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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]

Purpose: This study aims to explore the perceptions of quality of life among older Thai adults with hypertension. Design/methodology/approach: A descriptive qualitative design was used. Semistructured interviews were conducted with 40 older adults. Thematic analysis was used to analyze the data. Findings: The analyses were divided into six major themes: happiness in life; health and functionality; activity in social relationships; religion anchor; autonomy to manage their own life; and security in finances and environment. Practical implications: The findings can guide health care professionals and policymakers when planning and implementing interventions and policies for improving the quality of life of older adults, particularly that of rural older adults with low incomes. Originality/value: The findings showed minor differences between urban and rural older adults in financial security, where the rural participants expressed greater financial insecurity than the urban counterparts. However, no other major differences emerged. [ABSTRACT FROM AUTHOR]

Background: This study assessed knowledge, behaviors, and perceptions towards hypertension following community dissemination on cardiovascular disease (CVD) risk within the Navrongo Health and Demographic Surveillance Site in Northern Ghana. Methods: A cross-sectional mixed methods study was conducted among middle aged men and women following education on CVD and their risk factors. Knowledge and attitudes of participants regarding hypertension were measured in 310 participants using a survey tool and the resultant data was analyzed with descriptive statistics. Focus group discussions (FDG) were used to assess perceptions of 40 study participants on their lived experiences with hypertension. Recorded interviews were transcribed verbatim and coded into themes using Nvivo 12 software before thematic analysis. Results: Of the 310 surveyed participants, 54% were women and the mean age was 50 ± 6 years. The results showed that 84% of participants had heard about hypertension, 70% knew it was an increase in blood pressure and could be caused by excess salt intake, poor diet and physical inactivity. About 22.3% of participants were aware of the had hypertension. In terms of management, majority of the participants were aware that hypertension could be treated with antihypertensive medication and that untreated or uncontrolled hypertension could result in adverse health consequences. Few participants had ever had their blood pressure measured and did not access screening or healthcare care services and rather perceived the health system as inadequate to screen, and manage hypertension. Conclusion: Though, knowledge on hypertension was high, awareness of hypertension status and access to screening and healthcare services was low. Community beliefs and perceptions strongly influence treatment, and control of hypertension. Effective sustained community dissemination efforts addressing misperceptions could improve hypertension treatment and control. [ABSTRACT FROM AUTHOR]

Objective: This study aimed at assessing the effectiveness of cognitive‐behavioural therapy (CBT) integrated with psychoeducation in a group of hypertensive patients with clinically significant psychopathological symptoms. Methods: One hundred hypertensive patients completed the Symptom Checklist‐90‐Revised. Of them, 17 scored above the clinical range (cut‐off = 0.75) on the Global Severity Index and were included in the study. Psychological distress was assessed again after the intervention (T1) and 6 months after the end of treatment (T2). In addition, the cortisol dosage and the heart rate (HR) measurement were collected at both T0 and T2. Then, mediation analyses were carried out to calculate whether psychopathological distress might predict HR through elevated serum cortisol levels, at both T0 and T2. Results: The psychological intervention (CBT integrated with psychoeducation) reduced most of the psychopathological symptoms (anxiety, depression, somatisations, obsessions and compulsions, hostility, interpersonal sensitivity and paranoid ideation) but not cortisol dosage and HR measurement. However, psychological distress indirectly predicted HR via cortisol at T0 but not at T2. Conclusion: These results suggest and encourage the replicability of data in larger sample sizes and the comparison with a control group. Nevertheless, these results highlight a need for a multidimensional assessment of disorders affecting the mental and physical spheres of patients to support their overall well‐being. [ABSTRACT FROM AUTHOR]

INTRODUCTION This study evaluates the association between passive smoking, specifically secondhand smoke (SHS) and thirdhand smoke (THS) exposure, and sleep quality in a hypertensive population. METHODS We enrolled 1427 eligible hypertensive patients from a 2022 national cross-sectional survey in China. Data on tobacco smoke exposure and sleep were collected via questionnaires. Multiple logistic regression and linear regression were employed to assess the relationship between passive smoking and sleep quality characteristics, as well as the correlation between passive smoking exposure characteristics and sleep quality. RESULTS Among 589 hypertensive patients with no tobacco smoke exposure, 679 exposed to SHS, and 159 exposed to THS, SHS exposure was associated with a higher risk of poor sleep quality, even after adjusting for potential confounding factors (β=0.10; 95% CI: 0.32-0.95). No significant relationship was observed between THS exposure and sleep quality. SHS exposure was associated with various sleep quality characteristics, including shorter sleep duration (AOR=1.71; 95% CI: 1.06-2.76) and increased frequency of 1-72 sleep disturbances per week (AOR=1.68; 95% CI: 1.25-2.26). Individuals exposed to SHS were more likely to experience poorer subjective sleep quality (AOR=1.53; 95% CI: 1.07-2.21) and have sleep efficiency <65% (AOR=1.82; 95% CI: 1.22-2.71). Exposure to passive smoking at home, in the community, in public places, exposure to passive smoking with family and friends, and increased frequency of exposure, were all associated with a higher risk of poor sleep quality. CONCLUSIONS Our study suggests that SHS exposure in hypertensive populations is associated with poor sleep quality and various characteristics of sleep quality. No significant association was found between THS exposure and sleep quality. These findings underscore the need to enhance tobacco control efforts in China, particularly for individuals with chronic diseases, to safeguard public health. [ABSTRACT FROM AUTHOR]

This study applied a cross-sectional design to examine the relationship between self-management, psychological well-being, and quality of life in patients with hypertension and evaluated the mediation effect of psychological well-being on self-management and quality of life. Through purposive sampling, this study enrolled 255 patients with hypertension from the cardiology department of a teaching hospital in Taiwan. Mediation effects were estimated using linear regression and the Sobel test. Age, number of chronic diseases, waist circumference, self-management, and psychological well-being explained 18.7% of the total variance in quality of life. Psychological well-being partially mediated the effects of self-management on quality of life, with a total effect of 19.2%. Psychological well-being is an important factor correlated with self-management and quality of life in patients with hypertension. [ABSTRACT FROM AUTHOR]

Objectives: To explore the mediating role of self‐esteem in social anxiety and QoL during the COVID‐19 local epidemic in China. Design: A cross‐sectional survey. Methods: This study conveniently selected 344 hypertensive patients from a Grade‐A tertiary hospital in Wuhu, Anhui Province, as the study population. Participants completed the demographic questionnaire, the social phobia inventory, the self‐esteem scale and the 36‐item short‐form health survey. Results: Social anxiety, self‐esteem and QoL were significantly correlated with each other. Social anxiety showed no direct effect on QoL (β = 0.011, p > 0.05). Social anxiety showed an indirect effect on QoL (β = −0.248, p < 0.001). Self‐esteem fully mediated the association between social anxiety and QoL in hypertensive patients. Patient or Public Contribution: Hypertensive patients in this study were participants during the data collection process. Nursing staff from the cardiology department at the hospital of a hospital in Wuhu City, Anhui Province assisted in the recruitment phase of the data collection process. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety and stress are common among chronic disease patients, especially those who are in the Chronic Disease Care Program / Prolanis, namely, type-2 diabetes mellitus and hypertension. Psychoeducational therapy can reduce the level of anxiety and stress in Prolanis patients. This research aims to identify the influence of psychoeducation therapy on the anxiety and stress levels in Prolanis patients at Manisrenggo I Health Center. Method: This research used a pre-experiment method with one group pre-test post-test design approach. The respondents of this research were 30 Prolanis patients taken using a purposive sampling technique. The data were collected through 'depression anxiety and stress scale' (DASS) instruments which consist of 42 items. The data collected were analyzed using the Wilcoxon signed-rank test. Result: The research results showed that there was an influence from psychoeducation to the reduction of anxiety and stress in Prolanis patients at Manisrenggo I Health Center. Wilcoxon signed-rank analysis showed a significant level p = 0.05, where p-value = 0.000, therefore p < 0.05. Conclusion: (1) Most of the respondents experienced anxiety and stress at a medium level during the pre-test; (2) Most of the respondents experienced anxiety and stress at a low level during the post-test; (3) There was an influence of psychoeducation therapy to the anxiety and stress level in Prolanis patients at Manisrenggo I Health Center. [ABSTRACT FROM AUTHOR]

