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The present study investigated the characteristics of rare but often fatal cases of acute coronary syndrome and aortic dissection and the factors affecting mortality. HEART score, aortic dissection detection risk score, and Global Registry of Acute Coronary Event (GRACE) Score were calculated by evaluating biochemical tests and symptoms/signs of the 20 patients who were admitted to our clinic with a preliminary diagnosis of acute myocardial infarction and subsequently diagnosed with aortic dissection. The assumption of normal distribution was checked with the Shapiro–Wilk test, and independent group comparisons were made with the t test or the Mann–Whitney U test. Relationships between qualitative variables were analyzed with chi-square tests. Relationships between quantitative variables were analyzed with Pearson or Spearman correlation coefficients. Patients with conditions like hypertension and diabetes are at higher risk for aortic dissection. We recommend the use of the GRACE Score with the risk parameters we have determined for the prediction of operative mortality. We suggest that the axillary region and antegrade cerebral perfusion may be preferred as the cannulation area in dissection repair. We emphasize preliminary risk assessment according to the aortic dissection detection risk score and remind physicians that ECG ST-T and troponin changes may be misleading. [ABSTRACT FROM AUTHOR]

In this research, we investigated whether secondhand smoking (SHS) increases the possibility of hypertension. We used data from the Shaanxi baseline survey of the Regional Ethnic Cohort Study in Northwest China (RECS). Active smoking and SHS were determined by questionnaires. Hypertension was defined as self-reported or objectively measured. Multivariable logistic regression model was performed to estimate the risk of hypertension under active smoking and SHS. Compared to never-smokers, exposure to SHS had a 9% (P = 0.005) higher possibility of hypertension. The adjusted OR for exposure time of ≤ 3 h/week, 3–12 h/week, and > 12 h/week were 1.03 (P = 0.545), 1.10 (P = 0.040), and 1.15 (P = 0.015), respectively. The adjusted OR for frequency of SHS of 1–2 times/week, 3–5 times/week, and nearly every day were 0.94 (P = 0.421), 1.01 (P = 0.846), and 1.14 (P < 0.001), respectively. Compared to smokers, additional exposure to SHS had a more than threefold increased possibility of having hypertension. The adjusted OR for hypertension was 1.07 (P = 0.254), and 1.23 (P = 0.007) in only smokers and smokers with SHS, respectively. Our study provided evidence that SHS could be a risk factor for hypertension, and additional exposure of active smokers to SHS significantly increases the possibility of hypertension. Reducing the frequency or time of SHS may be effective in preventing hypertension. [ABSTRACT FROM AUTHOR]

Background: Although it is well established that obesity is a risk factor for hypertension, the effect of distinct long-term patterns of body mass index (BMI) on blood pressure (BP) in later life is poorly understood. Methods: Based on the China Health and Nutrition Survey, we analyzed 2920 participants aged 3–17 years with initial normal BP at baseline (1991–2011), who were followed up for the development of hypertension (1993–2015). The group-based trajectory model was applied to identify BMI trajectories, and Cox regression was used to assess their associations with hypertension risk. Stratified analyses were conducted to explore differences across subgroups. Results: During an average follow-up time of 11.20 (7.69) years for males and 7.20 (5.21) years for females, 339 males and 212 females were identified with hypertension, respectively. Three BMI trajectories were identified: low-increasing (60.58% of males and 73.03% of females), moderate-increasing (33.08% of males and 24.22% of females), and high-increasing (6.34% of males and 2.76% of females). Our study found a significant positive association between a higher BMI trajectory and hypertension risk in males (all P for trend < 0.05). Specifically, males in the high-increasing BMI group had a higher risk of hypertension compared with those in the low-increasing group (HR = 1.76, 95% CI: 1.04–2.97). Stratified analyses revealed stronger associations among smokers, drinkers, and inactive individuals. Conclusion: Our findings suggest that maintaining a normal BMI and healthy lifestyle from childhood may lower subsequent risk of hypertension. [ABSTRACT FROM AUTHOR]

Background/Objectives: A well-established association exists between the development of hypertension and sleep quality. The connection between self-reported sleep quality and the onset of hypertension is particularly significant in populations with metabolic deterioration, such as in Mexico. Methods: The Tlalpan 2020 Cohort was analyzed to explore this association. Clinical and anthropometric characteristics, along with the Medical Outcomes Study Sleep Scale (MOS-SS), were compared between participants who developed hypertension and those who did not over a follow-up period of 30.8 months. The potential role of poor sleep quality in the development of hypertension was assessed. Results: Among 1520 participants, 12% developed hypertension. These individuals had higher anthropometric and laboratory values and reported poorer sleep quality. An elevated sleep problems index was associated with a 50% higher relative risk of developing hypertension (OR: 1.5; 95% CI: 1.087 to 2.069). Additionally, self-reported snoring was associated with hypertension onset (36.3 vs. 43.3; p = 0.019). Conclusions: Poor sleep quality and respiratory disturbances during sleep increase the risk of developing hypertension. Furthermore, hypertension was associated with snoring, highlighting the importance of early interventions to improve sleep quality. [ABSTRACT FROM AUTHOR]

Background: Although hypertension is a significant public health challenge globally, only a few studies have assessed the effectiveness of risk factor control and adherence to recommended lifestyle among United States hypertension patients. Methods: In this study, a detailed, stratified analysis of the 1999–2018 National Health and Nutrition Examination Survey was conducted to assess the adequacy of risk factor control and conformity to recommended lifestyle among United States patients with hypertension. Logistic regression analysis was used to identify influencing factors associated with not acheving risk factors and lifestyle targets. Results: A total of 21,770 participants (mean age, 62 ± 15 years) were enrolled in this study. About one in five (20%) participants achieved the recommended body mass index goal, 40% achieved the low-density lipoprotein cholesterol goal, and 30% achieved the recommended waist circumference. Most patients (80%) achieved the recommended smoking goal, 58% met the recommended alcohol consumption, and 19% achieved the recommended physical activity goal. Multivariate analysis demonstrated that age, gender, race, education, metabolic syndrome, and diabetes mellitus were independent predictors of not achieving risk factors and lifestyle targets. Conclusions: Controlling risk factors and adherence to recommended lifestyles are not ideal for hypertension patients. Therefore, further research should assess how to improve the compliance rate and take targeted measures based on influencing factors for long-term prognosis. [ABSTRACT FROM AUTHOR]

Background: Catheter ablation has evolved as a safe treatment for atrial flutter (AFL) in patients with pulmonary hypertension (PH), and the recurrence of AFL may accelerate clinical decompensation. The aim of this study was to determine the recurrence rate and risk factors for recurrent AFL in PH patients after ablation. Methods: All PH patients who underwent AFL ablation at Fuwai Hospital between May 2015 and December 2020 were followed up. The recurrence rate and risk factors for recurrence were analyzed. Results: A total of 68 PH patients (mean age 44.0 ± 13.0 years, 36.8% male) were enrolled. The majority patients diagnosed PH had congenital heart disease-associated PH (63.2%), and 30.9% had idiopathic pulmonary arterial hypertension. At baseline, most patients (80.9%) had only cavotricuspid isthmus (CTI)-related AFL; the occurrence of non-CTI-related AFL among patients was 8.8%, and 10.3% of the patients had both types of AFL. During a median follow-up of 17.5 months, 22 patients developed at least one recurrent AFL episode (AFL-free survival: 76.5% at 1 year). The immediate success of ablation (HR 0.061, 95% CI 0.009 to 0.438; P = 0.005) and the right atrial volume index (RAVi, per 10 ml/m2; HR 1.064, 95% CI 1.011 to 1.120; P = 0.018) were associated with long-term ablation outcomes in PH patients. With 166.64 ml/m2 as a cutoff value, AFL-free survival was significantly greater in patients whose RAVi was < 166.64 ml/m2 (log-rank P = 0.024). Conclusion: The immediate success of ablation and the RAVi are associated with recurrent AFL. Patients with a RAVi ≥ 166.64 ml/m2 are likely experience recurrence. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a common disease, often overlooked in its early stages due to mild symptoms. And persistent elevated blood pressure can lead to adverse outcomes such as coronary heart disease, stroke, and kidney disease. There are many risk factors that lead to hypertension, including various environmental chemicals that humans are exposed to, which are believed to be modifiable risk factors for hypertension. Objective: To investigate the role of environmental chemical exposures in predicting hypertension. Methods: A total of 11,039 eligible participants were obtained from NHANES 2003–2016, and multiple imputation was used to process the missing data, resulting in 5 imputed datasets. 8 Machine learning algorithms were applied to the 5 imputed datasets to establish hypertension prediction models, and the average accuracy score, precision score, recall score, and F1 score were calculated. A generalized linear model was also built to predict the systolic and diastolic blood pressure levels. Results: All 8 algorithms had good predictions for hypertension, with Support Vector Machine (SVM) being the best, with accuracy, precision, recall, F1 scores and area under the curve (AUC) of 0.751, 0.699, 0.717, 0.708 and 0.822, respectively. The R2 of the linear model on the training and test sets was 0.28, 0.25 for systolic and 0.06, 0.05 for diastolic blood pressure. Conclusions: In this study, relatively accurate prediction of hypertension was achieved using environmental chemicals with machine learning algorithms, demonstrating the predictive value of environmental chemicals for hypertension. [ABSTRACT FROM AUTHOR]

