Assessment of serum soluble intercellular adhesion molecule-1 and albumin in human immuno-deficiency virus-infected individuals with or without malaria parasite infection in Nauth, Nnewi, Nigeria

Background: Human immunodeficiency virus (HIV) co-infection with malaria is the main cause of morbidity and mortality in developing countries, including Nigeria. Both infections have impact on the disease severity and progression. Methods: This was a cross-sectional study aimed to determine the serum soluble intracellular adhesion molecule-1 (sICAM-1) and albumin in HIV/malaria-infected individuals attending the antiretroviral therapy (ART) clinic at Nnamdi Azikiwe Teaching Hospital, (NAUTH) Nnewi, Nigeria. 168 randomly selected individuals aged 18-65 years grouped into 42 HIV-infected individuals on ART, 42 HIV-malaria c-o-infected individuals on ART, 42 malaria-infected individuals, and 42 apparently healthy individuals (control) were included in the study. Serum sICAM-1 and albumin were determined using enzyme linked immunosorbent assay (ELISA) and bromocresol green technique respectively while CD4 T-cell count was obtained from the patients� records. Results: The mean serum sICAM-1, albumin and systolic blood pressure (SBP) levels were significantly higher in HIV individuals with and without malaria infection when compared with control participants (p<0.05) respectively. The mean CD4 T-cell count was significantly lower in HIV/malaria co-infected individuals when compared with HIV infected individuals (p <0.05). A significant negative correlation was observed between CD4 count and sICAM-1 both in HIV infected individuals and HIV-malaria co-infection (p<0.05). Conclusions: The increased sICAM-1, SBP with decreased albumin levels suggests inflammatory and vascular changes with reduced hepatic synthesis which may result in endothelial dysfunction, adverse cardiovascular conditions, and disease progression.

The Relationship between Urinary NGAL and Flow-mediated Vasodilation in Prehypertension / 昆明医科大学学报

Objective To explore the correlation between the urinary neutrophil gelatinase-associated lipid carrier protein(NGAL)and Brachial artery flow-mediated vasodilation(FMD)in Prehypertension.Methods 156 patients with Prehypertension found to have the normal high blood pressure during a health examination at the Luo Shi Road Community Health Service Center of Wuchang Hospital in Wuhan from September 2022 to September 2023 were included and divided into the normal endothelial function group and the endothelial dysfunction group with 89 cases and 67 cases respectively in each group according to whether the FMD was above 10% .The sex,age,smoking history,height,weight,SBP,DBP,FBG,Scr,eGFR,BUN,UA,Hcy,urine NGAL,FMD and other indicators were collected.The correlation between FMD and NGAL in prehypertension was analyzed by using independent samples t-test,Pearson linear correlation,multiple linear regression,binary logistic regression,and receiver operator characteristic(ROC)curves.Results There were no significant differences in gender,smoking history,SBP,FBG,TG,LDL-c,TC,BUN,Scr,UA,eGFR and Hcy(all P>0.05).The age,BMI,DBP,HDL-c,and urine NGAL levels in the endothelial dysfunction group were significantly higher than those in the normal endothelial function group(P<0.05).Pearson linear correlation analysis showed that urine NGAL levels were negative correlated with FMD(r =-0.632 P<0.05).Multiple linear regression analysis:NGAL,DBP significantly affected FMD(all P<0.05).NGAL and diastolic blood pressure were independent risk factors for FMD.The area under the curve of ROC curve analysis was 0.813,0.895 and 0.906 respectively for urinary NGAL,DBP and urinary NGAL combined with DBP.DBP combined with urinary NGAL had the higher diagnostic efficacy.Conclusion Urinary NGAL and DBP are associated with the endothelial dysfunction,and urinary NGAL is expected to be a new biomarker for evaluating the vascular endothelial function loss and a target for the intervention of prehypertension

Prevalence of hypertension and its risk factors among urban school children of Belagavi- a cross sectional study

Background: Primary hypertension is becoming common among apparently healthy children. Measures for early diagnosis of pre hypertension and hypertension along with its risk factors during childhood could benefit from earlier intervention and follow-up. Methods: This cross sectional study was conducted among 270 urban school students of Belagavi of class 10th in 2016 by using a structured questionnaire followed by anthropometry and blood pressure measurement. Results: About 39% of children had family history of hypertension and 27% had family history of chronic diseases. Majority had inadequate consumption of vegetables (84.07%) and fruits (83.70%). The overall physical activity among the students was inadequate (78.15%) and about 46.30% of them got easily angered, stressed or irritated. The waist circumference of 14.07% students was falling in obese category. About 11.48% of them were overweight and 7.04% were obese according to their body mass index. Among the students, 71.85% had normal blood pressure and 18.15% had pre-hypertension. Hypertension was detected among 10.00% of students of which 5.56% belonged to stage I and 4.44% belonged to stage II hypertension. Statistical association between the blood pressures of school children showed significance with family history of chronic diseases (p=0.025), body mass index and waist circumference (p<0.001). Conclusions: One tenth of the children had hypertension and one fifth of the children had pre-hypertension. The children who were obese had increased blood pressure than those with normal weight. Health promotion at early phase of life can help in the prevention of hypertension.

