Background:Hypertension commonly coexists with diabetes and substantially increases the risk of cardiovascular and renal complications. However, data on the prevalence of hypertension and its associated factors among people with diabetes in Bangladesh remain limited. This study aimed to determine the prevalence of hypertension and identify factors associated with hypertension among adults with diabetes in the Sylhet region of Bangladesh. Methods:A total of 295 adults with diabetes were enrolled in this cross-sectional study. Data on anthropometric measurements, lifestyle factors, and sociodemographic characteristics were collected using a structured questionnaire and a review of medical records. Diabetes and hypertension were defined according to standard guidelines. Blood glucose and lipid profile parameters were measured using standard colorimetric methods. Multivariable logistic regression analysis was performed to identify factors associated with hypertension. Results:The overall prevalence of hypertension was 61.4% (181/295). Hypertension prevalence increased with age and adiposity, reaching 69.4% among participants aged > 55 years and 70.0% among those with obesity. In the multivariable logistic regression analysis, participants aged > 55 years had higher odds of hypertension than those aged 30-40 years (AOR = 2.09, 95% CI: 1.10-3.97). Compared with participants with normal BMI, overweight (AOR = 1.82, 95% CI: 1.03-3.20) and obesity (AOR = 2.46, 95% CI: 1.24-4.88) were significantly associated with hypertension. Abdominal obesity was also independently associated with hypertension (AOR = 2.57, 95% CI: 1.41-4.65). No significant associations were observed for sex, education level, dyslipidemia, lipid parameters, physical activity, or smoking status. Conclusions:Hypertension was highly prevalent among adults with diabetes in the Sylhet region of Bangladesh. Older age and both general and abdominal obesity were independently associated with hypertension, underscoring the importance of regular blood pressure screening and comprehensive weight management as integral components of diabetes care.
Background:Hypertension (HTN) is a leading risk factor for cardiovascular (CV) and renal morbidity and mortality, yet blood pressure (BP) control remains suboptimal worldwide. Understanding management patterns, especially among patients with coexisting Type 2 diabetes mellitus (T2DM), chronic kidney diseases (CKDs), or heart failure (HF), and assessing uncontrolled HTN burden across diverse health systems are critical to inform guideline-concordant strategies to improve care. Methods:Cross-sectional analysis includes participants with HTN, with or without comorbid T2DM, CKD, or HF enrolled in iCaReMe Global Registry across 29 countries. Demographic and clinical characteristics, antihypertensive treatment patterns, prevalence of uncontrolled HTN (defined as SBP ≥ 130 mmHg or DBP ≥ 80 mmHg), and its associated factors were assessed. Results:Among 23,063 participants, comorbidities included T2DM (71.4%), CKD (38.2%), and HF (14.6%). Key CV risk factors were family history of CV disease (34.3%), obesity (40.5%), and dyslipidemia (51.0%). Echocardiography (available in 28.6%) revealed left ventricular hypertrophy (LVH) in 30.6% and diastolic dysfunction in 42.4%. Overall, 88.7% were prescribed antihypertensive drugs: renin-angiotensin system (RAS) blockers (76.6%), calcium channel blockers (CCBs, 42.0%), beta-blockers (41.4%), diuretics (23.7%), with a majority (62.3%) on combination regimens. Uncontrolled HTN was prevalent in 75.4%, who were younger (59.8 vs 61.8 years) and exhibited higher burden of obesity (42.5% vs 34.6%), CKD (39.3% vs 33.1%), LVH (32.9% vs 24.8%), and treated less intensively with antihypertensives (60.2% vs 88.7%) and combinations (46.2% vs 61.8%) when compared to the controlled HTN group. Multivariate analysis confirmed independent association of non-use of RAS blockers/CCB/diuretics combinations (dual/triple therapy), obesity, and comorbid CKD, with uncontrolled HTN (OR [95% CI], 2.8 [2.44-3.18]/2.3 [1.66-3.16], 1.5 [1.38-1.65], and 1.4 [1.27-1.53], respectively, p < 0.0001). Conclusion:This study uncovers alarming rates of uncontrolled HTN in real-world settings, exacerbated by comorbid T2DM/CKD/HF, underscoring the need to identify HTN management gaps and tailor innovative strategies to mitigate CV risk. Trial Registration: ClinicalTrials.gov identifier: NCT03549754.
