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Introduction: The toxicity of fine particulate matter (PM2.5) is determined by its components, while the evidence regarding associations of PM2.5 components with blood pressure (BP) is limited, especially in rural areas. Objectives: This study aimed to explore the associations of PM2.5 and its chemical components with systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), mean artery pressure (MAP) levels and hypertension prevalence, and to identify key components in Chinese rural areas. Methods: 39,211 adults from the Henan Rural Cohort were included during 2015–2017. Different periods of PM2.5 and chemical components were estimated by hybrid satellite model. The single-pollutant, component-PM2.5 model, component-residual model and component-proportion model were applied to explore the associations of pollutants with BP levels and hypertension prevalence. Exposure-response (E-R) relationships, stratified analyses and sensitivity analyses were used to explore these associations further. Results: 12,826 (32.71%) were identified with hypertension. For each 1 μg/m3 increase of pollutants, the adjusted odds ratio (OR) for hypertension prevalence was 1.03 for PM2.5 mass, 1.40 for BC, 1.16 for NH4+, 1.08 for NO3–, 1.17 for OM, 1.12 for SO42− and 1.25 for SOIL in the single-pollutant model. BC and SOIL were statistically significant in the component-PM2.5 model, component-residual model and component-proportion model. Similarly, associations of these pollutants with elevated BP levels were also found in aforementioned four models. These pollutants produced a stronger association with SBP than DBP, PP and MAP. Most of associations were non-linear in E-R relationships. The groups of older, the men, with lower per capita monthly income, lower educational level and higher BMI were more vulnerable to these pollutants in stratified analyses. The results remained stable in sensitivity analyses. Conclusion: Long-term exposure to PM2.5 and its components, especially BC and SOIL, was associated with elevated BP and hypertension prevalence in rural adults, and decreasing pollutants may provide additional benefits.

[Display omitted] • PM 2.5 and its components is associated with elevated blood pressure and hypertension prevalence. • These pollutants produced a stronger association with the rise of SBP than DBP, PP and MAP. • BC and SOIL were most significant with adverse outcomes in different models. • Reduce the concentrations of PM 2.5 and its components may provide benefits in rural areas. The toxicity of fine particulate matter (PM 2.5) is determined by its components, while the evidence regarding associations of PM 2.5 components with blood pressure (BP) is limited, especially in rural areas. This study aimed to explore the associations of PM 2.5 and its chemical components with systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), mean artery pressure (MAP) levels and hypertension prevalence, and to identify key components in Chinese rural areas. 39,211 adults from the Henan Rural Cohort were included during 2015–2017. Different periods of PM 2.5 and chemical components were estimated by hybrid satellite model. The single-pollutant, component-PM 2.5 model, component-residual model and component-proportion model were applied to explore the associations of pollutants with BP levels and hypertension prevalence. Exposure-response (E-R) relationships, stratified analyses and sensitivity analyses were used to explore these associations further. 12,826 (32.71%) were identified with hypertension. For each 1 μg/m3 increase of pollutants, the adjusted odds ratio (OR) for hypertension prevalence was 1.03 for PM 2.5 mass, 1.40 for BC, 1.16 for NH 4 +, 1.08 for NO 3 –, 1.17 for OM, 1.12 for SO 4 2− and 1.25 for SOIL in the single-pollutant model. BC and SOIL were statistically significant in the component-PM 2.5 model, component-residual model and component-proportion model. Similarly, associations of these pollutants with elevated BP levels were also found in aforementioned four models. These pollutants produced a stronger association with SBP than DBP, PP and MAP. Most of associations were non-linear in E-R relationships. The groups of older, the men, with lower per capita monthly income, lower educational level and higher BMI were more vulnerable to these pollutants in stratified analyses. The results remained stable in sensitivity analyses. Long-term exposure to PM 2.5 and its components, especially BC and SOIL, was associated with elevated BP and hypertension prevalence in rural adults, and decreasing pollutants may provide additional benefits. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of hypertension increases with age and differs by race and ethnicity. Among U.S. Asian adults, prevalence is higher for Filipino adults than for other major Asian subgroups, but whether this disparity exists across the adult lifespan is unknown. This study examined hypertension prevalence by age decade, comparing Filipino adults with South Asian, Chinese, Black, Hispanic, and White adults. Methods: This cross-sectional study used 2015–2016 electronic health record data from a Northern California integrated healthcare delivery system for 1,839,603 adults aged 30–79 years, including 128,124 Filipino adults. Hypertension was defined by diagnosis codes. Sex-specific prevalence was calculated by race and ethnicity overall and by 10-year age decade from ages 30–39 years to 70–79 years. The prevalence of hypertension among 5 racial and ethnic groups was compared within each decade (with Filipino as the reference), adjusting for age, English language, diabetes, smoking, and weight category. Results: Decade-specific prevalence of hypertension among Filipino men and women, respectively, was 9.7% and 8.5% for ages 30–39 years, 26.0% and 23.9% for ages 40–49 years, 45.9% and 44.4% for ages 50–59 years, 65.4% and 63.9% for ages 60–69 years, and 82.1% and 82.9% for ages 70–79 years. Across all age decades, hypertension prevalence among Filipino adults largely tracked with Black adults and was much higher than among South Asian, Chinese, White, and Hispanic adults. This pattern remained after adjusting for covariates, with the largest differences observed for adults aged

