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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Objective To investigate the prevalence of comorbidities of hypertension, diabetes, and dyslipidemia among the elderly population in Hainan Province and analyze the influencing factors, providing basis for formulating and optimizing the strategies for managing these comorbidities among the elderly in Hainan Province, Methods The health management service records of the elderly population from January to December 2022 in the Basic Public Health Service Information System of Hainan Province were collected. The prevalence of comorbidities of hypertension, diabetes, and dyslipidemia among the elderly was analyzed using chi-square test, and binary logistic regression was used to explore the influencing factors. Results A total of 383 607 elderly individuals were included in the study. The prevalence rates of hypertension, diabetes, and dyslipidemia were 50.95%, 22.84%, and 3835%, respectively. The overall comorbidity rate of these three conditions was 6.65%. The binary logistic regression analysis showed that being female (Oi-=L105), older age groups (compared with 65 to 69 years, 70 to 74 years: OR=1A 14; 75-79 years: OR=1.367; -80 years: 0-=1.410), widowhood (02-=1.079), smoking cessation (07-=1.269), low exercise frequency (compared with no exercise, occasional exercise: OR=1A25; frequent exercise: Oi-=1370), preference for meatbased diet (Oi-=1.157), salt preference (OR=1292), sugar preference (OR =1.903), central obesity (OR=1.506), overweight BMI (OR=1.339), and obesity (0-=1.598) were all risk factors for comorbidities of hypertension, diabetes, and dyslipidemia (P<£k05). Conclusion The prevalence of comorbidities of hypertension, diabetes, and dyslipidemia among the elderly population in Hainan Province is relatively high. Relevant departments should take comprehensive measures to strengthen the management of these comorbidities and promote healthy aging, contributing to the construction of a "Healthy Hainan". [ABSTRACT FROM AUTHOR]

Background: Cushing's syndrome (CS) encompasses various causes of hypercortisolism including adrenocorticotropic hormone (ACTH) secreting pituitary adenoma with or without bilateral adrenal hyperplasia, an adrenal adenoma or carcinoma, ectopic ACTH or corticotrophin‐releasing hormone (CRH) secretion by a neoplasm or exogenous corticosteroid therapy. The diagnosis of CS in pregnancy presents a challenge due to overlapping clinical features of pregnancy (weight gain, striae, acne). If untreated, CS in pregnancy is associated with increased risk of maternal and fetal complications. Aims: With fewer than 250 cases currently published, we aim to review the clinical presentations, diagnostic methods, management, and outcomes of patients with CS in pregnancy to help optimise our clinical practice. Materials and methods: This is a single‐centre, retrospective review of woman with documented hypercortisolism receiving antenatal care at a tertiary maternity hospital in Perth between 2006 to 2022. Data were collated from electronic and chart reviews. OMNI calculator was used for birthweight calculations. Local ethics and patient consent were obtained. Results: Five women and seven pregnancies were identified. Four women had a pituitary source of ACTH‐dependent CS as confirmed by brain magnetic resonance imaging. One woman had an ectopic source of ACTH. Two women were diagnosed during pregnancy. All pregnancies occurring prior to treatment of the Cushing's disease were complicated by secondary hypertension and diabetes. Conclusion: CS represents a rare and difficult to diagnose condition in pregnancy. When untreated, maternal and fetal outcomes are compromised. Close monitoring of the associated complications with involvement of a multidisciplinary team are recommended. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases are the leading cause of morbidity and mortality in developed countries and are becoming increasingly significant in developing nations. Many cardiovascular risk factors originate early in life, even prenatally. Elevated blood pressure and hypertension are gaining attention in paediatrics due to their rising prevalence and impact on early cardiovascular risk in adulthood. Along with non-modifiable risk factors for hypertension, several modifiable factors can be addressed through primordial and primary prevention, emphasising lifestyle modifications. When these measures fail and elevated blood pressure develops, early detection is crucial (secondary prevention). Regular blood pressure measurement, a simple and non-invasive procedure, should be a standard practice in paediatric clinical settings. Diagnosing elevated blood pressure and hypertension should adhere to recommended guidelines. Lifestyle modifications are the first-line therapy for primary hypertension in children; if a secondary cause is identified, targeted treatment can be implemented, but a healthy lifestyle remains essential. The early detection and treatment of high-risk blood pressure enable timely interventions to prevent complications (tertiary prevention). Collectively, these preventive measures aim to reduce the incidence of cardiovascular disease in adulthood. Furthermore, quaternary prevention seeks to avoid unnecessary or harmful medical interventions including unwarranted examinations and pharmacotherapy. This underscores the importance of accurate diagnosis and treatment of elevated blood pressure and hypertension and emphasises the need for primordial and primary prevention to minimise unnecessary clinical interventions. [ABSTRACT FROM AUTHOR]

Cerebrocardiovascular diseases are a major global public health concern, significantly impacting morbidity, mortality, and posing substantial socio-economic challenges. In Cabo Verde, non-communicable diseases have become the leading causes of morbidity and mortality. This study aimed to estimate the prevalence of risk factors for cerebrocardiovascular diseases and their association with cardiac electrical alterations in adults on Santiago Island, Cabo Verde. A cross-sectional population-based study using simple random sampling was conducted on individuals over 18 years of age. The sample size of 599 was based on Santiago Island's 2021 population projection. Data collection occurred in October and November 2021, involving questionnaires on risk factors and cerebrocardiovascular diseases; blood pressure assessments; and capillary blood glucose measurements. The sample was predominantly female, with the 18–27 age group being the largest. Key risk factors included physical inactivity (65.1%), BMI ≥ 25 kg/m2 (42.6%), hypertension (32.6%), and family history of cerebrocardiovascular diseases (19.9%). Other factors were alcoholism (14.4%), hypercholesterolemia (8.3%), smoking (7.3%), diabetes (4.5%), and hypertriglyceridemia (1.3%). Notably, 9.3% had no risk factors, 27.5% had one, 36.2% had two, and 26.9% had three or more. There is a high prevalence of risk factors for cerebrocardiovascular diseases on Santiago Island, particularly among females. [ABSTRACT FROM AUTHOR]