Obesity-related renal dysfunction is largely attributed to hemodynamic alterations and insulin resistance. Among individuals with overweight or obesity, albuminuria has been shown to be independently and inversely associated with circulating adiponectin levels in the absence of diabetes. Accordingly, this study aimed to evaluate and quantify the independent association between obesity and the risk of kidney disease, as assessed by the presence of albuminuria in the Asian Population. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive and systematic search strategy was applied across multiple electronic databases, including PubMed, ProQuest, Taylor & Francis, and Wiley, to identify relevant studies meeting the eligibility criteria. Data synthesis and statistical analyses were carried out using Review Manager (RevMan) software Version 5.4, and the methodological rigor of the included studies was independently assessed using the Newcastle-Ottawa Scale (NOS). The pooled analysis demonstrated that obesity was significantly associated with albuminuria in the general population as well as in sex-specific subgroups. Specifically, the odds of albuminuria were higher among individuals with obesity in the overall population (OR = 1.76; 95% CI: 1.09-2.83; p = 0.02, I 2 = 78%), in men (OR = 1.34; 95% CI: 1.05-1.71; p = 0.02, I 2 = 63%), and in women (OR = 1.16; 95% CI: 1.05-1.28; p = 0.004, I 2 = 19%). Obesity was associated with albuminuria in Asian Populations.
Hypertension (HT) is associated with vascular dysfunction, chronic low-grade inflammation, and increased arterial stiffness, all of which contribute to elevated cardiovascular risk. Lifestyle-based interventions incorporating nutritional and exercise strategies may provide complementary vascular benefits. This study investigated the effects of chicken protein hydrolysate supplementation, administered alone or combined with concurrent training (CT), on arterial stiffness, blood pressure (BP), inflammatory markers, and physical fitness in adults with HT. In this randomized controlled trial, adults with HT who completed the study were included in the analysis: control (CON, n = 12), chicken protein hydrolysate supplementation alone (PRO, n = 10; 28 g/day), and supplementation combined with CT (PRO + CT, n = 12) following the 8-week intervention. BP, brachial-ankle pulse wave velocity (baPWV), high-sensitivity C-reactive protein (hs-CRP), and physical fitness outcomes-including peak oxygen consumption (V̇O2peak) and upper- and lower-body muscular endurance-were assessed at baseline and postintervention. Significant group × time interactions were observed for baPWV (p < 0.01), hs-CRP (p < 0.01), V̇O2peak (p < 0.01), and upper- and lower-body muscular endurance (p < 0.01). Both PRO and PRO + CT demonstrated greater reductions in baPWV compared with CON (p < 0.05). Significant reductions in hs-CRP were observed in both PRO and PRO + CT groups (p < 0.01); however, only PRO + CT demonstrated a significantly greater reduction compared with CON (p < 0.05). Improvements in V̇O2peak and muscular endurance occurred exclusively in the PRO + CT group (p < 0.01), whereas changes in BP were modest across intervention groups. Chicken protein hydrolysate supplementation, particularly when combined with CT, was associated with improvements in arterial stiffness, while the combined intervention further improved inflammatory status and physical fitness outcomes. These findings suggest a potential role for combined nutritional and exercise-based lifestyle interventions in improving vascular function in adults with HT. Trial Registration: Thai Clinical Trials Registry: TCTR20251210008.