Background The digital transformation of medical data enables health systems to leverage real‐world data from electronic health records to gain actionable insights for improving hypertension care. Methods and Results We performed a serial cross‐sectional analysis of outpatients of a large regional health system from 2010 to 2021. Hypertension was defined by systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or recorded treatment with antihypertension medications. We evaluated 4 methods of using blood pressure measurements in the electronic health record to define hypertension. The primary outcomes were age‐adjusted prevalence rates and age‐adjusted control rates. Hypertension prevalence varied depending on the definition used, ranging from 36.5% to 50.9% initially and increasing over time by ≈5%, regardless of the definition used. Control rates ranged from 61.2% to 71.3% initially, increased during 2018 to 2019, and decreased during 2020 to 2021. The proportion of patients with a hypertension diagnosis ranged from 45.5% to 60.2% initially and improved during the study period. Non‐Hispanic Black patients represented 25% of our regional population and consistently had higher prevalence rates, higher mean systolic and diastolic blood pressure, and lower control rates compared with other racial and ethnic groups. Conclusions In a large regional health system, we leveraged the electronic health record to provide real‐world insights. The findings largely reflected national trends but showed distinctive regional demographics and findings, with prevalence increasing, one‐quarter of the patients not controlled, and marked disparities. This approach could be emulated by regional health systems seeking to improve hypertension care.

Background: Sub-Saharan Africa is one of the regions in the world with the highest numbers of uncontrolled hypertension as well as people living with HIV/AIDS (PLHIV). However, the association between hypertension and antiretroviral therapy is controversial. Methods: Participant demographics, medical history, laboratory values, WHO clinical stage, current medication, and anthropometric data were recorded at study entry and during study visits at 1, 3, 6 months, and every 6 months thereafter until month 36. Patients who stopped or changed their antiretroviral therapy (tenofovir, lamivudine, efavirenz) were censored on that day. Office blood pressure (BP) was categorized using ≥ 2 measurements on ≥ 2 occasions during the first three visits. Factors associated with systolic and mean BP were analyzed using bivariable and multivariable multilevel linear regression. Results: 1,288 PLHIV (751 females, 58.3%) could be included and 832 completed the 36 months of observation. Weight gain and a higher BP level at study entry were associated with an increase in BP (p < 0.001), while female sex (p < 0.001), lower body weight at study entry (p < 0.001), and high glomerular filtration rate (p = 0.009) protected against a rise in BP. The rate of uncontrolled BP remained high (73.9% vs. 72.1%) and despite indication treatment, adjustments were realized in a minority of cases (13%). Conclusion: Adherence to antihypertensive treatment and weight control should be addressed in patient education programs at centers caring for PLHIV in low-resources settings like Malawi. Together with intensified training of medical staff to overcome provider inertia, improved control rates of hypertension might eventually be achieved. Trial registration: NCT02381275. [ABSTRACT FROM AUTHOR]

