639,163 research outputs found

    A population-based study of reduced sleep duration and hypertension : the strongest association may be in premenopausal women

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    Objectives: Recent evidence indicates that reduced sleep duration may be associated with an increased risk of hypertension with possibly stronger effects among women than men. We therefore examined cross-sectional sex-specific associations of sleep duration with hypertension in a large population-based sample from the Western New York Health Study (1996<2001). Methods: Participants were 3027 white men (43.5%) and women (56.5%) without prevalent cardiovascular disease (median age 56 years). Hypertension was defined as blood pressure at least 140 or at least 90&mmHg or regular use of antihypertensive medication. Multivariate logistic regression analyses were performed to estimate odds ratios (ORs) of hypertension comparing less than 6&h of sleep per night versus the reference category (&6&h) while accounting for a number of potential confounders. Results: In multivariate analyses, less than 6&h of sleep was associated with a significant increased risk of hypertension compared to sleeping at least 6&h per night, only among women [OR&=&1.66 (1.09 to 2.53)]. No significant association was found among men [OR&=&0.93 (0.62 to 1.41)]. In subgroup analyses by menopausal status, the effect was stronger among premenopausal women [OR&=&3.25 (1.37 to 7.76)] than among postmenopausal women [OR&=&1.49 (0.92 to 2.41)]. Conclusion: Reduced sleep duration, by increasing the risk of hypertension, may produce detrimental cardiovascular effects among women. The association is independent of socioeconomic status, traditional cardiovascular risk factors, and psychiatric comorbidities, and is stronger among premenopausal women. Prospective and mechanistic evidence is necessary to support causality

    Resistant arterial hypertension in a patient with adrenal incidentaloma multiple steno-obstructive vascular lesions and antiphospholipid syndrome

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    Resistant hypertension is defined as above of blood pressure (≤ 140/90 mmHg) despite therapy with three or more antihypertensive drugs of different classes at maximum tolerable doses with one bling a diuretic. An important consideration in defining a patient with resistant hypertension is the mislabeling of secondary hypertension as resistant hypertension. Here, we report a patients with resistant hypertension caused by multiple stenoocclusive arteries due to antiphospholipid syndrome and coexisting with subclinical Cushing’s syndrome

    Hypertension

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    Hypertension is a rapidly moving clinical field with frequent developments in new pharmacologic agents and management strategies. Perhaps more importantly, there have been substantial improvements in our understanding of how best to use the drugs available to us. In this article, I will review some of the more important advances in our understanding of hypertension over the past two years, specifically by reviewing six important trials, one survey and two sets of guidelines, all published between January 2002 and June 2004.peer-reviewe

    Obesity and Hypertension in Students of Jahangirnagar University: Alarming Issues

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    The prevalence of obesity and hypertension (HTN) in university students of Bangladesh has not reported yet. Considering the proper health maintenance of this population in mind, the study was aimed to determine the prevalence of obesity and HTN as well as relationship among them in the students of a residential university of Bangladesh, Jahangirnagar University. This descriptive cross sectional study included 500 randomly selected students (250 males and 250 females). Participants completed a questionnaire on physical activity, sedentary behaviour, dietary factors, smoking and family history of obesity, HTN, and coronary artery disease. Blood pressure and anthropometric parameters such as height, weight, waist and hip circumferences were measured following standard procedure. The Statistical analyses were performed using the software SPSS.The prevalence of overweight was 25% (31.1% males, 15.6% females) and obesity 7.2% (9.4% males, 4% females). Pre-HTN was found at 27.1% (38% males, 11.2% females) and HTN at 2.2% (3.3% males, 0.4% females). A high rate of smoking, sedentary behavior, physical inactivity, excessive consumption of unhealthy food, and caffeine-rich drinks was also observed. Significant correlation was found between parameters of obesity and HTN. High prevalence of pre-HTN in males and central obesity in females were found which is immediately needed to control for better health maintenance of this population

    How common is isolated nocturnal hypertension?

