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3.
Rev Med Chil ; 147(5): 545-556, 2019 May.
Artículo en Español | MEDLINE | ID: mdl-31859886

RESUMEN

INTRODUCTION AND OBJECTIVE: There is little evidence in Latin America about the impact of the ACC/AHA 2017 guideline. Taking as reference the JNC 7 guideline, the objective of our study is to estimate changes in the prevalence of arterial hypertension (HBP) according to socio-demographic characteristics and geographic regions, applying the criteria of the new ACC / AHA guide 2017. METHODS: Cross-sectional study of the Demographic and Family Health Survey conducted in Peru in 2017. Standardized weighted hypertension prevalence's were estimated for the WHO population according to both guidelines, and absolute differences with 95% CI. RESULTS: We included 30,682 people aged 18 years and over, with an average age of 42.3 years, 51.1% women. The standardized prevalence of HBP for 2017 according to JNC 7 was 14.4% (95% CI: 13.8-15.1) and according to ACC / AHA 2017 it was 32.9% (95% CI: 32.0-33.7), so the prevalence increase is 18.5 percentage points, being higher in males than females (24.2 vs 12.9 respectively). In people with obesity and / or who consume tobacco, the increases were higher (24.3 and 24.1 percentage points respectively). In the regions of Tacna, Ica and Metropolitan Lima, the increase, in comparison with the JNC 7 guidelines, overcome the national average (22.4, 20.7 and 20.4, percentage points, respectively). CONCLUSIONS: Considering the context of a Latin American country and knowing the epidemiology of hypertension in Peru, the potential adoption of the ACC/AHA 2017 guidelines for the prevention, detection, evaluation, and management of hypertension should be accompanied by an evaluation of the impact at the individual, system and social level.


Asunto(s)
Guías como Asunto , Hipertensión/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , American Heart Association , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/terapia , Masculino , Persona de Mediana Edad , Perú/epidemiología , Prevalencia , Estándares de Referencia , Distribución por Sexo , Fumar/epidemiología , Factores Socioeconómicos , Estados Unidos , Adulto Joven
4.
Vasc Health Risk Manag ; 15: 551-558, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31853180

RESUMEN

Introduction: As hypertension is a chronic cardiovascular disease that contributes to a high proportion of morbidity and mortality worldwide, favorable knowledge is crucial to control it. Objective: The objective of this study was thus to assess knowledge and associated factors of blood pressure control among hypertensive patients at the chronic illness follow-up Clinic of the University of Gondar comprehensive-specialized hospital, Gondar, Ethiopia. Methods: An institution-based cross-sectional study was conducted from March to April 2018. A systematic random sampling technique was used to select participants. Bi-variable and multivariable logistic regressions were done to assess the relationship between dependent and independent variables. The adjusted odds ratio with a 95% confidence interval was used to determine the presence and strength of association between covariates and the outcome variable. Results: A total of 404 participants took part in the study with a response rate of 97.3%. The overall good knowledge about blood pressure control was 51.7% (95% CI=46.3-56.8). Females were 3.79 (AOR= 3.79, 95% CI: (1.55, 9.28)) more knowledgeable about blood pressure control than males. In the multivariable analysis, the odds of being knowledgeable were 2.80 (AOR= 2.80, 95% CI (1.44, 5.46)), 8.05 (AOR=8.05, 95% CI (2.93, 22.10)), and 7.53 (AOR=7.53, 95% CI (2.52, 22.49)) for can read and write, secondary, preparatory and above education, respectively, compared to cannot read and write. Occupation was significantly associated with the knowledge of plod pressure control. For example, merchants 7.66 (AOR=7.66, 95% CI (3.01, 19.47)), government employee 6.33 (AOR=6.33, 95% CI (1.90, 22.07)), and self-employed 4.58 (AOR=4.58, 95% CI (1.80, 11.70)) times more likely to be knowledgeable than farmers, respectively. Participants with family history of hypertension were 2.36 (AOR=2.36, 95% CI (1.42, 3.92)) times more knowledgeable than their counterparts. Conclusion: In this study, knowledge of blood pressure control was lower compared to the finding of a study done at Bishoftu hospital, Ethiopia. But it is higher than studies in other African countries. Both pharmacological and non-pharmacological awareness is vital for blood pressure control.