Aim. To study the epidemiological characteristics and changes of hypertension (HTN), as well as factors associated with HTN in the Russian population aged 35-74 years.Material and methods. The Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study examined a representative sample of the population aged 35-74 years of 15 Russian regions with a response >70% (n=28611). Modular design questionnaire was used. Blood pressure (BP) was measured twice after a 5-minute rest in a sitting position on the right arm with an Omron blood pressure monitor. There were following criteria for hypertension: systolic blood pressure (SBP) ≥140 mm Hg and/or diastolic blood pressure (DBP) ≥90 mm Hg, and/or antihypertensive therapy. The effectiveness of treatment was considered the proportion (%) of people who achieved target blood pressure values among those being treated, while the control was considered the proportion (%) of patients with a BP

Abstract Objective Currently, the prevalence of hypertension is mainly ascertained using a one-visit population survey, which may lead to overestimation. The purpose of this study was to assess the accuracy of hypertension prevalence determined by a one-visit population survey. Methods For this cross-sectional study, we continuously enrolled 1116 volunteers without a hypertension history in Hebei province from January 2018 to December 2019. The study population included 511 (45.80%) males and 605 (54.20%) females with a mean age of 48 years. The hypertension prevalence was assessed using two methods: one-visit screening and daytime ambulatory blood pressure (BP) monitoring. We directly compared the performances of daytime ambulatory BP monitoring and one-visit screening in the same group of subjects. In addition, we explored possible thresholds to improve the detection of hypertension. Results During the one-visit survey, the mean BP value was about 8 mmHg higher than that determined by daytime ambulatory BP monitoring. The prevalence of hypertension was 29.84% and 14.07% during the one-visit and daytime multiple visit surveys, respectively. The risk factors for overestimated hypertension were female sex, body mass index

Abstract Background The role of socioeconomic status (SES) on hypertension prevalence and hypertension control has gotten much attention but with conflicting results. This paper aimed to quantify the association of SES with both hypertension prevalence and hypertension control rate in Nanjing, China. Methods A community-based cross-sectional study was conducted using multistage random sampling on 60,283 adults aged more than 18 years between March 2017 and June 2018. Hypertension was defined as systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg or self-reported diagnosis of hypertension or respondent's report of taking antihypertensive medications. The controlled hypertension was defined by systolic BP

Background: The role of socioeconomic status (SES) on hypertension prevalence and hypertension control has gotten much attention but with conflicting results. This paper aimed to quantify the association of SES with both hypertension prevalence and hypertension control rate in Nanjing, China.Methods: A community-based cross-sectional study was conducted using multistage random sampling on 60,283 adults aged more than 18 years between March 2017 and June 2018. Hypertension was defined as systolic blood pressure (BP) ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg or self-reported diagnosis of hypertension or respondent's report of taking antihypertensive medications. The controlled hypertension was defined by systolic BP < 140 mmHg and diastolic BP of < 90 mmHg among the subjects that self-reported exhibiting hypertensive and taking antihypertensive medications. The associations between SES with hypertension prevalence and hypertension control were quantified using generalized mixed model regression analysis and reported as odds ratios (ORs) and 95% confidence interval (CI).Results: There was a high prevalence of subjects with primary educational level (49.6%) or unemployed and retired (49.5%) or lower annual household income level (44.9%) in each SES group, respectively. After adjustments for potential confounding factors, there were higher odds of hypertension among those with primary educational level (OR = 1.56), but lower odds for controlled BP (OR = 0.51). Higher odds of hypertension could be found among unemployed and retired, and higher odds of controlled BP was observed in the mental laborers or students (OR = 1.30), compared with the other categories, respectively. The lower-income group was more likely to be hypertensive (OR = 1.35) and less likely to have controlled hypertension (OR = 0.73).Conclusion: Socioeconomic status played an important role in hypertension prevalence and hypertension control among adults in Nanjing, China. Strategies for hypertension prevention and control should especially focus on people in the vulnerable lower SES groups. [ABSTRACT FROM AUTHOR]