Obesity rates among children have been steadily rising over the past several decades. This epidemic has been accompanied by an increase in the prevalence of childhood hypertension, with children in low- and middle-income countries being affected to the same extent as children in high-income countries. This review will examine the trends in childhood blood pressure and the relationship between excess body weight and the development of hypertension. In addition, distinct mechanisms of obesity-related hypertension will be discussed. There will be an emphasis on recent studies conducted since the publication of new guidelines by the American Academy of Pediatrics in 2017 which resulted in the adoption of lower normative blood pressure cutoffs. The overall intent of this review is to provide the reader with an understanding of the ongoing impact, and complexities, of obesity-related hypertension. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance, compensatory hyperinsulinemia, and the development of hyperglycemia promote diabetic cardiomyopathy, a subtype of heart disease that develops apart from other cardiac risk factors like hypertension and coronary artery disease (CAD). The prevalence of heart failure symptoms was 19% in people with type 2 diabetes, and the chance of developing heart failure was two to eight times higher in those people. We intended to outline an overview of the Progression of Diabetic cardiomyopathy among Type 2 Diabetic Patients. Conclusions: Diabetes is one of the rare but rapidly increasing causes of cardiomyopathy globally. The condition is a common consequence of diabetes that is responsible for a great deal of death and disability. We provide a synopsis of the several potential pathogenic mechanisms that are now being studied that could lead to diabetes-related cardiomyopathy, including fibrosis, cell signaling disturbance, and left ventricular (LV) hypertrophy. Heart failure develops from these alterations. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although obstructive sleep apnea (OSA) is common among patients with obesity and linked to cardiovascular disease, there is a lack of studies evaluating the effects of reaching remission from OSA after metabolic and bariatric surgery. STUDY DESIGN: A registry-based nationwide study including patients operated with sleeve gastrectomy or Roux-en-Y gastric bypass from 2007 until 2019 in Sweden. Patients who reached remission of OSA were compared with those who did not reach remission and a propensity score-matched control group of patients without OSA at the time of operation. The main outcome was overall mortality, and secondary outcome was major cardiovascular events (MACEs). RESULTS: In total, 5,892 patients with OSA and 11,552 matched patients without OSA completed a 1-year follow-up and were followed for a median of 6.8 years. Remission of OSA was seen for 4,334 patients (74%). Patients in remission had a lower risk for overall mortality (cumulative incidence 6.0% vs 9.1%; p < 0.001) and MACE (cumulative incidence 3.4% vs 5.8%; p < 0.001) at 10 years after operation compared with those who did not reach remission. The risk was similar to that of the control group without OSA at baseline (cumulative incidence for mortality 6%, p = 0.493, for MACE 3.7%, p = 0.251). CONCLUSIONS: The remission rate of OSA was high after metabolic and bariatric surgery. This was in turn associated with reduced risk for death and MACE compared with patients who did not achieve remission reaching a similar risk seen among patients without OSA at baseline. A diligent follow-up of patients who do not reach remission remains important. [ABSTRACT FROM AUTHOR]

Cerebral small vessel diseases (CSVD) are neurological disorders associated with microvessels, manifested pathologically as white matter (WM) changes and cortical microbleeds, with hypertension as a risk factor. Additionally, a high-fat diet (HFD) can affect peripheral vessel health. Our study explored how HFD affects cerebral small vessels in normotensive WKY, hypertensive SHR, and SHR/SP rats. The MRI results revealed that HFD specifically increased WM hyperintensity in SHR/SP rats. Pathologically, it increased WM pallor and vacuolation in SHR and SHR/SP rats. Levels of blood–brain barrier (BBB) protein claudin 5 were decreased in SHR and SHR/SP compared to WKY, with HFD having minimal impact on these levels. Conversely, collagen IV levels remained consistent among the rat strains, which were increased by HFD. Consequently, HFD caused vessel leakage in all rat strains, particularly within the corpus callosum of SHR/SP rats. To understand the underlying mechanisms, we assessed the levels of hypoxia-inducible factor-1α (HIF-1α), Gp91-phox, and neuroinflammatory markers astrocytes, and microglia were increased in SHR and SHR/SP compared to WKY and were further elevated by HFD in all rat strains. Gp91-phox was also increased in SHR and SHR/SP compared to WKY, with HFD causing an increase in WKY but little effect in SHR and SHR/SP. In conclusion, our study demonstrates that HFD, in combined with hypertension, intensifies cerebral pathological alterations in CSVD rats. This exacerbation involves increased oxidative stress and HIF-1α in cerebral vessels, triggering neuroinflammation, vascular basement membrane remodeling, IgG leakage, and ultimately WM damage. [ABSTRACT FROM AUTHOR]

Objectives: Hypertension is one of the major modifiable risk factors for cardiovascular mortality and morbidity throughout the world. Increased life expectancy leads to increase prevalence of non‐communicable diseases among the elderly people including Bangladesh. However, different studies reported high prevalence of uncontrolled hypertension ranging from 52.6% to 67.9% among the elderly people in different countries. With this view, we aimed to assess the frequency of uncontrolled blood pressure (BP) among the elderly hypertensive people and its associated risk factors and treatment pattern in Bangladesh. Methodology: This cross‐sectional type of observational study recruited 246 eligible hypertensive elderly patients attending in 250 Bedded General Hospital, Jashore, Bangladesh dated from 1st July to 31st December 2022. A structured questionnaire was developed and data on associated risk factors, treatment pattern and current blood pressure (BP) measurement were collected by face‐to‐face interview for the purposive sampling technique. Results: The mean age of our study patients was 72 ± 7 years with a male and female ratio nearly 1:1. Of the total hypertensive patients aged over 65 years or more, 56.5% remained with uncontrolled hypertension even on their prescribed antihypertensive medications. The mean systolic (SBP) and diastolic (DBP) blood pressure were significantly high (P < 0.001) as 167 ± 22 mm Hg and 95 ± 11 mm Hg, respectively, among the uncontrolled hypertensive patients. However, we noticed the mean SBP and DBP among the total hypertensive patients were also significantly high (P < 0.001) as 148 ± 27 mm Hg and 87 ± 13 mm Hg, respectively. In this study, we reported that the mean number of last prescribed antihypertensive medications used by the total patients was 2 ± 1 (P =0.224) which was similar among the controlled and uncontrolled hypertensive patient groups. Among the elderly hypertensive patients, the most commonly prescribed antihypertensive medications were Amlodipine 39.8% (P =0.006), Olmesartan 29.3% (P = 0.186), Losartan 24.4% (P = 0.127), Bisoprolol 15.0% (P = 0.266) and Atenolol 14.6% (P = 0.224). Conclusion: We noticed high frequency of uncontrolled blood pressure among the elderly hypertensive patients, despite of using multiple antihypertensive medications in Jashore, Bangladesh. [ABSTRACT FROM AUTHOR]