Identifying Pre-hypertensives in the Community: At Risk Approach for Prevention of Hypertension

Introduction: Pre-hypertension is a borderline health state of increased blood pressure (BP) that falls short of the measurable parameters at which surveillance and/or therapy would be required. The approach of identifying people “At Risk” of developing hypertension can be more cost-effective and feasible for applying lifestyle interventions. Objectives: The objective of the present study is to find the prevalence of pre-hypertensives and associated bio-socio-demographic factors Materials and Methods: A cross-sectional study was conducted among 1946 participants aged 19 years and more in the Doiwala block of Dehradun, Uttarakhand. Multistage sampling was used to arrive at desired sample size. A pre-validated, structured questionnaire was used for data collection. The questionnaire included information on the socio-demographic profile (age, sex, education etc.), awareness about hypertension and its associated risk factors. Statistical Analysis: The chi-square test was used to compare proportions and draw inferences. Results: 958 (49.2%) study participants out of a total 1946 were found to be pre-hypertensives. A statistically significant association was found between pre-hypertension and factors such as male gender, age, education, occupation and waist-hip ratio. (p<0.05) Conclusion: It is recommended that identification on the pre-hypertensive group and subjecting them to lifestyle modification could be a fruitful strategy for preventing them from becoming hypertensive.

Psychological distress in relation to blood pressure among Andhra Pradesh state road transport corporation bus drivers, Vijayawada

Background: One of the major health problem worldwide is elevated blood pressure (BP). Prior research had shown that hypertensives experience psychological distress, although pre-hypertensives have not yet been subject to this research. Objectives were to assess the major risk factors of increasing BP among bus drivers and to assess psychological distress in relation to BP levels. Methods: A cross sectional study was conducted among Bus drivers aged above 20 years, study was carried out between July to October of 2022, a sample of 135 was taken. Inferential statistics such as Pearson Chi square test and an unpaired independent-sample t-test was used to assess the difference between pre-hypertensive and hypertensive individuals on GHQ score. Results: In the present study (n=135), 47% were normotensive, 34% were in hypertensive stage and 19% were in pre-hypertensive stage. On assessment of psychological distress in relation to BP among bus drivers the mean of (General health questionnaire) GHQ-12 was found to be 17.57 among hypertensives and 17.86 among pre-hypertensives. Two tailed significance value of 0.768 was observed between pre-hypertensive and hypertensive individuals indicating that psychological distress had significant effects. Conclusions: The prevalence of hypertension and pre-hypertension was among bus drivers, leading to cardio vascular diseases which in turn causes increased morbidity and mortality, lowering individual productivity and having an impact on the national economy. The prevalence of non-communicable diseases should be monitored by lifestyle changes and periodic screenings.

Epidemiology of prediabetes and prehypertension-progression, regression and interaction

Background: The major portion of the non-communicable diseases is formed by cardiovascular diseases. The two major modifiable risk factors are hypertension and diabetes. The probable CVD risk with pre-hypertension and pre-diabetes, to some extent, is dependent on whether pre-HTN leads to hypertension and pre-DM leads to diabetes. Our aim was to study: the progression of prehypertension and prediabetes to overt hypertension and diabetes or to normal status, and the association of pre-obesity and obesity with prehypertension and prediabetes. Methods: A total of 1200 patients equally distributed among three groups were studied for progression or regression. Group A included 400 patients of pre-hypertension, and group B included 400 patients of pre-diabetes and group C included 400 patients of pre-diabetes and pre-hypertension. Results: Among the 400 studied patients with prediabetes 31 (7.8%) progressed to diabetes and only 9 (2.3%) progressed to hypertension over a period of two years. Patients with both prehypertension and prediabetes had a higher risk of progression to hypertension and diabetes (3% to hypertension and 15.5% to diabetes). Males were more prone to develop both pre-hypertension and pre-diabetes mellitus and progression. Obesity increased the risk of progression to hypertension and diabetes significantly. Conclusions: The screening of people for pre-diabetes mellitus and pre-hypertension should be carried out at mass levels so as to diagnose them at an early stage and hence, their progression can be either halted or modified.