Aim: To examine the changes in prevalence, awareness, treatment and control of hypertension between 1998 and 2016 in ≥15-year-old South African men and women and the sociodemographic characteristics associated with those changes. Methods: In nationally representative surveys in 1998 and 2016, multi-stage sampling was used to select, interview and collect blood pressure and anthropometric measurements in ≥15-year-old adults. Logistic regression analyses evaluated the independent effects of selected sociodemographic characteristics on hypertension management. Results: Among 13,217 participants in 1998 and 7830 in 2016 (59–60% women in both surveys), hypertension prevalence increased from 27% to 45% in men and 31% to 48% in women. Hypertension increased equally in participants with and without obesity and in daily cigarette smokers vs. their counterparts. Prevalence of awareness among participants with hypertension increased from 7% to 18% (men) and from 17% to 29% (women). Among those aware, hypertension treatment improved markedly from 8% to 85% (men) and from 12% to 82% (women). Hypertension control among those on treatment increased from 17% to 26% (men) and from 21% to 30% (women). Increasing age and survey year were consistently associated with higher prevalence, awareness, treatment and control of hypertension. The richest vs. poorer women, and lower vs. higher educated women were more likely to be treated for hypertension. Conclusions: The high and rising hypertension burden together with suboptimal awareness and control levels warrant greater attention to curb hypertension-related morbidity and mortality in South Africans. Novel strategies involving community-based or workplace hypertension programmes may overcome some barriers to optimal care.

Abstractx: We studied awareness, treatment and control of hypertension and factors associated with hypertension prevalence in Barmer district, Rajasthan. A cross-sectional study was conducted among 300 adults aged ≥ 30 years. Data were collected using a modified World Health Organization STEPs tool. Bivariate and multivariate analyses were done to find the factors associated with hypertension prevalence. Hypertension and pre-hypertension prevalence were 22.0% and 50.7% respectively. A quarter (27%) was aware, 25% were on treatment and 9% achieved adequate control of hypertension. Hypertension prevalence was significantly higher among men, older adults, overweight adults and those reported higher income compared to their counterparts.

Background: In November 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated their definition of hypertension from 140/90 mm Hg to 130/80 mm Hg. Objectives: We sought to assess the situation of hypertension and the impact of applying the new threshold to a geographically and ethnically diverse population. Methods: We analyzed selected data on 237,142 participants aged ≥40 who had blood pressure taken for the 2014 China National Stroke Screening and Prevention Project. Choropleth maps and logistic regression analyses were performed to estimate the prevalence, geographical distribution and risk factors of hypertension using both 2017 ACC/AHA guidelines and 2014 evidence-based guidelines. Results: The present cross-sectional study showed the age- and sex-standardized prevalence of hypertension was 37.08% and 58.52%, respectively, according to 2014 evidence-based guidelines and 2017 ACC/AHA guidelines. The distribution of hypertension and risk factors changed little between guidelines, with data showing a high prevalence of hypertension around Bohai Gulf and in south central coastal areas using either definition. The age- and sex-standardized prevalence of newly labeled as hypertensive was 21.44%. Interestingly, the high prevalence region of newly labeled as hypertensive was found in the north China. Conclusion: The prevalence of hypertension increased significantly on 2017 ACC/AHA guidelines compared to the prevalence when using 2014 evidence-based guidelines, with high prevalence areas of newly labeled as hypertensive now seen mainly in north China. There need to be correspondingly robust efforts to improve health education, health management, and behavioral and lifestyle interventions in the north.