Although hyperglycemia and hypertension are well-known risk factors for glomerular injury in individuals with type 2 diabetes (T2D), specific risk factors for tubular injury remain unclear. We aimed to clarify the differences between risk factors for glomerular injury and risk factors for tubular injury in individuals with T2D. We categorized 1243 subjects into four groups based on urinary biomarkers, including the albumin-to-creatinine ratio (uACR) and L-type fatty acid-binding protein-to-creatinine ratio (uL-ABPCR) as a normal (N) group (uACR < 30 mg/gCr and uL-FABPCR < 5 μg/gCr; n = 637), a glomerular specific injury (G) group (uACR ≥ 30 mg/gCr and uL-FABPCR < 5 μg/gCr; n = 248), a tubular specific injury (T) group (uACR < 30 mg/gCr and uL-FABPCR ≥ 5 μg/gCr; n = 90), and a dual injury (D) group (uACR ≥ 30 mg/gCr and uL-FABPCR ≥ 5 μg/gCr; n = 268). Logistic regression analysis referencing the N group revealed that BMI, current smoking, and hypertension were risk factors for the G group, creatinine (Cr) and Fibrosis-4 (FIB-4) index were risk factors for the T group, and BMI, hypertension, HbA1c, Cr, and duration of diabetes were risk factors for the D group. While hypertension was a distinct specific risk factor for glomerular injury, the FIB-4 index was a specific contributor to the prevalence of tubular injury. On the other hand, the logistic regression analysis revealed that the hepatic steatosis index (HSI) did not show any significant association with the G group, T group, or D group. Taken together, the development of liver fibrosis rather than liver steatosis is an inherent threat relating to tubular injury in individuals with T2D. [ABSTRACT FROM AUTHOR]

Background: Elevated blood pressure, or hypertension, is one of the main health problems among adolescents globally. However, there are limited data on hypertension among adolescents in Sudan. This survey aimed to investigate the prevalence of elevated blood pressure/hypertension and associated factors among adolescents in Gadarif City, Sudan. Methods: A community-based cross-sectional survey was conducted during a three-month period (August to October 2023) in Gadarif City, Eastern Sudan. A face-to-face interview questionnaire was used to collect sociodemographic information. Adolescents' anthropometric (weight and height) measurements were taken, and blood pressure was measured. Multivariate binary and linear regression analyses were performed to analyze the data. Results: A total of 384 adolescents (178 [46.4%] boys and 206 [53.6%] girls) were included in the study. The median (interquartile range, IQR) of the age was 14.0 (12.1–16.1) years, and that of the body mass index (BMI) was 16.9 (15.2–20.0) kg/m2. Thirty-four (8.9%) adolescents had hypertension/elevated blood pressure (≥95th percentile). After adjusting for confounders, multivariable binary regression analysis showed that age (adjusted odds ratio [AOR], 1.20; 95% confidence interval [CI], 1.03–1.42) and BMI (AOR, 1.12; 95% CI, 1.04–1.20) were associated with hypertension. Conclusion: Approximately one in ten adolescents in Eastern Sudan was hypertensive. Adolescents with higher age and BMI were at higher risk for hypertension. Maintaining a healthy BMI during adolescence is recommended to promote adolescents' health. [ABSTRACT FROM AUTHOR]

Background and Objectives: Atrial fibrillation (AF) is the most frequent arrhythmia and the main cause of hospital admissions for cardioembolic stroke. The SIMETAP research project aims to update the prevalence rates of cardiovascular, renal, or metabolic factors and to evaluate their respective associations with factors that could be related. The present study aims to assess the AF prevalence rates in an adult population and its association with cardiovascular–kidney–metabolic (CKM) factors. Materials and Methods: This cross-sectional observational study was conducted in a primary care setting, with a population-based random sample of 6588 people aged 18.0–102.8 years. Crude and adjusted prevalence rates of AF were calculated. The associations of CKM factors with AF were assessed using bivariate and multivariate analysis. Results: The age- and sex-adjusted prevalence rates of AF were 2.9% in the overall adult population, 6.1% in the population aged ≥50 years, and 12.9% in the population aged ≥70 years, with no significant differences by sex. AF prevalence in the population under 50 years of age barely reached 1‰. Heart failure (HF), hypertension, chronic kidney disease (CKD), stroke, low HDL-cholesterol, and prediabetes were independent CKM factors associated with AF in the overall population, as were the same factors, except prediabetes, in the population ≥50 years old (p < 0.001). High or very high vascular risk was present in 92.4% [95% CI: 89.1–95.7]) of the population with AF. Conclusions: The adjusted prevalence rate of AF in the population aged 50 years or older was 6.1%, twice that of the overall adult population and half that of the population aged 70 years or older. The main independent CKM factors associated with AF were HF, stroke, CKD, hypertension, and low HDL-cholesterol. [ABSTRACT FROM AUTHOR]

Background and Objectives: End-stage kidney disease (ESKD) is a major risk factor for cardiovascular morbidity and mortality. This study aims to evaluate the contribution of traditional risk factors to the development of coronary artery disease (CAD) in patients on dialysis. Materials and Methods: In this study, 54 patients on dialysis with angina symptoms or a positive exercise stress test underwent coronary angiography. Lesions with obstruction >70% lumen diameter of the coronary artery were considered significant. Traditional risk factors included hypertension, diabetes, smoking, dyslipidemia, age, gender, and time spent on dialysis. Results: Out of 54 participants, 41 (75.92%) were men and 13 (24.07%) women. CAD was present in 34 (62.96%) patients, and 20 (37.03%) patients were without CAD. The average age of the participants was 66.51 years. In the group with CAD, the average age was 69.52 years with an average time spent on dialysis of 2.73 years. In the group without CAD, the average age was 61.40 years with a time spent on dialysis of 2.35 years. Hypertension was present in 92.59% of all participants and 97.05% of those with CAD. Diabetes was present in 41.17 patients with CAD and 40% of those without CAD. Dyslipidemia was present in 76.47 participants with CAD and in 40% of those without CAD. Smoking was noticed in 35.29% of the participants with CAD and 57.14% of those without CAD. Besides hypertension, significant predictors for the development of CAD in patients on dialysis were dyslipidemia (OR 3.698, Cl 1.005–13.608, p = 0.049) and age (OR 1.056, Cl 1.004–1.110, p = 0.033). Conclusions: Among the traditional risk factors, hypertension, dyslipidemia, and age are the predictors for the development of CAD in patients on dialysis. Further large randomized clinical studies are needed to clarify the role of traditional risk factors for CAD in patients with ESKD. [ABSTRACT FROM AUTHOR]