Mechanism of Banxia Baizhu Tianma decoction to prevent the development of prehypertension and excessive phlegm-dampness syndrome in rats based on metabonomics technology / 药学学报

The alterations of serum biological endogenous chemicals in rats with phlegm dampness accumulation syndrome of prehypertension (PHT) were interfered by Banxia Baizhu Tianma decoction (BBT), and the metabolic regulatory pathway of BBT was clarified using serum metabonomics analysis. To replicate the rat model of prehypertension phlegm dampness syndrome, blood pressure, behavioral markers, and serum biochemical markers of rats were collected. BBT's effectiveness in controlling blood pressure and blood lipids was assessed, and changes in endogenous small molecules in rat serum were determined using UPLC-Q-Orbitrap MS metabolic analysis. The results showed that BBT could regulate 9 metabolites, including arachidonic acid, cholic acid, glycodeoxycholic acid, N-adenosyltyrosine, arginine, lysophosphatidylethanolamine (20:0/0:00), lysophospholipid (P-18:0), lysophospholipid (18:0), lysophospholipid (22:5(7Z,10Z,13Z,16Z,19Z)). MetaboAnalyst was used to analyze the metabolic pathway. There were 7 metabolic pathways closely related to the change of blood pressure in rats, among which arachidonic acid metabolic pathway was the most critical. The metabolism difference foreign body in the model rats tends to return to the normal level, which provides a research basis for the mechanism of BBT from the perspective of metabonomics. This study was approved by the Experimental Animal Welfare Ethics Review Committee of Shandong University of Traditional Chinese Medicine (approval number: SDUTCM20211103001).

Effect of exercise on prehypertension and hypertension in middle-aged and elderly people in Asian populations: a meta-analysis / 中华行为医学与脑科学杂志

Objective:To systematically evaluate the effect of exercise on blood pressure of middle-aged and elderly Asian populations with prehypertension and hypertension, and to provide theoretical basis for formulating accurate exercise prescriptions.Methods:Randomized controlled trials on the effect of exercise on blood pressure in middle-aged and elderly patients with prehypertension and hypertension were collected by PubMed, EMBASE, the Cochrane Library, Web of Science, CNKI and Wanfang Database.The quality of the included studies was evaluated by the Cochrane risk bias assessment tool, and the meta-analysis was performed with Stata 15.0 software.Results:A total of 23 articles and 2 095 subjects were included.Meta analysis showed that compared with the control group, aerobic exercise(WMD=-9.94, 95% CI=-12.59--7.29, P<0.001), resistance exercise(WMD=-11.15, 95% CI=-18.36--3.95, P=0.002) and aerobic combined resistance exercise(WMD=-6.09, 95% CI=-8.87--3.31, P=0.005) could reduce the systolic blood pressure level.Aerobic exercise(WMD=-6.46, 95% CI=-8.20--4.72, P<0.001) and resistance exercise(WMD=-4.38, 95% CI=-8.07--0.69, P=0.02) could reduce the level of diastolic blood pressure, while aerobic combined resistance exercise(WMD=-4.88, 95% CI=-12.87-3.11, P=0.232)had no significant effect on diastolic blood pressure.The results of subgroup analysis indicated that the differences of age, baseline blood pressure, exercise intensity, exercise time, exercise frequency, and motion cycle were the main sources of heterogeneity.The funnel plot and Egger's test indicated that there was no publication bias in this Meta-analysis. Conclusion:Aerobic exercise and resistance exercise both have positive effects on reducing blood pressure of middle-aged and elderly Asian populations with prehypertension and hypertension.

Socio-demographic factors, overweight/obesity and nutrients associated with hypertension among rural adults (≥18 years): Findings from National Nutrition Monitoring Bureau survey

Background: Hypertension is the leading cause of death throughout the world. The study was conducted to assess the prevalence, determinants and knowledge & practices about hypertension among rural adults in India. Methods: A community-based cross-sectional study was carried out in 10 major states of India. Information on socio-economic & demographic particulars was collected and anthropometric measurements like height, weight, waist & hip circumference and blood pressure were measured. Foods and nutrient intakes were assessed by 24-h recall method. Analysis was done using SPSS window 22. Results: The prevalence of pre-hypertension was 45.3% (95% CI: 44.6e46.0) and hypertension was 22% (95% CI: 21.5e22.3) (age standardized prevalence; 20.2%) while, overweight/obesity was 22.6% (95% CI: 22.2e23.0) as per Asian cut offs (BMI_x0001_23). The prevalence of hypertension was higher in West Bengal (29.5%) and Kerala (28.9%) and low in Madhya Pradesh and Uttar Pradesh (16e19%). The odds of hypertension was 1.2 times higher among forward communities, businessmen, tobacco users and those consuming alcohol, 2e3 times higher among overweight (CI: 1.87e2.25) and obese (2.65e3.27). The odds of hypertension was 1.2 times higher among those consuming lower tertile of carbohydrates (CI ¼ 1.02e1.41) and zinc (CI ¼ 1.11e1.42). About 76% were aware of hypertension, 21% were old hypertensive & 19% were on treatment. Conclusions: Age standardized prevalence of hypertension was 20% among adults and was associated with age, occupation, overweight/obesity, tobacco and alcohol use, low intake of carbohydrates and zinc. Therefore, increasing awareness and consumption of healthy diet through behavior change communication will help to control hypertension among adults.

