Consensus recommendations on fasting during Ramadan for patients with kidney disease: review of available evidence and a call for action (RaK Initiative).

Ramadan fasting (RF) involves abstaining from food and drink during daylight hours; it is obligatory for all healthy Muslims from the age of puberty. Although sick individuals are exempt from fasting, many will fast anyway. This article explores the impact of RF on individuals with kidney diseases through a comprehensive review of existing literature and consensus recommendations. This study was conducted by a multidisciplinary panel of experts.The recommendations aim to provide a structured approach to assess and manage fasting during Ramadan for patients with kidney diseases, empowering both healthcare providers and patients to make informed decisions while considering their unique circumstances.

Global blood pressure screening during the COVID-19 pandemic: results from the May Measurement Month 2021 campaign.

BACKGROUND: Raised blood pressure (BP) remains the biggest risk factor contributing to the global burden of disease and mortality, despite the COVID-19 pandemic. May Measurement Month (MMM), an annual global screening campaign aims to highlight the importance of BP measurement by evaluating global awareness, treatment and control rates among adults with hypertension. In 2021, we assessed the global burden of these rates during the COVID-19 pandemic. METHODS: Screening sites were set up in 54 countries between May and November 2021 and screenees were recruited by convenience sampling. Three sitting BPs were measured, and a questionnaire completed including demographic, lifestyle and clinical data. Hypertension was defined as a systolic BP at least 140 mmHg and/or a diastolic BP at least 90 mmHg (using the mean of the second and third readings) or taking antihypertensive medication. Multiple imputation was used to impute the average BP when readings were missing. RESULTS: Of the 642 057 screenees, 225 882 (35.2%) were classified as hypertensive, of whom 56.8% were aware, and 50.3% were on antihypertensive medication. Of those on treatment, 53.9% had controlled BP (<140/90 mmHg). Awareness, treatment and control rates were lower than those reported in MMM campaigns before the COVID-19 pandemic. Minimal changes were apparent among those testing positive for, or being vaccinated against COVID-19. Of those on antihypertensive medication, 94.7% reported no change in their treatment because of the COVID-19 pandemic. CONCLUSION: The high yield of untreated or inadequately treated hypertension in MMM 2021 confirms the need for systematic BP screening where it does not currently exist.

Addressing global disparities in blood pressure control: perspectives of the International Society of Hypertension.

ABSTRACT: Raised blood pressure (BP) is the leading cause of preventable death in the world. Yet, its global prevalence is increasing, and it remains poorly detected, treated, and controlled in both high- and low-resource settings. From the perspective of members of the International Society of Hypertension based in all regions, we reflect on the past, present, and future of hypertension care, highlighting key challenges and opportunities, which are often region-specific. We report that most countries failed to show sufficient improvements in BP control rates over the past three decades, with greater improvements mainly seen in some high-income countries, also reflected in substantial reductions in the burden of cardiovascular disease and deaths. Globally, there are significant inequities and disparities based on resources, sociodemographic environment, and race with subsequent disproportionate hypertension-related outcomes. Additional unique challenges in specific regions include conflict, wars, migration, unemployment, rapid urbanization, extremely limited funding, pollution, COVID-19-related restrictions and inequalities, obesity, and excessive salt and alcohol intake. Immediate action is needed to address suboptimal hypertension care and related disparities on a global scale. We propose a Global Hypertension Care Taskforce including multiple stakeholders and societies to identify and implement actions in reducing inequities, addressing social, commercial, and environmental determinants, and strengthening health systems implement a well-designed customized quality-of-care improvement framework.

Hypertension and Blood Pressure Pattern among Teenagers.

Because of its high prevalence, hypertension (HTN) will continue to exert an increased financial burden on both the individual and the governmental health budgets unless we consider changing our efforts in managing HTN.[1] Since the discovery of the first antihypertensive agent, during the 19th century, we had been focusing on blood pressure (BP) treatment by lowering the systolic and diastolic levels. Over decades, multiple drugs and combinations were introduced to lower the BP and reduce target organ damage, but they were unsuccessful in reducing the incidence or significantly limiting the prevalence. This study focuses on screening teenagers among middle and high schools. Looking for the prevalence and increasing awareness at the same time. It is about time to consider a different approach to stand against HTN. A world without HTN could be optimistic. However, looking into reducing the incidence and limiting the prevalence by early intervening and increasing awareness could be a reasonable first step in that direction. In this study, we screened 2747 students in 14 middle and high schools in Bahrain. The mean systolic BP was 114 mm Hg [standard deviation (SD): 13.9/standard error (SE): 0.27]. The mean diastolic BP was 67 mm Hg (SD 9.6/SE 0.18). Of the screened students, 38% had abnormal elevated BP. Among elevated BP, 68% had isolated systolic high pressure. Younger teenagers were having the higher BP. Age, gender, waist circumference, school, and nationality were among the independent variables associated with elevated BP. Body mass index was not related to elevated BP. Focusing more on prevention and early diagnosis could be a first step toward elimination of HTN, or at least reducing its prevalence.