Background: Stress is today a common feature of patients seeking medical care and a growing public health issue in society. A method has been developed to measure biological chronic stress by Hair Cortisol Concentrations (HCC). This biomarker, for chronic stress, captures information about cumulative cortisol levels over the course of several months. Long-term stress might be one of the factors contributing to the onset of cardiovascular conditions and also affecting different risk factors. The aim of this study was to analyse the association between Hair Cortisol Concentrations and previous cardiovascular diseases and cardiovascular risk factors. Methods: The method of measuring chronic stress by Hair Cortisol Concentration was applied in a large Swedish national observational cross-sectional study. A population-based random sample of N = 4,821 Swedish middle-aged men and women was analysed for hair cortisol levels in relation to diagnosed previous cardiovascular diseases and biologically measured cardiovascular risk factors. Results: Long-term stress, measured by hair cortisol, was significantly associated with the classical cardiovascular risk factors hypertension and high cholesterol, but not smoking. Those with elevated HCC levels also had a significantly increased pre-history of myocardial infarction, type 2 diabetes, atrial fibrillation and by-pass surgery, but not regarding stroke, angina pectoris or sleep apnoea. Higher HCC was significantly associated (p < 0.001) with Body mass index and waist circumference, but only for females. HCC was also associated with the risk markers leukocytes, and high-sensitivity CRP, indicating a possible linkage between HCC and inflammation and hypothetically also the bodily immune defense. No association was found between perceived stress and HCC. Conclusions: An overall conclusion of our results is that health care should put more emphasis on patients reporting that they have been exposed to long term stress. Altogether, these analyses of Hair cortisol levels in a large middle-aged population show that chronically elevated cortisol levels represent a relevant and significant factor associated with cardiovascular diseases and classical cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Background: Recent data from European studies (EUROASPIRE V, DA VINCI, SANTORINI) indicate that achieving the LDL cholesterol (LDL-C) target in patients at very high cardiovascular risk is uncommon. Additionally, using a combination therapy involving statins and ezetimibe remains infrequent. Methods: A single-center assessment of a pre-defined lipid lowering treatment algorithm's effectiveness at achieving the LDL-C target in patients at very high cardiovascular risk one month and one year after hospitalization. Results: 81 patients were included, all in secondary prevention. The average age of the patient was 66.9 years, and the main cardiovascular risk factors included hypertension, diabetes mellitus, and smoking history. Following the predefined lipid-lowering algorithm specific to our study, which involves initiating high-intensity statin therapy or a combination of statin and ezetimibe depending on initial LDL-C levels and patient history; 30 (37%) patients initiated high-intensity statin therapy (Atorvastatin (40 mg, 80 mg) or Rosuvastatin (20 mg, 40 mg)), while 51 (63%) started combination therapy with high-intensity statin and ezetimibe 10 mg. After one year, 57 (70.4%) remained adherent to their initial treatment, achieving a mean LDL-C of 49.5 ± 16.9 mg/dL, with 36 (63.2%) of them reaching the LDL-C target of <55 mg/dL. A total of 13 patients discontinued treatment, and 9 were lost to follow-up, withdrew from the study, or died. Conclusion: Initiating dual statin and ezetimibe therapy or high-intensity statin therapy early, based on the expected treatment efficacy, holds the potential to more rapidly and effectively achieve LDL-C targets in a larger proportion of very high-risk cardiovascular patients. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a leading contributor to global morbidity and mortality rates, particularly in urban areas where lifestyle and socioeconomic factors significantly influence its prevalence. Understanding these factors is crucial for developing effective public health interventions. Methods: This cross-sectional study involved 200 urban adults to assess the prevalence of hypertension and identify its associated risk factors. Participants underwent blood pressure measurement and completed questionnaires on lifestyle behaviors and socioeconomic status. Statistical analysis was conducted to evaluate the relationships between hypertension and various risk factors. Results: The prevalence of hypertension increased with age, with the highest prevalence (25%) observed in individuals over 60 years. Lifestyle factors such as smoking and obesity were significantly associated with hypertension, with odds ratios of 1.7 and 2.2, respectively. High stress was also a notable risk factor, with an odds ratio of 1.9. A strong correlation was found between lower socioeconomic status and higher prevalence of hypertension (odds ratio of 2.3 for lowincome groups). Conclusion: The study highlights the significant impact of age, lifestyle, and socioeconomic status on the prevalence of hypertension among urban adults. These findings suggest that public health strategies focusing on lifestyle modifications and socioeconomic improvements could be effective in managing and preventing hypertension in urban populations. [ABSTRACT FROM AUTHOR]

INTRODUCTION The World Health Organization attributes hypertension, as the leading cause of cardiovascular mortality. According to NFHS-5, Overall prevalence of hypertension among age group 15 years and above in India is 29%. The sex specific prevalence is 33.1% for males and 24.9% for females. Overall prevalence of hypertension among age group 15-49 years in Madhya Pradesh is 14%. This study was undertaken to estimate the prevalence and associated risk factors of hypertension in Sagar city. METHODOLOGY A community based cross-sectional study was carried out among the people aged 20 to 60 years living in Sagar city. Multi-stage sampling method was used. The study was conducted from September 2022 to August 2023. Modified and pretested WHO stepwise approach to chronic disease risk factor surveillance (STEPS) was used for data collection. Data was compiled using MS-Excel and analysis was done with the help of IBM SPSS 26.0. RESULTS Present study showed that prevalence of hypertension was 17.2% among study participants. Out of 550 study participants, 283 (51.5%) were male and 267 (48.5%) were females. Hypertension was found to be more in old aged male. Hypertension was found more in smokers, those who were consuming extra salt in diet and those who had family history of hypertension. CONCLUSION Present study showed that nearly one sixth of the study participants were found to be hypertensive. As the awareness of the hypertension status among hypertensive cases was very poor, improving the health education regarding hypertension to increase the awareness about hypertension is the need of the hour. [ABSTRACT FROM AUTHOR]

Background and Aim: Elevated serum uric acid levels have been increasingly recognized as a potential risk factor for hypertension and cardiovascular events. Hyperuricemia has been associated with endothelial dysfunction, inflammation, and oxidative stress, all of which contribute to the development and progression of hypertension. This study seeks to fill this gap by examining serum uric acid levels in newly diagnosed hypertensive patients and investigating their association with the severity of hypertension and the occurrence of cardiovascular events. Methods: This observational, cross-sectional study was conducted at the Department of General Medicine, Sharda Hospital, SMSR, from August 2022 to March 2023. The study included 100 newly diagnosed hypertensive patients and 100 healthy controls matched for age and sex. Results: Laboratory findings indicate a significantly higher serum creatinine level in cases (1.1 mg/dL vs. 1.0 mg/dL, p=0.024), while other biochemical markers such as fasting and postprandial glucose levels showed no significant differences between groups. Uric acid levels were found to be positively correlated with both systolic and diastolic blood pressures among cases (p<0.001), with higher grades of hypertension associated with elevated uric acid levels. ECG findings showed significant associations with both systolic and diastolic blood pressure gradings, and cases demonstrated more frequent abnormal ECG (p=0.025) and ECHO findings (p=0.022) compared to controls. Additionally, lipid levels varied significantly with hypertension grading, indicating worsening lipid profiles with increasing blood pressure severity (e.g., LDL cholesterol: p=0.010 for Grade 3 hypertension). Conclusions: Elevated serum uric acid levels were strongly associated with hypertension severity and cardiovascular abnormalities, highlighting its potential as a marker for cardiovascular disease risk. Our findings emphasize the need for early detection and management of hypertension to reduce cardiovascular risks. [ABSTRACT FROM AUTHOR]

Background: Stroke or cerebrovascular accident is a leading cause of mortality and morbidity throughout the world including both developed and developing countries. Identification of potential prognostic factors for ischaemic stroke may enable better prediction for outcome and conducting early interventions may improve the prognosis. Present study was aimed to study outcome of patients of acute ischemic stroke at tertiary care hospital. Material and Methods: Present study was prospective, observational study, conducted in patients with ischemic stroke, confirmed by CT scan of brain, presenting within 72 hours of onset of symptom, willing to participate in study. Results: In present study 126 patients with acute ischemic stroke were included. Most common age group was 61-70 years (34.13 %) followed by 51-60 years (24.6 %) age group. Male patients (65.38 %) were more than female patients (34.13%). Male to female ratio was 1.9:1. Common risk factors observed were stage 1 hypertension (19.84 %), stage 2 hypertension (SBP>160, DBP>100) (25.4 %), diabetic (36.51 %), smoker (29.37 %), alcoholic (22.22 %), dyslipidemia (20.63 %), history of cardiovascular disease (18.25 %), obesity (15.87 %), family history of stroke (14.29 %) & tobacco chewing (10.32 %). On admission, according to NIHSS scale severity majority had minor stroke (37.3 %) followed by moderate stroke (35.71 %), moderate to severe stroke (18.25 %) & severe stroke (8.73 %). Functional outcome was assessed using the modified ranking score (MRS) at 6 months. Majority had MRS score 3 (44.29 %) followed by MRS score 2 (38.06 %), MRS score 1 (7.96 %). Conclusion: Areas for improvement in management of stroke are public awareness, lifestyle modification (modifiable risk factors are hypertension, smoking, dyslipidemia, alcohol consumption, and diabetes mellitus), early diagnosis, treatment & availability of facilities and expertise. [ABSTRACT FROM AUTHOR]