High prevalence of uncontrolled blood pressure in older adults is a major health concern, and mostly results from poor medication adherence. The study assessed blood pressure profile and factors that influence medication adherence in older persons. Association of adherence factors with systolic and diastolic blood pressure was also determined. Cross-sectional and retrospective survey were conducted among 310 out-patients of ≥ 65 years of age in two hospitals. A pretested questionnaire measured medication adherence factors on a 5-point Likert scale. Data on last blood pressure and medications of study participants were retrospectively obtained from case notes. Descriptive analysis and Chi-square were performed using SPSS version 25. (P ≤ 0.05). A total of 300 patients participated in the study. The study noted slightly high mean systolic and diastolic blood pressure (147.65 ± 20.607 and 92.82 ± 15.137) among respondents, however, diastolic hypertension was prevalent 171 (57.0%). Average mean score for respondents' reported medication-related and attitude-related adherence factors were 2.40 ± 1.09 and 2.66 ± 1.24, respectively. Systolic and diastolic blood pressure were statistically significant with; number of pills (p = 0.008 and p = 0.003 respectively) and dosing regimen (p = 0.000 and p = 0.052, respectively). Systolic blood pressure was statistically significant with; frequency of dosing (p = 0.011), non-availability or scarcity of prescribed medicines (p = 0.027), pharmacists' attitude (p = 0.000), physician's attitude (p = 0.000) and phobia for medicines (p = 0.002). Forgetfulness was statistically associated with diastolic blood pressure (p = 0.011). Diastolic hypertension was prevalent, and several factors of adherence significantly influenced systolic and diastolic blood pressure in older adults. Improved medication counselling is required for maximum benefits in older persons. [ABSTRACT FROM AUTHOR]

Introduction: The high prevalence and consequences of hypertension in teachers has doubled the importance of identifying factors affecting blood pressure disease, the purpose of this study was to investigate the role of the diagnostic role of health-oriented strategies, self-management and incompatible strategies on hypertension: A discriminant analysis in Khorram Abad city. Materials and Methods: The current research method was cross-sectional in year1402. The statistical population was made up of teachers in Khorramabad city, the sample size of the study was equal to 324 people, of which 175 teachers without hypertension and 149 teachers with hypertension were selected by available sampling method. In this study, the standard questionnaire of psychological factors affecting blood pressure was used to collect data, and these data were analyzed with the help of spss24 software and by variance analysis and discriminant analysis. Results: The results of the discriminant analysis showed that the discriminant function has a very high clean power to distinguish and diagnose teachers with and without hypertension (p<0.05), such that 81.7% of the position of the discriminant function is based on the components of health-oriented strategies, self-management and inconsistent strategies. Also, the diagnostic power related to the subscale of awareness of the disease has been higher(p<0.05). Conclusion: Based on the findings of the present research, it can be concluded that psychological factors play an important role in diagnosing and predicting teacher’s hypertension, and for this purpose, psychologists, counselors and education professionals should pay attention to these factors to prevent and treat teacher’s hypertension. [ABSTRACT FROM AUTHOR]

Background: Chronic diseases like hypertension have become a global burden in the older population and are associated with high mortality rates and poor quality of life. The tenacity of these diseases could increase the comorbidities and impact older patients who need palliative care (PC) services to manage the symptoms and improve their quality of life. This study aims to determine the characteristics and determinants of PC needs of older Indonesian adult patients with chronic hypertension. Methods: This cross-sectional study applied a quantitative research design. The study was conducted in a primary healthcare facility in Kolaka Regency, Southeast Sulawesi, Indonesia, from July to October 2022. The study subjects were 142 elderlies with chronic hypertension who were recruited by the census method. The data were collected using a demographic questionnaire and the Indonesian version of the supportive and PC indicators tool (SPICT 2019 version). The data were analyzed with the Pearson chi-square test at a significant level P<0.05 in IBM SPSS software, version 25. Results: According to the findings, 47.2% of the respondents were in the age group of 55 to 64 years, most were women (55.6%), and living in rural areas (54.9%). Also, most had comorbidities (77.5%), at least one comorbidity (66.9%), and 26.8% needed palliative care. The bivariate analysis showed that comorbidities are associated with PC needs among older adults with chronic hypertension (P<0.05). Conclusion: This study showed that comorbidity has a significant relationship with PC needs in older patients with chronic hypertension. This condition demands the treatment team members’ attention to comorbidities in patients with chronic hypertension. To enhance the results’ generalizability and provide stronger evidence, it is advisable to conduct research with a larger sample size. [ABSTRACT FROM AUTHOR]

Hypertension may also be referred to as essential hypertension. The circulatory movement is in its early stages. Hypertension is a self-contained systemic ailment characterised by elevated arterial blood pressure, leading to detrimental effects on various organs such as the heart, brain, kidneys, and other bodily systems. The term "high" refers to a state or condition that is elevated or above average. Hypertension is a prevalent and highly morbid condition within the cardiovascular system. The prevalence of hypertension in our nation is experiencing an upward trend, with a concomitant rise in the proportion of hypertensive adults observed annually. Currently, the predominant approach to managing hypertension in our nation revolves around pharmacological interventions; however, it is worth noting that these drug treatments are associated with certain adverse effects. In the long term, there is a significant fluctuation in blood pressure following discontinuation. There is an urgent need for an improvement to be made regarding this particular phenomenon. The objective of this study is to examine the impact of aerobic exercise on stress levels, quality of life, and lipid and glucose metabolism among hypertensive adults. A total of 92 individuals diagnosed with hypertension were assigned to two groups: a control group consisting of 46 participants, and a study group also consisting of 46 participants. The allocation of individuals to each group was determined based on digital criteria. Both cohorts were administered a regimen of pharmaceutical compounds, with the experimental group additionally engaging in aerobic exercise as an adjunctive intervention. The researcher employed the Self-Assessment Scale (SAS) to assess levels of anxiety, and the Health Questionnaire (MOSSF36) to evaluate the quality of life in both experimental groups prior to and following a 10-week intervention period. In the present study, we compared the levels of total fat (TC), triacylglycerol (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), fasting blood glucose (FPG), and insulin (FINS) in addition to insulin sensitivity index (ISI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) between the two groups. Following the intervention, the study group exhibited a statistically significant decrease in SAS scores compared to both the pretreatment and control groups (P<0.05). Additionally, both the pretreatment and control groups demonstrated elevated levels of cardiac (RE) and mental health (MH) roles. The study group exhibited higher scores in physical health (PH), general health (GH), vitality (VT), role emotional (RE), and mental health (MH) compared to the control group after treatment (p < 0.05). However, there was no significant difference observed between the two groups in terms of physical pain (BP) and social functioning (SF) (p > 0.05). There were no statistically significant differences observed between the before and after treatment groups (P>0.05) in terms of LDL-C, FINS, FPG, SBP, and MP. The results of the study indicate that the observed values of HDL-C and ISI in the study group were significantly higher than those in the control group after treatment (P<0.05). Additionally, it was found that the values of HDL-C and ISI in the study group were also higher after treatment compared to their own values before treatment (P<0.05). Hypertensive diseases can be attributed to elevated hormone levels, increased blood lipid concentrations, and reduced nitric oxide levels within the body. The phenomenon is attributed to underlying factors of a lesser magnitude. Aerobic exercise interventions of extended duration have been shown to have a positive impact on both systolic and diastolic blood pressure levels in individuals diagnosed with hypertension. The reduction in blood lipids and plasma endothelin levels leads to improved blood glucose regulation and enhanced nitric oxide- mediated vasodilation, thereby contributing to the maintenance of stable blood pressure levels within the body. Aerobic exercise has been found to have a beneficial impact on stress levels, quality of life, and blood lipid profiles. The voluntary enhancement of blood glucose and blood pressure has been observed in elderly individuals with hypertension. [ABSTRACT FROM AUTHOR]

Aim: The data of South Africa Demographic and Health Survey 2016 were analyzed to find out the prevalence and associated factors of hypertension according to the 2017 American College of Cardiology / American Heart Association (ACC/AHA 2017) and the Joint National Committee 7 (JNC7) guidelines. Subject and methods: A weighted sample of 4799 adults aged ≥ 18 years were included in the final analyses. After conducting bivariate analyses to identify the differences in prevalence according to both the guidelines, multilevel multivariable logistic regression was applied to obtain adjusted odds ratio (AOR) along with 95% confidence interval (CI). Results: According to the JNC7 and the ACC/AHA 2017 guidelines, the prevalence of hypertension was 50.4% (95% CI: 48.3%, 52.5%) and 75.0% (95% CI: 73.1%, 76.7%) respectively. The significant factors positively associated with hypertension according to the ACC/AHA 2017 guideline were: age-groups of ≥ 70 years, 50–69 years (AOR: 6.6, 95% CI: 5.2, 8.3) and 30–49 years (AOR: 2.3, 95% CI: 1.9, 2.7), being overweight (AOR: 1.2; 95% CI: 1.0, 1.5) and obese (AOR: 2.1; 95% CI: 1.7, 2.6), residing in urban area (AOR: 1.4, 95% CI: 1.1, 1.7), and belonging to the Free State province (AOR: 1.6, 95% CI: 1.0, 2.5) and the KwaZulu–Natal province (AOR: 1.8, 95% CI: 1.2, 2.7). No statistically significant association was found between hypertension and sex and wealth index as per the new guideline. Conclusion: The health promotion programs of South Africa should focus on the abovementioned factors in order to prevent and control hypertension irrespective of sex and wealth index. [ABSTRACT FROM AUTHOR]