Background: In November 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated their definition of hypertension from 140/90 mm Hg to 130/80 mm Hg. Objectives: We sought to assess the situation of hypertension and the impact of applying the new threshold to a geographically and ethnically diverse population. Methods: We analyzed selected data on 237,142 participants aged =40 who had blood pressure taken for the 2014 China National Stroke Screening and Prevention Project. Choropleth maps and logistic regression analyses were performed to estimate the prevalence, geographical distribution and risk factors of hypertension using both 2017 ACC/AHA guidelines and 2014 evidence-based guidelines. Results: The present cross-sectional study showed the age- and sex-standardized prevalence of hypertension was 37.08% and 58.52%, respectively, according to 2014 evidence-based guidelines and 2017 ACC/AHA guidelines. The distribution of hypertension and risk factors changed little between guidelines, with data showing a high prevalence of hypertension around Bohai Gulf and in south central coastal areas using either definition. The age- and sex-standardized prevalence of newly labeled as hypertensive was 21.44%. Interestingly, the high prevalence region of newly labeled as hypertensive was found in the north China. Conclusion: The prevalence of hypertension increased significantly on 2017 ACC/AHA guidelines compared to the prevalence when using 2014 evidence-based guidelines, with high prevalence areas of newly labeled as hypertensive now seen mainly in north China. There need to be correspondingly robust efforts to improve health education, health management, and behavioral and lifestyle interventions in the north. [ABSTRACT FROM AUTHOR]

Abstract Background High blood pressure is increasing worldwide, disproportionately so in developing countries. Inadequate health care systems and adoption of unhealthy lifestyles have been linked to this emergent pattern. To better understand this trend, it is imperative we measure prevalence of hypertension, and examine specific risk factors, at a local level. This study provides a cross-sectional view of urban residents of Arusha City to determine prevalence and associated risk factors. Methods Blood pressure was measured using a digital sphygmomanometer. Interviews were conducted using the WHO STEPwise survey questionnaire to assess lifestyle factors. Dietary intake information was collected by a standardized Food Frequency Questionnaire (FFQ). Descriptive statistics were used to analyze demographic characteristics. Means and standard deviations were calculated for continuous variables and percentages for categorical variables. Pearson’s Chi Square (χ 2) tests were used to determine significant risk factors for hypertension, and multivariate log binomial regression was used to reveal potential predictors of hypertension. Dietary patterns were analyzed by principal component analysis. Results Approximately 45% of the study population was found to be hypertensive. The mean arterial blood pressure (MABP) of the sample was 102.3 mmHg (SD = 18.3). Mean systolic and diastolic blood pressure were 136.3 (SD = 30.5) and 85.3 (SD = 16.1) mmHg, respectively. Through multivariate analysis, age and body mass index were found to be independently, positively, associated with hypertension. Adherence to ‘healthy’ dietary pattern was negatively independently associated with hypertension. Conclusions With nearly half of participants being hypertensive, this study suggests that hypertension is a significant health risk in Arusha, Tanzania. Obesity, healthy diet, and age were found to be positively associated with hypertension risk. This study did not establish any significant association between increased blood pressure and Western-dietary pattern, cigarette smoking, alcohol intake, and physical activities.

Abstract Background Ghana faces an increasing burden of non-communicable disease with rates of hypertension estimated as high as 36% in adults. Despite these high rates, hypertension control remains very poor in Ghana (4%). The current project aims to implement and evaluate a community-based programme to raise awareness, and to improve treatment and control of hypertension in the Eastern Region of Ghana. In this paper, we present the findings of the baseline cross-sectional survey focusing on hypertension prevalence, awareness, treatment, and control. Methods To evaluate the ComHIP project, a quasi-experimental design consisted of a before and after evaluations are being implemented in the intervention and comparison districts. A cohort study component is being implemented in the intervention district to assess hypertension control. Background anthropometric and clinical data collected as part of the baseline survey were analyzed in STATA Version 11. We examined the characteristics of individuals, associated with the baseline study outcomes using logistic regression models. Results We interviewed 2400 respondents (1200 each from the comparison and intervention districts), although final sample sizes after data cleaning were 1170 participants in the comparison district and 1167 in the intervention district. With the exception of ethnicity, the control and intervention districts compare favorably. Overall 32.4% of the study respondents were hypertensive (31.4% in the control site; and 33.4% in the intervention site); 46.2% of hypertensive individuals were aware of a previous diagnosis of hypertension (44.7% in the control site, and 47.7% in the intervention site), and only around 9% of these were being treated in either arm. Hypertension control was 1.3% overall (0.5% in the comparison site, and 2.1% in the intervention site). Age was a predictor of having hypertension, and so was increasing body mass index (BMI), waist, and hip circumferences. After adjusting for age, the risk factors with the greatest association with hypertension were being overweight (aOR = 2.30; 95% CI 1.53–3.46) or obese (aOR = 3.61; 95% CI 2.37–5.51). Older individuals were more likely to be aware of their hypertension status than younger people. After adjusting for age people with a family history of hypertension or CVD, or having an unhealthy waist hip ratio, were more likely to be aware of their hypertension status. Conclusions The high burden of hypertension among the studied population, coupled with high awareness, yet very low level of hypertension treatment and control requires in-depth investigation of the bottlenecks to treatment and control. The low hypertension treatment and control rates despite current and previous general educational programs particularly in the intervention district, may suggest that such programs are not necessarily impactful on the health of the population.