Objective:Sleep deprivation is associated with an increased risk of hypertension (HTN), and many individuals practice weekend catch-up sleep (WCS). However, evidence of an association between WCS and HTN in adults in the United States remains limited. This study examines this relationship using a nationally representative sample. Methods:Data from NHANES 2017-2023 (16,268 adults aged ≥ 20 years) were analyzed. The WCS was defined as weekend sleep minus weekday sleep. Multivariate logistic regression was used to adjust for sociodemographic, lifestyle, and metabolic factors. WCS was examined as a binary (> 0 vs. ≤ 0 h), continuous, and categorical (≤ 0, 0-1, 1-2, 2-3, and ≥ 3 h) variable. Subgroup analyses were exploratory and not corrected for multiple testing. Results:In the fully adjusted models, neither the binary nor continuous WCS duration was significantly associated with HTN (p > 0.05). Among categorical analyses, only the 0-1 h WCS group showed lower odds of HTN compared with the ≤ 0 h group (OR = 0.814, 95% CI: 0.666-0.995, p = 0.033); all other WCS categories (1-2 h, 2-3 h, and ≥ 3 h) were nonsignificant. No dose-response relationship was observed. Subgroup analyses suggested potential effect modification by sex and education, but these results are hypothesis-generating given the lack of correction for multiple comparisons. Conclusion:In this large cross-sectional study, the WCS was not robustly associated with HTN. The isolated finding of 0-1 h of WCS requires confirmation in prospective studies and should not be interpreted as evidence for a preventive or therapeutic strategy.
Introduction:Childhood-onset systemic lupus erythematosus (cSLE) primarily affects children and adolescents and is a potentially life-threatening condition. In contrast to adult-onset SLE, children with cSLE tend to have a more severe and aggressive course of disease. One of the most prevalent and concerning comorbidities in SLE patients is hypertension (HTN). This study evaluates diverse aspects of HTN in pediatric patients afflicted with cSLE at a tertiary hospital. Method:This historical study includes medical records of all patients with cSLE referred to Children's Medical Hospital for two years (2020-2022). Data were collected on various clinical features and laboratory findings and were analyzed by SPSS software. Results:A total of 76 patients with cSLE were included, of whom 59.2% had lupus nephritis at diagnosis. Forty-one patients (53.9%) had normal blood pressure, while 35 patients (46.1%) were diagnosed with HTN. Although the mean age of the HTN group was higher than that of the non-HTN group, the difference, however, was not statistically significant (p value = 0.548). Similarly, the gender distribution between the HTN and non-HTN groups was not significantly different (p value = 0.350), suggesting that neither age nor sex is a major determinant of HTN in this population. Significant differences were observed between the HTN and non-HTN groups in hemoglobin, hematocrit, polymorphonuclear cell count, complement Component 3, creatinine, blood urea nitrogen, sodium, and calcium levels. Conclusion:Laboratory changes associated with increased disease activity, including lower C3 levels, lower hemoglobin, and higher BUN and Cr were reported in cSLE patients with HTN. Given the high prevalence of HTN among cSLE patients, early diagnosis and treatment of HTN and renal involvement are crucial in the long-term outcomes of these patients.
Objective:Blood pressure (BP) variability provides prognostic information beyond mean BP. However, the class-specific associations of antihypertensive medications with BP variability remain uncertain, and few studies have directly contrasted home and office BP variability within the same patients while accounting for the white-coat effect. Methods:In a multicenter prospective registry, patients with hypertension and adequate measurements (≥ 10 home and ≥ 5 office readings) were analyzed. The primary outcomes were systolic and diastolic average real variability (ARV) of home and office BP. Associations of renin-angiotensin system inhibitors, beta-blockers, dihydropyridine calcium channel blockers (DHP-CCBs), and diuretics with BP variability were estimated using inverse probability of treatment weighting (IPTW) and doubly robust models. The white-coat effect was further adjusted using both a continuous office-home mean difference and a guideline-based white-coat definition. A true-monotherapy subcohort sensitivity analysis and class-by-class interaction tests were additionally performed. Results:Among 495 participants, home ARV differed minimally by antihypertensive class; a small beta-blocker-associated increase in home systolic BP (SBP)-ARV was attenuated with additional adjustment. In contrast, office BP ARV was higher with DHP-CCBs and diuretics, although the beta-blocker association was weakened after further adjustment. Following white-coat effect adjustment, home BP ARV remained neutral across drug classes, whereas DHP-CCB remained associated with higher office SBP-ARV and diuretics with higher office diastolic BP ARV. DHP-CCBs were also associated with a lower probability of office BP control. Home BP control rates did not differ significantly by antihypertensive class. Conclusions:In this cross-sectional observational cohort, antihypertensive medication classes showed context-dependent associations with BP variability, which were minimal for home BP but more pronounced for office BP, partially independent of the white-coat effect. Given potential residual confounding by indication, these hypothesis-generating findings warrant prospective confirmation.