AbstractPrevious studies have demonstrated that a low skeletal muscle mass (SMM) is an adverse factor for overall survival (OS) in diffuse large B-cell lymphoma (DLBCL). However, its association with the treatment response has not been extensively investigated. This study aimed to determine the association between low skeletal muscle mass (SMM) and treatment response in DLBCL patients. We conducted a retrospective cohort study of 123 patients with DLBCL, in whom SMM was assessed using computed tomography before chemotherapy administration. The demographic characteristics of the patients with low SMM and those with normal SMM were not statistically different. However, there were notable differences in weight and BMI; patients with low SMM had a lower mean weight (59.2 vs 63, p = 0.002) and a higher proportion of patients with normal BMI (61.5% vs. 21.1%, p < 0.001). In addition, patients with low SMM were more likely to receive R-CHOP-like treatment (21.2% vs. 7%, p = 0.022) and experienced more delays in administration (42.9% vs. 33.3%, p = 0.452). Low SMM was not associated with failure to achieve CR (HR 1.9; 95% CI [0.9–4.1] p = 0.84), but it was reported to risk OS in univariate analysis (HR 2.1; 95% CI [1.03–4.2], p = 0.041). An interesting result was the interaction of low SMM with hypertension as a risk factor for not achieving CR (HR 2.7; 95% CI [1.1–6.5] p = 0.034) or OS (HR 7.9; 95% CI [3.4–18.8] p < 0.001). Low SMM was not a risk factor for achieving CR in patients with DLBCL and seemed to play a role in OS. [ABSTRACT FROM AUTHOR]

Background: The relationship between lifestyle and migraine is complex, as it remains uncertain which specific lifestyle factors play the most prominent role in the development of migraine, or which modifiable metabolic traits serve as mediators in establishing causality. Methods: Independent genetic variants strongly associated with 20 lifestyle factors were selected as instrumental variables from corresponding genome-wide association studies (GWASs). Summary-level data for migraine were obtained from the FinnGen consortium (18,477 cases and 287,837 controls) as a discovery set and the GWAS meta-analysis data (26,052 cases and 487,214 controls) as a replication set. Estimates derived from the two datasets were combined using fixed-effects meta-analysis. Two-step univariable MR (UVMR) and multivariable Mendelian randomization (MVMR) analyses were conducted to evaluate 19 potential mediators of association and determine the proportions of these mediators. Results: The combined effect of inverse variance weighted revealed that a one standard deviation (SD) increase in genetically predicted Leisure screen time (LST) was associated with a 27.7% increase (95% CI: 1.14–1.44) in migraine risk, while Moderate or/and vigorous physical activity (MVPA) was associated with a 26.9% decrease (95% CI: 0.61–0.87) in migraine risk. The results of the mediation analysis indicated that out of the 19 modifiable metabolic risk factors examined, hypertension explains 24.81% of the relationship between LST and the risk of experiencing migraine. Furthermore, hypertension and diastolic blood pressure (DBP) partially weaken the association between MVPA and migraines, mediating 4.86% and 4.66% respectively. Conclusion: Our research findings indicated that both LST and MVPA in lifestyle have independent causal effects on migraine. Additionally, we have identified that hypertension and DBP play a mediating role in the causal pathway between these two factors and migraine. [ABSTRACT FROM AUTHOR]

Background: Hypertension is the number one risk factor for cardiovascular death worldwide and its prevalence has been on the increase in LMICs including Nigeria. There is an increasing awareness and recognition of the contributions of the community health workers (CHWs) in the healthcare system. This study assessed their current role in the management of hypertension and patient satisfaction with the care received. Methods: A mixed method study (cross-sectional study of 381 CHWs and key informant interview of 14 patients with hypertension selected using multi-stage and purposive sampling respectively) was conducted across five states in different geopolitical zones of Nigeria to assess the role of CHWs in hypertension management and the patients' level of satisfaction with services of CHWs. Chi-square test was used to assess relationship between categorical variables. A p-value ≤ 0.05 was considered statistically significant. Thematic analysis of the text data from the KII was done using Nvivo® version 12 pro. Results: A total of 381 CHWs completed the study. They were predominantly males (63%) with mean age of 40.96 ± 12.51 years. Only about one-third of the CHWs (31%) could correctly diagnose hypertension while only 15% knew the base-line investigations to be requested. Being female (FE = 9.205, p = 0.008) and resident in northwest geopolitical region (χ2 = 20.920, p < 0.001) had statistically significant associations with appropriate diagnostic skills for hypertension. Being supervised by doctors was associated with appropriate knowledge of baseline investigations for hypertension (χ2 = 5.534, p = 0.019). Mostly, hypertensive patients reported positive experiences and satisfaction with the services provided by the CHWs. Conclusions: Community health workers currently have critical contributions in the management of hypertension in Nigeria. Hypertensive patients generally reported satisfactory experience with CHWs managing them. The services rendered by CHWs can be improved upon by adequate supervision and training. [ABSTRACT FROM AUTHOR]