Healthy lifestyle levels are low among adults with hypertension (HTN). Unfortunately, psychosocial factors contributing to patients' inability to meet healthy lifestyle recommendations are not well-understood. This integrative review examined the relationships of three psychosocial factors (self-efficacy, outcome expectancy, and social support) with dietary adherence (DA) and physical activity (PA) among adults with HTN. In total, 24 peer-reviewed studies were assessed. Results showed self-efficacy had small-to-large relationships with PA (r = 0.02–0.46) and DA (r = 0.06–0.79), with the strength of the associations varying by the assessed domain and country of origin. However, few studies reported a small relationship between the remaining factors (outcome expectancy and social support) and PA and DA. Thus, more efforts are needed to delineate the contributions of social support and outcome expectancies on DA or PA. When designing an intervention that focuses on improving PA or DA among adults with HTN, these psychosocial factors should be targeted. [ABSTRACT FROM AUTHOR]

To compare the effectiveness of 12 weeks of community-based, in-person, group Tai Chi (TC) and Health Education (HAP-E) in improving health and wellbeing in older adults with hypertension and in promoting psychological resilience during COVID-19. A 12-week randomized controlled trial (RCT) in San Diego County, USA. Self-reported depressive symptoms, anxiety, sleep disturbances, gratitude, resilience, mental and physical health were assessed in-person pre- and post-intervention, and by long-term follow-up surveys during COVID-19. Linear mixed-effects models were used to assess study arm differences over time and logistic regression to identify predictors of positive intervention response. Of 182 randomized participants (72.6 ± 7.9 yrs; 72% female), 131 completed the intervention. Modest improvements in health and wellbeing occurred post-intervention in both arms (Cohen's d: TC = 0.38, 95% CI: 0.25–0.51; HAP-E = 0.24, 0.11–0.37), though positive intervention responses were more than twice as likely in TC (OR = 2.29, 1.07–4.57). Younger age, higher anxiety, and poorer mental health at baseline predicted greater odds of response. Small declines in health and wellbeing were reported at the first COVID-19 follow-up, with smaller declines in the TC arm (Cohen's d: TC = −0.15, −0.31–0.00; HAP-E = −0.34, −0.49 to −0.19). Health and wellbeing stabilized at the second COVID-19 follow-up. Most participants (>70%) reported that the interventions benefitted their health and wellbeing during COVID-19. TC and HAP-E improved health and wellbeing, though TC conferred greater odds of an improved mental health response. Declines in health and wellbeing were observed at pandemic follow-up, with smaller declines in the TC arm, suggesting increased resilience. [ABSTRACT FROM AUTHOR]

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To assess the psychometric properties of the Turkish version of the Self-care of Hypertension Inventory (SC-HI) among older adults with hypertension. This was a methodological study. The study sample enrolled 176 older adults. The study carried out preliminary psychometric analyses. Item-level content validity index ranged between 0.87 to 1.0, and the index of content validity was 0.98. The Cronbach's α for the total scale was 0.84. The cross-cultural adaptation of SC-HI has been realized successfully in Turkish. Health care providers may utilize the scale to evaluate "older individuals" hypertension self-care abilities. [ABSTRACT FROM AUTHOR]

Aims Depressive symptoms in hypertensive patients are linked to poor adherence to treatment. Sedentary behaviours and chronic pain can increase blood pressure and depressive symptoms, respectively. However, the impact of their coexistence on depressive symptoms in older adults with hypertension has not yet been investigated. This study aimed to identify the combined influence of sedentary behaviours and chronic pain on depressive symptoms in older adults with hypertension in Korea. Methods and results This cross-sectional study used data from the sixth Korea National Health and Nutrition Examination Survey from January to December 2014. The survey adopted multistage stratified sampling by geographical region, gender, and age. For the data analysis, a total of 573 patients with hypertension aged 65 years or older were included. Approximately, 61.0% of depressed older patients had both sedentary behaviours and chronic pain compared with patients without depressive symptoms. In multivariate logistic regression analysis, compared with patients without either sedentary behaviours or chronic pain, older adults with hypertension who presented both sedentary behaviours, and chronic pain had the highest risk of depressive symptoms (odds ratio = 13.86, 95% confidence interval = 5.87–32.71; P < 0.001). Conclusion Coexistence of sedentary behaviours and chronic pain in older hypertensive patients may lead to depressive symptoms. Evaluating both sedentary behaviours and chronic pain when assessing depressive symptoms in patients with hypertension would be beneficial in planning a patient-centred approach for controlling blood pressure. More prospective cohort studies with larger samples are required to identify the causal relationships. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has restricted some common activities for hypertensive patients undergoing the Chronic Disease Management Program at primary health care, decreasing the quality of life. This study aimed to measure the quality of life of hypertensive patients undergoing the Chronic Disease Management Program at primary health care of Manado City, North Sulawesi Province, Indonesia, during the COVID-19 pandemic. Also to determine factors influencing hypertension such as sex, age, education, employment status, monthly income and duration of hypertension. This cross-sectional study was carried out on 150 hypertensive patients randomly sampled at primary health care from June to September 2021. The data were analyzed using the Mann-Whitney test. The utility value and the visual analog scale of hypertensive patients with and without complications were 0.808±0.13 and 80.2±8.16 and 0.761±0.17 and 75.1±7.56, respectively. The quality of life of hypertensive patients without complication is better than that of hypertensive patients with complication. [ABSTRACT FROM AUTHOR]

Objective: To report a study that explored hypertension (HTN) stress and coping experiences of West-Africa-born immigrant (WABI) women in Washington DC Metropolitan area of the United States. Design and sample: This qualitative study conducted from December 2017 to May 2018 involved WABI women (n = 15) in Washington Metropolitan area that selfreported diagnosis of HTN. The transactional model of stress and coping (TMSC) provided the conceptual framework. Data collection was through semi-structured one-onone interviews. Data analysis was done through manual open-hand coding of themes. Results: Three themes emerged from the analysis: Perceived Stressors, Sources of Stress, and Coping Measures. Participants perceived that their HTN diagnosis contributed to their stress; reported other financial, school, work, trauma, household and marriage-related stressors, and coping measures that include faith-based and other recreational leisure activities. Conclusion: Participants mentioned stressors related to lack of support with domestic house chores and described various religious practices as coping strategies. These findings provide additional insights relevant to several ongoing public health nursing conversations on acute and chronic stress management in different parts of the globe. Public health nurses need to utilize these findings when assessing stressors and considering safe coping measures that appeal to WABI women experiencing HTN or chronic illness. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a major risk factor of cardiovascular mortality. Mood disorders represent a growing public health problem worldwide. A complex relationship is present between mood disorders and cardiovascular diseases. However, less data is available about the level of depression and anxiety in different hypertension phenotypes. The aim of our study was to evaluate psychometric parameters in healthy controls (Cont), in patients with white-coat hypertension (WhHT), with chronic, non-resistant hypertension (non-ResHT), and with chronic, treatment-resistant hypertension (ResHT). Methods: In a cross-sectional study setup 363 patients were included with the following distribution: 82 Cont, 44 WhHT, 200 non-ResHT and 37 ResHT. The patients completed the Beck Depression Inventory (BDI) and the Hamilton Anxiety Scale (HAM-A). Results: BDI points were higher in WhHT (7 (3–11)) and ResHT (6 (3–11.5)) compared with Cont (3 (1–6), p < 0.05). Similarly, HAM-A points were higher in WhHT (8 (5–15)) and ResHT (10.5 (5.25–18.75)) compared with Cont (4 (1–7), p < 0.05) and also compared with non-ResHT (5 (2–10), p < 0.05). ResHT was independently associated with HAM-A scale equal or above 3 points (Beta = 3.804, 95%CI 1.204–12.015). WhHT was independently associated with HAM-A scale equal or above 2 points (Beta = 7.701, 95%CI 1.165–18.973) and BDI scale equal or above 5 points (Beta = 2.888, 95%CI 1.170–7.126). Conclusions: Our results suggest psychopathological similarities between white-coat hypertension and resistant hypertension. As recently it was demonstrated that white-coat hypertension is not a benign condition, our findings can have relevance for future interventional purposes to improve the outcome of these patients. [ABSTRACT FROM AUTHOR]