Background:Hypertension is a critical global health issue, with self-monitoring of blood pressure emerging as an essential tool for its management. In Ghana, clinic visits are mostly scheduled at 2-3 monthly intervals, making it difficult to assess patient blood pressure control in between visits. The use of mobile health applications for the self-monitoring of blood pressure among hypertensive patients is not well-documented. Empowering patients through self-monitoring of blood pressure along with feedback from an interactive mobile health application could potentially improve blood pressure control. To ensure that such applications are effective, patient knowledge, perceptions and practices with regard to hypertension must be taken into consideration in the development of the interactive mobile health application. This study investigated patient knowledge of hypertension and the prevalence and practice of self-monitoring, as well as perceptions of hypertension and self-monitoring of blood pressure among Ghanaian patients diagnosed with hypertension at two teaching hospitals. Methods:A cross-sectional pilot study using a mixed-methods approach was conducted among patients aged 30 years and above who have been newly diagnosed without comorbidities with hypertension (blood pressure levels exceeding 140/90 mmHg). The pilot study explored perceptions and practices of the patients with regard to self-monitoring for blood pressure control prior to the introduction of a mobile health technology intervention. Newly diagnosed patients without comorbidities were specifically recruited so that the focus of the study would be solely on hypertension management, ensuring that participants' perceptions, knowledge and self-monitoring practices were not influenced or confounded by the concurrent management of other medical conditions. Recruiting patients at the point of diagnosis also ensured that baseline assessments were conducted prior to any formal patient education or structured self-monitoring coaching by healthcare providers, thereby providing an uncontaminated preintervention baseline for the planned mobile health intervention. Pregnant women and individuals with pre-existing hypertension and coexisting medical conditions were excluded. Quantitative data were analysed using STATA Version 16, while qualitative data from in-depth interviews were transcribed and analysed using NVivo Version 12. Themes from the qualitative analysis were used to contextualize the quantitative results. Results:The study included 32 hypertensive patients, with more males [53.1% (17/32)] than females. Overall, 71.9% (23/32) of patients knew normal and abnormal blood pressure values, with only 59.4% (19/32) demonstrating good general knowledge of hypertension. Notably, only 37.5% (12/32) of patients indicated that they routinely measured their blood pressure at home. Of the 12 respondents who did so, only nine ever recorded their blood pressure readings. Altogether, 62.5% (20/32) of respondents indicated that they felt comfortable measuring their blood pressure in the presence of others. With regard to confidence in using the blood pressure device independently, 59.4% (19/32) admitted to lacking confidence. Overall, 87.5% (28/32) indicated that they were comfortable using general smartphone applications with 56.2% (18/32) of respondents admitting to using phones for tracking their health status. Conclusions:This study highlights the need for enhanced information, education and communication if Ghanaian patients are to adopt self-monitoring of their blood pressure in between clinic visits to take charge of their own health and improve hypertension control. Understanding these perceptions and knowing what the existing practices are is critical for healthcare providers to support patients effectively in managing their blood pressure and for the introduction of policies that support and promote the use of mobile health technologies in managing hypertension.