Asunto(s)
Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Conocimientos, Actitudes y Práctica en Salud , Estilo de Vida Saludable , Hospitales Universitarios , Hipertensión/terapia , Servicio Ambulatorio en Hospital , Conducta de Reducción del Riesgo , Adulto , Anciano , Estudios Transversales , Escolaridad , Etiopía , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Hipertensión/psicología , Masculino , Persona de Mediana Edad , Ocupaciones , Factores de Riesgo , Factores Sexuales
5.
Nihon Yakurigaku Zasshi ; 154(5): 270-274, 2019.
Artículo en Japonés | MEDLINE | ID: mdl-31735757

RESUMEN

In the 18th century, Edward Jenner proposed the vaccine for smallpox as a first vaccine therapy based on the legend that a vaccinia prevents the infection with smallpox. Recently, the therapeutic target of vaccine will expand from infectious diseases to various diseases, such as amyloid ß or tau vaccine for Alzheimer's disease. We are now going to develop a therapeutic vaccine to lifestyle-related diseases (i.e. high blood pressure), and aim to realize a novel therapy which will be injected once or twice per year from a daily medication. For this purpose, the appropriate choice of an antigen, carrier and adjuvants should be required to activate hormonal immunity by the vaccine, leading to efficient antibody production without toxicity, because the therapeutic target of our vaccine is an endogenous protein (i.e. hormone). The clinical advantage of this therapeutic vaccine is to improve the medical adherence and drug management because the multiple drug users are increased in particular old patients, so called polypharmacy. If the vaccine will take place of a part of medicine in future, it may give us a novel therapeutic option with several social benefits.


Asunto(s)
Hipertensión/terapia , Estilo de Vida , Vacunas/uso terapéutico , Humanos
6.
Presse Med ; 48(11 Pt 1): 1288-1294, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31727484

RESUMEN

Menopause is associated with a significant increase in arterial and metabolic risk. Systolic hypertension is common in post-menopausal women. Measurement of blood pressure should be repeated systematically at each visit. Ambulatory blood pressure measurements should be encouraged, especially to detect nocturnal hypertension and to prevent more efficiently women at risk. Self-testing of hypertension by home blood pressure should be encouraged at menopause. Antihypertensive treatment should be initiated after ambulatory blood pressure monitoring in association with reinforced lifestyle. Furthermore, global level of cardiovascular risk should take into account before starting antihypertensive treatment. There are no women specificities in the choice of the initial treatment except thiazide diuretics which should be preferred in osteoporotic women. In hypertensive women and with disabling climacteric symptoms under 60 and within 10 years after the onset of menopause, post-menopausal hormone therapy can be offered in absence of arterial or venous contraindications. A preliminary discussion between gynecologist, cardiologist and general practionner is necessary before deciding to treat a post-menopausal women for her climacteric symptoms. A clear information on the benefit-risk balance of post-menopausal hormone therapy should be given to the women. The information should be recorded in the medical file. Cooperation between cardiologists, gynecologists and general practionners should be promoted in France, to optimize the care pathways in these women at risk and to improve medical practices.


Asunto(s)
Hipertensión , Posmenopausia , Factores de Edad , Antihipertensivos/uso terapéutico , Determinación de la Presión Sanguínea/métodos , Cardiología , Femenino , Ginecología , Humanos , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/prevención & control , Hipertensión/terapia , Persona de Mediana Edad , Grupo de Atención al Paciente , Medicina de Precisión , Autocuidado , Factores de Tiempo
7.
Presse Med ; 48(11 Pt 1): 1301-1305, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31727486

RESUMEN

Menopause requires the implementation of organized screening and dedicated care pathways in collaboration with the attending physician, the gynaecologist-obstetrician and the cardiovascular physician. It will be necessary to take into account the hormonal specificities of the cardiovascular risk, in order to know-how to properly prescribe hormonal treatments.