Background: We aimed to determine the role of demographic, lifestyle, and personality trait factors in predicting control of blood pressure (BP) among patients with hypertension (HTN) in West Azerbaijan, Iran. Methods: In this case control study we recruited participants from all primary health centers of Salmas city; who were at least 18 years of age, had a HTN diagnosis during the previous six months, and had a mandatory household record. Of 490 random subjects approached, 441 (84.2%) fulfilled our inclusion criteria (case: 221; control: 220). The age-matched controls were recruited from the same source population and were required to have controlled HTN. Data were collected through demographic Checklist, Ten-Item Personality Inventory (TIPI) and International Physical Activity Questionnaire (IPAQ). Results: Upon multivariate analyses, factors related to personality traits subdomains including extraversion personality (odd ratio [OR]: 0.85; CI: 0.73, 0.97) was effective in control of BP. Factors related to uncontrolled BP were agreement and consciences subdomains (OR 1.26 [CI: 1.07, 1.48] and OR 1.21 [CI: 1. 02, 1.44]), rare fruit consumption (OR 5.95 [CI: 1.24, 12.1]), Grade 1 and 2 obesities (OR 2.29 [CI: 1.28, 4.09] and OR 7.11 [CI: 2.21, 12.52]) and smoking (OR 3.27 [CI: 1.56, 6.89]). Conclusion: In addition to regular physical activity and fruit consumption and quitting smoking; personality traits such as Agreement and conscience personality traits were predictive of HTN control. We believe our work provides the required knowledge to design comprehensive HTN prevention programs by taking into account the multi-level causality approach. [ABSTRACT FROM AUTHOR]

Hypertension is one of the leading causes of morbidity and mortality among women in sub‐Saharan Africa. Although research on the relationship between individual‐level socioeconomic status (SES) and hypertension exists, to the best of our knowledge, limited empirical studies examined the effects of neighbourhood‐level SES/wealth on the risks of living with hypertension in Ghana. Using data from the 2009 Women's Health Study of Accra (WHSA‐II), and applying multilevel logistic regression, this study investigates the effects of both individual and neighbourhood wealth status on hypertension among women in the Greater Accra Region of Ghana. The results show that individual‐level SES/wealth is a significant determinant of hypertension among Ghanaian women in Accra. Specifically, wealthy women are more likely to be hypertensive compared to poorer women. However, the effect of neighbourhood SES/wealth was attenuated after adjusting for individual‐level SES/wealth. These findings suggest that it is important to develop health promotion programs targeted at a segment of SES group in the prevention, control and management of hypertension among women in the Greater Accra Region of Ghana. [ABSTRACT FROM AUTHOR]

Background: Depression is common in patients with multimorbidity, but little is known about the relationship between depression and multimorbidity. The purpose of our research was to investigate multimorbidity patterns and their association with depression in a sample of older people covered by long‐term care insurance in Shanghai, China. Method: This was a population‐based cross‐sectional study, with 1871 participants aged ≥60 years old who are covered by Shanghai long‐term care insurance. Multimorbidity was defined as the presence of two or more chronic diseases at the same time. We collected information on chronic conditions using a self‐reported medical history, and we used the 30‐item Geriatric Depression Scale (GDS‐30) to evaluate depressive symptoms. Patterns of multimorbidity were identified with exploratory factor analysis, using oblimin rotation. Logistic regression was used to estimate the relationship between multimorbidity patterns and depressive symptoms. Results: Among the participants, the prevalence of multimorbidity was 64.7%, and the prevalence of depression was 64.6%. Hypertension, cardiovascular disease, cerebrovascular disease (CVD), and cataracts showed strong associations with depression when co‐occurring with other conditions. Three patterns of multimorbidity were identified: a musculoskeletal pattern, cardiometabolic pattern, and degenerative disease pattern. Among these, the cardiometabolic (adjusted odds ratio (AOR) 1.223; 95% confidence interval (CI) 1.102, 1.357) and degenerative disease (AOR 1.185; 95% CI 1.071, 1.311) patterns were associated with a higher risk of depressive symptoms. Conclusion: Two of three multimorbidity patterns were found to be associated with depression. Physical and psychological dimensions require greater attention in the care of older adults who are covered by long‐term care insurance. [ABSTRACT FROM AUTHOR]

Objectives: Differences in health among migrant groups are related to the length of stay in host countries. We examined the health of people reporting Caribbean ethnic origins within and outside of Canada; and the possible associations between length of stay and poorer physical and mental health outcomes. Method: Analyses were conducted on population data collected in Canada (2000/2001, 2003, 2005), Jamaica (2005) and Guyana (2005). Physician-diagnosed and self-rated health measures were used to assess physical and mental health statuses. Results: Rates of chronic conditions were generally higher among people reporting Caribbean ethnic origins in Canada compared to those living in the Caribbean region. Self-rated fair or poor general health rates, however, were higher among participants in the Caribbean region. Higher rates of any mood disorders were also found among Caribbean region participants in comparison to those in Canada. Logistic regression analyses revealed that new Caribbean immigrants (less than 10 years since immigration) in Canada had better physical health than those who were more established. Those who immigrated more than 20 years ago showed consistently better health conditions than those who had immigrated between 11 and 20 years ago. This healthy immigration effect, however, was not present for all chronic conditions among all Caribbean origin migrant groups. Moreover, mood disorders were highest among new immigrants compared to older immigrants. Conclusions: When and where ethnic Caribbeans migrate to and emigrate from matters in health statuses. These results have implications for policies related to health and well-being in support of ethnic Caribbean origin individuals who relocate to Canada. The paper concludes with suggestions for future studies regarding the health of ethnic origin Caribbeans living within and outside their regions of birth. [ABSTRACT FROM AUTHOR]

The prevalence of hypertension is increasing in pediatric populations. While clinical data and practice guidelines identify the impact of hypertension on organ dysfunction and emphasize the importance for end-organ damage screening, the bidirectional effects of pediatric hypertension on neurocognitive and psychological outcomes are understudied. The objective of this review is to highlight the association between hypertension and cognition, attention, learning, and mental health in children and adolescents. In doing so, this review provides a framework and toolkit to integrate neuropsychology and psychology into the screening and management stages of pediatric hypertension. By recognizing the effects of hypertension on cognition, behavior, and mental health, screenings and interventions can be implemented to proactively and comprehensively improve the health outcomes for children with blood pressure concerns. [ABSTRACT FROM AUTHOR]

Introduction: Unhealthy lifestyle habits, including sedentary behaviour and improper diet are major risk factors for obesity. Overweight is very frequent in hypertensive and type 2 diabetic patients. Psychosocial factors are associated with multiple health behaviors related to overweight/ obesity. The aim of the study was to evaluate the relationship between obesity and psychosocial risk factors in hypertensive patients having different levels of education. Material and methods: 623 hypertensive patients, admitted to the Cardiovascular Rehabilitation Clinic in Tîrgu Mureș were evaluated by weight, height, waist circumference, laboratory analyses and psychosocial risk based on a validated questionnaire on nine topics. Non-paired Student t test was used for statistical evaluation of the obtained data. Results: Obesity or overweight affected 86.9% of the studied hypertensive patients. Obesity was more frequent in subjects having type 2 diabetes as comorbidity. Mean BMI was significantly higher in the lower education group (p=0.007) compared to those with higher level of education. Average triglyceride and uric acid levels were significantly higher in obese subjects compared to those having lower BMI (p<0.0001). Patients living alone had significantly lower mean BMI (p=0.006) and waist circumference values (p=0.001) compared to those living with their spouse. Conclusions: Weight excess in very frequent in the studied hypertensive patients, especially in those with type 2 diabetes as comorbidity and having lower educational level. Hypertriglyceridemia and hyperuricemia occurred more frequently in obese subjects compared to non-obese ones. Overweight is less frequent in patients living alone. [ABSTRACT FROM AUTHOR]

Few studies have considered psychosocial characteristics when investigating the associations between sleep duration and blood pressure (BP). In this study, we took propensity score matching (PSM) to adjust for psychosocial characteristics when comparing BP between individuals with short sleep duration and those with normal sleep duration. A total of 429 participants were included. 72 participants with sleep duration ≤6 h and 65 participants with sleep duration >6 h were matched after PSM. We compared office BP, 24-hour BP, and prevalence of hypertension in the populations before and after PSM, respectively. In the unmatched population, participants with sleep duration ≤6 h were observed with higher office diastolic BP (DBP) and 24-h systolic BP (SBP)/DBP (all P < 0.05). In the matched populations, the differences between the two groups (sleep duration ≤6 h vs. sleep duration >6 h) in office DBP (88.4 ± 10.9 vs. 82.5 ± 11.1 mm Hg; P = 0.002), 24-h SBP (134.7 ± 12.0 vs. 129.3 ± 11.6 mm Hg; P = 0.009), and 24-h DBP (83.4 ± 9.9 vs. 78.1 ± 10.1 mm Hg; P = 0.002) become more significant. Participants with sleep duration ≤6 h only show higher prevalence of hypertension based on 24-h BP data, while analysis after PSM further revealed that these with sleep duration ≤6 h presented about 20% higher prevalence of elevated BP up to office diagnosed hypertension threshold. Therefore, psychosocial characteristics accompanied with short sleep duration should be fully valued in individuals at risks for elevated BP. This trial is registered with NCT03866226. [ABSTRACT FROM AUTHOR]