Importance: Epidemiological evidences regarding the association between whole grain intake and the risk of new-onset hypertension are still controversial. Objective: We aimed to investigate the relationship between whole grain intake and new-onset hypertension and examine possible effect modifiers in the general population. Methods: A total of 10,973 participants without hypertension from the China Health and Nutrition Survey were enrolled, with follow-up beginning in 1997 and ending in 2015. Whole grain intake was assessed by 3 consecutive 24-h dietary recalls combined with a household food inventory. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression model after adjusting for potential risk factors. Results: During a median follow-up of 7.0 years, 3,733 participants developed new-onset hypertension. The adjusted HRs (95% CIs) were as follows: for quartile 2 (HR: 0.52; 95% CI: 0.47–0.57), quartile 3 (HR: 0.46; 95% CI: 0.42–0.51), and quartile 4 (HR: 0.35; 95% CI: 0.31–0.38), compared with quartile 1. Different types of whole grain types, including wheat (adjusted HR, 0.35; 95% CI, 0.32–0.39), maize (adjusted HR, 0.50; 95% CI, 0.42–0.59), and millet (adjusted HR, 0.38; 95% CI, 0.30–0.48), showed significant associations with a reduced risk of hypertension. The association between whole grain intake and new-onset hypertension was stronger in individuals with older age (P for interaction < 0.001) and higher BMI (P for interaction < 0.001). Conclusion: Higher consumption of whole grains was significantly associated with a lower risk of new-onset hypertension. This study provides further evidence supporting the importance of increasing whole grain intake for hypertension prevention among Chinese adults. [ABSTRACT FROM AUTHOR]

Traditional cardiovascular risk factors, including hypertension, only explain part of major adverse cardiac events (MACEs). Understanding what other risk factors contribute to MACE is essential for prevention. Constipation shares common risk factors with hypertension and is associated with an increased risk of several cardiovascular diseases. We hypothesized that constipation is an underappreciated risk factor for MACE. We used the population healthcare and genomic data in the UK Biobank (n = 408,354) to study the contribution of constipation (ICD10 K59.0) to the risk of MACE, defined by any episode of acute coronary syndrome (ACS), ischemic stroke, and heart failure (HF). Analyses were controlled for traditional cardiovascular risk factors. We also assessed genetic correlations (rg) between constipation and MACE. Constipation cases (n = 23,814) exhibited a significantly higher risk of MACE compared with those with normal bowel habits [odds ratio (OR) = 2.15, P < 1.00 × 10−300]. Constipation was also significantly associated with individual MACE subgroups, in order: HF (OR = 2.72, P < 1.00 × 10−300), ischemic stroke (OR = 2.36, P = 2.02 × 10−230), and ACS (OR = 1.62, P = 5.82 × 10−113). In comparison with patients with constipation-free hypertension, patients with hypertension with constipation showed significantly higher odds of MACE (OR = 1.68, P = 1.05 × 10−136) and a 34% increased risk of MACE occurrence (P = 2.3 × 10−50) after adjustment for medications that affect gut motility and other traditional cardiovascular risk factors. Finally, we detected positive genetic correlations between constipation and MACE subgroups ACS (rg = 0.27, P = 2.12 × 10−6), ischemic stroke (rg = 0.23, P = 0.011), and HF (rg = 0.21, P = 0.0062). We identified constipation as a potential risk factor independently associated with higher MACE prevalence. These findings warrant further studies on their causal relationship and identification of pathophysiological mechanisms. NEW & NOTEWORTHY: Analyzing 408,354 participants of the UK Biobank, we show that constipation cases exhibited a significantly higher risk of major adverse cardiac events (MACEs) than those with regular bowel habits. In comparison with patients with constipation-free hypertension, patients with hypertension with constipation showed significantly higher odds of MACE and a 34% increased risk of subsequent MACE occurrence. Finally, we detected positive genetic correlations between constipation and MACE. This association holds potential for therapeutic exploitation and prevention based on individuals' risk assessment. [ABSTRACT FROM AUTHOR]

Objective: The current cross-sectional study determines the prevalence and associated factors of microalbuminuria in a focused population in Eastern India. Methods: The study was conducted in Kolkata from June to December 2022 among type 2 diabetes mellitus (T2DM) patients. Patients with T2DM aged more than 18 were included in the study, and those with overt albuminuria (>300 mg/day), congestive cardiac failure, urinary tract infection, pregnancy, human immunodeficiency virus, hepatitis B, or hepatitis C infection were excluded. Results: Among 297 T2DM patients, 130 (43.8%) had high albumin creatinine ratio (> 30 mg/g). Diabetic patients with elevated blood pressure (BP > 130/80 mm Hg) were 1.68 times (95% CI, 1.12-2.53) at risk of developing microalbuminuria. Similarly, patients with a diabetes duration of 5 years or more were 1.48 (95% CI 1.09-2.02) times more likely to develop microalbuminuria. Logistic regression also concluded that elevated blood pressure (BP > 130/80 mm Hg, P = .027) and duration of diabetes (>5 years, P = .016) were predictive of microalbuminuria. Conclusion: The current study observes a high prevalence of microalbuminuria among diabetes patients. This indicates the need for the implementation of preventive strategies for diabetic nephropathy, especially among patients with long-standing diabetes and elevated blood pressure. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a leading risk factor for cardiovascular diseases, significantly contributing to global morbidity and mortality. Understanding the determinants of hypertension is crucial for effective prevention and management. This study investigates the relationships between demographic and physiological factors and hypertension status in a cohort of adults. Materials and Methods: A cross-sectional study was conducted with 105 adult participants, comprising 47 hypertensive and 58 non-hypertensive individuals. Data on age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, and fasting blood sugar (FBS) were collected. Statistical analyses included summary statistics, Pearson correlation coefficients, and logistic regression to identify significant predictors of hypertension. Results: There were significant differences between hypertensive and non-hypertensive groups regarding SBP, DBP, and BMI. Hypertensive individuals had higher mean SBP (141.4 ± 10.5 mmHg) and DBP (86.4 ± 8.0 mmHg) compared to non-hypertensive individuals (118.1 ± 11.5 mmHg and 72.2 ± 6.8 mmHg, respectively; p < 0.001 for both). BMI was also significantly higher in the hypertensive group (36.8 ± 11.8 kg/m² vs. 32.6 ± 9.8 kg/m²; p < 0.001). Age and BMI positively correlated with both SBP and DBP, while HDL showed a significant negative correlation with DBP. Logistic regression analysis identified age (OR = 1.07, 95% CI: 1.05-1.09, p = 0.02), BMI (OR = 1.06, 95% CI: 1.01-1.15, p = 0.01), and LDL (OR = 1.04, 95% CI: 1.00-1.02, p = 0.04) as significant predictors of hypertension. Conclusion: This study reinforces the significant roles of age, BMI, and LDL cholesterol in the risk of hypertension. These findings highlight the importance of targeting these modifiable risk factors through effective interventions to reduce the prevalence and impact of hypertension. Future research should explore the mechanisms linking these predictors to hypertension to develop comprehensive prevention and management strategies. [ABSTRACT FROM AUTHOR]

Objective: To compare the maternal‐fetal/neonatal outcome in patients with systemic lupus erythematosus (SLE) with and without lupus nephritis (LN) in remission or with active disease. Methods: A prospective cohort of pregnant patients with SLE (ACR 1997 criteria) was studied from January 2009 to December 2021. Demographic, clinical, biochemical, and immunological variables as well as the usual maternal‐fetal/neonatal complications were recorded. We compared four groups according to the status of SLE during pregnancy: patients with quiescent SLE without lupus nephritis, patients with active SLE without lupus nephritis, patients with quiescent lupus nephritis, and patients with active lupus nephritis. Statistical analysis included descriptive statistics, bivariate analysis, and Cox regression analysis. Results: A total of 439 pregnancies were studied, with a median age of 28 ± 6, SLE duration of 60 months (interquartile range 36–120). A higher frequency of maternal and fetal/neonatal complications was observed in patients with active SLE with or without lupus nephritis. Multivariate analysis showed that active LN was a risk factor for gestational hypertension (hazard ratios [HR] 1.95; 95% confidence intervals [CI]: 1.01–6.39), premature rupture of membranes (HR 3.56; 95% CI: 1.79–16.05) and more frequent cesarean section (HR 1.82; 95% CI: 1.13–2.94). Conclusion: LN is associated with a higher frequency of maternal complications, especially in those patients with active disease during pregnancy, and those maternal complications had an impact on poor fetal/neonatal outcomes. Strict control and timely care of LN could improve the obstetric prognosis. Synopsis: In this prospective cohort, active lupus nephritis during pregnancy was associated with an increased rate of maternal and fetal/neonatal complications. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the blood pressure (BP) status, including arterial stiffness parameters, hemodynamic indicators, circadian profile, and its association with albuminuria in adolescents with type 1 diabetes mellitus (DM1). Methods: The analysis included 46 patients, with diabetes duration of 7.38 ± 3.48 years. Ambulatory blood pressure monitoring (ABPM) was conducted using an oscillometric device, the Mobil-O-Graph, which is a Pulse Wave Analysis Monitor. Results: Hypertension (HT) was diagnosed in 31 adolescents (67% of patients), primarily due to isolated nocturnal BP (21 cases, 68% of HT cases). The HT group exhibited significantly increased diastolic load (DL). Pulse wave velocity (PWV, a measure of arterial stiffness) values showed a strong correlation with both peripheral systolic BP (r = 0.954) and central systolic BP (r = 0.838). Additionally, non-dipping status was found in 61% of the HT group. Urinary albumin excretion (UAE) was positively correlated with diastolic BP (particularly nocturnal) peripheral and central BP, DL, heart rate, augmentation index (AIx@75), and nocturnal total vascular resistance (TVR). Diastolic non-dippers exhibited a significant increase in UAE. Conclusions: Hypertension is a common complication in adolescents with type 1 diabetes mellitus, primarily caused by elevated nocturnal diastolic BP. Albuminuria is mainly associated with diastolic BP, especially during the nocturnal period and in cases of diastolic non-dipping status. The association of UAE with AIx@75 and nocturnal TVR suggests the presence of early-stage vascular disease in diabetic adolescents. [ABSTRACT FROM AUTHOR]