Background: Donor shortage limits the utilization of heart transplantation, making it available for only a fraction of the patients on the transplant waiting list. Therefore, continuous-flow left ventricular assist devices (CF-LVADs) have evolved as a standard of care for end-stage heart failure. It is imperative therefore to investigate long-term survival in this population. Methods: This study assesses the impact of demographics, infections, comorbidities, types of cardiomyopathies, arrhythmias, and end-organ dysfunction on the long-term survival of LVAD recipients. The TriNetX database comprises de-identified patient information across healthcare organizations. The log-rank test assessed post-implant survival effects, while Cox regression was used in the univariate analysis to obtain the Hazard Ratio (HR). All analyses were conducted using the Python programming language and the lifelines library. Results: This study identified CMV, hepatitis A exposure, atrial fibrillation, paroxysmal ventricular tachycardia, ischemic cardiomyopathy, renal dysfunction, diabetes, COPD, mitral valve disease, and essential hypertension as risk factors that impact long-term survival. Interestingly, hypokalemia seems to have a protective effect and gender does not affect survival significantly. Conclusions: This is the first report of a detailed long-term survival assessment of the LVAD population using a decoded database. [ABSTRACT FROM AUTHOR]

Simple Summary: The PELICan hypothesis speaks to the role of perinatal and early life stressors (including malnutrition) in the causation of young-onset cancers. To date, there is no evidence correlating perinatal malnutrition and the risk of young-onset cancer. The Great Famine of China was a significant event in human history. The present study compared the incidence of young-onset cancers in individuals born during and just after the famine to those born prior to the famine. Perinatal exposure to famine, especially in females, was associated with a higher risk of young-onset cancer. This was particularly evident for young-onset genitourinary cancers. Background/Objectives: Perinatal exposure to malnutrition has been hypothesised to influence the development of young-onset cancer (≤50 years of age). This study aimed to determine if perinatal malnutrition in individuals exposed to the Great Famine of China increased their risk of developing young-onset cancer compared to other individuals born prior to the famine. Subjects/Methods: This cross-sectional study involved 7272 participants from the China Health and Nutrition Survey who were classified into four groups based on birth year: participants born between 1953 and 1955 (before the famine) were designated as the pre-famine group (unexposed); the remainder formed perinatal exposure groups comprised of those exposed during the famine (1959–1961), those exposed in the early post-famine period (1962–1964), and those exposed in the late post-famine period (1965–1967). Multivariable adjusted log-binomial regression models were used to calculate the RR and 95% CI of young-onset cancer (including genitourinary cancer) across four groups. Results: Perinatal exposure to early post-famine (RR 2.08; 95%CI 1.04, 4.34; p = 0.043) and the female sex (RR 15.6, 95%CI 4.54, 60.3; p < 0.001) were noted to have a significantly increased risk of young-onset cancer. In addition, the early (RR 13.8; 95%CI 2.68, 253; p = 0.012) and late post-famine (RR 12.3; 95%CI 2.16, 231; p = 0.020) cohorts demonstrated a significantly increased risk of young-onset genitourinary cancer. The latter was accompanied by an increased risk of hypertension (RR 3.30; 95%CI 1.28, 7.87; p = 0.009). Conclusions: Perinatal exposure to famine, especially in females, was associated with a higher risk of young-onset cancer. This was particularly evident for young-onset genitourinary cancers. These findings highlight the potential long-term impact of perinatal malnutrition on young-onset carcinogenesis. [ABSTRACT FROM AUTHOR]

There are no nationwide surveys on antihypertensive drugs in China. In order to assess the current status of antihypertensive drug therapy in patients with hypertension and analyzed factors that may affect combination therapy, using convenience sampling, we recruited 305,624 patients with hypertension from the Chinese Cardiovascular Association Database‐Hypertension Center between January 2019 and December 2021. Chi‐squared test was performed to analyze the administered antihypertensive drug types and their combinations in different hospital settings. Logistic regression was used to assess the factors influencing combination therapy. We found around 33.1% of the participants had stage 2 and above hypertension, of which 67.9% were treated with combination therapy. In community or general hospitals, the most common monotherapy was calcium channel blockers (CCB), angiotensin‐converting enzyme inhibitor/angiotensin II receptor inhibitor (ACEI/ARB) and diuretic were the main single‐pill combinations (SPCs), and ACEI/ARB and CCB were the main free combination. From 2019 to 2021, the rates of combination therapy increased (58.8%–64.1%) with SPCs from 25.9% to 31.0% and free combination from 31.9% to 32.6%. Patients aged < 60 years, with stage 2 and above hypertension, with an education level of high school and above, visiting general hospitals, living in the eastern region of China, with hypertension risk factors and comorbidities, and without anxiety or depression were more likely to receive combination therapy (all P < .05). The combination therapy use rate increased yearly and the rate of SPCs rose obviously. Individual, hospital, and regional differences in patients with hypertension influenced combination therapy. [ABSTRACT FROM AUTHOR]

Background: Intracerebral hemorrhage (ICH) is a severe form of stroke with high mortality and limited treatment options. While traditional risk factors like hypertension have been well-studied, the role of emotional states as acute triggers for ICH remains unclear. This study employs Mendelian Randomization (MR) to investigate the causal relationship between emotional traits of worry and anxiety and the incidence of ICH. Methods: We used a two-sample MR approach, leveraging summary-level data from genome-wide association studies (GWAS) for emotional traits and ICH. The primary analysis was conducted using the Inverse-Variance Weighted (IVW) method, supplemented by multiple sensitivity analyses including Maximum Likelihood and MR PRESSO methods. Results: Our MR analysis revealed a robust and significant causal relationship between the emotional trait "Worrier/anxious feelings" and ICH, supported by 195 instrumental variables (SNPs). The odds ratio (OR) was 2.98 (95% CI: 1.16, 7.61) with a p-value of 0.0229. Sensitivity analyses corroborated these findings, enhancing the reliability of our results. In contrast, other emotional traits such as "Nervous feelings" and "Sensitivity/hurt feelings" did not show significant associations, reinforcing the specificity of our primary finding. Conclusion: Our study provides compelling evidence for a causal relationship between the emotional traits of worry and anxiety and the incidence of ICH, offering a new dimension in our understanding of this devastating condition and paving the way for more nuanced risk stratification and preventive strategies. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the relationship between oral contraceptive use and blood pressure values and in a national cohort of women adolescents and to investigate the level of coexistence of the high blood pressure levels, dyslipidemia or insulin resistance. Methods: This is a retrospective cohort study that evaluated data form 14,299 adolescents aged 14 to 17 years. Crude and race-and age-adjusted analyses were performed using Poisson regression to estimate the prevalence ratios. Data clustering analysis was performed using machine learning approaches supported by an unsupervised neural network of self-organizing maps. Results: We found that 14.5% (n = 2076) of the women adolescents use oral contraceptives. Moreover, an increased prevalence of high blood pressure, dyslipidemia, and insulin resistance (all P < 0.001) was observed among adolescents who use oral contraceptives as compared to those who do not. Our analysis also showed that 2.3% of adolescents using oral contraceptives had both high blood pressure levels and dyslipidemia, whereas 3.2% had high blood pressure levels combined with insulin resistance (all P < 0.001). The algorithmic investigative approach demonstrated that total cholesterol, LDLc, HDLc, insulin, and HOMA-IR were the most predicted variables to assist classificatory association in the context of oral contraceptive use among women adolescents with high blood pressure. Conclusions: These findings suggest that oral contraceptives were associated with an increased prevalence of high blood pressure, dyslipidemia, and insulin resistance among women adolescents. Although the indication of this therapy is adequate to avoid unintended pregnancies, their use must be based on rigorous individual evaluation and under constant control of the cardiometabolic risk factors. [ABSTRACT FROM AUTHOR]