This study aimed to explore the association between readiness for hospital discharge and 30-day adherence to treatment among patients with coronary heart disease who have undergone coronary stent implantation. A prospective, observational study design was adopted. A total of 153 participants were recruited from five cardiovascular units of a tertiary care teaching hospital in China. Data were collected using the Readiness for Hospital Discharge Scale, Morisky, Green, and Levine Adherence Scale, and Patients' Adherence to Treatment Questionnaire. The results showed that patient-readiness for discharge was high whereas the 30-day adherence to treatment remained suboptimal. Readiness for hospital discharge and medical history of hypertension were significantly associated with patients' 30-day adherence to blood pressure self-monitoring and control (p < .05). This study demonstrates the importance of paying attention to discharge preparation service as it may improve patients' 30-day adherence to treatment after coronary stent implantation. [ABSTRACT FROM AUTHOR]

Background. Effective functional family was beneficial for older adults' health, which may affect the quality of life (QoL) in hypertension patients. This study aimed to clarify the association between family function, anxiety, and QoL for older adults with hypertension in low-income communities. Methods. A questionnaire survey was conducted on 363 older adults with hypertension in low-income communities in Wuhan from September 2019 to November 2019. The relationships among the variables were examined by Pearson's correlation analysis. Predictor effects were tested using hierarchical multiple regressions, controlling for demographic characteristics. The structural equation model (SEM) was used to test the mediation effects of anxiety on the pathway from family function to QoL. Results. Family function was negatively correlated with the self-rating anxiety scale (SAS) score and positively correlated with the mental component score (MCS), but had no influence on the physical component score (PCS). Both PCS and MCS were negatively correlated with SAS. Anxiety was the negative predictor of MCS and PCS. Family function was the positive predictor of MCS, but had no influence on PCS. The path model indicated that anxiety significantly mediated the link between family function and QoL (R2 = 32.8%), but only partially. Conclusion. A significant correlation between anxiety, family function, and QoL was found. Anxiety had a partial mediating effect on the relationship between family function and QoL. Further research should focus on increasing the level of family function and reducing the perceived anxiety of older adults with hypertension to improve their QoL level. [ABSTRACT FROM AUTHOR]

Background. Hypertension prevalence is continuously rising and is projected to be 1.56 billion cases by the year 2025. Despite the great progress made in the treatment of hypertension, many patients still do not achieve optimal results and experience devastating complications due to uncontrolled high blood pressure. Objective. The aim of this study is to assess self-care practice and associated factors among hypertensive patients. Methods. An institution-based cross-sectional study was conducted at Debre Tabor Referral Hospital, Northwest Ethiopia, from October to November 2020. A single population proportion formula and systematic random sampling technique was used to recruit 392 study participants. The data were entered to Epi-Info software version 7.1 and then exported to SPSS version 23 for analysis. A descriptive statistic was expressed as percentage, frequency, and mean. Finally, multivariable logistic regression was used to identify factors associated with dependent variable using a p value of <0.05. Results. A total 392 eligible hypertensive patients participated in the study. The self-care practice among hypertension patients was found to be 54.1%. Urban residency (AOR = 2.17; 95% CI, 1.2–3.9), social support (AOR = 2.12; 95% CI, 1.13–3.39), good knowledge (AOR = 1.83; 95% CI, 1.15–2.91), age between 40 and 64 (AOR = 3.15; 95% CI, 1.19–8.3), age ≥65 (AOR = 3.81; 95% CI, 1.35–10.7), and stress control (AOR = 1.6; 95% CI, 1.06–2.67) were predictors of hypertension self-care practice. Conclusion and Recommendation. The study revealed that almost one out of two hypertension patients had good hypertension self-care practice. Good social support, age greater than 40 years, urban residency, good basic knowledge, and having stress control were positively associated with hypertensive self-care practice. [ABSTRACT FROM AUTHOR]

Background: Increasing evidence suggests that hypertension is a risk factor for cognitive impairment and dementia. The relationship between blood pressure and cognition in a racially and ethnically diverse population remains unclear.Objective: To study association of blood pressure with cognition cross-sectionally and longitudinally in the elderly.Methods: Participants are stroke-free individuals from the racially and ethnically diverse Northern Manhattan Study (NOMAS) (n = 1215). General linear models are constructed to examine blood pressure in relation to cognition cross-sectionally and longitudinally at a five-year follow-up.Results: We found a cross-sectional association of systolic blood pressure (SBP) with word fluency/semantic memory, executive function, and processing speed/visual motor integration (VMI) function. This association was independent of demographics, vascular risk factors, white matter hyperintensity volume (WMHV), and carotid intima-media thickness (cIMT). The cross-sectional association of SBP with processing speed/VMI and executive function was attenuated after adjusting anti-hypertension medications in the models. Baseline SBP was associated with the change of processing speed/VMI function after adjusting vascular risk factors, WMHV, and cIMT at a 5-year follow-up. This longitudinal association was not found after adjusting anti-hypertension medications in the models. Further analyses revealed that individuals with category SBP from < 120 mmHg to≥140 mmHg had a linear decline in processing speed/VMI function at a 5-year follow-up.Conclusion: We show that SBP is negatively associated with cognition cross-sectionally and longitudinally in the elderly. Anti-hypertension treatment eliminates the negative association of SBP with processing speed/VMI function longitudinally. Our findings support the treatment of stage 1 systolic hypertension in the elderly. [ABSTRACT FROM AUTHOR]

Background: Cerebrovascular disease (CeVD) is an underlying cause of cognitive impairment and dementia. Hypertension is a known risk factor of CeVD, but the effects of mean of visit-to-visit blood pressure (BP) on incident CeVD and functional-cognitive decline remains unclear.Objective: To determine the association between mean of visit-to-visit BP with the incidence and progression of CeVD [white matter hyperintensities (WMH), infarcts (cortical infarcts and lacunes), cerebral microbleeds (CMBs), intracranial stenosis, and hippocampal volume] as well as functional-cognitive decline over 2 years of follow-up.Methods: 373 patients from a memory-clinic underwent BP measurements at baseline, year 1, and year 2. The mean of visit-to-visit systolic BP, diastolic BP, pulse pressure, and mean arterial pressure were calculated. Baseline and year 2 MRI scans were graded for WMH, infarcts, CMBs, intracranial stenosis, and hippocampal volume. Functional-cognitive decline was assessed using locally validated protocol. Logistic and linear regression models with odds ratios, mean difference, and 95%confidence interval were constructed to analyze associations of visit-to-visit BP on CeVD incidence and progression as well as functional-cognitive decline.Results: Higher mean of visit-to-visit diastolic BP was associated with WMH progression. Higher tertiles of diastolic BP was associated with WMH progression and incident CMBs. There was no association between mean of visit-to-visit BP measures with incident cerebral infarcts, intracranial stenosis, change in hippocampal volume, and functional-cognitive decline.Conclusion: These findings suggest the possibility of hypertension-related vascular brain damage. Careful monitoring and management of BP in elderly patients is essential to reduce the incidence and progression of CeVD. [ABSTRACT FROM AUTHOR]

Hypertension is often associated with adverse psychosocial outcomes and psychological factors have been advanced for better explanatory models and to enhance the development of effective interventions in the treatment of hypertensive patients. Although the link between anxiety sensitivity (AS) and poor mental health outcomes has been established, the mechanism through which it results in psychological distress (PD) is not yet well understood. In addition to investigating the direct associations of AS and experiential avoidance (EA) to PD, the present study examines whether AS predicts adverse mental health outcomes via EA. Hypertensive patients (N = 240; women = 135; Mean age = 41.09, SD = 9.11 years) drawn from cardiology unit of a Nigerian teaching hospital completed the following measures: Psychological Distress Scale, Anxiety Sensitivity Index – 3, and Acceptance and Action Questionnaire. Results showed that that greater AS and greater EA predicted increased PD, even when controlling for age and gender. The mediation hypothesis was further supported suggesting that the association between AS with increase in PD was a function of heightened EA. These findings are consistent with the notion that acceptance of daily experiences may serve to buffer against the potential adverse mental health outcomes and may be a critical target for interventions to ameliorate PD in patients with chronic health conditions such as hypertension. Psychological interventions that deals with experiential avoidance could be used in the management of distressed hypertensive patients. [ABSTRACT FROM AUTHOR]