BACKGROUND: The flow reaching the vocal folds may be lower than that at the output of high-flow nasal cannula (HFNC) system. This could be due to upper-respiratory obstruction, oxygen leakage, or other factors. The objective of this study was to observe the effect of flow through a nasopharyngeal airway on intrapharyngeal pressure (IPP) in subjects undergoing fiberoptic bronchoscopy (FOB). METHODS: Patients scheduled for FOB were invited to participate. Measurements were performed at flows of 0-60 L/min; the subjects wore WN-N95 folding medical protective masks (N95) and either underwent FOB or not. IPP at each flow was recorded following 15 s of ventilation, and the cross-sectional area (CSA) of the gastric sinus was measured before and after FOB. Hypoxemia, reflux aspiration, and other pertinent events were recorded. RESULTS: Sixty subjects undergoing FOB at the Affiliated Hospital of Jiaxing University participated in this trial from October 2022-September 2023. IPP increased significantly with an increase in flow and also increased after placing the N95 mask with the same flow (P < .001). When results from before to after FOB were compared, the difference in CSA was statistically significant 263.6 (220.7-300.5) mm² vs 305.5 (275.4-329.5) mm², P < .001, but the difference in the risk of reflux aspiration was not statistically significant (0% vs 6.7%, P = .13). Complication rates during treatment were 8.3% for hypoxemia, 0% for reflux aspiration, 1.7% for hypertension, 1.7% for hypotension, 6.7% for tachycardia, 5% for bradycardia, and 10% for postoperative nausea and vomiting. CONCLUSIONS: HFNC can provide effective oxygen therapy for people undergoing FOB, and increases in IPP with flow in the range of 0-60 L/min may not increase the risk of reflux aspiration. [ABSTRACT FROM AUTHOR]

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Background/Objectives: People of African Descent (PoAD) in the United Kingdom (UK) are at an increased risk of hypertension and cardiovascular disease (CVD), partly due to dietary habits such as high salt intake. This study sought to understand the dietary salt-related knowledge, attitudes, and practises (KAP) of PoAD in the UK, to inform the development of culturally tailored interventions to reduce dietary salt intake in this population. Methods: We collected data on KAP from 21 PoAD across various regions in the UK through online semi-structured interviews and analysed them using reflexive thematic analysis (TA). Results: The age of the participants ranged from 20 to 70 years (43 ± 11). Six overarching themes were identified: (i) the multifaceted roles of salt in culinary practises, (ii) the increased awareness of health risks associated with high salt intake, (iii) the existence of knowledge gaps regarding recommended daily salt intake, (iv) the cultural influences on salt consumption levels, (v) the lack of engagement with food labels, and (vi) a limited awareness of salt reduction initiatives. Conclusions: Our findings highlight the significance of salt in the culture and culinary practises of PoAD. Despite general awareness of the health risks of excessive salt consumption, there was a notable deficiency in knowledge about the recommended salt intake levels as well as minimal engagement with nutritional labelling. These findings underline a need for culturally sensitive health interventions that integrate culinary practises, beliefs, and preferences of PoAD, aiming to effectively reduce salt intake and mitigate associated health risks. [ABSTRACT FROM AUTHOR]

Objectives: This study, utilizing data from the 2021 Korean Community Health Survey (KCHS), aimed to investigate the role of health literacy in mitigating depression among individuals with chronic diseases, particularly focusing on how sociodemographic and subjective factors influence this relationship. Methods: With a sample of 77,133 subjects primarily dealing with hypertension and diabetes, the study employed various analytical tools to identify factors associated with an increased risk of depression. Results: These factors included marital status (OR 1.47, 95% CI 1.40–1.54), residential district (OR 1.43, 95% CI 1.39–1.50), unemployment (OR 1.47, 95% CI 1.41–1.54), enrollment in the national basic living security program (OR 1.50, 95% CI 1.40–1.62), unmet healthcare needs (OR 2.32, 95% CI 2.14–2.51), fair subjective health status (OR 1.74, 95% CI 1.63–1.90), poor subjective health status (OR 4.33, 95% CI 4.05–4.63), and stress (OR 4.56, 95% CI 4.36–4.77). Notably, individuals with higher health literacy showed a significantly lower susceptibility to depression (OR 0.74, 95% CI 0.68–0.75), underscoring the importance of health literacy as a critical factor in mental health outcomes. Conclusions: Such initiatives could serve as effective preventive measures against depression in this vulnerable population. [ABSTRACT FROM AUTHOR]

Objective: The aim of this systematic review is to understand the relationship between alcohol use disorders (AUDs) and three non-communicable diseases [NCD] (cardiovascular diseases, respiratory diseases, and diabetes) in low- and middle-income countries (LMICs). Methods: We searched the following databases using a systematic search strategy: Medline, EMBASE, PsycINFO, Global Health, LILACS (Latin American and Caribbean Health Sciences Literature), and AJOL (African Journal Online). Results: We identified 1431 references through the database search and through a systematic screening process identified 13 studies that met our eligibility criteria. Amongst those with any kind of AUD, depending on the type of NCD, the prevalence ranged from 14% (diabetes) to 58% (hypertension). Amongst those with the selected NCDs, depending on the type of AUD, the prevalence ranged from 1.8% (diabetes) to 27.4% (ST-segment-elevation myocardial infarction). A range of AUDs were associated with hypertension in men, cardiovascular diseases, left ventricular hypertrophy, and diabetes mellitus. In some studies, inverse associations were observed between AUD and two NCDs – hypertension and diabetes. Conclusion: The burden of comorbid AUDs and NCDs in LMICs is high, and this should be countered through appropriate public health response such as policy interventions to control availability of alcohol, and through screening and brief interventions in primary care. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate the risk factors for glaucoma in patients with keratoconus following keratoplasty and to identify potential factors that could affect post-transplant complications. Methods: A retrospective analysis was conducted on the medical records of 192 keratoconus patients who underwent keratoplasty. Data on treatment history, perioperative information, tissue bank data, postoperative regimens, complications, and infections were collected and analyzed. Statistical analysis was performed to identify risk factors associated with glaucoma and transplant complications. Results: There was a 41.6% incidence of glaucoma (high IOP) (p < 0.001), with the median time to glaucoma development being 314 ± 67 days post-transplant. A significant number of patients required surgical intervention, accounting for 48.05%. Our analysis revealed a 14% graft failure rate. On univariable Cox proportional hazard analysis, the following factors demonstrated statistically significant associations with the risk of glaucoma after transplantation: donor endothelial cell density, the use of a single continuous suture type, and the surgeon (performing the surgery). For many variables, the only factor that remained significant was the surgeon. Among the factors analyzed for risks of failure post-transplantation, significant associations were observed for the donor age, the time from harvest to transplant, and the surgeon. In the multivariable analysis, donor age emerged as a significant predictor of post-transplant complications. Conclusions: Risk factors such as donor endothelial cell density, suture type, surgeon, host and donor size, and host gender were found to increase the risk of developing glaucoma post-keratoplasty. Surgeon type was identified as a significant risk factor, while donor age was predictive of post-transplant complications. [ABSTRACT FROM AUTHOR]

Background: Plasma neurofilament light chain (NfL) is a blood biomarker of neurodegeneration, including Alzheimer's disease. However, its usefulness may be influenced by common conditions in older adults, including amyloid-β (Aβ) deposition and cardiometabolic risk factors like hypertension, diabetes mellitus (DM), impaired kidney function, and obesity. This longitudinal observational study using the Alzheimer's Disease Neuroimaging Initiative cohort investigated how these conditions influence the prognostic capacity of plasma NfL. Methods: Non-demented participants (cognitively unimpaired or mild cognitive impairment) underwent repeated assessments including the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) scores, hippocampal volumes, and white matter hyperintensity (WMH) volumes at 6- or 12-month intervals. Linear mixed-effect models were employed to examine the interaction between plasma NfL and various variables of interest, such as Aβ (evaluated using Florbetapir positron emission tomography), hypertension, DM, impaired kidney function, or obesity. Results: Over a mean follow-up period of 62.5 months, participants with a mean age of 72.1 years (n = 720, 48.8% female) at baseline were observed. Higher plasma NfL levels at baseline were associated with steeper increases in ADAS-Cog scores and WMH volumes, and steeper decreases in hippocampal volumes over time (all p-values < 0.001). Notably, Aβ at baseline significantly enhanced the association between plasma NfL and longitudinal changes in ADAS-Cog scores (p-value 0.005) and hippocampal volumes (p-value 0.004). Regarding ADAS-Cog score and WMH volume, the impact of Aβ was more prominent in cognitively unimpaired than in mild cognitive impairment. Hypertension significantly heightened the association between plasma NfL and longitudinal changes in ADAS-Cog scores, hippocampal volumes, and WMH volumes (all p-values < 0.001). DM influenced the association between plasma NfL and changes in ADAS-Cog scores (p-value < 0.001) without affecting hippocampal and WMH volumes. Impaired kidney function did not significantly alter the association between plasma NfL and longitudinal changes in any outcome variables. Obesity heightened the association between plasma NfL and changes in hippocampal volumes only (p-value 0.026). Conclusion: This study suggests that the prognostic capacity of plasma NfL may be amplified in individuals with Aβ or hypertension. This finding emphasizes the importance of considering these factors in the NfL-based prognostic model for neurodegeneration in non-demented older adults. [ABSTRACT FROM AUTHOR]