To assess the prevalence of clinical and subclinical cardiac autonomic dysfunction in adolescent with family history of hypertension and adolescent with prehypertension; correlating with adolescent anthropometric parameters

Objectives: Hypertension (HTN) is an inherited disorder and these patients manifest with cardiac autonomic dysfunction (CAD). The present study intends to assess the presence of pre HTN, clinical and subclinical CAD in adolescents with a family history of HTN, and to obtain its correlation with anthropometric values. Materials and Methods: After obtaining ethical clearance and informed consent, three groups containing 50 subjects each, of age 17–19 years were included in the study. (Group-I: Normotensives without a family history of HTN; Group-II: Normotensives with a family history of HTN and Group-III: prehypertensives). CAD was done by performing (1) resting tachycardia, (2) loss of sinus arrhythmia, and (3) heart rate response to the Valsalva manoeuvre. If any two of them are positive then the presence of CAD was confirmed. Results: Height, weight, BMI, SBP and DBP was significantly higher in group 3 (prehypertensives). Confirmed CAD findings was seen in 36% of group 2 and 46% of group 3 participants. Of the anthropometric parameters, a significant positive correlation was seen between weight and SBP, DBP and CAD parameters, and height with SBP and DBP. Conclusion: Clinical and subclinical CAD exists in adolescents with risk factors for HTN including heredity, obesity, and pre-HTN values. These risk factors show multiplicative effects for disease genesis and indicate high sympathetic and low parasympathetic drives. Extra care should be taken to curb the onset of clinical HTN and CAD in these young adults. Additional work needs to be done on pathophysiological mechanisms for the same.

Effects of an internet-based blood pressure monitoring and management platform on blood pressure control in a prehypertensive population: an intervention study / 中华健康管理学杂志

Objective:To explore the intervention effects of an Internet-based blood pressure monitoring and management platform in a prehypertensive population.Methods:One hundred and fifty-eight prehypertensive patients who were examined at the Third Xiangya Hospital in Changsha, China, from August to December 2019 were randomly divided into either the experimental or control groups using the random number table method. The experimental group utilized an Internet-based blood pressure monitoring and management platform, whereas the control group utilized regular telephone and SMS health management routines. The intervention duration was 12 months for both groups. Data were analyzed using descriptive analysis, t-tests, chi-square tests, χ 2 tests, and rank-sum tests. Results:Post intervention systolic blood pressure (124.79±9.71 mmHg) (1 mmHg=0.133 kPa) and diastolic blood pressure measurements (77.41±8.21 mmHg) of the participants in the experimental group were significantly lower than those before the intervention (128.29±5.10 mmHg and 79.99±6.01 mmHg, respectively), and significantly lower than those of the control group′s measurements after the intervention (130.00±7.78 mmHg and 80.33±7.90 mmHg, respectively) (all P<0.05). The blood pressure goal attainment rate was significantly higher in the experimental group (23.08%) than that of the control group (8.75%), with statistically significant differences within the experimental group before and after intervention, as well as between the groups post intervention ( P<0.05). Positive lifestyle changes, such as prehypertension knowledge score, active restriction and control of salt and oil intake, reduction of smoking, and exercising weekly, were significantly higher than those in the control group before the intervention (all P<0.05). Conclusion:The use of an Internet-based blood pressure monitoring and management platform can effectively help patients with prehypertension control their blood pressure levels, improve their knowledge about the condition, and improve their lifestyle choices.

Correlation between TyG and TyG combined obesity index and prehypertension in middle-aged and elderly population / 公共卫生与预防医学