Importance: Depression is a leading contributor to disease burden globally. Digital mental health interventions can address the treatment gap in low- and middle-income countries, but the effectiveness in these countries is unknown.Objective: To investigate the effectiveness of a digital intervention in reducing depressive symptoms among people with diabetes and/or hypertension.Design, Setting, and Participants: Participants with clinically significant depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score ≥10) who were being treated for hypertension and/or diabetes were enrolled in a cluster randomized clinical trial (RCT) at 20 sites in São Paulo, Brazil (N=880; from September 2016 to September 2017; final follow-up, April 2018), and in an individual-level RCT at 7 sites in Lima, Peru (N=432; from January 2017 to September 2017; final follow-up, March 2018).Interventions: An 18-session, low-intensity, digital intervention was delivered over 6 weeks via a provided smartphone, based on behavioral activation principles, and supported by nurse assistants (n = 440 participants in 10 clusters in São Paulo; n = 217 participants in Lima) vs enhanced usual care (n = 440 participants in 10 clusters in São Paulo; n = 215 participants in Lima).Main Outcomes and Measures: The primary outcome was a reduction of at least 50% from baseline in PHQ-9 scores (range, 0-27; higher score indicates more severe depression) at 3 months. Secondary outcomes included a reduction of at least 50% from baseline PHQ-9 scores at 6 months.Results: Among 880 patients cluster randomized in Brazil (mean age, 56.0 years; 761 [86.5%] women) and 432 patients individually randomized in Peru (mean age, 59.7 years; 352 [81.5%] women), 807 (91.7%) in Brazil and 426 (98.6%) in Peru completed at least 1 follow-up assessment. The proportion of participants in São Paulo with a reduction in PHQ-9 score of at least 50% at 3-month follow-up was 40.7% (159/391 participants) in the digital intervention group vs 28.6% (114/399 participants) in the enhanced usual care group (difference, 12.1 percentage points [95% CI, 5.5 to 18.7]; adjusted odds ratio [OR], 1.6 [95% CI, 1.2 to 2.2]; P = .001). In Lima, the proportion of participants with a reduction in PHQ-9 score of at least 50% at 3-month follow-up was 52.7% (108/205 participants) in the digital intervention group vs 34.1% (70/205 participants) in the enhanced usual care group (difference, 18.6 percentage points [95% CI, 9.1 to 28.0]; adjusted OR, 2.1 [95% CI, 1.4 to 3.2]; P < .001). At 6-month follow-up, differences across groups were no longer statistically significant.Conclusions and Relevance: In 2 RCTs of patients with hypertension or diabetes and depressive symptoms in Brazil and Peru, a digital intervention delivered over a 6-week period significantly improved depressive symptoms at 3 months when compared with enhanced usual care. However, the magnitude of the effect was small in the trial from Brazil and the effects were not sustained at 6 months.Trial Registration: ClinicalTrials.gov: NCT02846662 (São Paulo) and NCT03026426 (Lima). [ABSTRACT FROM AUTHOR]

Background. The dual burden of cardiovascular diseases and Human Immunodeficiency Virus (HIV) in sub-Saharan Africa is of public health concern. Persons living with HIV are 1.5–2 times more likely to develop CVD risk factors compared to the noninfected individuals. Hypertension is a major risk factor leading to the rising CVD epidemic in SSA. However, the burden of hypertension among HIV patients in Kenya is not well documented. Objective. This study determined the prevalence and the associated factors of hypertension among HIV patients receiving regular care at Thika Level 5 Hospital Comprehensive Care Clinic (CCC), within metropolitan Nairobi, Kenya. Methods. The current cross-sectional study involved review of patients' records/charts. Charts for adult patients seen in the last 6 months at Thika Level 5 Hospital CCC were included in the study. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg on two different readings one month apart, while overweight/obesity was defined as body mass index (BMI) ≥ 25 kg/m2. Results. In a sample of 939 HIV patients, the majority, 68.8% (646), were female. The patients' ages ranged from 18 to 84 years with a median age of 44 (IQR 37–51) years. The mean BMI was higher for females (25.8 kg/m2) compared to that of males (23.1 kg/m2). However, the prevalence of hypertension was higher among males (25.3%) compared to females (16.9%). Age >40 years (AOR = 2.80, p ≤ 0.001), male sex (AOR = 2.10; p = 0.04), history of alcohol consumption (AOR = 2.56, p ≤ 0.001), and being overweight/obese (AOR = 2.77 p ≤ 0.001) were significantly associated with hypertension. The antiretroviral (ARV) regimen and, additionally, the duration of antiretroviral therapy had no association with being hypertensive. Conclusion. The prevalence of hypertension is high among HIV patients. Traditional cardiovascular risk factors were associated with hypertension, but no association was observed with ART regime or duration of ARV use. There is a need to integrate hypertension management into regular HIV care. [ABSTRACT FROM AUTHOR]

Background: The prevalence of hypertension (HTN) in Blacks is among the highest in the world. For Black women, 46% experience stage 2 HTN (blood pressure [BP] ≥140/90 mm Hg) as compared with 42% of Black men. Because of higher rates of stage 2 HTN, Black women have greater rates of cardiovascular disease and stroke. For reasons unknown, nonadherence to lifestyle modifications and antihypertensive medications continues. An understudied potential factor associated with poor adherence to the treatment regimen and negative health outcomes is stigma. Objective: The aim of this study was to gain insight and describe the psychological factor of stigma as an influence on poorly controlled HTN in Black women. Methods: Hypertensive Black women attending a 6-week self-management program were invited to participate in an open-ended questionnaire. Six groups were held with 62 women aged 24 to 70 years, with group size ranging from 10 to 15. Women anonymously wrote their answer to 2 questions to capture individual responses without group persuasion. Data were analyzed using thematic analysis. Results: Five themes were generated inductively from the data and included (1) desire to get control, (2) shame and embarrassment, (3) obesity characterizations, (4) stereotype threats, and lastly, (5) disrupted normality. During member checking, younger participants were more vocal about stigma, whereas older participants did not view stigma as problematic. Conclusions: Hypertension stigma could potentially deter adherence to high BP treatment. Further research is needed to explore the prevalence of stigma in this population and its impact on behaviors that hinder BP control. [ABSTRACT FROM AUTHOR]

Background: A previous qualitative assessment of the psychosocial consequences of labelling hypertension describes the diagnosis of hypertension as a labelling event with potential unintended negative long-term psychosocial consequences (labelling effects). Until now, the benefits of diagnosing hypertension have been far more reported than the harms. To obtain the net result of the preventive interventions for cardiovascular disease, such as diagnosing and treating mild hypertension, assessing benefits and harms in the most comprehensive way possible is necessary, including the psychosocial consequences of labelling. When measuring psychosocial consequences of labelling hypertension, a questionnaire with high content validity and adequate psychometric properties is needed. Objectives: The aim of this study was to describe the psychometric parameters of face and content-validated pool of items. Other objectives were also to screen the item pool by using Rasch model analysis and confirmatory factor analysis (CFA) for identifying such items with sufficient fit to the hypothesised models. Methods: We surveyed the pool of items as a draft questionnaire to Brazilians recruited via social networks, sending e-mails, WhatsApp® messages and posting on Facebook®. The inclusion criteria were to be older than 18 years old, to be healthy and to have only hypertension. We used Rasch model analysis to screen the item pool, discarding items that did not fit the hypothesised domain. We searched for local dependence and differential item functioning. We used CFA to confirm the derived measurement models and complementarily assessed reliability using Cronbach's coefficient alpha. Results: The validation sample consisted of 798 respondents. All 798 respondents completed Part I, whereas 285 (35.7%)—those with hypertension—completed Part II. A condition-specific questionnaire with high content validity and adequate psychometric properties was developed for people labelled with hypertension. This measure is called 'Consequences of Labelling Hypertension Questionnaire' and covers the psychosocial consequences of labelling hypertension in two parts, encompassing a total of 71 items in 15 subscales and 11 single items. Conclusion: We developed a tool that can be used in future research involving hypertension, especially in scenarios of screening, prevention, population strategies and in intervention studies. Future use and testing of the questionnaire may still be required. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is one of the leading causes of death globally and is a major cause of disability worldwide. It is a preventable and treatable disease by the prevention of modifiable risk factors and early recognition of warning signs, respectively.Objective: To assess knowledge on stroke warning signs and associated factors among hypertensive patients at South Gondar Zone Comprehensive Specialized Hospital, Northwest Ethiopia, 2020.Methods: An institution-based cross-sectional study was conducted in South Gondar Zone Comprehensive Specialized Hospital from June 1-30, 2020. A systematic random sampling technique was used and data were collected through face to face interviews. Data were entered into Epi data version 4.6.0.0 and exported to SPSS version 25 for cleaning and analysis. Bivariate and multivariable logistic regression analysis was used and variables with p <0.05 in the multivariable analysis were considered as statistically significant.Results: Two hundred and fifty-three hypertensive patients completed the questionnaire with a response rate of 100%. Among the total respondents, 15% (95% CI: 10.7, 19.4) of participants had good knowledge of stroke warning signs. Younger age (AOR: 2.82; 95% CI: 1.18, 6.74), urban residence (AOR: 2.9; 95% CI: 1.04, 8.11), being educated (AOR: 2.6; 95% CI: 1.09, 6.23) and having long duration hypertension follow up (AOR: 2.7; 95% CI: 1.25, 5.81) were significantly associated with good knowledge of stroke warning signs.Conclusion: This study revealed that participants had poor knowledge of stroke warning signs. Younger age, urban residence, being educated and having long duration hypertension follow up were predictors of good stroke warning signs knowledge. Health information dissemination needs to be strengthened for hypertensive patients, particularly for older, rural residents, the non-educated and those having short duration of hypertension follow up. [ABSTRACT FROM AUTHOR]