End-stage renal disease (ESRD) patients are particularly susceptible to hypertension, as blood pressure (BP) dysregulation leads to increased mortality and morbidity, especially considering the heightened risk of cardiovascular complications, including myocardial infarction, stroke, and congestive heart failure. Given the lack of specific guidelines on therapies aimed at achieving adequate BP control in ESRD patients, we conducted a thorough literature review to identify relevant studies and articles exploring the associations of various therapies in ESRD patients and to provide a qualitative analysis based on these results. These include ACE inhibitors, ARBs, calcium channel blockers (CCBs), beta-blockers, diuretics, alpha-2 agonists, and direct vasodilators. ARBs are not affected by dialysis, while ACE inhibitors are dialyzable. Studies suggest that the incidence of cardiovascular events is significantly lower in ESRD patients receiving treatment compared to those without treatment. CCBs are nondialyzable and, thus, serve as a second-line treatment for BP control in ESRD patients. Limited evidence suggests that diuretic-based combination therapy may improve BP control in selected hemodialysis patients, but its effect on cardiovascular mortality remains uncertain. Beta-blockers have demonstrated a favorable profile but differ in dialyzability and cardioselectivity, making it challenging to endorse an ideal choice of drug. Direct vasodilators have been shown to reduce left ventricular hypertrophy, but further studies are needed to determine optimal dosing strategies. Clonidine, an alpha-2 agonist, lacks safety and efficacy evaluations but has been shown to reduce BP in ESRD patients.
Central adiposity is closely linked to blood pressure (BP), yet body mass index (BMI) and waist circumference (WC) may not fully capture fat distribution. We analyzed 4307 adults from NHANES 2011-2018 with whole-body dual-energy X-ray absorptiometry (DXA) to examine whether the trunk-to-appendicular fat ratio (TAR), a marker of trunk-predominant adiposity, was associated with BP. Survey-weighted multivariable linear regression and restricted cubic spline models were applied. TAR showed the strongest correlation with systolic BP (SBP) and diastolic BP (DBP) (r = 0.326 and 0.330, respectively; both p < 0.001). After adjustment for demographic and clinical covariates and either BMI or WC, TAR remained associated with higher SBP and DBP (p < 0.001). Additional adjustment for serum lipids modestly attenuated these associations, with triglycerides showing the largest attenuation. Higher TAR was consistently associated with higher predicted BP, supporting TAR as a useful adiposity index for hypertension research.
Resistant hypertension (RH), defined as uncontrolled blood pressure despite the use of at least three optimally dosed antihypertensive agents, including a diuretic, remains a major clinical challenge associated with elevated cardiovascular risk. Metabolomics offers a dynamic approach to characterize biochemical perturbations related to amino acid metabolism, lipid remodeling, mitochondrial dysfunction, oxidative stress, renal impairment, and gut microbiota-derived metabolites. However, current evidence remains limited by small sample sizes, cross-sectional designs, heterogeneous definitions of RH, inadequate exclusion of pseudoresistance, medication confounding, and limited external validation. This structured narrative review synthesizes RH-specific metabolomic evidence and distinguishes it from findings extrapolated from broader hypertension populations. We further discuss methodological challenges, replication gaps, pharmacometabolomic confounding, and validation standards required for clinical implementation. Integrating metabolomics with clinical phenotyping, genomics, proteomics, and microbiome profiling may eventually support RH phenotyping, treatment-response prediction, and biomarker-guided precision medicine, but large longitudinal cohorts with confirmed true RH are needed before clinical translation.
