = 7887), 55.1 and 22.7% had high blood pressure measure by ACC/AHA and JNC-7 guidelines, respectively. From JNC7 to ACC/AHA, the overall difference in unawareness about HTN increased by 32.4%. CONCLUSION: Prevalence of hypertension associated measures increased over two folds by using the ACC/AHA criteria compared to JNC 7. Also, change in the criteria, reduces awareness of the disease and increases uncontrolled hypertension respectively. More research is needed to determine if the new definitions can affect management of hypertension in societies. Considering local priorities and implication of cost effective may improve implementation of new definitions for hypertension in different countries.

Awareness, treatment, and control of hypertension and related factors in adult Iranian population.

BACKGROUND: Hypertension, known as the silent killer, is a major risk factor for cardiovascular disease. Awareness and treatment of hypertension is not appropriate in the world, and this has led to an increase in mortality and morbidity caused by uncontrolled hypertension. This study aims to estimate awareness, treated, and controlled hypertensive and relevant predictors in an adult Iranian population. METHODS: This cross-sectional study was conducted on 10,000 adults aged 20-69 years in Yazd, Iran. They were selected through multi-stage random cluster sampling in 2015-2016. Blood pressure was measured three-time with standard protocol by trained health workers. Those with a positive history of hypertension and using anti-hypertensive drugs, prescribed by a physician, were considered hypertensive. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic BP of ≥90 mmHg. Uncontrolled hypertension was defined in accordance with recommended treatment targets by the Joint National Committee (JNC7). Logistic regression was used to assess the predictors of hypertension awareness, treatment and control. RESULTS: The prevalence of hypertension was 37.3%, and the prevalence of pre-hypertension was 46.4%. 49.7% of People with hypertension were aware of their disease, and 71.5% of them were using antihypertensive drugs prescribed by physicians. Blood pressure was controlled in 38.9% of the treated patients. In the adjusted model, older age, female sex, and history of diabetes mellitus were positively associated with higher awareness. High physical activity, tobacco smoking, and diabetes are the only predictors of treated high blood pressure. Younger age, female sex, and higher education were determinants of controlled hypertension. Having health insurance was significantly correlated with awareness and control of hypertension. CONCLUSION: Hypertension is a public health problem in this population, which is not well controlled. Half of the patients were unaware. Intervention for increased screening coverage is needed. It should plan to raise public awareness about hypertension and improve hypertension control under the supervision of physicians. Implement a family physician program is recommended in the health system.

Recovery of sphalerite from a high zinc grade tailing.

In this work, the flotation recovery of sphalerite and pyrite from an old high zinc grade tailing was studied. In particular, the effect of different flotation reagents such as collector, auxiliary collector, depressant, activators, and frother on the flotation performance were investigated. The synergic effect of the collector blends, as well as frother blends were also studied. In addition, the effect of the pre-conditioning of flotation pulp with scrubbing or ultrasonic on the selective separation of sphalerite and pyrite minerals were studied. More than 73% of the sphalerite was recovered from the accumulated tailings in the rougher stage. The pulp viscosity was considerably increased by increasing the pH from 5.5 to 10.5. As a result, sphalerite recovery and Zn selective separation were both considerably dropped. It was also found that frothers (MIBC and A65) have a synergic effect, and their mixture showed better metallurgical results than when each frother were solely used. The pre-conditioning with scrubbing or ultrasonic resulted in a major increase in the sphalerite floatability.

Starch nanoparticle as a vitamin E-TPGS carrier loaded in silk fibroin-poly(vinyl alcohol)-Aloe vera nanofibrous dressing.

Core-sheath nanofibrous mat as a new vitamin E (VE) delivery system based on silk fibroin (SF)/poly(vinyl alcohol) (PVA)/aloe vera (AV) was successfully prepared by the electrospinning method. Initially, VE-loaded starch nanoparticles were produced and then incorporated into the best beadless SF-PVA-AV nanofibers. The successful loading of VE in starch nanoparticles was proved by Fourier-transform infrared spectroscopy. The scanning electron microscopy and transmission electron microscopy indicated that spherical nanoparticles were successfully embedded within the nanofibers. In vitro release studies demonstrated that the release of VE was controlled by Fickian diffusion and was faster in samples containing more nanoparticles. Fibroblast attachment, proliferation, and collagen secretion were enhanced after adding AV and VE to the SF-PVA nanomatrix. Moreover, the incorporation of VE into the nanocomposite dressing enhanced antioxidant activity, which can have a positive effect on wound healing process by protecting the cells from toxic oxidation products.