Objective To explore the correlation between Triglyceride Glucose Index (TyG) and its combined obesity Index and prehypertension in middle-aged and elderly population in China, and to provide a monitoring tool for better hierarchical management of prehypertension population. Methods A total of 5 099 people with non-hypertension were enrolled through the database of the China Health and Retirement Longitudinal Study (CHARLS). Body mass index (BMI), waist circumference (WC) and waist to height ratio (WTHR) were obtained, and TyG-BMI, TyG-WC and TyG-WTHR indexes were calculated by multiplying the TyG index with the three indexes respectively. Logistic regression analysis was used to explore the relationship between TyG index and obesity index and prehypertension. The DeLong method was used to compare the values of Area Under the Curve (AUC) of each index to distinguish their value in identifying prehypertension. Results Compared with the normal blood pressure group, the prehypertension group was older, and the blood pressure was higher. Logistic regression analysis showed that higher levels of TyG-BMI and TyG-WC index were significantly associated with prehypertension. Compared with the lowest quartile array Q1, the OR values of TyG-BMI Q2-Q4 were 1.24 (95%CI :1.03-1.49), 1.40 (95%CI :1.10-1.76) and 1.91 (95%CI :1.43-2.56), while the OR values of TyG-WC index Q2-Q4 group were 1.45 (95%CI :1.19-1.75), 1.49 (95%CI :1.13-1.95), and 2.12 (95%CI: 1.47-3.07), respectively. There was no statistically significant difference in the AUC value between TyG-WC and TyG-BMI (P =0.0998). Conclusion Among the four novel indexes, higher levels of TyG-WC and TyG-BMI are positively correlated with prehypertension. Compared with TyG and TyG-WTHR, TyG-WC and TyG-BMI have the potential to become an effective auxiliary means in the individual hierarchical management of prehypertension in the middle-aged and elderly.

Underlying Mechanisms of Bile Acids in Progression of Hypertension Based on Metabolomics and Network Analysis / 中国实验方剂学杂志

ObjectiveTo explore the underlying mechanism of bile acids and metabolites as well as the key metabolic pathways and important endogenous targets in prehypertension. MethodThe metabolic mechanism of prehypertension was explored with non-targeted metabolomics combined with network analysis. The serum metabolomics of patients with prehypertension was analyzed by ultra-high performance liquid chromatography quadrupole time-of-flight tandem mass spectrometry. The relevant biological functions and signal targets were predicted and generated by network analysis. Finally，the predicted targets of this important pathway were verified by in vitro experiments，and the relevant information was verified by enzyme-linked immunosorbent assay （ELISA） and Western blot. ResultAs revealed by non-targeted metabolomics，there were 64 potential biomarkers and 13 metabolic pathways in the normal group，the prehypertension group， and the hypertension group. The results of network analysis and biological verification showed that the occurrence of prehypertension was related to vascular inflammation caused by the abnormal metabolism of bile acids and aromatic amino acids. Bile acid metabolism plays an important role in the occurrence and development of prehypertension by regulating the vascular inflammatory response. Amino acid N-acyltransferase，myeloperoxidase， and bile acid downstream receptor TGR5 are critical in the changes of the metabolic network. ConclusionIn prehypertension，bile acids are presumedly involved in regulating vascular inflammation， resulting in damage to blood vessels in prehypertension.

Fatores associados à pré-hipertensão e hipertensão arterial em trabalhadores de saúde que atuam em serviços de alta complexidade / Factors associated with prehypertension and hypertension among healthcare workers working in high-complexity services

Resumo Objetivou-se estimar a prevalência e fatores associados à pré-hipertensão e hipertensão arterial entre trabalhadores de saúde que atuam em setores de alta complexidade para pacientes críticos e crônicos. Foi realizado um estudo epidemiológico, transversal com 490 trabalhadores de saúde da macrorregional do norte de Minas Gerais, Brasil. A variável dependente pressão arterial foi categorizada em normal, pré-hipertensão e hipertensão. Para análise múltipla, foi utilizada a Regressão Logística Multinomial. A prevalência da hipertensão arterial foi de 21,8% e da pré-hipertensão foi de 25,9%. As chances de se desenvolver a hipertensão arterial e a pré hipertensão foram maiores nos profissionais do sexo masculino, com idade ≥40 anos, em trabalhadores com vínculo empregatício concursado e naqueles obesos ou com sobrepeso. O uso de medicamento contínuo e o trabalho no turno noturno estiveram associados à hipertensão e pré-hipertensão, respectivamente. A prevalência de hipertensão arterial no grupo de trabalhadores foi menor do que a da população brasileira. São necessários estudos com trabalhadores desse grupo e investimentos em medidas preventivas e que incentivem a mudança para um estilo de vida saudável.

Abstract The objective was to estimate the prevalence and factors associated with prehypertension and hypertension among health workers who work in high-complexity services for critically-ill and chronic patients. An epidemiological, cross-sectional study was carried out with 490 health workers in the macroregional region of Northern Minas Gerais, Brazil. The dependent variable blood pressure (BP) was categorized as normal BP, prehypertension and hypertension. Multinomial Logistic Regression was used for the multiple analysis. The prevalence of arterial hypertension was 21.8% and that of prehypertension was 25.9%. The chances of developing arterial hypertension and prehypertension were higher in male professionals, aged ≥40 years, in civil servant workers and those who were obese or overweight. The use of continuous medication and night shift work were associated with hypertension and prehypertension, respectively. The prevalence of arterial hypertension in the group of workers was lower than that of the Brazilian population. It is necessary to carry out studies with workers from this group and investments are required in preventive measures that encourage a change to a healthy lifestyle.