Large-scale protein assays have the potential to identify novel biomarkers and improve prediction of cardiovascular disease (CVD) risk. The burden of atherosclerotic CVD and related risk factors is disproportionately high in Afro-Caribbean populations in whom novel risk prediction strategies may be warranted. Thus, we analyzed the association of early atherosclerosis markers with peripheral blood proteomic biomarkers quantified using the Olink Target 96 Cardiovascular III panel in 342 community-dwelling men from the Tobago Health Study. Atherosclerosis markers included pulse wave velocity (PWV), abdominal aortic calcification (AAC), and coronary artery calcification (CAC). Blood pressure, height, and weight were measured by trained clinic staff. Hypertension, dyslipidemia, and diabetes status were classified via clinical measures and the prescription of relevant medication. Statistical methods included differential expression analysis fully adjusted for assay batch, age, BMI, smoking, diabetes, dyslipidemia, and blood pressures. Men ranged from 53 to 89 years of age (mean ± SD = 63.3 ± 8.1 years). Average BMI was 27.7 ± 4.3 kg/m2, 79.2% had hypertension, average LDL cholesterol was 129.4 ± 37.7 mg/dL, 24.6% had diabetes, and 5.9% were current smokers. In fully adjusted models, 18 proteins were associated with PWV and 1 was associated with CAC. There were no significant associations with AAC. Thirteen of these significant associations (12 PWV and 1 CAC) were novel, having never been identified as associated with these atherosclerosis measures in any previous study. While these proteins are involved in physiological processes known to contribute to CVD, such as inflammation, the strongest effects were seen for previously unreported protein associations. Our work is the first large-scale protein assay performed in an Afro-Caribbean population and adds to existing evidence that indicates that protein biomarker signatures of CVD may differ by racial/ethnic group. Further research is needed to understand the role of protein biomarkers in the prediction and progression of CVD among this high-risk group.
Objective:This study aimed to evaluate the patient characteristics, effectiveness, safety, adherence, and persistence of ramipril/indapamide (R/I) free combination therapy in patients with essential hypertension inadequately controlled with monotherapy. Methods:This retrospective observational cohort study used anonymized UK primary care electronic health records from IQVIA's Medical Research Database (IMRD), incorporating "The Health Improvement Network" (THIN), a Cegedim Database. Adults with essential hypertension who switched from ramipril or indapamide monotherapy to R/I between database inception and January 1, 2021, were enrolled. Outcomes included changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP), proportions achieving BP < 140/90 mmHg or SBP ≥ 20 mmHg/DBP ≥ 10 mmHg decrease, proportion of days covered (PDC), persistence, and adverse events (AEs) over 12 months. Results:A total of 1089 patients met inclusion criteria (mean age 63.5 years; 55.6% female). Mean baseline BP on monotherapy was 156.0/89.1 mmHg. Over 12 months, mean SBP decreased by 18.7 mmHg and DBP by 8.9 mmHg (both p < 0.001); 54.3% of patients achieved BP < 140/90 mmHg, and 61.6% met the predefined BP decrease threshold. A dose-response relationship was observed for BP outcomes. Mean PDC was 92.4% at 3 months and 86.2% at 12 months; persistence was 87.7% and 81.5%, respectively. The most frequent AE was cough (10.38%); gout occurred in 0.73%, exclusively in indapamide-naïve patients. The outcomes remained consistent across sensitivity and subgroup analyses. Conclusion:Switching from ramipril or indapamide monotherapy to their free combination was associated with clinically meaningful BP decreases, high adherence and persistence, and a favorable safety profile in routine practice. These findings are consistent with current therapeutic guidelines that endorse its use in essential hypertension management.