Asunto(s)
Vías Clínicas/organización & administración , Hipertensión/terapia , Menopausia , Cardiología , Femenino , Francia , Ginecología , Humanos , Hipertensión/diagnóstico , Persona de Mediana Edad , Obstetricia , Grupo de Atención al Paciente/organización & administración
9.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1139-1144, 2019 Sep 10.
Artículo en Chino | MEDLINE | ID: mdl-31594161

RESUMEN

Objective: To investigate the prevalence, awareness, treatment and control of hypertension in adult residents in Jiangsu province and provide evidence for the prevention and control of hypertension. Methods: A population-based cardiovascular disease screening project was conducted during 2015-2018 in Jiangsu, a total of 95 348 community-dwelling adults aged 35-75 years from 6 project areas were included in the study. The prevalence rate of hypertension and rates of awareness, treatment and control of hypertension in the adults with different characteristics were analyzed. Multilevel model was applied to identify the influencing factors. Results: Among 95 348 adults surveyed, 54 407 were hypertensive, the standardized prevalence rate was 48.1%. The prevalence rate was significantly higher in males than in females (62.1% vs. 54.0%, P<0.05). Among the hypertension patients, the rates of awareness, treatment and control of hypertension were 56.6%, 45.3% and 12.0% (standardized rates: 52.2%, 41.0% and 11.2%), respectively, and all the rates were positively associated with age (all P<0.05). Multilevel model analysis showed that those who were males, at older age, lived in rural area, suffered from diabetes, had frequent alcohol drinking and those who were overweight/obese had higher risk for hypertension (all P<0.05). Among people with hypertension, those who had younger age, lower education level, lower household income level and those who had frequent alcohol drinking had lower awareness, treatment and control rates of hypertension (all P<0.05). Conclusions: The prevalence rate of hypertension was high, but related awareness, treatment and control rates were low in adult residents in Jiangsu province. Comprehensive measures should be taken to improve awareness, treatment and control of hypertension in whole population, especially in young adults, and those with low education or income levels.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Hipertensión/epidemiología , Adulto , Anciano , Concienciación , China/epidemiología , Femenino , Humanos , Hipertensión/terapia , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Adulto Joven
10.
Rev Lat Am Enfermagem ; 27: e3166, 2019.
Artículo en Portugués, Inglés, Español | MEDLINE | ID: mdl-31596406

RESUMEN

OBJECTIVE: to identify patterns of associations between the degree of compliance to laboratory test requests by risk strata and the parameters of quality of care outcomes in primary health care (PHC). METHOD: a cross-sectional study involving 108 elderly patients with hypertension and/or diabetes treated in PHC. A semi-structured questionnaire and electronic medical record data were used. To evaluate the quality of care, the Patient Assessment of Chronic Illness Care (PACIC) questionnaire was used. Descriptive analysis, multiple correspondence analysis and k-means grouping were performed. RESULTS: it was observed low compliance of the care practice, standing out as the worst parameter the evaluation of the diabetic foot (2.2%). Three clusters were identified, with cluster 1 having the highest number of individuals (37.0%), with better indicators of quality of care, evidenced by above 50% of compliance with laboratory tests (75.0%), high PACIC score (47.2%), control of blood pressure (70.0%) and metabolic levels (95.0%), and satisfaction with health (92.5%) and health access (90.0%). In contrast, cluster 3 (29.6%) was made up of individuals with worse outcomes of care. CONCLUSION: low compliance of care practice and asymmetries among health actions and users' needs were observed, indicating failures in the care process in PHC.