Background of the Study: Hypertension and self-care behavior in older persons with hypertension are chronic health problems and this continues to increase in the Thai population. Objectives of the Study: To identify factors influencing self-care behavior among older persons with hypertension in relation to personal factors and risk factors pertaining to illness and treatment. Method: This was a prospective observational study design. The samples were to be 60 years of age, diagnosed with hypertension more than six months, and receiving the treatment at aTambol Health Promotion Hospital. The 127 patients were enrolled in the study. Data were collected during March -- September 2020. Finally, data were analyzed using binary logistic regression analysis method. Result: There were 127 patient included in the present study, it was found that the samples who are farmers had dietary behavior score 6.74 times higher than other occupations (AOR = 6.74, 95% CI:1.47- 30.97, p=0.01). The female subjects with waist circumference over 80 cm had a adherence score of stress management 5.69 times higher than those with waist circumference less than 80 cm (AOR = 5.69, 95%CI: 1.19-27.17, p=0.020) and the older persons with a good level of knowledge of hypertension had proper self-care behavior better than those with a lower level of the knowledge with statistical significance at 0.05. In addition, factors not associated with self-care behavior included age, gender, body mass and duration of hypertension. Conclusion: Personal factors and factors related to illness that influence of self-care behavior included farmers, waist circumference and knowledge of hypertension. [ABSTRACT FROM AUTHOR]

Background: Results from the Systolic Blood Pressure Intervention Trial (SPRINT) showed that intensive control of systolic blood pressure significantly reduced the occurrence of mild cognitive impairment, but not probable dementia. We investigated the effects of intensive lowering of systolic blood pressure on specific cognitive functions in a preplanned substudy of participants from SPRINT.Methods: SPRINT was an open-label, multicentre, randomised controlled trial undertaken at 102 sites, including academic medical centres, Veterans Affairs medical centres, hospitals, and independent clinics, in the USA and Puerto Rico. Participants were adults aged 50 years or older with systolic blood pressure higher than 130 mm Hg, but without diabetes, history of stroke, or dementia. Participants were randomly assigned (1:1) to a systolic blood pressure goal of less than 120 mm Hg (intensive treatment) versus less than 140 mm Hg (standard treatment). All major classes of antihypertensive agents were included. A subgroup of randomly assigned participants including, but not limited to, participants enrolled in an MRI substudy was then selected for a concurrent substudy of cognitive function (target 2800 participants). Each individual was assessed with a screening cognitive test battery and an extended cognitive test battery at baseline and biennially during the planned 4-year follow-up. The primary outcomes for this substudy were standardised composite scores for memory (Logical Memory I and II, Modified Rey-Osterrieth Complex Figure [immediate recall], and Hopkins Verbal Learning Test-Revised [delayed recall]) and processing speed (Trail Making Test and Digit Symbol Coding). SPRINT was registered with ClinicalTrials.gov, NCT01206062.Findings: From Nov 23, 2010, to Dec 28, 2012, 2921 participants (mean age 68·4 years [SD 8·6], 1080 [37%] women) who had been randomly assigned in SPRINT were enrolled in the substudy (1448 received intensive treatment and 1473 received standard treatment). SPRINT was terminated early due to benefit observed in the primary outcome (composite of cardiovascular events). After a median follow-up of 4·1 years (IQR 3·7-5·8), there was no between-group difference in memory, with an annual decline in mean standardised domain score of -0·005 (95% CI -0·010 to 0·001) in the intensive treatment group and -0·001 (-0·006 to 0·005) in the standard treatment group (between-group difference -0·004, 95% CI -0·012 to 0·004; p=0·33). Mean standardised processing speed domain scores declined more in the intensive treatment group (between-group difference -0·010, 95% CI -0·017 to -0·002; p=0·02), with an annual decline of -0·025 (-0·030 to -0·019) for the intensive treatment group and -0·015 (-0·021 to 0·009) for the standard treatment group.Interpretation: Intensive treatment to lower systolic blood pressure did not result in a clinically relevant difference compared with standard treatment in memory or processing speed in a subgroup of participants from SPRINT. The effect of blood pressure lowering might not be evident in specific domains of cognitive function, but instead distributed across multiple domains.Funding: National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute on Aging, National Institute of Neurological Disorders and Stroke, and the Alzheimer's Association. [ABSTRACT FROM AUTHOR]

Background: Stress is a major contributor to the physiology of hypertension (HTN) and is linked closely to mental well-being and overall quality of life (QoL). Health issues pertaining to women's health have usually focused on reproduction, while mental well-being has largely been neglected. Objectives: The objective of the study was to assess the perceived stress and QoL among homemakers with HTN. Materials and Methods: A community-based cross-sectional study was carried out, among 426 homemakers with HTN residing in Udupi, Karnataka. The sociodemographic and disease characteristics, Cohen's Perceived Stress Scale-10, World Health Organization QoL Brief Questionnaire (WHOQOL-BREF), anthropometry, and vitals were measured. Results: Of the study participants, 245 (57.5%) were aged ≤60 years and 317 (74.4%) had been diagnosed with HTN in the past decade. Low and high perceived stress was seen among 306 (71.8%) and 120 (28.2%) women, respectively. Among the four domains of WHOQOL-BREF, the physical domain had the highest mean (±standard deviation) score of 67.44 (±16.50), whereas the lowest score of 54.49 (±19.75) was observed in the social domain. The odds of high stress among single women and those with a pill burden of >2/day were 1.93 (P=0.004, 95% CI=1.228, 3.054) and 1.77 (P=0.038, 95% CI CI=0.962, 3.270) respectively. The QoL was significantly better among those aged <60 years, married, and literate women. Conclusions: Mental well-being among the hypertensive homemakers was good, with low perceived stress and high mean scores of QOL domains. [ABSTRACT FROM AUTHOR]

Great efforts to advance the diagnosis and treatment of hypertension for controlling hypertension have been made; however, the rates of uncontrolled blood pressure are still high. This study explored the rate of uncontrolled hypertension in patients with hypertension managed in an urban hospital of Vietnam and identified associated factors. A cross-sectional survey was performed from August to October 2019 among hypertensive patients at an urban hospital in Hanoi, Vietnam. Blood pressure was evaluated at the time of medical examination. Demographic, clinical, and behavioral characteristics were also collected. Multivariate logistic regression was used to identify the factors related to uncontrolled hypertension. Among 220 patients, the rate of uncontrolled hypertension was 40.5%. Females had a lower likelihood of having uncontrolled hypertension compared to males (adjusted OR = 0.33; 95% CI = 0.11–0.98). Higher duration of diseases (adjusted OR = 1.07; 95% CI = 1.01–1.14) and higher body mass index (adjusted OR = 1.23; 95% CI = 1.05–1.45) were positively associated with uncontrolled hypertension. Patients who carried supplies needed for self-care, cut down on stress, exercised regularly, and stopped/cut down on smoking were also less likely to develop uncontrolled hypertension. This study reveals that uncontrolled hypertension was common among hypertensive patients in Vietnam. Improving self-care capacity and encouraging healthy behaviors are critically important to control blood pressure, particularly among patients who were males and had high disease duration and body mass index. [ABSTRACT FROM AUTHOR]

Introduction: Comorbid depression and anxiety have been found to be highly present in patients suffering from chronic physical illnesses such as diabetes mellitus (DM) and hypertension (HTN). These comorbid psychiatric conditions further reduce the quality of life (QOL) in the sufferers. The present study aimed to assess the association between depression, anxiety, and QOL among patients with DM and/or HTN. Materials and Methods: This cross-sectional study was carried out in the outpatient setting of the medicine department of the tertiary care referral hospital of East Central Indian Railways. One hundred and twenty-three individuals of DM and/or HTN of more than 1-month duration were assessed for depression, anxiety, and QOL using the Hospital Anxiety and Depression Scale (HADS) and the World Health Organization QOL Brief (WHOQOL-BREF) version scale. Results: The mean age of the sample (53.7% had HTN, 12.2% had diabetes, and 34.1% had both HTN and diabetes) which comprised 87% males was 50.20 (±6.0) years. The mean HADS (anxiety and depression) scores were 3.6 for both (range 0--14). Nearly 10.6% and 17.1% of the samples had scores above the cutoff for HADS anxiety and depression subscales. The WHOQOL-BREF scores were highest for the environmental domain and were lower for psychological, physical, and social domains. The HADS anxiety and depressive scores correlated significantly negatively with the WHOQOL-BREF physical and psychological domains. Female gender and the presence of an additional medical illness were significantly associated with higher HADS depression scores. Conclusion: Fair proportion of patients with HTN and/or diabetes has been affected with higher anxiety and depressive scores, which predicted a poor QOL. This calls for early identification of these mental health issues in sufferers of depression and HTN, which will facilitate an early holistic management. [ABSTRACT FROM AUTHOR]

