Purpose: The complex pathogenesis of hypertension, potentially involving inflammatory pathways, remains elusive. This study aimed to evaluate the relationship between 24-hour urinary sodium excretion and inflammatory cytokines alongside C-reactive protein (CRP) in a nationwide Finnish sample. Materials and methods: 265 participants from the FINRISK 2002 study were included in the analyses. Multivariable-adjusted associations of 24-hour urinary sodium with circulating CRP and 26 cytokines were examined. Results: 24-hour urinary sodium was not significantly associated with any of the cytokines or CRP (p >= 0.02 for all, significance at <0.001). Adjustments for age, sex, serum creatinine concentration, and alcohol intake did not alter these results. Conclusion: This cross-sectional study revealed no associations between 24-hour urinary sodium and cytokine or CRP levels. This does not suggest reducing salt intake would be unbeneficial in hypertension. Additional research is required to clarify the mechanisms through which salt may induce hypertension. Assessing sodium intake in epidemiological studies is also challenging.
Background: Although depression is a frequently occurring mental disorder in patients with hypertension, little is known about the symptoms of depression among Afghan hypertensive patients. Objective: This study aimed to analyze the prevalence and predictors of depression symptoms among Afghan hypertensive patients. Methods: This was a secondary analysis of a multi-center cross-sectional study conducted between August and December 2022 across three major provinces in Afghanistan. Socio-demographic and clinical characteristics of the eligible participants were used in the analysis. A score of >= 5 on the PHQ-9 (Patient Health Questionnaire) was considered the cut-off point for labeling hypertensive patients as screening positive for depressive symptoms. We performed binary logistic regression to determine the predictors of depression symptoms among hypertensive patients. Results: Out of 853 hypertensive patients, 51.8% (95% CI: 48.4-55.2%) had depressive symptoms. Binary logistic regression revealed that low monthly household income [AOR=1.42, 95% CI (1.01-1.97), low education level [2.41 (1.57-3.71)], physical inactivity [1.81 (1.22-2.71)], poor blood pressure control [2.41 (1.57-3.71)], and the presence of medical comorbidity [1.59 (1.15-2.19)] were the predictors of depression symptoms. Conclusion: This study showed a high prevalence of depressive symptoms among Afghan hypertensive patients. Moreover, we found that low monthly household income, physical inactivity, low education level, poor blood pressure control, and the presence of medical comorbidity were the predictors of depression symptoms. Our findings suggest that hypertensive patients should be screened for mental health symptoms, and those most at risk for depression should seek supportive counseling.
Cardiovascular Disease (CVD), a term encompassing various disorders affecting the heart and blood vessels, includes coronary artery disease (CAD). CAD is primarily due to the development of atherosclerotic plaques that disrupt blood flow, oxygenation, and nutrient delivery to the myocardium. Risk factors contributing to CAD progression include smoking, hypertension, diabetes mellitus (DM), dyslipidaemia, and obesity. While aerobic exercise (AE) has shown promising results in controlling CVD risk factors, the impact of resistance training (RT) has not been extensively investigated. This review aims to describe the effects of RT on CVD risk factors based on studies retrieved from PubMed and Google Scholar databases. Both isometric and isotonic RT have been found to decrease systolic blood pressure (SBP), diastolic blood pressure, or mean arterial pressure, with SBP showing a more significant reduction. Hypertensive patients engaging in RT alongside a calorie-restricted diet demonstrated significant improvements in blood pressure. RT is associated with increased nitric oxide bioavailability, sympathetic modulation, and enhanced endothelial function. In type -2 DM patients, 8-12 weeks of RT led to improvements in fasting blood glucose levels, insulin secretion, metabolic syndrome risk, and glucose transporter numbers. Combining AE with RT had a more significant impact in reducing insulin resistance and enhancing blood glucose compared to performing exercises separately. It also significantly decreased total cholesterol, triglycerides, and low-density lipoprotein levels while increasing high-density lipoprotein within 12 weeks of application. However, improvements are considered insignificant when lipid levels are already low to normal at baseline. The administration of RT resulted in weight loss and improved body mass index, with more pronounced effects seen when combining AE with RT and a calorie-restricted diet. Considering these results, the administration of RT, either alone or in combination with AE, proves beneficial in rehabilitating CAD patients by improving various risk factors.