Modulação Autonômica Cardíaca é Fator Chave para Pressão Alta em Adolescentes / Cardiac Autonomic Modulation is a Key Factor for High Blood Pressure in Adolescentes

Resumo Fundamento O interesse pela hipertensão em crianças e adolescentes aumentou desde a atualização do sistema de classificação da pressão arterial para comparar com o sistema de classificação dos adultos, alterando a terminologia de "normal alta" para "pré-hipertensão". Objetivo O objetivo deste estudo foi analisar a associação da modulação autonômica cardíaca com os níveis pressóricos dos adolescentes. Métodos 203 adolescentes foram agrupados de acordo com a pressão arterial sistólica (PAS) e a pressão arterial diastólica (PAD). Um grupo foi caracterizado como pré-hipertensão, e o outro como normotenso. Foram coletadas características antropométricas, cardiovasculares e de qualidade do sono. Inicialmente, os dados foram submetidos ao teste de normalidade Kolmogorov-Smirnov . As variáveis quantitativas contínuas foram analisadas por meio do teste T de Student não pareado. Para análise das variáveis categóricas, foi utilizado o teste qui-quadrado. Um modelo de regressão logística foi realizado. O nível de significância estabelecido foi p<0,05. Os dados foram expressos como média ± desvio padrão e intervalo de confiança. O software R foi utilizado para análise dos dados. O tamanho do efeito foi calculado com a fórmula de Cohen. Resultados O grupo pré-hipertensão apresentou aumento da entropia de Shannon e diminuição da variância total. Além disso, no modelo de regressão logística, os adolescentes deste grupo tiveram 1,03 mais chances de ter a entropia de Shannon afetada quando a PAS foi ajustada ao gênero, maturação sexual, tempo escolar, idade, circunferência da cintura e qualidade do sono. Conclusão Nossos dados mostram que a modulação autonômica pode desempenhar um papel importante no desenvolvimento da pressão arterial elevada em adolescentes ao controlar fatores como tempo escolar e qualidade do sono.

Abstract Background The interest regarding hypertension among children and adolescents has increased since the blood pressure rating system was updated to be compared with the adult rating system, changing the terminology from "normal high" to "prehypertension". Objective This study aimed to analyze the association between cardiac autonomic modulation and pressure levels of adolescents. Methods 203 adolescents were grouped according to systolic blood pressure (SBP) and diastolic blood pressure (DBP). One group was characterized as prehypertension, and the other as normotensive. Anthropometric, cardiovascular and sleep quality characteristics were collected. Initially, the data were submitted to the Kolmogorov-Smirnov normality test. Continuous quantitative variables were analyzed using the unpaired Student t-test. For the analysis of categorical variables, a chi-square test was used. A logistic regression model was performed. The level of significance was set at p<0.05. The data were expressed as mean ± standard deviation and confidence interval. The R software was used for data analysis. The effect size was calculated using the Cohen's formula. Results The prehypertension group showed an increase in Shannon entropy and a decrease in total variance. Also, in the logistic regression model, adolescents in this group were 1.03 times more likely to have Shannon entropy's affected when SBP was adjusted for gender, sexual maturation, school time, age, waist circumference, and sleep quality. Conclusion Our data show that autonomic modulation may play an important role in the development of elevated blood pressure in adolescents, when controlling for other factors, such as school time and sleep quality.

Índice tobillo-brazo obtenido mediante fotopletismografía como marcador de insuficiencia arterial periférica asintomática en pacientes prehipertensos

RESUMEN Introducción: La enfermedad arterial periférica (EAP) puede presentarse de forma asintomática, de ahí la necesidad de su diagnóstico para evitar complicaciones. Objetivo: Determinar la presencia de enfermedad arterial periférica mediante el índice tobillo-brazo obtenido por fotopletismografía en pacientes prehipertensos. Método: Se realizó un estudio descriptivo de corte transversal, en un universo constituido por los 35 pacientes mayores de 18 años, con diagnóstico presuntivo de prehipertensión arterial, del Consultorio 2 perteneciente al Policlínico Universitario Josué País García de Santiago de Cuba. Para medir el índice tobillo-brazo se empleó el pletismógrafo digital ANGIODIN® PD 3000. Resultados: El 100% de los pacientes carecía de síntomas de EAP, pero al realizar la medición del índice tobillo-brazo se encontró que el 51,43% de ellos tenía signos de esta enfermedad. La EAP fue más frecuente en hombres (52,94 vs. 50,0%), sin que se encontraran diferencias estadísticas significativas (p>0,05). Conclusiones: El índice tobillo-brazo obtenido mediante fotopletismografía resultó útil para determinar la presencia de enfermedad arterial periférica asintomática en pacientes prehipertensos. Se identificó una alta incidencia de la enfermedad, con mayor frecuencia en el sexo masculino.