Background: Since the roll-out of antiretroviral therapy (ART) in sub-Saharan Africa (sSA) in the early 2000s, the life expectancy of people infected with the human immunodeficiency virus (HIV) has increased. However, the gains made in reducing mortality from HIV-related complications have been mitigated by the emergence of age-related chronic non-communicable diseases (NCDs), such as hypertension. Protease inhibitors (PIs), and prolonged exposure to highly active ART (HAART) have been implicated in the development of hypertension in HIV-positive people. Aim: To investigate the prevalence of hypertension and its associated risk factors among HIV-positive patients receiving ART. Setting: The study was carried out at an urban-based clinic that provides HAART and primary care to HIV-positive people in Harare, Zimbabwe. Methods: A descriptive, cross-sectional study was conducted among non-pregnant adults on HAART attending the clinic between July and August 2018. Results: We studied 600 HIV-positive adult patients, of which 56% were women. The prevalence rate of hypertension was 29.9%. Of the participants in the hypertensive group, 11.2% were not previously diagnosed or on treatment. Factors associated with hypertension were advanced age, use of HAART for longer than 10 years, being overweight, a family history of hypertension and smoking. There was a 68.8% prevalence of body mass index greater than 25 kg/m2 among all participants. Conclusion: High hypertension prevalence was recorded. Hypertension was not associated with gender or use of PI regimens but being overweight was highly prevalent. Greater vigilance and integration of resources is required in the overall treatment and monitoring of HIV-positive patients for co-morbidities.

This study examines the prevalence, awareness, treatment, and control of hypertension in Ulaanbaatar, Mongolia, using both the American Heart Association and conventional thresholds (130/80 and 140/90 mm Hg, respectively). In this randomized cross-sectional study, two-stage cluster sampling was used to obtain a sample of 4515 individuals aged ≥20 years. Hypertension was defined by the use of antihypertensives in the last 2 weeks or a blood pressure at or above the thresholds of 140/90 and 130/80 mm Hg. The mean age of the participants was 41.1 ± 14.0 years and 54.5% were women. Hypertension prevalence was 25.6% (using 140/90 mm Hg) and 46.5% (using 130/80 mm Hg). Prevalence increased with age and below 50 years men were consistently more likely to be hypertensive. Among hypertensive participants, the rates of awareness, treatment, and control were 69.7%, 46.8%, and 24.0% (using 140/90 mm Hg) and 49.1%, 25.8%, and 6.4% (using 130/80 mm Hg, respectively). Men had lower rates of awareness, treatment, and control compared with women, with the most pronounced differences at younger ages. This study shows that awareness, treatment, and control rates in Ulaanbaatar are better than in most low- and middle-income countries but are still suboptimal. The largest "care gap" was in young men where a regulatory requirement for annual workplace blood pressure screening has the potential to enhance care. A major hypertension control program has just been initiated in Ulaanbaatar. [ABSTRACT FROM AUTHOR]