Background: In recent years, the incidence of Endometrial cancer (EC) has been on the rise due to high-fat, high-calorie diets and low-exercise lifestyles. However, the relationships between metabolic disorders and the progression of EC remain uncertain. The purpose of our study was to explore the potential association between obesity, hypertension, hyperglycemia and clinicopathologic characteristics in EC patients. Methods: In categorical variables, Chi-square tests were used to calculate P values. Univariate logistic regression and multivariate logistic regression were used to identify the risk factors of myometrial invasion>1/2 and lymph node metastasis. Overall survival (OS) was estimated using the Kaplan-Meier method. Results: The study included 406 individuals with EC, 62.6% had type I and 37.4% had type II. Hypertension was seen in 132 (32.5%), hyperglycemia in 75 (18.5%), and overweight or obesity in 217 (53.4%). Hypertension, hyperglycemia, and obesity are strongly associated with the clinicopathologic features of EC. Multivariate logistic regression revealed that hyperglycemia (OR=2.439,95% CI: 1.025-5.804, P = 0.044) was a risk factor for myometrial invasion depth >1/2 in patients with type I EC, and hypertension (OR=32.124,95% CI: 3.287-313.992, P = 0.003) was a risk factor for lymph node metastasis in patients with type I EC. Survival analysis found that hyperglycemia (P < 0.001) and hypertension (P = 0.002) were associated with OS in type I EC. Neither hyperglycemia, hypertension, nor obesity were associated with the prognosis in type II EC. Conclusion: Hyperglycemia was a risk factor for myometrial invasion depth >1/2 in patients with type I EC and hypertension was a risk factor for lymph node metastasis in patients with type I EC. Hypertension and hyperglycemia were associated with poor prognosis in patients with type I EC. [ABSTRACT FROM AUTHOR]

Background: Existing research indicates that the Mediterranean diet has a positive impact on preventing and treating hypertension. However, its specific effect on hypertension among elderly Chinese individuals is unclear. Aims: The objective of this research was to explore the association between the Chinese version of the Mediterranean-DASH Intervention for Neurodegenerative Delay (cMIND) diet and hypertension among elderly Chinese individuals, aiming to offer novel strategies for alleviating the burden of hypertension in this demographic. Methods: In this study, we used cross-sectional data published in 2018 by the China Longitudinal Health and Longevity Survey (CLHLS) to develop a binary logistic regression model to investigate the correlation between cMIND diet and hypertension in a Chinese elderly population. Restricted cubic spline was used to test for linear associations, and further subgroup analyses were performed to test for interactions. Results: In total, 7,103 older adults were included in the study, with a prevalence of hypertension of 39.0%. When the cMIND diet score was used as a continuous variable, a significant protective effect against hypertension was present (OR = 0.955, 95% CI:0.923–0.988, p = 0.008); when used as a categorical variable, this protective effect was still present at higher levels (compared to lower levels) of the cMIND diet (OR = 0.869, 95% CI: 0.760–0.995, p = 0.042). Discussion: Although the Mediterranean diet has great potential to reduce the chance of hypertension, it should also consider the effect on the Chinese population. The results of this study provide new ways to reduce the disease burden of hypertension in Chinese older adults and improve quality of life in later life. Conclusion: The cMIND diet can considerably reduce the risk of hypertension among older adults in China. [ABSTRACT FROM AUTHOR]

Background: Although aging and being of African descent are well-known risk factors for masked uncontrolled hypertension (MUCH), data on MUCH among elderly black sub-Saharan Africans (BSSA) are limited. Furthermore, it is unclear whether the determinants of MUCH in younger individuals differ from those in the elderly. Objective: This study aimed to determine the prevalence and risk factors associated with MUCH in both elderly and younger BSSA individuals. Methods: In this study, 168 patients with treated hypertension were assessed for medical history, clinical examination, fundoscopy, echocardiography, and laboratory data. All patients underwent ambulatory blood pressure (BP) monitoring for 24 h. MUCH was diagnosed if the average 24-h mean BP ≥ 130/80 mmHg, the daytime mean BP ≥ 135/85 mmHg, and/or the nighttime mean BP ≥ 120/70 mmHg, despite controlled clinic BP (≤ 140/90 mmHg). Logistic regression analysis was performed to assess independent factors associated with MUCH, including elderly and younger adults separately. P-values < 0.05 were used to indicate statistical significance. Results: Of the 168 patients aged 53.6 ± 11.6 years, 92 (54.8%) were men, with a sex ratio of 1.2, and, 66 (39%) were aged ≥ 60 years. The proportion of patients with MUCH (27.4% for all patients) was significantly higher (p = 0.002) among elderly patients than among younger patients (45.5% vs. 15.7%). Diabetes mellitus (adjusted odds ratio [aOR], 2.44; 95% confidence interval [CI], 1.27–4.46; p = 0.043), anemia (aOR, 3.18; 95% CI, 1.07–5.81; p = 0.043), hypertensive retinopathy (aOR, 4.50; 95% CI, 1.57–5.4; p = 0.043), and left ventricular hypertrophy (aOR, 4.48; 95% CI, 2.26–8.35; p = 0.043) were independently associated with MUCH in the elderly. In younger individuals, male gender (aOR, 2.16; 95% CI, (1.33–4.80); p = 0.029), obesity (aOR, 3.02; 95% CI, (1.26–5.32); p = 0.001), and left ventricular hypertrophy (LVH) (aOR, 3.08; 95% CI, (2.14–6.24); p = 0.019) were independently associated with MUCH were independently associated with MUCH. Conclusion: MUCH is more prevalent among elderly than among younger BSSA individuals. Determinants of MUCH vary by age. MUCH prevention and management strategies should be age-specific. [ABSTRACT FROM AUTHOR]

Introduction: Over the past 40 years, there has been a significant increase in the global prevalence of childhood obesity, which is associated with an increased risk of heart problems and the earlier onset of heart diseases. Objective: The aim of this research is to assess the prevalence of obesity and its risk factors in children and adolescents among students from the second and third cycle and secondary education of a school grouping in the interior of Portugal. Materials and Methods: The sample was collected from a school grouping in Alcains, among attending students from the fifth to the twelfth grade. The sample consisted of a total of 156 students aged between 10 and 18 years. A questionnaire was proposed, and blood pressure measurement and lipid profile evaluation were performed for each individual. The collection and statistical treatment of data for this study required a submission and authorization request to the Ethics Committee of the Polytechnic Institute of Castelo Branco, followed by authorization from the school group's administration. Results: The percentage of elevated BMI was 30.8%, and was higher in males. A higher prevalence of hypertension (37.8%), elevated triglyceride levels in students who did not exercise outside of school, and in individuals who consumed larger amounts of meat, who also showed a higher prevalence of lower-than-expected high-density lipoprotein (HDL) cholesterol levels, were observed. Discussion: A high percentage of elevated BMI, high blood pressure levels, and changes in lipid profile were observed among high school students in this school in the interior of Portugal, as has been observed in other studies. Conclusions: It is essential to conduct more studies, screenings, and investigations that can identify these cases early, in order to mitigate risk factors. [ABSTRACT FROM AUTHOR]

This study aimed to examine blood pressure changes during ketamine infusion for depression and exploring the factors associated with these changes. This study is a retrospective chart-review of patients with depression undergoing ketamine infusion at Yale Psychiatry Hospital during a 7-year period. Blood pressure (BP) was recorded every 10 min during the infusion. Surges in systolic and diastolic blood pressure (SBP, DBP), along with severe hypertension events, were analyzed in relation to patient demographics. A total of 138 patients received a total of 2342 infusions. SBP and DBP peaked at 40 min after the start of the infusion with a mean change of 16.0 (SD: 11.2) and 11.0 mmHg (SD: 8.45) respectively. Severe hypertension was observed in 17 patients (12.5%) and 23 infusion sessions (0.98%), occuring more frequently during the first three infusions (43.4%). Age (OR = 1.04 [1.02,1.05], p -value <0.001) was significantly associated with a surge in SBP and all patients with a past medical history of hypertension experienced a BP surge during their infusions. Ketamine infusions can cause significant blood pressure increases, particularly in older and hypertensive patients, highlighting the need for careful cardiovascular monitoring to mitigate risks during treatment. [ABSTRACT FROM AUTHOR]