Background:Hypertension is the leading cause of global cardiovascular diseases and deaths, but its management remains poor in sub-Saharan Africa. Ambulatory blood pressure monitoring (ABPM) provides more detailed information on variations in blood pressure during the day and circadian patterns than office measurements. Unfortunately, there is a paucity of information regarding ABPM patterns among Nigerian adults. Objective:To determine the prevalence and circadian patterns of abnormal ambulatory blood pressure, as well as to identify sociodemographic, anthropometric and lifestyle predictors of systolic and diastolic dipping status in the adult population of Ido Ekiti, Nigeria. Methods:A community-based cross-sectional study involving 352 adults aged ≥ 18 years was conducted using a multistage sampling method. Office blood pressure and 24-h ABPM were recorded with validated automated devices. Dipping patterns were classified as dipper (10%-20%), nondipper (< 10%), reverse dipper (no decrease or increase) or extreme dipper (≥ 20%). Logistic regression was used to identify predictors of nondipping patterns. Results:The mean age was 48.6 ± 17.9 years, and 55.7% of the participants were females. Thirty-nine-point-eight percentage of the subjects had abnormal 24-h blood pressure (≥ 130/80 mmHg). Only 22.2% and 36.9% showed normal systolic and diastolic dipping, respectively. Nondipping was associated with higher income (₦70,000-₦500,000; adjusted odds ratio [AOR] 7.91-104.0; p < 0.05) and central obesity (AOR 1.67 × 103-1.95 × 104; p < 0.05). Elevated 24-h systolic blood pressure increased the likelihood of nondipping (AOR 6.35-7.63), whereas abnormal diastolic blood pressure appeared to have a protective effect (AOR 0.09-0.84). Following WHO physical activity recommendations resulted in a reduction of systolic nondipping (AOR 0.23; p = 0.010), whereas it was associated with an increase in diastolic nondipping (AOR 3.97; p = 0.004). Being male and having a higher office diastolic blood pressure level were protective against systolic nondipping. Conclusion:Abnormal circadian blood pressure patterns are frequent among Nigerian adults, and nondipping is the predominant pattern. Socioeconomic status, central adiposity and 24-h BP load are the most influential factors. The promotion of ABPM in primary care is a vital step in detecting hypertension early and managing it in a personalised way.
Preeclampsia (PE) is characterized by new-onset hypertension at or after 20 weeks of pregnancy, associated with either uteroplacental dysfunction and/or maternal organ dysfunction that involves any of the hematological, renal, hepatic, cardiovascular, and central nervous systems. It complicates 2%-8% of pregnancies worldwide and is a significant contributor to maternal and perinatal morbidity and mortality. The multiorgan involvement in PE may extend beyond the immediate puerperium period and significantly impact the health of both affected women and their children in later life. In sub-Saharan Africa, long-term data on PE remain limited, irrespective of the substantial HIV burden in the region and the probable interaction between hypertensive disorders of pregnancy, HIV infection, and antiretroviral therapy. Therefore, this narrative review provides an update on the short- and long-term clinical outcomes of PE in the context of HIV infection, for both the mother and affected child. For instance, there is an increased risk of long-term cardiovascular disease development and renal impairment in the mother. Neonates born from such pregnancies are also at increased risk of low birth weight and the sequelae of prematurity.
Objective:This study aims to explore the clinical efficacy of mindfulness-based stress reduction (MBSR) combined with ear triple therapy in improving blood pressure, symptoms, emotions, and other multidimensional conditions of young and middle-aged patients with hypertension. Methods:Using convenient sampling, young and middle-aged patients with hypertension who visited Jiangsu Provincial Hospital of Chinese Medicine from January 2024 to January 2025 were selected as participants. They were divided into an intervention group and a control group using a random number table, with 115 cases in each group. The control group received standard treatment and nursing, while the intervention group was additionally given MBSR combined with ear triple therapy on the basis of the control group's intervention, with an intervention cycle of 8 weeks. Before the intervention and after 8 weeks, the therapeutic effect, immediate blood pressure-lowering effect, improvement of TCM symptoms, psychological status, and mindfulness level were compared between the two groups. Results:There were no significant differences in baseline characteristics and medication use between the 2 groups. After 8 weeks, the intervention group showed superior performance to the control group in terms of therapeutic effect, immediate blood pressure-lowering effect, TCM syndrome score, SAS score, and MAAS score, with statistically significant differences (p < 0.05). Conclusion:MBSR combined with ear triple therapy can improve hypertension conditions in young and middle-aged patients with hypertension, alleviate symptoms, reduce negative emotions, and enhance mindfulness level, thereby improving medication compliance and self-management ability.