Aims To investigate the clinical value of a lower blood pressure (BP) cut-off for Stage 1 (S1) hypertension (130–139 mmHg systolic or 80–89 mmHg diastolic) in comparison to the currently established Stage 2 (S2) cut-off (≥140/90 mmHg) in a population-based cohort. Methods and results We assessed the hypertension prevalence and associated cardiovascular disease (CVD) events in a sample of 11 603 participants (52% men, 48% women; mean 47.6 years) from the MONICA/KORA prospective study. The implementation of the new S1 cut-off increased the prevalence of hypertension from 34% to 63%. Only 24% of S2 hypertension patients were under treatment. Within a follow-up period of 10 years (70 148 person-years), 370 fatal CVD events were observed. The adjusted CVD-specific mortality rate per 1000 persons was 1.61 [95% confidence interval (CI) 1.10–2.25] cases in S2 and 1.07 (95% CI 0.71–1.64) cases in S1 hypertension in comparison to normal BP. Cox proportional regression models were significant for the association of S2 and CVD mortality (1.54, 95% CI 1.04–2.28, P = 0.03), also in the presence of competing risks (1.47, P = 0.05). However, statistical significance for S1 hypertension was not reached (0.93, 95% CI 0.61–1.44, P = 0.76). Among S2 participants, there was a significantly higher prevalence of depressed-mood in treated patients (47%) in comparison to non-treated patients (33%) (P < 0.0001). Conclusion The lower BP cut-off substantially increased hypertension prevalence, while capturing a population with lower CVD mortality. Additionally, participants under treatment were more likely to have depressed-mood in comparison to non-treated participants, which might reflect a negative labelling effect. View large Download slide View large Download slide [ABSTRACT FROM AUTHOR]

Crop available soil potassium is generally low and on the decline in the southeastern states of the USA because of the increasing crop and runoff removal and decreasing application of potassium fertilizer. Hypertension-related mortality rates are also high in the southeastern states and are on the rise. Among 41 elements analyzed from 4856 sites across all 48 states, potassium is identified as the only independent element whose soil concentration has significant association with spatial disparities of essential hypertension and hypertension-related mortality rates in the 48 states between 1999 and 2014. Essential hypertension and hypertension-related mortality rates of the 6 states with the lowest soil potassium concentration are about 50-26% higher than that of the 6 states with the highest soil potassium concentration in the 48 states (RR: 1.50, 1.26, low CI 95% 1.47, 1.25 and upper CI 95% 1.53, 1.27, respectively). Though sodium was not identified as an independent factor, an apparent significant inverse correlation exists between hypertension prevalence rates and soil sodium concentration in the 48 states (r = − 0.66, p = 0.00). There likely has been a decline of potassium in USA produces per unit weight over time and a likely association between this decline and increasing hypertension rate, particularly in the southeastern states. Hence, results of this study suggest the need of increasing potassium intakes for reducing hypertension-related mortality rates in the southeastern states. Results of this study also support further examination of potential benefits of sodium from mixture of non-chloride salts in natural produces. [ABSTRACT FROM AUTHOR]

Masked hypertension refers to the phenomenon of having a non-elevated clinic blood pressure (BP) despite having an elevated out-of-clinic BP. Masked hypertension is a common phenotype with a cardiovascular risk profile similar to that of sustained hypertension, defined as elevated clinic and out-of-clinic BP. Current guidelines offer little guidance on the best practices for detecting and treating masked hypertension. This is in part due to insufficient evidence upon which to base recommendations as many questions remain regarding the optimal clinical management of masked hypertension. In this review, we will discuss the recent literature on masked hypertension related to disease prevalence, diagnosis, screening strategies, adverse outcomes, and treatment, and will highlight critical areas for future research. [ABSTRACT FROM AUTHOR]