Introduction: Acute ischemic stroke (AIS) is a devastating complication of COVID-19 with high morbidity and mortality. In this study, we reported the frequency, characteristics, and outcome of AIS in patients with COVID-19. Methods: This multicenter and cross-sectional study was conducted between April 2020 and February 2021. Among the hospitalized patients with COVID-19, the detailed characteristics of those with and without AIS were recorded and compared. Results: Six hundred ninety-three patients were included in the study. Acute ischemic stroke was detected in 16 (2.31%) patients, the median age was 77 (range, 48-91) years, and 10 (62.5%) were female. The median NIHSS score at admission was 9 (range, 3-17). Total anterior circulation infarction (TACI) was the most common (37.5%) type and cardioembolism was the most common etiology (37.5%). Nine patients (56.25%) developed AIS within 24 hours of having COVID-19. COVID-19 severity was severe or critical in seven patients (43.75%). Eight patients died, and eight were discharged. Patients with AIS had a higher rate of hypertension, coronary artery disease, heart failure, a history of myocardial infarction, a history of cerebrovascular disease, severe and critical COVID-19, a higher mean age, and a longer ICU stay compared with those without AIS (p<0.001 for each). Conclusions: AIS can occur in patients with COVID-19 and is associated with mortality. Acute ischemic stroke is encountered at any stage of COVID-19, especially within the first 72 hours of the diagnosis, in older patients with comorbidities and severe COVID-19. There is an increased risk of AIS in patients with COVID-19 with a history of stroke. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to examine age, period, and cohort effects contributing to the prevalence of diabetes and hypertension among older Koreans. Additionally, it sought to investigate how sociodemographic characteristics interact with period and cohort effects to influence the disease prevalence. Methods Using the 2004–2020 data from the National Survey of Older Koreans, a nationally representative sample of older adults aged 65 or older, hierarchical age–period–cohort cross-classified random effects models (HAPC-CCREMs) were employed to estimate separate age, period, and cohort components of the recent trends in diabetes and hypertension. Sociodemographic characteristics were tested for their interactions with period and cohort effects. Results Significant period effects were observed, indicating a steady increase in the likelihood of being diagnosed with diabetes and hypertension over time. Age effects revealed a quadratic trend, with disease risks generally increasing with age, but the rate of increase diminishing at older ages. Cohort effects exhibited an inverted U-shaped pattern, with higher risks observed in the 1930s and early 1940s cohorts compared to earlier and later cohorts. Gender and educational attainment emerged as significant moderators. Women than men born in the early 1930s exhibited higher risks of diabetes and hypertension, whereas individuals with lower educational attainment showed a steadily increasing risk of hypertension over time. Discussion The results underscore the complex interplay of age, period, and cohort effects in shaping disease prevalence among older Koreans. Our findings highlight the importance of considering historical context and sociodemographic factors in understanding disease trends and designing targeted interventions to mitigate health disparities. [ABSTRACT FROM AUTHOR]

The present study aimed to assess the relationship between body shape, physical activity (PA), and systolic blood pressure (SBP) and diastolic blood pressure (DBP). A novel visualization method was used to examine the effects of body shape combined with physical activity on hypertension. Data from 54,303 participants were obtained from the China Health and Nutrition Survey (CHNS) and analyzed using logistic regression models and standardized regression coefficients of linear models. These models were used to explore factors and effects of body shape indices and other parameters on SBP and DBP. The logistic regression model revealed that compared to transport‐related PA, the aggregated variables (weight and waist) were associated with a 2.44‐fold and 1.65‐fold increase in the risk of hypertension, respectively (p <.05). The average aggregated standardized coefficient of the linear model, based on 1000 bootstrap resamples, indicated that the Base Shape group had the strongest explanatory power for hypertension, followed by the Habits group. However, the explanatory power of the PA group was around 10 and 22 times lower than that of the Base Shape group for DBP and SBP, respectively (p <.05). These results demonstrate that increasing physical activity, with emphasizing a healthy body shape, and adopting positive lifestyle habits can effectively contribute to the prevention and control of hypertension. [ABSTRACT FROM AUTHOR]

Evidence regarding the combined effects of green space and air pollutants on hypertension remains limited and complex. This study aims to investigate the varying effects of greenness under different air pollution levels in China, using data from the wave 2018 China Health and Retirement Longitudinal Study (CHARLS) involving 17 468 adults (aged ≥ 45 years). As a result, the prevalence rate of hypertension was 42.04%. Logistic regression analyses revealed the positive associations between air pollution concentrations at the city level and prevalent hypertension and the negative associations between NDVI and prevalent hypertension, all of which were more prominent in the populations of the eastern and rural regions. Notably, the negative effect of green space was greater at the lowest quartiles of each air pollutant (OR for PM2.5 quartiles = 0.724, 0.792, 0.740, and 0.931). Improving air quality and greenness could potentially reduce hypertension risk, and minimizing air pollution might optimize the protective effects of greenness. [ABSTRACT FROM AUTHOR]

This article discusses the use of Cyclosporine A (CsA) in treating organ transplant rejection and inflammatory skin diseases, highlighting its potential side effect of causing hypertension. The incidence of hypertension in transplant recipients on CsA is high, ranging from 65 to 100%, while in dermatologic patients, it varies with lower incidences in Korean patients. The study conducted a retrospective analysis of 761 patients treated with CsA for chronic inflammatory skin diseases and found that 25.4% of patients developed high blood pressure after a median period of 70 days. Risk factors for CsA-associated hypertension included pre-existing diabetes, uric acid abnormality, diagnosis of psoriasis, male sex, older age, and higher cumulative dose of CsA. The study emphasizes the importance of monitoring blood pressure during CsA therapy and considering alternative treatment options for high-risk patients. [Extracted from the article]

Ethnic and racial sexual minority men with HIV have a disproportionately higher risk of HIV-related cardiovascular disease (CVD). There is a lack of tailored and culturally salient behavioral interventions to address HIV-related chronic illness in ethnic and racial sexual minority men, and literature on their understanding and awareness of modifiable behavioral risks is limited. The purpose of this study was to assess illness perceptions about HIV and HTN, and describe physical activity, tobacco, and e-cigarette use in Black and Latinx sexual minority men living with HIV. We used the validated Illness Perception Questionnaire-Revised (IPQ-R) to assess perceptions about two interrelated chronic diseases, HIV and CVD. To assess CVD behavioral risk, we assessed physical activity using the International Physical Activity Questionnaire. Tobacco and e-cigarette use were assessed using items from the Behavioral Risk Factor Surveillance System. Sleep difficulties were the most prevalent symptom attributed to HIV, and were statistically associated with fatigue, upset stomach, and loss of strength. Anxiety was reported to be caused by HIV (57%) and HTN (39%). Half of the participants engaged in vigorous activity for 128 min (SD = 135) daily, and 63% engaged in moderate activity for 94 min (SD = 88) daily. Over a third reported current tobacco use and 20% reported current e-cigarette use. This study provides formative data to better understand how Black and Latinx sexual minority men with HIV perceive intersecting chronic illnesses and their engagement in modifiable CVD risk behaviors. Sleep, mental health disparities, and financial hardships were commonly reported. More research is needed to address intersecting chronic illnesses and mental health conditions that are influenced by social positioning over the life course, and impact CVD risk factors. This study was not registered. [ABSTRACT FROM AUTHOR]

BACKGROUND Hypertension is a risk factor for atrial fibrillation (AF), and brain and muscle arnt-like protein 1 (Bmal1) regulate circadian blood pressure and is implicated in several fibrotic disorders. Our hypothesis that Bmal1 inhibits atrial fibrosis and susceptibility to AF in salt-sensitive hypertension (SSHT) and our study provides a new target for the pathogenesis of AF induced by hypertension. METHODS The study involved 7-week-old male Dahl salt-sensitive that were fed either a high-salt diet (8% NaCl; DSH group) or a normal diet (0.3% NaCl; DSN group). An experimental model was used to measure systolic blood pressure (SBP), left atrial ejection fraction (LAEF), left atrial end-volume index (LAEVI), left atrial index (LAFI), AF inducibility, AF duration, and atrial fibrosis pathological examination and the expression of Baml1 and fibrosis-related proteins (TNF-α and α-SMA) in left atrial tissue. RESULTS DSH increased TNF-α and α-SMA expression in atrial tissue, level of SBP and LAESVI, atrial fibrosis, AF induction rate, and AF duration, and decreased Bmal1 expression in atrial tissue, the circadian rhythm of hypertension, and level of LAEF and LAFI. Our results also showed that the degree of atrial fibrosis was negatively correlated with Bmal1 expression, but positively correlated with the expression of TNF-α and α-SMA. CONCLUSIONS We demonstrated that a high-salt diet leads to circadian changes in hypertension due to a reduction of Bmal1 expression, which plays a crucial role in atrial fibrosis and increased susceptibility to AF in SSHT rats. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the association between total consumption of fruits (F), vegetables (V), and legumes (L) and their subgroups and hypertension risk in adults aged ≥ 40 years in the Cardiovascular Disease Association Study (CAVAS). Methods: We analyzed data from 10,325 normotensive participants using cumulative average dietary consumption from repeated food frequency questionnaires during the follow-up. Incidence rate ratios (IRRs) were estimated with a modified Poisson regression model and a robust error estimator to evaluate the association between hypertension risk and total consumption of fruits, vegetables, and legumes, as well as their 17 subgroups. Results: During an average follow-up of 5.20 years, 2159 cases of hypertension were recorded. Total consumption of FVL, FV, fruits, vegetables, and legumes showed overall inverse trends with hypertension risk. Considering multiplicity, fruit consumption was inversely associated with hypertension risk in both men (IRR 0.64; 95% CI 0.52–0.79) and women (IRR 0.76; 95% CI 0.64–0.91). Vegetables were inversely associated with hypertension in women (IRR 0.67; 95% CI 0.53–0.86). Most subgroups showed inverse associations, especially in men with overweight/obesity. However, frequent pickled green leafy vegetable consumption was positively associated with hypertension risk in postmenopausal women but not in premenopausal women (Pinteraction = 0.0004). Conclusion: Consumption of FVL, including their subgroups, generally shows inverse associations with hypertension risk. However, caution is advised for recommending pickled vegetables, particularly for postmenopausal women, due to the potential adverse effects of sodium. The benefits of these foods in preventing hypertension are especially pronounced in men with overweight/obesity. [ABSTRACT FROM AUTHOR]