The neutrophil-to-albumin ratio (NPAR), which represents a surrogate sign of systemic inflammation, has recently garnered interest as a novel prognostic biomarker in cardiovascular pathology, with a particular focus on heart failure (HF) in patients diagnosed with hypertension. The present analysis explored the relationship between NPAR and HF prevalence based on cross-sectional data derived from the 2017-2020 cycle of the National Health and Nutrition Examination Survey (NHANES). A total of 3045 hypertensive adults were analyzed, and multivariable logistic regression was employed with sequential adjustment for a comprehensive range of demographic, lifestyle, and clinical variables, including age, sex, ethnicity, body mass index, smoking status, alcohol consumption, diabetes, coronary artery disease, previous myocardial infarction, and history of stroke. The overall weighted prevalence of HF in this hypertensive cohort was 6.27%, and participants with HF had significantly higher NPAR levels than those without HF. After comprehensive adjustment for potential confounders, elevated NPAR remained independently associated with greater odds of HF (OR = 1.17, 95% CI: 1.09-1.25, p < 0.001). Additional quartile, blood pressure-adjusted sensitivity, and spline analyses further supported the robustness and approximately linear nature of this association. ROC analysis indicated that NPAR had acceptable discriminatory ability for HF, with an AUC of 0.649 and an optimal cutoff value of 14.24. Subgroup analyses further identified notable interaction effects for alcohol use and stroke history (interaction p < 0.05), indicating potential effect modification. These findings suggest that NPAR may serve as an accessible and cost-effective marker for HF risk stratification in hypertensive individuals.
Background:Hypertension (HTN) remains one of the most common and modifiable risk factors for cardiovascular diseases worldwide. While several studies have explored its risk factors, updated national data covering long-term trends in Türkiye has been limited. Methods:We conducted a cross-sectional study using data from seven national health surveys carried out in Türkiye between 2008 and 2022, including a total of 97562 participants aged 19 and older. We calculated HTN prevalence across years and performed univariable and multivariable logistic regression analyses to examine associations with demographic, socioeconomic, and lifestyle factors. Results:Overall, 18.9% of participants reported to have HTN. Prevalence increased modestly from 2008 to 2016 and then stabilized by 2022 (18.4%). HTN was significantly associated with older age, female gender, higher BMI, larger waist circumference, lower education level, unemployment, physical inactivity, and having a spouse or parent with HTN. Notably, individuals with graduate-level education had a higher prevalence of HTN than those without a high school education, and regular smokers showed a slightly lower prevalence compared to nonsmokers. There was also a significant regional difference in HTN diagnoses. Conclusion:Our findings offer an updated picture of HTN in Türkiye and highlight the influence of age, gender, lifestyle, geographical region, and family context on its prevalence. These results can guide future public health strategies of risk reduction at the individual, household, and regional levels.
Hypertension remains a major public health concern in Bangladesh, yet comprehensive nationwide studies examining prescription-based medication adherence are limited. To address this gap and understand adherence patterns for effective hypertension management, this study utilized secondary data from the Bangladesh Demographic and Health Survey (BDHS) 2022. A total of 1597 hypertensive individuals aged 18 years or older (670 urban, 927 rural) were included after excluding cases with missing values. Medication adherence was defined by self-reported use of prescribed antihypertensive drugs among those identified with hypertension (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg or currently taking medication). Univariate, bivariate, and multilevel binary logistic regression analyses were conducted to identify key factors influencing adherence. Findings revealed that 83.2% of participants were adherent to medication. Adherence varied significantly by gender, wealth status, and diabetes comorbidity. In urban males, those from middle and rich households were 90.4% and 86.8% less likely to be adherent than poor counterparts, while nondiabetic men were over four times more likely to be adherent (AOR: 4.459, 95% CI = (1.371, 13.224), p value = 0.013). Among rural females, higher wealth status increased adherence (AOR: 1.998, 95% CI = (1.221, 3.268), p value = 0.006), but those with primary or secondary education showed lower odds of adherence. Urban females from rich households had significantly higher odds of adherence (AOR: 4.759, 95% CI = (1.838, 12.335), p value = 0.002). These findings highlight the substantial gender and urban-rural disparities in hypertension medication adherence in Bangladesh. Targeted policies, such as educational outreach for rural women, expanded diabetes screening in urban men, and subsidized medication access in rural areas, are urgently needed to improve hypertension management.