Objectives: Hypertension (HTN) is a major risk factor for cardiovascular disease, it is an epidemic health problem with 1 billion people affected worldwide. Limited studies have examined the impact of HTN on physical, psychological and social functioning of HTN patients. Furthermore, little is known about factors that impair these domains among these patients. Thus, the aim of the present study is to assess health-related quality of life (HRQoL) and to explore predictors of poor HRQoL in patients with HTN in Jordan.Methods: Hypertensive patients visiting cardiology and internal medicine departments were recruited from three major hospitals in Jordan. Patients' Socio-demographics and medical data were collected via direct patient encounters and medical records. The validated Arabic version of EQ-5D tool was used to assess HRQoL. Simple linear regression was performed to explore the factors associated with poor HRQoL.Results: The mean score of the EQ-5D index of the 300 participants was 0.732 (SD = 0.29, range from -0.594 to 1.0). While extreme problems were only reported by 10% of the participants, most of them reported "some problems" through the five dimensions with the highest percentage (43.3%) for mobility dimension. Gender, monthly income, number of medical conditions, number of medications, number of HTN medications, duration of HTN and the presence of any atherosclerotic cardiovascular diseases were significantly associated with the EQ-5D index value (P-value <.05).Conclusions: The current study highlights factors that negatively impact HRQoL in patients with HTN. Such findings should provide useful information for future pharmaceutical care intervention programmes aimed at improving HRQoL and other health outcomes in patients with HTN. [ABSTRACT FROM AUTHOR]

Introduction: Breast cancer (BC) and its treatment is associated with several physical and psychosocial changes that may influence sexuality for years after treatment. Women with BC show significantly greater rates of sexual dysfunction than do healthy women. The purpose of the study was to evaluate how a BC diagnosis associates with women's perceived sexuality and sexual satisfaction.Material and Methods: The data of the ongoing prospective Health and Social Support (HeSSup) survey was linked with national health registries. Respondents with registry data confirmed BC (n = 66), mental depression (n = 612), arterial hypertension (n = 873), and healthy women (n = 9731) formed the study population. The importance of and satisfaction with sex life were measured by a self-report questionnaire modified from the Schover's and colleagues' Sexual History Form.Results: Women with BC considered sex life less important than did healthy women (p < 0.001). They were significantly less satisfied with their sex life than healthy women (p = 0.01) and women with arterial hypertension (p = 0.04). Living single or educational level did not explain the differences between the groups.Conclusions: BC survivors depreciate their sex life and experience dissatisfaction with it. Sexuality can be a critical issue for the quality of life of women surviving from BC, and hence, the area deserves major attention in BC survivorship care. Health care professionals should regularly include sexual functions in the assessment of BC survivors' wellbeing. [ABSTRACT FROM AUTHOR]

Background: With the growing epidemic of Cardiovascular Disease (CVD) in sub-Saharan Africa, behavioural change interventions are critical in supporting populations to achieve better cardiovascular health. Population knowledge regarding CVD is an important first step for any such interventions. This study examined CVD prevention knowledge and associated factors among adults in Mukono and Buikwe districts in Uganda.Methods: The study was cross-sectional in design conducted among adults aged 25 to 70 years as part of the baseline assessment by the Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa (SPICES) - project. Data were collected using pretested semi-structured questionnaires, and respondents categorized as knowledgeable if they scored at least five out of six in the knowledge questions. Data were exported into STATA version 15.0 statistical software for analysis conducted using mixed-effects Poisson regression with fixed and random effects and robust standard errors.Results: Among the 4372 study respondents, only 776 (17.7%) were knowledgeable on CVD prevention. Most respondents were knowledgeable about foods high in calories 2981 (68.2%), 2892 (66.1%) low fruit and vegetable intake and high salt consumption 2752 (62.9%) as CVD risk factors. However, majority 3325 (76.1%) thought the recommended weekly moderate physical activity was 30 min and half 2262 (51.7%) disagreed or did not know that it was possible to have hypertension without any symptoms. Factors associated with high CVD knowledge were: post-primary education [APR = 1.55 (95% CI: 1.18-2.02), p = 0.002], formal employment [APR = 1.69 (95% CI: 1.40-2.06), p < 0.001] and high socio-economic index [APR = 1.35 (95% CI: 1.09-1.67), p = 0.004]. Other factors were: household ownership of a mobile phone [APR = 1.35 (95% CI: 1.07-1.70), p = 0.012] and ever receiving advice on healthy lifestyles [APR = 1.38 (95% CI: 1.15-1.67), p = 0.001].Conclusions: This study found very low CVD knowledge with major gaps around recommended physical activity duration, diet and whether hypertension is asymptomatic. Observed knowledge gaps should inform suitable interventions and strategies to equip and empower communities with sufficient information for CVD prevention.Trial Registration: ISRCTN Registry ISRCTN15848572 , January 2019, retrospectively registered. [ABSTRACT FROM AUTHOR]

Background. Hypertension is a global problem, for which high-altitude residents exhibit higher burden. Hypertension in Tajik nomads from Pamirs with an average altitude above 4000 m remains less studied. We aimed to determine the prevalence, awareness, treatment, control, and risk factors associated with hypertension among Tajik population in Pamirs. Methods. A cross-sectional survey was conducted between August and September 2015 using stratified three-stage random sampling in Taxkorgan county, Pamirs, China. Hypertension is defined as mean systolic and/or diastolic blood pressure (SBP, DBP) ≥140/90 mmHg and/or taking antihypertensive medication within the past two weeks. The prevalence (SBP ≥130 or DBP ≥80 mmHg) was also estimated using the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) High Blood Pressure Guideline. The awareness, treatment, and control of hypertension and associated factors were evaluated. Results. Totally, 797 subjects aged ≥18 years were enrolled with 46.3% men and 88.8% nomads with the mean age of 42.3 ± 15.2 years. The prevalence of hypertension was 24.2% (140/90 mmHg), and the prevalence was as high as 40.3%, based on the 2017 ACC/AHA guideline. Overall awareness, treatment, and control of hypertension were 52.8%, 40.9%, and 9.3%, respectively. In multivariate logistic regression, BMI ≥24.0 kg/m2 (OR: 2.41, 95% CI: 1.44–4.04) was a risk factor for prehypertension, and age ≥60 years (OR: 2.04, 95% CI: 1.15–3.61), BMI ≥24.0 kg/m2 (OR: 2.04, 95% CI: 1.15–3.61), and abdominal obesity (OR: 1.87, 95% CI: 1.09–3.22) were risk factors for hypertension. Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers were the most commonly used antihypertensive medication (45.4%) as monotherapy, and 13.6% of treated hypertensive patients used two drugs. Conclusions. There is a considerable prevalence of hypertension with low awareness, treatment, and control rates among Tajik nomads in Pamirs, where health programs improving the hypertension status are urgently needed, with the excess weight loss as a strategy. [ABSTRACT FROM AUTHOR]

Background: Home remedies (HRs) are described as foods, herbs, and other household products used to manage chronic conditions. The objective of this study was to examine home remedy (HR) use among Blacks with hypertension and to determine if home remedy use is correlated with blood pressure and medication adherence.Methods: Data for this cross-sectional study were obtained from the TRUST study conducted between 2006-2008. Medication adherence was measured using the Morisky Medication Adherence Scale, and HR use was self-reported. Multivariable associations were quantified using ordinal logistic regression.Results: The study sample consisted of 788 Blacks with hypertension living in the southern region of the United States. HR use was associated with higher systolic (HR users 152.79, nonusers 149.53; P=.004) and diastolic blood pressure (HR users 84.10, nonusers 82.14 P=.005). Use of two or more HRs was associated with low adherence (OR: .55, CI: .36-.83, P= .004).Conclusion: The use of HR and the number of HRs used may be associated with medication nonadherence, and higher systolic and diastolic blood pressure among Blacks with hypertension. Medication nonadherence is of critical importance for individuals with hypertension, and it is essential that health care providers be aware of health behaviors that may serve as barriers to medication adherence, such as use of home remedies. [ABSTRACT FROM AUTHOR]