Asunto(s)
Diabetes Mellitus/terapia , Servicios de Salud para Ancianos/organización & administración , Hipertensión/terapia , Atención Primaria de Salud , Calidad de la Atención de Salud/normas , Anciano , Anciano de 80 o más Años , Brasil , Enfermedad Crónica , Femenino , Servicios de Salud para Ancianos/normas , Humanos , Masculino , Cooperación del Paciente , Satisfacción del Paciente , Derivación y Consulta , Medición de Riesgo , Encuestas y Cuestionarios
11.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(4 (Supl)): 383-386, out.-dez. 2019. tab
Artículo en Portugués | LILACS | ID: biblio-1047316

RESUMEN

Objetivo: Determinar a prevalência da disfunção erétil (DE) em pacientes com hipertensão arterial (HA) primária em tratamento medicamentoso e sua relação e análise do impacto psicossocial. Métodos: O estudo abordou homens hipertensos em tratamento medicamentoso e idade superior a 40 anos que foram avaliados segundo o Índice Internacional de Função Erétil (IIFE- 5), Escala de Ansiedade e Depressão e um questionário sobre sua opinião quanto à relação da DE com as medicações anti-hipertensivas. A dosagem da testosterona sérica foi usada para exclusão de causas orgânicas da DE. Os dados foram analisados visando identificar o coeficiente de correlação entre as varáveis. Resultados: Foi observada prevalência de DE em 74% dos pacientes e, destes, 43% referiram piora do desempenho sexual após uso crônico da medicação anti-hipertensiva. Não foi possível provar uma correlação direta entre o uso de anti-hipertensivos e a DE, entretanto observou-se aumento do coeficiente de correlação em função da progressão da idade dos pacientes. Os betabloqueadores mostraram maior coeficiente de correlação com a DE (25%), seguido dos inibidores da enzima conversora de angiotensina (19%). Dos pacientes, 43% foram classificados com provável diagnóstico de ansiedade ou depressão e 35% com possível diagnóstico. Conclusão: Foi possível inferir, mas não afirmar uma correlação entre DE, HA e o uso de anti-hipertensivos


Objective: To determine the prevalence of erectile dysfunction (ED) in patients with primary arterial hypertension (AH) undergoing drug treatment and its relationship and analysis of psychosocial impact. Methods: The study addressed hypertensive men on drug treatment and over 40 years of age who were evaluated according to the International Index of Erectile Function (IIFE-5), Anxiety and Depression Scale, and a questionnaire about their opinion regarding the relationship between ED and antihypertensive medications. Serum testosterone dosage was used to rule out the organic causes of ED. Data were analyzed to identify the correlation coefficient between variables. Results: Prevalence of ED was observed in 74% of patients and, of these, 43% reported worsened sexual performance after chronic use of antihypertensive medications. It was not possible to prove any direct correlation between the use of antihypertensive drugs and ED, however an increase in the correlation coefficient was observed as a function of patients' age progression. Beta-blockers showed higher correlation coefficient with ED (25%), followed by angiotensin-converting enzyme inhibitors (19%). 43% of patients were classified with probable diagnosis of anxiety or depression and 35% with possible diagnosis. Conclusion: It was possible to infer but not to affirm a correlation between DE, HA and the use of antihypertensive drugs


Asunto(s)
Hipertensión/terapia , Disfunción Eréctil , Antihipertensivos , Ansiedad , Enfermedades Cardiovasculares , Enfermedad Crónica , Prevalencia , Estudios Prospectivos , Encuestas y Cuestionarios , Factores de Riesgo , Depresión , Quimioterapia
12.
Rev Med Suisse ; 15(662): 1597-1602, 2019 Sep 11.
Artículo en Francés | MEDLINE | ID: mdl-31508910

RESUMEN

Hypertension is highly prevalent in elderly and represents the number one risk factor for cardiac and cerebrovascular complications including cognitive dysfunction. Recently published AHA/ACC and ESC/ESH guidelines for the management of hypertension in adults have modified the approach of hypertension in patients older than 65 years and particularly in those older than 85. The new concepts are the following: the thresholds and target blood pressures for patients older than 65 years are less conservative; emphasis is made on biological rather than chronological age; the use of single pill combinations is favored to simplify treatment algorithms and increase long-term drug adherence. At last, a regular assessment of adherence in collaboration with health care partners is highlighted.