For over a century the use of brachial blood pressures in determining cardiovascular risk has been a cornerstone of medical practices globally. Clear evidence confirms that increased blood pressure results in stroke, heart disease, kidney disease and death, and by lowering blood pressure effectively, significantly less cardiovascular events occur. But based on 24-hour blood pressure measurements we now know that a clinic or office blood pressure measurement does not necessarily reflect the true blood pressure of a patient – out-of-office readings are often completely different from those in the clinic. Approximately 15–30% of individuals present with white-coat hypertension, i.e. very high blood pressure in the medical environment, and normal out-of-office blood pressure. Even more disconcerting is masked hypertension, where patients present with normal pressures in the clinic, but are hypertensive out of the medical environment. It occurs in 18–45% of patients (depending on factors such as age and disease conditions), and carries similar cardiovascular risk than true hypertension. These realities clearly advise that burden of disease estimates for hypertension are likely to be inaccurate, and potentially significantly underestimate true hypertension. Furthermore, healthcare practitioners should be aware of the limitations of conventional clinic blood pressures, and take note of the usefulness of additional blood pressure monitoring options. [ABSTRACT FROM AUTHOR]

Background: High blood pressure is increasing worldwide, disproportionately so in developing countries. Inadequate health care systems and adoption of unhealthy lifestyles have been linked to this emergent pattern. To better understand this trend, it is imperative we measure prevalence of hypertension, and examine specific risk factors, at a local level. This study provides a cross-sectional view of urban residents of Arusha City to determine prevalence and associated risk factors.Methods: Blood pressure was measured using a digital sphygmomanometer. Interviews were conducted using the WHO STEPwise survey questionnaire to assess lifestyle factors. Dietary intake information was collected by a standardized Food Frequency Questionnaire (FFQ). Descriptive statistics were used to analyze demographic characteristics. Means and standard deviations were calculated for continuous variables and percentages for categorical variables. Pearson's Chi Square (χ 2) tests were used to determine significant risk factors for hypertension, and multivariate log binomial regression was used to reveal potential predictors of hypertension. Dietary patterns were analyzed by principal component analysis.Results: Approximately 45% of the study population was found to be hypertensive. The mean arterial blood pressure (MABP) of the sample was 102.3 mmHg (SD = 18.3). Mean systolic and diastolic blood pressure were 136.3 (SD = 30.5) and 85.3 (SD = 16.1) mmHg, respectively. Through multivariate analysis, age and body mass index were found to be independently, positively, associated with hypertension. Adherence to 'healthy' dietary pattern was negatively independently associated with hypertension.Conclusions: With nearly half of participants being hypertensive, this study suggests that hypertension is a significant health risk in Arusha, Tanzania. Obesity, healthy diet, and age were found to be positively associated with hypertension risk. This study did not establish any significant association between increased blood pressure and Western-dietary pattern, cigarette smoking, alcohol intake, and physical activities. [ABSTRACT FROM AUTHOR]

Background: Business owners in the Republic of Korea must take part in the workers' general health examination. However, there have been few formal analyses of the uptake of this examination by employees. In the present study, we examined the rates of participation in medical examinations according to age group, health insurance type, and enterprise size, and then compared these results with those of the national general health screening. Furthermore, we determined the distribution of patients with abnormal results for diabetes and hypertension, and outlined the significance and history of domestic health examinations. Methods: We started by comparing participation rates extracted from the among health examination data of the National Health Insurance Service from 2006-2013 by sex, age, insurance type, and enterprise size of workplace health insurance beneficiaries (i.e., those whose insurance is provided by their workplace). In addition, we analyzed the prevalence rates of abnormal results for hypertension and diabetes, and explored the history and significance of health examinations in the Republic of Korea. Results: The overall participation rate in the primary health examination in 2006 was 56%, and this increased to 72% in 2013. However, the rates of the secondary screening did not increase much. Among workplace policyholders (i.e., those whose insurance is provided by their workplace), the participation rates of workers in enterprises with less than 50 employees were lower than were those in enterprises with 50 or more employees. Notably, the rates and odds ratios of patients with abnormal results for diabetes and hypertension were relatively high, particularly among those working in smaller enterprises. Conclusions: Although the workers' general health examination has been replaced with the national general health screening, it remains necessary to ensure uniform health management services among all workers in the Republic of Korea. This can, in turn, promote occupational health and improve working conditions throughout the Republic of Korea. [ABSTRACT FROM AUTHOR]