Background: Lipodystrophy is characterized by progressive loss of adipose tissue and consequential metabolic abnormalities. With new treatments emerging for lipodystrophy, there is a growing need to understand the prevalence of specific comorbidities that may be commonly associated with lipodystrophy to contextualize the natural history of lipodystrophy without any disease modifying therapy. Objective: To examine the risk of specific clinical characteristics in people living with lipodystrophy (LD) in 2018–2019 compared with the general US population, among the commercially insured US population. Methods: A retrospective cohort study was conducted using the 2018–2019 Clinformatics® Data Mart database. An adult LD cohort (age ≥ 18 years) with at least ≥ 1 inpatient or ≥ 2 outpatient LD diagnoses was created. The LD cohort included non-HIV-associated LD (non-HIV-LD) and HIV-associated LD (HIV-LD) subgroups and compared against age- and sex-matched control groups with a 1:4 ratio from the general population with neither an LD or an HIV diagnosis using odds ratios (ORs) with 95% confidence intervals. Results: We identified 546 individuals with non-HIV-LD (mean age, 60.3 ± 14.9 years; female, 67.6%) and 334 individuals with HIV-LD (mean age, 59.2 ± 8.3 years; female, 15.0%) in 2018–2019. Compared with the general population, individuals with non-HIV-LD had higher risks (odds ratio [95% confidence interval]) for hyperlipidemia (3.32 [2.71–4.09]), hypertension (3.58 [2.89–4.44]), diabetes mellitus (4.72 [3.85–5.79]), kidney disease (2.78 [2.19–3.53]), liver fibrosis or cirrhosis (4.06 [1.66–9.95]), cancer (2.20 [1.59–3.01]), and serious infections resulting in hospitalization (3.00 [2.19–4.10]). Compared with individuals with HIV, those with HIV-LD have higher odds of hypertension (1.47 [1.13–1.92]), hyperlipidemia (2.46 [1.86–3.28]), and diabetes (1.37 [1.04–1.79]). Conclusions: LD imposes a substantial burden on affected individuals due to a high prevalence of metabolic comorbidities and other complications as compared with the general non-LD population. Future longitudinal follow-up studies investigating the causality between LD and observed comorbidities are warranted. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Sleep promotion is not specifically recommended as a target for hypertension management. We examined associations of sleep duration and timing with blood pressure parameters in patients referred to pediatric nephrology clinic for elevated blood pressure evaluation. METHODS: This is a retrospective study of initial ambulatory blood pressure monitoring data and self-report sleep data collected from patients referred to nephrology clinic for the evaluation of elevated blood pressure. Linear and logistic regression modeling determined associations between sleep exposures (duration and timing) and continuous and dichotomous blood pressure outcomes, respectively, adjusted for age, sex, body mass index, and weekday versus weekend status. RESULTS: The study sample included 539 patients with mean age 14.6 years and 56% meeting hypertension criteria. Sleep duration averaged 9.1 hours per night. Average timing of sleep onset and offset were 11:06 PM and 8:18 AM, respectively. Longer sleep duration was associated with better daytime blood pressure parameters (eg, every extra hour of sleep duration was associated with a reduced odds of wake hypertension [odds ratio, 0.88; 95% CI, 0.79-0.99]). Later sleep onset was associated with worse daytime blood pressure parameters (eg, each additional hour of later sleep onset was associated with higher wake systolic blood pressure index [mean wake blood pressure/95th percentile]) (β = 0.07; 95% CI, 0.02-0.13). Associations were consistent across sex, age, body mass index, and weekday status. CONCLUSIONS: Longer sleep duration and earlier sleep onset were associated with lower blood pressure. This suggests that sleep optimization may be an important target for intervention in hypertension management. [ABSTRACT FROM AUTHOR]

The objective of our study was to reanalyse the Ethiopia STEPwise approach to Surveillance Noncommunicable Disease Risk Factors survey (NCD STEPS), using causal path diagrams constructed using expert subject matter knowledge in conjunction with graphical model theory to map the underlying causal network of modifiable factors associated with prediabetes/diabetes and hypertension. We used data from the 2015 Ethiopia NCD STEPS representative cross‐sectional survey (males; n = 3977 and females; n = 5823 aged 15–69 years) and performed directed acyclic graph‐informed logistic regression analyses. In both sexes, a 1‐unit higher in body mass index (BMI) and waist circumference (WC) were positively associated with prediabetes/diabetes (BMI: males: adjusted odds ratio [aOR]: 1.07 [95% confidence interval: 1.0, 1.1], females aOR: 1.03 [1.0, 1.1]; WC: males: aOR: 1.1 [0.9, 1.2], females: aOR: 1.2 [1.1, 1.3]) and hypertension (BMI: males: aOR: 1.2 [1.1, 1.2], females aOR: 1.1 [1.0, 1.1]; WC: males: aOR: 1.6 [1.4, 1.8], females: aOR: 1.3 [1.2, 1.5]). Although residing in urban settings was associated with higher odds of hypertension in both males (aOR: 1.79 [1.49, 2.16]) and females (aOR: 1.70 [1.49, 1.95]), it was only associated with prediabetes/diabetes in males (aOR: 1.56 [1.25, 1.96]). Males and females in pastoralist areas had lower odds of prediabetes/diabetes compared with their agrarian counterparts (males: aOR: 0.27 [0.14, 0.52], females: aOR: 0.31 [0.16, 0.58]). Physical activity was associated with lower odds of prediabetes/diabetes among females (aOR: 0.75 [0.58, 0.97]). Other diet‐related modifiable factors such as consumption of fruit and vegetable, alcohol or salt were not associated with either prediabetes/diabetes or hypertension. Our findings highlight the need to implement interventions that prevent overweight/obesity and nutrition‐related NCDs, particularly in urban areas. Key messages: Body mass index and waist circumference were positively associated with hypertension and prediabetes/diabetes for both sexes. Residing in urban settings was associated with increased odds of hypertension in both sexes, and with prediabetes/diabetes in males. Physical activity was associated with lower odds of prediabetes/diabetes among women.Diet‐related factors (consumption of fruit and vegetables, alcohol, and salt) were not associated with either hypertension or prediabetes/diabetes.There is a need for longitudinal, nationally representative dietary surveys, which enable the derivation of relevant indicators of the nutrition transition in Ethiopia. [ABSTRACT FROM AUTHOR]