Asunto(s)
Hipertensión/terapia , Guías de Práctica Clínica como Asunto , Anciano , Humanos , Hipertensión/complicaciones
13.
Rev Med Suisse ; 15(662): 1620-1624, 2019 Sep 11.
Artículo en Francés | MEDLINE | ID: mdl-31508913

RESUMEN

Obstructive sleep apnea syndrome (OSAS) and arterial hypertension (HT) are two frequent, often concomitant diseases, who are both associated with an increased cardiovascular risk. In the last years, an association between these two entities has been established. The purpose of this article is to review the current knowledge about the link between HT and OSAS, the pathophysiological mechanisms involved in the common genesis of the two conditions and the characteristics suggesting an underlying OSAS in a hypertensive subject. We will also update readers about the current screening of OSAS in which primary care physicians are directly involved, and review the pros and cons of different treatment options for HT in OSAS.


Asunto(s)
Hipertensión/complicaciones , Hipertensión/terapia , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/diagnóstico , Humanos , Hipertensión/fisiopatología , Apnea Obstructiva del Sueño/fisiopatología
14.
Rev Med Suisse ; 15(662): 1629-1632, 2019 Sep 11.
Artículo en Francés | MEDLINE | ID: mdl-31508915

RESUMEN

Arterial hypertension (HT) affects hundreds millions of people suffering from chronic kidney disease: it could be a cause or a consequence. HT can aggravate their prognosis and then lead to a very high cardiovascular morbidity and mortality. HT must be systematically screened and optimally taken care of. However, general practitioners actually lack unambiguous guidelines regarding patients with kidney diseases. This article underlines the necessity and modalities of a precise diagnosis, and aims to discuss the last studies supporting new and better therapeutic targets. The pathophysiological aspects of HT in chronic kidney diseases are also discussed.


Asunto(s)
Hipertensión/complicaciones , Hipertensión/terapia , Insuficiencia Renal Crónica/complicaciones , Humanos , Hipertensión/mortalidad , Guías de Práctica Clínica como Asunto , Pronóstico , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/terapia , Factores de Riesgo
16.
Clin Interv Aging ; 14: 1407-1418, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31496668

RESUMEN

Purpose: Acute reduction in blood pressure (BP) following an exercise session is evidenced in controlled settings with formal supervision in hypertensive older populations. This study investigated the effect of a self-selected exercise (SSE)-intensity session on ambulatory BP in hypertensive older women in a "real-world" setting. Methods: Twenty inactive older women with hypertension (64.9±4.5 years) were included in this randomized, controlled, crossover trial. After baseline assessments, participants performed 30 minutes of an SSE-intensity session on an outdoor track and a control session, separated by 7-10 days. Heart rate (HR), rating of perceived exertion (RPE), and affective response were assessed. Ambulatory BP was monitored for 20 hours following both sessions. Paired t-tests and generalized estimation were used for data analysis. Results: Participants exercised at 5.1±1.1 km/h, spent ~90% of the exercise time at moderate-vigorous intensity (≥40% of heart rate reserve). SSE-intensity session was reported as light (RPE 11.0±1.5) and pleasant (affect 3.4±1.2). SSE-intensity session elicited reductions in systolic BP in the first 6 hours postexercise (6.0 mmHg, CI 2.7-9.3 mmHg; P<0.001). Average systolic BP in the 20-hour (-3.4 mmHg, CI -5.9 to -0.9 mmHg; P=0.010) and awake (-4.0 mmHg, CI -6.4 to -1.6 mmHg; P=0.003) periods were lower following SSE-intensity session compared to control session. No differences were observed in average systolic BP during asleep period and diastolic BP during the 20-hour awake and asleep periods between the SSE-intensity session and control session (P>0.05). Conclusion: An SSE-intensity session elicited a reduction in ambulatory systolic BP in inactive older women with hypertension during awake and 20-hour periods. Also, the SSE-intensity session was reported as light and pleasant.