ABSTRACT Introduction: Peripheral artery disease (PAD) may present with no symptoms at all, hence the need for diagnosis to avoid complications. Objective: To determine the presence of peripheral artery disease by means of the ankle-brachial index obtained by photoplethysmography in prehypertensive patients. Method: A descriptive cross-sectional study was carried out in a population of 35 patients over 18 years of age, with a presumptive diagnosis of prehypertension, belonging to the Family Doctor's Office 2 from the Policlínico Universitario Josué País García in Santiago de Cuba. The ANGIODIN® PD 3000 digital plethysmograph was used to measure the ankle-brachial index. Results: None of the patients had symptoms of PAD, but after measuring the ankle-brachial index, 51.43% of them were found to have signs of this disease. Peripheral artery disease was more frequent in men (52.94 vs. 50.0%), with no significant statistical differences (p>0.05). Conclusions: The ankle-brachial index obtained by photoplethysmography was useful in determining the presence of asymptomatic peripheral artery disease in prehypertensive patients. A high incidence of the disease was identified, with a higher frequency in the male sex.

Non-targeted metabolomics study and biomarker screening of prehypertensive liver-fire hyperactivity syndrome based on UPLC-Q-Exactive MS technology / 中国中药杂志

In this study, patients with prehypertensive liver-fire hyperactivity syndrome(LFHS) were selected as the research objects. The plasma samples of healthy volunteers and patients with prehypertensive LFHS were analyzed by non-targeted metabolomics based on UPLC-Q-Exactive MS. The differential biomarkers and metabolic pathways were screened out by multivariate statistics and metabolic pathway analysis, which revealed the characteristics of metabolic patterns of the syndrome. Thirty-three potential biomarkers such as androsterone and lysophosphatidylcholine and 16 related metabolic pathways such as steroid hormone metabolism and lipid metabolism were identified, and a partial least squares-discriminant analysis(PLS-DA) model of traditional Chinese medicine(TCM) syndromes was preliminarily constructed: Y =-0.070X_(13)-0.006X_8+ 0.040X_5-0.152X_1+0.131X_(10)+0.036X_(11)+0.043X_(23)+0.076X_(16)+0.132X_(20)+0.081X_(19)-0.101X_(31)+0.082X_(15)-0.038X_9+0.079X_(24). The predictive value of the model was 88.1%, and the explanatory power was 88.4%. In this study, the characteristic metabolic pattern of the prehypertensive LFHS was distinguished and revealed by metabolomics. The constructed PLS-DA model is expected to provide an objective basis for the identification of TCM syndromes in prehypertension, and inspiration for exploring the biological basis of TCM syndromes at small-molecular and overall levels.

The association of abnormal thyroid stimulating hormone levels with elevated blood pressure among females of child-bearing potential / 中华内分泌代谢杂志

Objective:To explore the association between abnormal thyroid stimulating hormone (TSH) and elevated blood pressure among females of child-bearing potential.Methods:A total of 294 674 females of child-bearing age who participated in pre-pregnancy health examination in Shenzhen from 2013 to 2019 were selected. Demographic characteristics, blood pressure, TSH, fasting blood glucose and other indexes were collected. Multivariate logistic regression model was used to analyze the association between abnormal TSH levels and elevated blood pressure (including prehypertension and hypertension).Results:This study showed that females of child-bearing potential with prehypertension and hypertension accounted for 21.77% and 2.41%, respectively. Compared with females of child-bearing potential with normal TSH, the risk of prehypertension and hypertension increased by 34.0% ( OR=1.340, 95% CI 1.248-1.438) and 59.6% ( OR=1.596, 95% CI 1.301-1.938) among those with decreased TSH, respectively, whereas the risk of prehypertension and hypertension increased by 13.6% ( OR=1.136, 95% CI 1.076-1.198) and 38.0% ( OR=1.380, 95% CI 1.198-1.581) among those with elevated TSH, respectively. Subgroup analysis showed that abnormal TSH levels in most subgroups, such as age, ethnicity, educational level, occupation, spouse smoking, alcohol drinking, body mass index, and fasting blood glucose, were associated with the risk of elevated blood pressure. Heterogeneity test showed that the association between decreased TSH and elevated blood pressure was higher in females with high school and below or alcohol drinking, and the association between elevated TSH and elevated blood pressure was higher in females with college/bachelor′s degree and above or non-smoking spouse. Conclusion:There is a significant association between abnormal TSH levels and the risk of prehypertension and hypertension in females of child-bearing potential, and the association should be explored with stratified educational level, alcohol drinking, and spouse smoking status.