To evaluate associations between serum analytes used for genetic screening and obstetric complications among twin pregnancies. This cohort included twins delivered at a tertiary care hospital from 2009 to 2017. Abnormal levels of pregnancy associated plasma protein (PAPP-A), first and second trimester human chorionic gonadotropin (hCG), alpha fetoprotein (AFP), estriol, and inhibin, reported as multiples of the median (MoM), were defined as <5 %ile or >95 %ile for our cohort. Associations between abnormal analytes and preterm delivery, small for gestational age, and pregnancy-associated hypertension were calculated using Fisher's exact test. A total of 357 dichorionic/diamniotic and 123 monochorionic/diamniotic twins were included. Among dichorionic/diamniotic twins, elevated AFP (>3.70 MoM) was associated with increased preterm delivery <34 weeks (44.4 vs. 16.5 %, p=0.007), while elevated inhibin (>4.95 MoM) was associated with increased preterm delivery<37 weeks (94.1 vs. 58.8 %, p=0.004). For monochorionic/diamniotic twins, elevated inhibin (>6.34 MoM) was associated increased preterm delivery <34 weeks (66.7 vs. 24.8 %, p=0.04) and hypertension (66.7 vs. 21.4 %, p=0.03). Selected abnormal analyte levels were associated with increased rates of adverse outcomes in twin pregnancies, which differed by chorionicity. Our findings assist providers in interpreting abnormal analyte levels in twin pregnancies and may help to identify those at increased risk for adverse outcomes. [ABSTRACT FROM AUTHOR]

Introduction: It remains unclear how hypertension affects subjective well-being, especially in light of its potential gender-specific impacts. Aim: In this study, we aimed to study the association between hypertension and subjective well-being and the potential gender differences in this relationship as well as mediating factors. Methods: We use individual-level data from > 1 million Americans who participated in six waves of the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) survey. We employ descriptive and regression analyses to determine the association between hypertension and subjective well-being while controlling for the usual well-being covariates identified from the related literature. Results: Hypertension was negative associated with subjective well-being (p < 0.001) and our results for covariates were in line with the findings in the related literature. The association between hypertension and subjective well-being was only found in males (p < 0.001) but not in females. The relationship is mediated by age and exercising but only for females. Conclusion: Hypertension is negatively associated with well-being among males. The diagnosis of hypertension should not only lead to medical treatments but also involve a careful psychological management. [ABSTRACT FROM AUTHOR]

The article investigates the efficacy of furosemide in preventing de novo postpartum hypertension among high-risk individuals. It aims to determine whether oral furosemide reduces mean arterial pressure within 24 hours before discharge or before starting antihypertensive medications compared to a placebo. It addresses the significant health implications of postpartum hypertension, highlighting its potential complications and the need for effective management strategies.

Context: Hypertension is one of the most common medical disorders complicating pregnancies and complicates 5 to 10% of all pregnancies. Aims: To estimate the prevalence of hypertension among pregnant women and to determine the associated obstetric risk factors of hypertension among them in rural areas of Dibrugarh district, Assam. Settings and Design: Community-based cross-sectional study. Materials and Methods: The present study was conducted on pregnant women of villages under two health blocks at that point of time from May 2017 to April 2018. The sample size was calculated to be 384. The estimated number of pregnant women in each block was noted, and the pregnant women to be included from each block and from each sub-centre was determined by proportional allocation. Data were collected by house-to-house survey in the villages of the respective sub-centre. A pre-designed and pre-tested proforma was used to collect the data. Statistical Analysis Used: Data were analysed using Chi-square test, Fisher's exact test, and logistic regression. Results: A total of 384 pregnant women gave consent for participation. The prevalence of hypertension in pregnancy was 9.1%. Among the obstetric factors, multigravidity, multiparity, period of gestation >20 weeks, history of hypertension in previous pregnancy, and history of prior still birth were statistically significant risk factors of hypertension in pregnancy. Logistic regression analysis showed period of gestation >20 weeks to be independent predictor of hypertension in pregnancy. Conclusion: The awareness of obstetric risk factors for hypertension in pregnancy may give ways for prevention in this population. [ABSTRACT FROM AUTHOR]

Objective: Previous studies focused on the benefits of adequate prosthodontic treatment, while few studies have investigated the prosthodontic‐related risks to health. As a modifiable oral health indicator, the association of ill‐fitting prosthesis (IFP) with hypertension has not been fully explored. Methods: This cross‐sectional study involved 158,659 adults in Beijing (2009–2017) receiving intra‐oral examinations and blood pressure measurements. Logistic regression models were applied to assess the association of IFP with the prevalence of hypertension, systolic blood pressure (SBP) ≧ 140 mmHg and diastolic blood pressure (DBP) ≧ 90 mmHg, as well as subgroup analyses by different fixed IFP subgroups (according to involved teeth number) and removable IFP subgroup. We further investigated effect modifications among stratified populations. Results: 158,659 individuals were included for analysis, 346 (26.86%) in IFP group and 27,380 (17.40%) in non‐IFP group (p < 0.001) were hypertensive. After adjustment of sex, age, obesity, dyslipidaemia, diabetes, hsCRP, family history of CVD, self‐reported smoking, self‐reported drinking and WC, ORs of hypertension, SBP ≧ 140 mmHg and DBP ≧ 90 mmHg were 1.330 (95% CI: 1.162–1.522), 1.277 (95% CI: 1.098–1.486) and 1.376 (95% CI: 1.186–1.596), respectively (p < 0.05). Furthermore, after full adjustment, the number of involved teeth showed a significant incremental trend with hypertension risk in the population with and without IFP (p for trend <0.001). The IFP–blood pressure associations were more pronounced in females, 18–60 years, non‐obese and diabetic participants. Conclusion: As a modifiable oral indicator, IFP was significantly associated with a higher risk of hypertension. [ABSTRACT FROM AUTHOR]

