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International Journal of Hypertension,2021年

Kassahun Fikadu Tessema, Feleke Gebremeskel, Firdawek Getahun, Nega Chufamo, Direslgne Misker

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Background . Preeclampsia is the second most common problem that causes maternal morbidity and complication in low-income countries. In contrast to death due to other direct causes, preeclampsia-related death is appeared to be connected with multiple factors; yet, factors have paucity and are limited. Considering the clinical significance, this study aimed to identify that individual and obstetric factors of preeclampsia can be an input for disease identification involving clinicians in southern Ethiopia. Methods . A case-control study was conducted among mothers with a singleton pregnancy who attended perinatal care in all six public hospitals in the provinces around the Omo stream. A sample size of 487 women with a singleton pregnancy (163 cases and 326 controls) was involved in the study. All cases were enrolled, while controls were selected consecutively using a random sampling technique. Data were gathered using a structured questionnaire and data extraction sheet. Descriptive data were presented using percentages and numbers. Multivariable logistic regression analysis was carried out to identify factors at a value of less than 0.05. Results . There was a statistically significant association between the family history of hypertension (AOR = 2.42, 95% CI: 1.16–5.05), no pregnancy interval (AOR = 1.62; 95% CI: 1.03–2.55), and normal body mass index (AOR = 0.42, 95% CI: 0.21–0.87) and the occurrence of preeclampsia. Conclusion . Primary relatives with a history of chronic hypertension and no pregnancy interval were identified as risk factors of preeclampsia, while having a normal body mass index was found to be a protective factor of preeclampsia occurrence. To improve early detection and timely management of preeclampsia, the clinician should give attention to women who have no previous childbirth and whose close relatives had a history of chronic hypertension, as well as working on the protective factor is recommended.

    International Journal of Hypertension,2021年

    Zahra Pezeshki, Mehdi Nematbakhsh

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    Background . The prevalence and severity of hypertension, as well as the activity of the systemic and local renin angiotensin systems (RASs), are gender related, with more symptoms in males than in females. However, the underlying mechanisms are not well understood. In this study, we investigated sex differences in renal vascular responses to angiotensin II (Ang II) administration with and without Ang II type 1 and Mas receptor (AT 1 R and MasR) antagonists (losartan and A779) in the 2K1C rat model of renovascular hypertension. Methods . Male and female 2K1C rats were divided into 8 experimental groups (4 of each sex) treated with vehicle, losartan, A779, or A779+losartan. Responses of mean arterial pressure (MAP), renal blood flow (RBF), and renal vascular resistance (RVR) to Ang II were determined. Results . In both sexes, the basal MAP, RBF, and RVR were not significantly different between the four groups during the control period. The Ang II administration decreased RBF and increased RVR in a dose-related manner in both sexes pretreated with vehicle or A779 ( ), but in vehicle pretreated groups, RBF and RVR responses were different between male and female rats ( ). AT 1 R blockade increased RBF and decreased RVR responses to Ang II, and no difference between the sexes was detected. Coblockades of AT 1 R and MasR receptors increased RBF response to Ang II significantly in males alone but not in females ( ). Conclusion . The impact of Ang II on RBF and RVR responses seems to be gender related with a greater effect on males, and this sex difference abolishes by Mas receptor blockade. However, the paradoxical role of dual losartan and A779 may provide the different receptor interaction in RAS between male and female rats.

      International Journal of Hypertension,2021年

      Fatima Ghaddar, Lama Hammad, Rania A. Tohme, Tamar Kabakian-Khasholian, Nahla Hwalla, Abla M. Sibai

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      Introduction . Hypertension unawareness is context-specific, and our understanding of factors associated with it has implications on primary healthcare practices locally and contributes to achieving cardiovascular disease (CVD) targets, globally. In this study, we examine the prevalence and correlates of hypertension unawareness among adult Lebanese population. Methods . The study sample included a nationally representative sample of 2214 adults ≥25 years of age from the Noncommunicable Disease (NCD) Risk Factor WHO-STEPS cross-sectional survey conducted in Lebanon. In the first step, hypertension was assessed based on reported morbidity using face-to-face interviews, and in the second step, based on blood pressure (BP) measurement. We defined hypertension prevalence as systolic/diastolic blood pressure ≥140/90 mmHg and/or ongoing treatment for hypertension. Hypertension unawareness was described as lack of prior knowledge of hypertensive status. Those responding negatively to the face-to-face interview question “whether they had ever been told by a health worker that they have hypertension” were labelled as “apparently healthy.” Results . Overall prevalence of hypertension was 30.7%. A total of 369 subjects were unaware of their condition, representing 51.8% of all hypertensives and 15.9% of the apparently healthy. Multivariable analysis controlling for a number of confounders showed that, among apparently healthy participants, insurance coverage and contact with healthcare services were not associated with higher likelihood for hypertension awareness. Among all hypertensives, hypertension unawareness was significantly higher in the young, those with BMI <25 kg/m 2 (adjusted OR (aOR): 2.52; 95% CI: 1.35–4.69), no CVD (aOR: 3.30; 95% CI: 1.74–6.29), and participants with no reported family history of hypertension (aOR: 4.87; 95% CI: 2.89–8.22), compared to their counterparts. Conclusion . In Lebanon, unawareness of hypertension occurred in those clinically least perceived to be at risk. These findings are key for optimizing current screening practices and informing NCD prevention efforts in the country and contribute to achieving global targets of the SDGs of “leaving no one behind.”.

