IntroductionPopulation-based surveys in Nepal have demonstrated significant geographical variation with hypertension (HTN) prevalence ranging from 32.5% to 41.5% with a triple increase in the same place in a span of 25 years. This study aimed to identify HTN prevalence and its predictors among people in a rural community in Nepal.MethodsA cross-sectional survey was conducted among 596 adults in a rural municipality of Nepal. Data were collected through face-to-face interviews using the WHO STEPS questionnaire and the Pittsburgh Sleep Quality Index, in the local language. Following the interviews, physical measurements including height, waist and hip circumference (in centimeters), weight (in kilograms), and blood pressure were recorded. Body mass index (BMI) was calculated (weight in kg/height in m2), and waist-to-hip ratio (WHR) was computed by dividing waist circumference by hip circumference. The data were analyzed using SPSS Version 20 (IBM SPSS). Bivariate and multivariate analyses were employed to identify the independent predictors of the outcome variables.ResultsMost of the respondents were female with an average age of 36.54 +/- 14.95 years. Regarding body weight, 71.5% had normal BMI, 85.9% had high health risk WHR, 13.6% had raised BP, and 12% respondents had poor sleep quality. Factors associated with higher odds of hypertension included lesser education (OR = 5.889 and CI = 2.779-12.480), poor sleep quality (OR = 1.254 and CI = 1.070-1.471), current tobacco use (OR = 4.102 and CI = 2.730-16.165), current alcohol consumption (OR = 2.096 and CI = 1.388-3.163), and exposure to second-hand smoke (OR = 2.103 and CI = 1.311-3.375).ConclusionPoor sleep quality, tobacco use, including second-hand smoke exposure, alcohol consumption, and physical inactivity are significant risk factors for HTN. Therefore, public health programs need to be focused on such a high-risk population.
Real-time pulmonary artery (PA) stenting under magnetic resonance imaging (MRI) guidance may eliminate radiation exposure during complex vascular interventions. This study evaluated the feasibility of performing PA stenting in a swine model using a commercially available 0.55-T MRI system with ferumoxytol-enhanced imaging. Ten juvenile pigs underwent attempts at MRI-guided PA stent deployment using stainless-steel balloon-expandable stents. Stenting was successful in 7 animals, with all successes achieved after switching from femoral to external jugular venous access. Real-time gradient echo imaging provided sufficient visualization for catheter navigation, device delivery, and stent deployment. Postdeployment phase contrast imaging demonstrated flow continuity, minimal artifact, and trivial pressure gradients across the stent (0.2 ± 0.12 mm Hg). Peak velocities increased by 21.2 ± 7.0 cm/s distal to the stent, confirming preserved patency. These findings demonstrate the technical feasibility of CMR-guided PA stenting at 0.55-T and support the potential for future radiation-free PA interventions.
Measuring cyclic changes in intramyocardial blood volume (iMBV) from systole to diastole has been used as an imaging marker for assessing coronary microcirculation and detecting coronary artery disease (CAD) without the need for vasodilator stress. However, an MRI-based method for detecting cyclic iMBV dynamics does not exist. The aim of this study is to demonstrate the feasibility of using ferumoxytol-enhanced (FE) MRI to detect systolic-to-diastolic iMBV dynamics on clinical scanners enabled by a new myocardial "T1 tracking" technique. To this end, a continuous steady-state sequence was developed, combining slice/slab-selective excitation, to generate high-resolution T1-weighted images such that the myocardial signal dynamically tracks the fractional volume of blood while minimizing the influence of confounding factors such as in-flow effects, through-plane motion, and spin history. In addition to phantom studies, FE studies in swine (n = 10) were conducted to generate systolic/diastolic T1 maps from the T1-tracking data. For comparison, MOLLI T1 maps were acquired. For both the T1-tracking method and MOLLI, T1 values before/after ferumoxytol were used to calculate iMBV at end-systole (ES) and end-diastole (ED). The T1-tracking method showed a significant iMBV difference between ES and ED (ES: 6.2 ± 1.8%, ED: 7.7 ± 2.0%, p < 10-3) as opposed to MOLLI (ES: 8.1 ± 2.9%, ED: 8.6 ± 3.1%, p = 0.4), and detected lower iMBV at ES vs. ED in all 10 studies, consistent with physiology, while MOLLI showed contradictory ES-to-ED change in 3 out of 10 studies. The proposed method showed a mean iMBV decrease of 19.1% from ED to ES, consistent with the nuclear imaging literature. In conclusion, the results show that the newly developed FE myocardial T1-tracking technique captures cyclic changes in iMBV, i.e., consistently reveals the expected drop in iMBV from diastole to systole, offering the potential to detect CAD without the need for pharmacological stress.