Asunto(s)
Terapia por Ejercicio/métodos , Ejercicio/fisiología , Frecuencia Cardíaca , Hipertensión/terapia , Anciano , Presión Sanguínea/fisiología , Monitoreo Ambulatorio de la Presión Arterial , Estudios Cruzados , Femenino , Humanos , Hipertensión/fisiopatología , Persona de Mediana Edad , Flujo Sanguíneo Regional
17.
Lancet ; 394(10205): 1231-1242, 2019 10 05.
Artículo en Inglés | MEDLINE | ID: mdl-31488369

RESUMEN

BACKGROUND: Hypertension is the leading cause of cardiovascular disease globally. Despite proven benefits, hypertension control is poor. We hypothesised that a comprehensive approach to lowering blood pressure and other risk factors, informed by detailed analysis of local barriers, would be superior to usual care in individuals with poorly controlled or newly diagnosed hypertension. We tested whether a model of care involving non-physician health workers (NPHWs), primary care physicians, family, and the provision of effective medications, could substantially reduce cardiovascular disease risk. METHODS: HOPE 4 was an open, community-based, cluster-randomised controlled trial involving 1371 individuals with new or poorly controlled hypertension from 30 communities (defined as townships) in Colombia and Malaysia. 16 communities were randomly assigned to control (usual care, n=727), and 14 (n=644) to the intervention. After community screening, the intervention included treatment of cardiovascular disease risk factors by NPHWs using tablet computer-based simplified management algorithms and counselling programmes; free antihypertensive and statin medications recommended by NPHWs but supervised by physicians; and support from a family member or friend (treatment supporter) to improve adherence to medications and healthy behaviours. The primary outcome was the change in Framingham Risk Score 10-year cardiovascular disease risk estimate at 12 months between intervention and control participants. The HOPE 4 trial is registered at ClinicalTrials.gov, NCT01826019. FINDINGS: All communities completed 12-month follow-up (data on 97% of living participants, n=1299). The reduction in Framingham Risk Score for 10-year cardiovascular disease risk was -6·40% (95% CI 8·00 to -4·80) in the control group and -11·17% (-12·88 to -9·47) in the intervention group, with a difference of change of -4·78% (95% CI -7·11 to -2·44, p<0·0001). There was an absolute 11·45 mm Hg (95% CI -14·94 to -7·97) greater reduction in systolic blood pressure, and a 0·41 mmol/L (95% CI -0·60 to -0·23) reduction in LDL with the intervention group (both p<0·0001). Change in blood pressure control status (<140 mm Hg) was 69% in the intervention group versus 30% in the control group (p<0·0001). There were no safety concerns with the intervention. INTERPRETATION: A comprehensive model of care led by NPHWs, involving primary care physicians and family that was informed by local context, substantially improved blood pressure control and cardiovascular disease risk. This strategy is effective, pragmatic, and has the potential to substantially reduce cardiovascular disease compared with current strategies that are typically physician based. FUNDING: Canadian Institutes of Health Research; Grand Challenges Canada; Ontario SPOR Support Unit and the Ontario Ministry of Health and Long-Term Care; Boehringer Ingelheim; Department of Management of Non-Communicable Diseases, WHO; and Population Health Research Institute. VIDEO ABSTRACT.


Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Participación de la Comunidad/métodos , Hipertensión/complicaciones , Anciano , Colombia , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/prevención & control , Hipertensión/terapia , Malasia , Masculino , Conducta de Reducción del Riesgo
18.
Medicine (Baltimore) ; 98(36): e16894, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31490374

RESUMEN

Hypertension is a common global health problem including China. This study aimed to assess the prevalence and awareness of hypertension, and evaluate risk factors associated with hypertension among multi-ethnic population in northwest China using a random sampling cross-sectional data.A cross-sectional survey was conducted between 2014 and 2015 as part of a nationwide survey using stratified four-stage random sampling in Xinjiang. Hypertension was defined as mean systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥140/90 mm Hg and/or taking anti-hypertensive medication. In addition, the prevalence of hypertension (SBP ≥ 130 or DBP ≥ 80 mm Hg) was also estimated according to the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline. Awareness of hypertension was based on self-report. An optimized risk score model was used to assess the risk and determine the predictive power of risk factors on hypertension.Totally 6722 subjects aged ≥18 years were enrolled and prevalence of hypertension was 24.3%, while the prevalence of hypertension based on the 2017 ACC/AHA guideline was approximately twice as high as that based on 2010 Chinese guideline (37.6%). Among individuals with hypertension, 55.5% were aware of their condition. Six potential factors were estimated to be associated with increased risk of hypertension including age, ethnicity, marital status, body mass index (BMI), waistline circumference, and comorbidity. In the analyses of calculated risk score, BMI ≥ 28.0 corresponded to the highest risk score of 23 points. The area under the receiver operation curve for the multivariable prediction model was 0.803 (95%CI: 0.789-0.813).There is a considerable prevalence of hypertension among Xinjiang adults, northwest China; awareness of hypertension is low. Excess weight loss may be a vital strategy for controlling hypertension, particularly if accompanied with other preventive measures in this region.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud/etnología , Hipertensión/etnología , Hipertensión/terapia , Pérdida de Peso , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Glucemia , Índice de Masa Corporal , Pesos y Medidas Corporales , China/epidemiología , Comorbilidad , Estudios Transversales , Grupos Étnicos , Femenino , Humanos , Lípidos/sangre , Masculino , Persona de Mediana Edad , Factores de Riesgo , Autoinforme , Factores Sexuales , Factores Socioeconómicos , Adulto Joven
20.
Hypertension ; 74(4): 1041-1051, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31476904

RESUMEN

Transient hypertension is a risk factor for Alzheimer disease (AD), but the effects of this interaction on brain vasculature are understudied. Addressing vascular pathology is a promising avenue to potentiate the efficacy of treatments for AD. We used arterial spin labeling magnetic resonance imaging to longitudinally assess brain vascular function and immunohistopathology to examine cerebrovascular remodeling and amyloid load. Hypertension was induced for 1 month by administration of l-NG-nitroarginine-methyl-ester in TgF344-AD rats at the prodromal stage. Following hypertension, nontransgenic rats showed transient cerebrovascular changes, whereas TgF344-AD animals exhibited sustained alterations in cerebrovascular function. Human umbilical cord perivascular cells in combination with scyllo-inositol, an inhibitor of Aß oligomerization, resulted in normalization of hippocampal vascular function and remodeling, in contrast to either treatment alone. Prodromal stage hypertension exacerbates latter AD pathology, and the combination of human umbilical cord perivascular cells with amyloid clearance promotes cerebrovascular functional recovery.


Asunto(s)
Enfermedad de Alzheimer/fisiopatología , Hipertensión/fisiopatología , Enfermedad de Alzheimer/etiología , Enfermedad de Alzheimer/metabolismo , Péptidos beta-Amiloides/metabolismo , Animales , Encéfalo/fisiopatología , Modelos Animales de Enfermedad , Hemodinámica/fisiología , Hipertensión/complicaciones , Hipertensión/terapia , Imagen por Resonancia Magnética , Ratas , Marcadores de Spin
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