Aging is a non-modifiable understudied risk factor for hypertension. We hypothesized that sympathetically mediated activation of renal sodium reabsorption drives age-dependent hypertension and the salt sensitivity of blood pressure (BP). Using 3-, 8-, and 16-month-old male and female Sprague–Dawley rats as a model of normal aging, we assessed BP, indices of sympathetic tone, and the physiological responses to acute and chronic sodium challenge including sodium chloride cotransporter (NCC) regulation. The effects of renal nerve ablation and NCC antagonism were assessed in hypertensive male rats. We observed sex-dependent impaired renal sodium handling (24 h sodium balance (meq), male 3-month 0.36 ± 0.1 vs. 16-month 0.84 ± 0.2; sodium load excreted during 5% bodyweight isotonic saline volume expansion (%) male 3-month 77 ± 5 vs. 16-month 22 ± 8), hypertension (MAP (mmHg) male 3-month 123 ± 4 vs. 16-month 148 ± 6), and the salt sensitivity of BP in aged male, but not female, rats. Attenuated sympathoinhibitory afferent renal nerve (ARN) responses contributed to increased sympathetic tone and hypertension in male rats. Increased sympathetic tone contributes to renal sodium retention, in part through increased NCC activity via a dysfunctional with-no-lysine kinase-(WNK) STE20/SPS1-related proline/alanine-rich kinase signaling pathway, to drive hypertension and the salt sensitivity of BP in aged male rats. NCC antagonism and renal nerve ablation, which reduced WNK dysfunction and decreased NCC activity, attenuated age-dependent hypertension in male Sprague–Dawley rats. The contribution of an impaired sympathoinhibitory ARN reflex to sex- and age-dependent hypertension in an NCC-dependent manner, via an impaired WNK1/WNK4 dynamic, suggests this pathway as a mechanism-based target for the treatment of age-dependent hypertension. [ABSTRACT FROM AUTHOR]

Background: Comorbid anxiety in hypertensive patients yields poor remedy adherence which may additionally restrict treatment choices. Objective: To assess the magnitude and severity of anxiety and risk factors among hypertensive patients attending public hospitals in Arba Minch town, Ethiopia, 2022. Methods: A hospital-based cross-sectional study design was performed from June 1 to July 30/2022. The overall sample size was 336 and a systematic random sampling technique was used to pick out sufferers. Used Epi data version 3.1 for data entry and SPSS version 25 for analysis. Logistic regression analysis was done and variables with p -values less than.25 were taken into multivariable. Statistical significance was declared at a p -value of less than.05 with a 95% confidence interval in the adjusted odds ratio. Result: The magnitude of anxiety among hypertensive patients was 32.1% with 95% CI (26.2%–37.1%). Sex [AOR: 2.25, 95%CI: 1.22–4.13], status of blood pressure [AOR: 0.30, 95%CI: 0.15–0.63], family history of hypertension [AOR: 2.48, 95%CI: 1.20–5.12], family history of mental illness [AOR: 0.19, 95%CI: 0.09–0.39], history of admission [AOR: 5.14, 95%CI: 2.73–9.68], social support status [AOR: 2.96, 95%CI: 1.09–7.97], and current alcohol use [AOR: 0.39, 95%CI: 0.18–0.86] had been notably related. Conclusion: About three in 10 hypertensive patients attending public hospitals in Arba Minch town public hospitals were anxious. Approximately two in 10 hypertensive sufferers had moderate to severe anxiety. Sex, status of blood pressure, family history of hypertension, family history of mental illness, history of admission, social support status, and current alcohol use have been substantially associated with anxiety among hypertensive patients. Therefore, enhancing gender identity, controlling blood pressure, screening and treating a family history of high blood pressure and family history of mental illness, coping with previous admission, improving social help, and cessation of alcohol use might lessen the burden of anxiety among hypertensive sufferers. [ABSTRACT FROM AUTHOR]

Background: The updated status of hypertension and its risk factors are poorly evaluated in Tibetan highland areas. We initiated a large-scale cross-sectional survey to provide updated status of hypertension and its risk factors (especially salt intake) in the Ganzi Tibetan Plateau, China. Methods: Stratified multistage random sampling was performed to obtain a representative sample of 4,036 adult residents from 4 counties in the Ganzi Tibetan area. The whole survey population was used to present the epidemiology and risk factors of hypertension. The participants with blood and urine biochemistry data were used to analyze the relationship between salt intake parameters and hypertension. Results: Stratified multistage random sampling was performed to obtain a representative sample of 4,036 adult residents. The overall prevalence rate of hypertension was 33.5% (the age-adjusted prevalence rate was 28.9%). A total of 50.9% of the hypertensive patients knew their conditions; 30.1% of them received antihypertensive treatment; and 11.2% of them had their blood pressure controlled. Age, male sex, living altitude ≥ 3500 m, overweight and abdominal obesity were positively correlated with hypertension. In addition, the adjusted odds ratio (OR) for hypertension was 1.33 (95% CI: 1.01–1.74) for drinking tea with salt, and 1.51 (95% CI: 1.32–1.72) for per SD increase in the estimation of 24-hour urinary sodium excretion (e24hUSE). Furthermore, per 100mmol/day increase in e24hUSE was associated with elevation of blood pressure (+ 10.16, 95% CI: 8.45–11.87 mmHg for SBP; +3.83, 95% CI: 2.74–4.93 mmHg for DBP) in this population. Conclusions: Our survey suggests a heavy disease burden of hypertension in the Ganzi Tibetan Plateau. Age, male sex, altitude of residence ≥ 3500 m, overweight, abdominal obesity, and excessive salt intake (shown as drinking tea with adding salt and a higher level of e24hUSE) all increased the risk of hypertension in this highland area. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a common heart condition in the United States (US) and severely impacts racial and ethnic minority populations. While the understanding of hypertension has grown considerably, there remain gaps in US healthcare research. Specifically, there is a lack of focus on undiagnosed and uncontrolled hypertension in primary care settings. Aim: The present study investigates factors associated with undiagnosed and uncontrolled hypertension in primary care patients with hypertension. The study also examines whether Black/African Americans are at higher odds of undiagnosed and uncontrolled hypertension compared to White patients. Methods: A cross-sectional study was conducted using electronic health records (EHR) data from the University of Utah primary care health system. The study included for analysis 24,915 patients with hypertension who had a primary care visit from January 2020 to December 2020. Multivariate logistic regression assessed the odds of undiagnosed and uncontrolled hypertension. Results: Among 24,915 patients with hypertension, 28.6% (n = 7,124) were undiagnosed and 37.4% (n = 9,319) were uncontrolled. Factors associated with higher odds of undiagnosed hypertension included age 18–44 (2.05 [1.90–2.21]), Hispanic/Latino ethnicity (1.13 [1.03–1.23]), Medicaid (1.43 [1.29-1.58]) or self-pay (1.32 [1.13-1.53]) insurance, CCI 1-2 (1.79 [1.67-1.92]), and LDL-c ≥ 190 mg/dl (3.05 [1.41–6.59]). For uncontrolled hypertension, risk factors included age 65+ (1.11 [1.08–1.34]), male (1.24 [1.17–1.31]), Native-Hawaiian/Pacific Islander (1.32 [1.05-1.62]) or Black/African American race (1.24 [1.11-1.57]) , and self-pay insurance (1.11 [1.03-1.22]). Conclusion: The results of this study suggest that undiagnosed and uncontrolled hypertension is prevalent in primary care. Critical risk factors for undiagnosed hypertension include younger age, Hispanic/Latino ethnicity, very high LDL-c, low comorbidity scores, and self-pay or medicaid insurance. For uncontrolled hypertension, geriatric populations, males, Native Hawaiian/Pacific Islanders, and Black/African Americans, continue to experience greater burdens than their counterparts. Substantial efforts are needed to strengthen hypertension diagnosis and to develop tailored hypertension management programs in primary care, focusing on these populations. [ABSTRACT FROM AUTHOR]