Hypertensive Patients in Bahir Dar City Hospitals, North West Ethiopia" by Geremew et al, 1 recently published in Journal of Integrated Blood Pressure Control.I congratulate the authors on this successful article and make some contributions.This study has three notable strengths: Firstly, it used validated tools to comprehensively measure multiple factors related to lifestyle behaviors, knowledge, social support, and the patient-physician relationship among hypertensive patients.This allowed the study to gain useful insights into various personal and social influences on adherence.Secondly, the study provided an overview of adherence to lifestyle modifications in the target population by assessing the current status in the study area.This broad snapshot gives useful baseline information.Lastly, the study investigated an important research topic of adherence to lifestyle changes among hypertensive patients.Exploring modifiable factors associated with adherence can help improve hypertension management strategies.However, I have also discovered several limitations that need to be addressed in future research namely: 1) The study was conducted in a single city of Ethiopia so findings may not be generalized to other settings.2) Additionally, lifestyle behaviors were assessed at a single time point and may not reflect long-term adherence patterns.3) Self-reported data was conducted which can be subjected to recall and social desirability biases.4) Some other individual factors like mental health and motivation that could impact adherence were not included in the analysis.To obtain better results, I recommend that research to carried out by 1) Develop longitudinal intervention studies to test strategies for enhancing modifiable factors found to be associated with adherence, such as knowledge, social motivation, and the patient-doctor bond.This could help determine causal relationships and identify the most effective approaches.2) Consider multicenter studies involving both urban and rural hospitals across different regions of Ethiopia.This would allow for a more nationally representative assessment of adherence rates and influential contextual factors.Comparisons across diverse settings could provide insights into the scalability of successful local programs.3) Should use objective as well as self-reported measures when evaluating lifestyle behaviors over time.Objective indicators such as clinical measurements of blood pressure, weight reduction, limiting sodium intake, increasing physical exertion, quitting smoking, and avoiding alcohol and help validate adherence levels. 2 Using both types of measures would generate more robust data for guiding the development of culturally sensitive and sustainable lifestyle modification programs in Ethiopia.
Purpose: Hypertension is a major contributor to morbidity and mortality worldwide. Many people however are not aware of their possession of risk factors for hypertension. There is a paucity of literature in Uganda describing the risk profile of faculty at public universities. The purpose of this study was to determine the prevalence of hypertension risk factors among university teaching staff.Methods: This study was conducted among faculty at Makerere University in Uganda. The modified World Health Organization STEP-wise approach for non-communicable disease surveillance was used in data collection. Hypertension was defined as having a systolic blood pressure of >= 140mmHg and/or a diastolic blood pressure of >= 90mmHg, or being on antihypertensive medications. Participants were enrolled from the faculty lists by proportionate to size systematic sampling until the sample size for each college was obtained. Data was collected from January to March 2018. Multivariate logistic regression was used to determine factors associated with hypertension.Results: A total of 141 participants were recruited into the study. The prevalent risk factors for hypertension include physical inactivity (78.7%), overweight (46.8%), obesity (20.6%), addition of extra salt to food (46.8%), current alcohol consumption (33.3%), history of smoking (10.6%), inadequate fruit and vegetable servings per day (100%), family history of hypertension (40.4%) and a family history of diabetes (22.7%). Hypertension was prevalent at 26.2% (95% CI 18.94-33.46%). The risk factors significantly associated with hypertension included a family history of hypertension (p=0.009), obesity (p=0.008) and male gender (p = 0.029).Conclusion: The prevalence of known hypertension risk factors among university teaching staff in urban Uganda is high. Majority of these risk factors are modifiable highlighting the need for continuous screening as well as introduction of prevention and health promotion strategies to reduce the risk burden.