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    The growing use of methods to measure blood pressure (BP) under everyday life conditions in ‘out-of-office’ settings, through either 24-h ambulatory BP monitoring (ABPM) or home BP monitoring (HBPM), for defining BP status has led to identification of four specific hypertension phenotypes, characterized by variable agreement or disagreement between office BP (OBP) and out-of-office BP: true normotension (normal office and out-of-office BP), sustained hypertension (both elevated office and out-of-office BP), masked hypertension (normal office BP and out-of-office BP), and white-coat hypertension (WCH), when OBP is elevated, but out-of-office BP levels are within normal limits. The term ‘white-coat hypertension’ is probably a misnomer and a misconception, because it does not necessarily reflect, or at most partially, an alerting reaction or white-coat effect. However, the suggestion to use the term ‘isolated office hypertension’ instead of the more appealing ‘white coat hypertension’ has not gained popularity in clinical practice

    Report of the International Society of Hypertension (ISH) Hypertension Teaching Seminar organized by the ISH Africa Regional Advisory Group: Maputo, Mozambique, 2016

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    The International Society of Hypertension (ISH), in fulfilment of its mission of promoting hypertension control and prevention and also of advancing knowledge globally, organizes hypertension teaching seminars or ‘summer schools’ worldwide through the ISH Regional Advisory Groups. In Africa, seven of such seminars have been organized. This is a report of the eighth seminar held in Maputo, Mozambique, April, 2016. The seminar was attended by over 65 participants from 11 African countries. The Faculty consisted of 11 international hypertension experts. The eighth African hypertension seminar was a great success as confirmed by a pre- and post-test questionnaire

    Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms

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    Hypertension and type 2 diabetes are common comorbidities. Hypertension is twice as frequent in patients with diabetes compared with those who do not have diabetes. Moreover, patients with hypertension often exhibit insulin resistance and are at greater risk of diabetes developing than are normotensive individuals. The major cause of morbidity and mortality in diabetes is cardiovascular disease, which is exacerbated by hypertension. Accordingly, diabetes and hypertension are closely interlinked because of similar risk factors, such as endothelial dysfunction, vascular inflammation, arterial remodelling, atherosclerosis, dyslipidemia, and obesity. There is also substantial overlap in the cardiovascular complications of diabetes and hypertension related primarily to microvascular and macrovascular disease. Common mechanisms, such as upregulation of the renin-angiotensin-aldosterone system, oxidative stress, inflammation, and activation of the immune system likely contribute to the close relationship between diabetes and hypertension. In this article we discuss diabetes and hypertension as comorbidities and discuss the pathophysiological features of vascular complications associated with these conditions. We also highlight some vascular mechanisms that predispose to both conditions, focusing on advanced glycation end products, oxidative stress, inflammation, the immune system, and microRNAs. Finally, we provide some insights into current therapies targeting diabetes and cardiovascular complications and introduce some new agents that may have vasoprotective therapeutic potential in diabetes

    Novel immune mechanisms in hypertension and cardiovascular risk

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    Purpose of Review: Hypertension is a common disorder with substantial impact on public health due to highly elevated cardiovascular risk. The mechanisms still remain unclear and treatments are not sufficient to reduce risk in majority of patients. Inflammatory mechanisms may provide an important mechanism linking hypertension and cardiovascular risk. We aim to review newly identified immune and inflammatory mechanisms of hypertension with focus on their potential therapeutic impact. Recent Findings: In addition to the established role of the vasculature, kidneys and central nervous system in pathogenesis of hypertension, low-grade inflammation contributes to this disorder as indicated by experimental models and GWAS studies pointing to SH2B3 immune gene as top key driver of hypertension. Immune responses in hypertension are greatly driven by neoantigens generated by oxidative stress and modulated by chemokines such as RANTES, IP-10 and microRNAs including miR-21 and miR-155 with other molecules under investigation. Cells of both innate and adoptive immune system infiltrate vasculature and kidneys, affecting their function by releasing pro-inflammatory mediators and reactive oxygen species. Summary: Immune and inflammatory mechanisms of hypertension provide a link between high blood pressure and increased cardiovascular risk, and reduction of blood pressure without attention to these underlying mechanisms is not sufficient to reduce risk
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