Objective To explore the relationship between H - type hypertension and chronic kidney disease (CKD) and provide scientific basis for the prevention and treatment of chronic kidney disease. Methods From December 2021 to December 2022, 257 patients with CKD were randomly collected from the Department of Nephrology of Hunan Provincial People' s Hospital, and 257 patients were collected in the physical examination department as the control group. Data on general demographic characteristics, lifestyle habits, disease history, and clinical indicators were collected for all study subjects. The epidemic status and influencing factors of CKD, and the relationship between H - type hypertension and CKD were analyzed by univariate and multivariate analysis methods. An interaction model was constructed to analyze the interaction effect of homocysteine (Hey) and hypertension on the onset of CKD. The effect of H - type hypertension and related influencing factors on CKD were explored by subgroup analysis. Results The results of univariate analysis of general demographic characteristics and clinical indicators between CKD and control groups showed: age, ethnicity, educational level, per capita income, exercise status, sleep duration, BMI, history of H - type hypertension, triglycerides (TG), High - density lipoprotein cholesterol (HDL), albumin (ALB), glomerular filtration rate (GFR), blood urea nitrogen (BUN), uric acid (UA), Hcy, total bilirubin (TBIL), direct bilirubin (DBIL), C reactive protein (CRP) levels (P < 0. 05). Dichotomized Logistic regression analysis showed that the risk of CKD, adjusted for age, nationality, educational level, family income, exercise, sleep duration, BMI, TG, HDL, ALB, GFR, BUN, UA, TBIL, CRP was 2. 333 times higher than in those without H - type hypertension (OR - 2.333, 95% CI: 1.365 - 3.989, P = 0.002). The interaction results between hyperhomocysteinemia (HHcy) and hypertension suggested that there was a positive additive interaction between HHcy and hypertension, with no multiplicative interaction. There was an interaction between H - type hypertension and age, educational level, average annual family income, and sleep duration on the onset of CKD (P < 0. 05). Conclusion H - type hypertension is a risk factor for CKD, and there is an additive interaction between the effects of HHcy and hypertension on CKD. [ABSTRACT FROM AUTHOR]

Background/Objectives: Mortality due to various non-communicable diseases, including hypertension, is increasing globally. Studies have reported that periodontitis, a chronic inflammatory disorder caused by oral pathogens, is a potential risk factor for hypertension. These pathogens can invade arterial walls, leading to vascular inflammation and endothelial dysfunction, which then increases the likelihood of developing hypertension. However, evidence of the association between periodontitis and hypertension remains limited. Therefore, the aim of this study is to determine whether periodontitis is associated with hypertension among adults in Rwanda. Methods: A cross-sectional study was carried out among 420 participants (hypertensive and non-hypertensive) at the University Teaching Hospital of Kigali (CHUK) and Ruhengeri Hospital in Rwanda. Periodontitis was assessed using clinical parameters: clinical attachment loss (CAL), bleeding on probing (BoP), and periodontal pocket depth (PDD). Hypertension was defined as a patient with a systolic or diastolic blood pressure (SBP/DBP) of ≥140/90 mmHg. Descriptive statistics, the Chi-square test, and logistical regression were performed using SPSS version 29 for statistical data analysis. Results: The prevalence of periodontitis was found to be 69.5% among hypertensive patients and 52.4% among non-hypertensive patients. Clinical attachment loss was 6.24 times (AOR = 6.24, 95% CI: 1.99–19.56) higher among hypertensive patients and the difference was significant (p = 0.001). Other periodontal parameters such as periodontal pocket depth and bleeding on probing showed a more significant association among hypertensive than non-hypertensive patients. Conclusions: Our study found a significant association between periodontitis and hypertension in Rwandan adults. However, further intervention studies are needed to explore causality and potential interventions. [ABSTRACT FROM AUTHOR]

Hypertension is a very common comorbidity in type 2 diabetes patients, which leads to important health and treatment challenges. The present study was conducted with the aim of determining the prevalence of hypertension and its risk factors in type 2 diabetes patients. This study was conducted using cross-sectional data from 1245 participants aged between 35 and 70 years and diagnosed with type 2 diabetes at baseline in the Fasa cohort study. The prevalence hypertension was determined and multivariate logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between various risk factors and hypertension prevalence. The average age of the participants was 53.5 ± 8.7 years and 71.7% (n = 893) were female and 28.3% (n = 352) were male. The prevalence of hypertension in people with type 2 diabetes was 45.5% (n = 566). Higher age (AOR, 95% CI: 8.1, 4.6–14.3), female gender (OR, 95% CI: 1.8, 1.2–2.5), Fars (AOR, 95% CI: 1.6, 1.1–2.4) and Turk (AOR, 95% CI: 1.6, 1.1–2.5) vs. other ethnicity, and overweight (AOR, 95% CI: 1.8, 1.38–2.38) and obesity (AOR, 95% CI: 2.7, 2.0–3.8) vs. BMI < 25 was associated with a higher prevalence of hypertension, while higher physical activity (AOR, 95% CI: 0.57, 0.42–0.78) was associated with lower prevalence of hypertension in the multivariable model. The prevalence of hypertension in persons with type 2 diabetes was high and increased with greater age, in some ethnic groups, and with higher BMI and low physical activity. Further prospective studies are needed to investigate these associations in this population. [ABSTRACT FROM AUTHOR]

Prediction of heart diseases on time is significant in order to preserve life. Many conventional methods have taken efforts on earlier prediction but faced with challenges of higher prediction cost, extended time for computation and complexities with larger volume of data which reduced prediction accuracy. In order to overcome such pitfalls, AI (Artificial Intelligence) technology has been evolved in diagnosing heart diseases through deployment of several ML (Machine Learning) and DL (Deep Learning) algorithms. It improves detection by influencing with its capacity of learning from the massive data containing age, obesity, hypertension and other risk factors of patients and extract it accordingly to differentiate on the circumstances. Moreover, storage of larger data with AI greatly assists in analysing the occurrence of the disease from past historical data. Hence, this paper intends to provide a review on different AI based algorithms used in the heart disease prognostication and delivers its benefits through researching on various existing works. It performs comparative analysis and critical assessment as encompassing accuracies and maximum utilization of algorithms focussed by traditional studies in this area. The major findings of the paper emphasized on the evolution and continuous explorations of AI techniques for heart disease prediction and the future researchers aims in determining the dimensions that have attained high and low prediction accuracies on which appropriate research works can be performed. Finally, future research is included to offer new stimulus for further investigation of AI in cardiac disease diagnosis. [ABSTRACT FROM AUTHOR]

Background: Anemia is common and associated with increased morbidity among people with HIV (PWH). Classification of anemia using the mean corpuscular volume (MCV) can help investigate the underlying causative factors of anemia. We characterize anemia using MCV among PWH receiving antiretroviral therapy (ART), and identify the risk factors for normocytic, macrocytic, and microcytic anemias. Methods: Including PWH with anemia (hemoglobin measure < 12.9 g/dL among men and < 11.9 g/dL among women) in the NA-ACCORD from 01/01/2007 to 12/31/2017, we estimated the annual distribution of normocytic (80–100 femtolitre (fL)), macrocytic (> 100 fL) or microcytic (< 80 fL) anemia based on the lowest hemoglobin within each year. Poisson regression models with robust variance and general estimating equations were used to estimate crude and adjusted prevalence ratios and 95% confidence intervals for risk factors for macrocytic (vs. normocytic) and microcytic (vs. normocytic) anemia stratified by sex. Results: Among 37,984 hemoglobin measurements that identified anemia in 14,590 PWH, 27,909 (74%) were normocytic, 4257 (11%) were microcytic, and 5818 (15%) were macrocytic. Of the anemic PWH included over the study period, 1910 (13%) experienced at least one measure of microcytic anemia and 3208 (22%) at least one measure of macrocytic anemia. Normocytic anemia was most common among both males and females, followed by microcytic among females and macrocytic among males. Over time, the proportion of anemic PWH who have macrocytosis decreased while microcytosis increased. Macrocytic (vs. normocytic) anemia is associated with increasing age and comorbidities. With increasing age, microcytic anemia decreased among females but not males. A greater proportion of PWH with normocytic anemia had CD4 counts ≤ 200 cells/mm3 and had recently initiated ART. Conclusion: In anemic PWH, normocytic anemia was most common. Over time macrocytic anemia decreased, and microcytic anemia increased irrespective of sex. Normocytic anemia is often due to chronic disease and may explain the greater risk for normocytic anemia among those with lower CD4 counts or recent ART initiation. Identified risk factors for type-specific anemias including sex, age, comorbidities, and HIV factors, can help inform targeted investigation into the underlying causes. [ABSTRACT FROM AUTHOR]

Background: The proliferation of internet use in the 21st century has brought about a pluralistic effect on health. Users of the internet are more exposed to health information, thus, making them more health literate and more likely to adopt healthy behaviors. However, frequent use of the internet has been found to adversely affect mental health (e.g., depression), social wellbeing, and obesity. Yet, the link between internet use and physical health outcomes such as hypertension remains less explored. We examined the association between frequency of internet use and hypertension risk among women and men in Kenya using data from the 2022 Kenyan demographic and health survey. Results: Overall, the prevalence of hypertension was higher among women (1,398 [8.69%]) compared to men (504 [3.49%]). Those who reported using the internet often reported higher prevalence of hypertension (women: n = 638 [10.49%]; men: n = 279 [3.98%]). The mean age was 29.3 years (SD = 9.6) for women and 29.9 years for men (SD = 10.9). After adjusting for potential confounders, women who reported often using the internet also demonstrated a significant association [AOR = 1.21; 95%CI: 1.03–1.43]. However, we found no significant association between frequency of internet use and hypertension among men after adjusting for confounders. Conclusion: Our study concludes that frequent use of internet is positively associated with hypertension risk among women but not men. Policymakers may consider implementing guidelines or regulations to promote healthy internet usage habits and encourage breaks or limits on screen time, especially for individuals at risk of hypertension (i.e., older women of reproductive age, women with higher education, married and previously married women, those in affluent households, parous women, those who consume alcohol and those overweight/obese). Healthcare providers should educate patients about the potential health consequences of prolonged internet usage and incorporate discussions about screen time management into routine clinical encounters. [ABSTRACT FROM AUTHOR]