        International Journal of Hypertension,2021年

        Marcus Vinicius Machado, Thais de Paola Chequer Barbosa, Thais Camasmine Chrispino, Fabricia Junqueira das Neves, Gabriel Dias Rodrigues, Pedro Paulo da Silva Soares, Antonio Claudio Lucas da Nóbrega

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        The aim of this paper is to assess the integrated responses of ambulatory blood pressure (BP), cardiac autonomic modulation, spontaneous baroreflex sensitivity (BRS), and vascular reactivity after a single bout of resistance exercise (RE) in men with stage 2 hypertension who have never been treated before. Ten hypertensive men were subjected to a RE session of three sets of 20 repetitions and an intensity of 40% of the 1-repetition maximum (RM) test in seven different exercises. For the control (CTR) session, the volunteers were positioned on the exercise machines but did not perform any exercise. Forearm blood flow was measured by venous occlusion plethysmography. We also analyzed the heart rate variability (HRV), ambulatory BP, blood pressure variability (BPV), and BRS. All measurements were performed at different timepoints: baseline, 20 min, 80 min, and 24 h after both RE and CTR sessions. There were no differences in ambulatory BP over the 24 h between the RE and CTR sessions. However, the area under the curve of diastolic BP decreased after the RE session. Heart rate (HR) and cardiac output increased for up to 80 and 20 min after RE, respectively. Similarly, forearm blood flow, conductance, and vascular reactivity increased 20 min after RE ( ). In contrast, HRV and BRS decreased immediately after exercise and remained lower for 20 min after RE. We conclude that a single bout of RE induced an increase in vascular reactivity and reduced the pressure load by attenuating AUC of DBP in hypertensive individuals who had never been treated with antihypertensive medications.

          International Journal of Hypertension,2021年

          Mikyung Ryu, Ji Sun Ha, Sol Lee, Weon-Chil Baek, Heejin Kimm, Ho Gym

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          Purpose . Previous studies reported the relation of osteoarthritis (OA) and hypertension (HTN) mostly in postmenopausal women. This study aimed to identify the association between OA and HTN in pre- and postmenopausal women. Methods . We used data of 4,627 middle-aged (40–59 years) women from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2012 to 2016. Chi-square and t -test compared the characteristics of the participants. Binomial logistic regression was used to identify an association between OA and HTN under controlling covariates such as age, tobacco smoking, alcohol consumption, and obesity. Results . There were 1,859 participants with non-OA and menopause, 104 with OA and nonmenopause, and 375 with OA and menopause, respectively. The number of women with OA and HTN was 129. OA was significantly associated with HTN diagnosis in postmenopausal women under controlling covariates (odds ratio: 1.408, 95% CI: 1.092–1.815, ). However, this relationship was weakened in premenopausal women (odds ratio: 1.651, 95% CI: 0.950–2.869, ). Conclusion . In conclusion, women with HTN showed a distinct association with OA than the normotensives, and this relationship was more apparent among postmenopausal women. Further research is needed for a preventive approach.

            International Journal of Hypertension,2021年

            Demin Liu, Jing Wang, Haijuan Hu, Guoqiang Gu, Rui Ding, Ruiqin Xie, Wei Cui

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            Background . Hypertension contributes to the progression of cardiac remodeling and renal damage. In turn, renal sympathetic hyperactivation showed elevated sympathetic nervous system activity and led to blood pressure increase in certain patients. The purpose of this study was to observe the effect of renal nerve denervation on blood pressure and target organ changes in two hypertensive rat models. Methods . Hypertensive rats were randomly divided into a renal denervation (RDN) group and sham operation group. Wistar–Kyoto (WKY) rats of the same age were set as the baseline control group. In the secondary hypertension model, SD rats were randomly divided into five groups. Blood pressure and bodyweight were measured every week until they were euthanized. Results . The two rat models underwent RDN at key timepoints. At these timepoints, the hearts and kidneys were collected for norepinephrine and angiotensin II measurements and histological analysis. Conclusion . RDN performed before development of hypertension showed a significant antihypertensive effect on the secondary hypertension model.