High blood pressure levels and cardiovascular risk among Munduruku indigenous people / Níveis pressóricos elevados e risco cardiovascular entre indígenas Munduruku / Niveles altos de presión arterial y riesgo cardiovascular entre los indígenas Munduruku

Objective: to identify the risk factors associated with prehypertension and arterial hypertension among Munduruku indigenous people in the Brazilian Amazon. Method: a cross-sectional study carried out with 459 Munduruku indigenous people selected by means of stratified random sampling. Sociodemographic variables, habits and lifestyles, anthropometric data, fasting glucose and lipid profiles were evaluated. An automatic device calibrated and validated to measure blood pressure was used. The analyses of the data collected were carried out in the R software, version 3.5.1. For continuous variables, the Kruskall-Wallis test was used; for the categorical ones, Fischer's Exact. The significance level was set at 5% and p-value≤0.05. Results: the prevalence of altered blood pressure levels was 10.2% for values suggestive of hypertension and 4.1% for pre-hypertension. The risk of prehypertension among indigenous people was associated with being male (OR=1.65; 95% CI=0.65-4.21) and having a substantially increased waist circumference (OR=7.82; 95% CI=1.80-34.04). Regarding the risk for arterial hypertension, it was associated with age (OR=1.09; 95% CI=1.06-1.12), with increased waist circumference (OR=3.89; 95% CI=1.43-10, 54) and with substantially increased waist circumference (OR=5.46; 95% CI=1.78-16.75). Conclusion: among Munduruku indigenous people, men were more vulnerable to developing hypertension; age and increased waist circumference proved to be strong cardiovascular risk factors.

Objetivo: identificar os fatores de risco associados à préhipertensão e hipertensão arterial entre indígenas Munduruku da Amazônia brasileira. Método: estudo transversal realizado com 459 indígenas Munduruku selecionados por meio de amostragem aleatória estratificada. Foram avaliadas variáveis sociodemográficas, hábitos e estilos de vida, dados antropométricos, glicemia de jejum e perfis lipídicos. Utilizou-se aparelho automático calibrado e validado para medir a pressão arterial. As análises dos dados coletados foram realizadas pelo software R versão 3.5.1. Para as variáveis contínuas, utilizou-se o teste Kruskall-Wallis; para as categóricas, o Exato de Fischer. Considerou-se nível de significância de 5% e valor p≤0,05. Resultados: a prevalência de níveis pressóricos alterados foi de 10,2% para valores sugestivos de hipertensão e de 4,1% para pré-hipertensão. O risco de pré-hipertensão entre indígenas associou-se a ser do sexo masculino (OR=1,65; IC95% 0,65-4,21) e ter circunferência da cintura aumentada substancialmente (OR=7,82; IC95% 1,80-34,04). Quanto ao risco para hipertensão arterial, associou-se à idade (OR=1,09; IC95% 1,06-1,12), à circunferência da cintura aumentada (OR=3,89; IC95% 1,43-10,54) e à circunferência da cintura aumentada substancialmente (OR=5,46; IC95% 1,78-16,75). Conclusão: entre indígenas Munduruku, os homens estavam mais vulneráveis para desenvolver hipertensão; a idade e a circunferência da cintura aumentada mostraram-se como fortes fatores de risco cardiovascular.

Objetivo: identificar los factores de riesgo asociados con la prehipertensión y la hipertensión arterial entre los indígenas Munduruku en la Amazonía brasileña. Método: estudio transversal realizado con 459 indígenas Munduruku seleccionados mediante muestreo aleatorio estratificado. Se evaluaron variables sociodemográficas, hábitos y estilos de vida, datos antropométricos, glucosa en ayunas y perfiles lipídicos. Se utilizó un dispositivo automático calibrado y validado para medir la presión arterial. Los análisis de los datos recopilados se llevaron a cabo mediante el software R versión 3.5.1. Para las variables continuas se utilizó la prueba de KruskalWallis; para las categóricas, Exacto de Fischer. El nivel de significancia se estableció en 5% y p≤0,05. Resultados: la prevalencia de niveles alterados de presión arterial fue del 10,2% para valores sugestivos de hipertensión y del 4,1% para prehipertensión. El riesgo de prehipertensión entre los indígenas se asoció al sexo masculino (OR=1,65; IC95% 0,65-4,21) y a un aumento sustancial de la circunferencia de cintura (OR=7,82; IC95% 1,80-34,04). En cuanto al riesgo de hipertensión arterial, se asoció con la edad (OR=1,09; IC95% 1,06-1,12), con un aumento de la circunferencia de la cintura (OR=3,89; IC95% 1,43-10,54) y con un aumento sustancial de la circunferencia de la cintura (OR=5,46; IC95% 1,78-16,75). Conclusión: entre los indios Munduruku, los hombres eran más vulnerables a desarrollar hipertensión, la edad y el aumento de la circunferencia de la cintura demostraron ser fuertes factores de riesgo cardiovascular.