• We confirmed the predictive value of ESC/EAS 2019 risk stratification in a Portuguese cohort. • Total ASCVD events, fatal and non-fatal, were included in the analysis. • Poor LDL-C goal attainment was observed by the time patients entered risk categories. • Moderate intensity statins were the most frequently prescribed for all risk categories. • Individual risk criteria had a significant impact on cardiovascular outcomes. Cardiovascular (CV) risk scores identify individuals at higher long-term risk of CV events that may benefit from more aggressive preventive interventions. To assess the association of CV-risk categories and criteria with long-term CV events. Observational cohort study between 2000–2019 on patients aged 40–80 years, followed by 14 primary care centers assisted by 1 hospital in Portugal. Follow-up began when electronic health records data allowed for CV-risk classification and dynamic reassessment per 2019 ESC/EAS Guidelines. Inclusion criteria required at least one appointment with a primary care physician within three years before follow-up initiation. We assessed the 10-year adjusted hazard-ratio of combined CV death and non-fatal atherosclerotic cardiovascular disease (ASCVD) hospitalization, across SCORE risk categories and criteria, using Cox proportional hazards models adjusted for sex, age, competing comorbidities, and medication. The study included 161 681 observations from 87 035 unique patients. During the observation period, 71 787 patients were classified as low/moderate, 51 476 as high and 38 418 as very-high CV-risk categories. In the very-high group, prevalent comorbidities were hypertension (69%), hypercholesterolemia (69%) and type 2 diabetes (61%), and 13% were hospitalized for ASCVD. The adjusted 10-year hazard ratio of the composite of CV death or ASCVD hospitalization was 2.10 (95% CI: 1.91–2.32) for high-risk and 3.56 (95% CI: 3.21–3.96) for very-high-risk patients (low-risk as reference). Our study reinforces the prognostic relevance of CV-risk stratification for long-term prediction of CV death and ASCVD hospitalization in an unselected cohort, independently of sex, age, competing comorbidities and medication. [ABSTRACT FROM AUTHOR]

Background: Hypertensive disorders of pregnancy (HDP) are maternity-related increases in blood pressure (eg, gestational hypertension, preeclampsia, and eclampsia). Compared with women of other races in high-income countries, Black women have a comparatively higher risk of an HDP. Intersectionality helps to provide a deeper understanding of the multifactorial identities that affect health outcomes in this high-risk population. Objective: In this review, we sought to explore the literature on HDP risk factors in Black women living in high-income countries and to assess the interaction of these risk factors using the conceptual framework of intersectionality. Methods: We conducted this review using the Arksey and O'Malley methodology with enhancements from Levac and colleagues. Published articles in English on HDP risk factors with a sample of not less than 10% of Black women in high-income countries were included. Six databases, theses, and dissertations were searched from January 2000 to July 2021. A thematic analysis was used to summarize the results. Results: A final total of 36 studies were included from the 15 480 studies retrieved; 4 key themes of HDP risks were identified: (1) biological; (2) individual traditional; (3) race and ethnicity, geographical location, and immigration status; and (4) gender related. These intersectional HDP risk factors intersect to increase the risk of HDP among Black women living in high-income countries. Conclusion: Upstream approaches are recommended to lower the risks of HDP in this population. [ABSTRACT FROM AUTHOR]

Hypertension stands as a pervasive global health challenge, contributing significantly to mortality rates worldwide. Various factors, including lifestyle choices and dietary habits, contribute to the development of hypertension. In recent years, oxidative stress has garnered significant attention as a factor influencing hypertension risk, prompting a shift in research focus towards exploring it as a potential target for prevention and treatment. Antioxidants found in our diet, such as vitamins C, E and carotenoids exhibit the ability to neutralize reactive oxygen species, thereby mitigating oxidative stress. In addition, Vitamin A has an antioxidant effect despite not being an antioxidant itself. Consequently, supplementation or increased intake of these antioxidants has been hypothesized to potentially lower blood pressure levels and aid in the management of hypertension, thereby potentially prolonging life expectancy. Research findings regarding this effect have been diverse. This paper examines the existing literature demonstrating favorable outcomes associated with antioxidant supplementation. [ABSTRACT FROM AUTHOR]

A composite cardiometabolic risk prediction tool will support the systematic identification of women at increased cardiometabolic risk during pregnancy to enable early screening and intervention. This study aims to identify and select predictor variables for a composite risk prediction tool for cardiometabolic risk (gestational diabetes mellitus and/or hypertensive disorders of pregnancy) for use in the first trimester. A two-round modified online Delphi study was undertaken. A prior systematic literature review generated fifteen potential predictor variables for inclusion in the tool. Multidisciplinary experts (n = 31) rated the clinical importance of variables in an online survey and nominated additional variables for consideration (Round One). An online meeting (n = 14) was held to deliberate the importance, feasibility and acceptability of collecting variables in early pregnancy. Consensus was reached in a second online survey (Round Two). Overall, 24 variables were considered; 9 were eliminated, and 15 were selected for inclusion in the tool. The final 15 predictor variables related to maternal demographics (age, ethnicity/race), pre-pregnancy history (body mass index, height, history of chronic kidney disease/polycystic ovarian syndrome, family history of diabetes, pre-existing diabetes/hypertension), obstetric history (parity, history of macrosomia/pre-eclampsia/gestational diabetes mellitus), biochemical measures (blood glucose levels), hemodynamic measures (systolic blood pressure). Variables will inform the development of a cardiometabolic risk prediction tool in subsequent research. Evidence-based, clinically relevant and routinely collected variables were selected for a composite cardiometabolic risk prediction tool for early pregnancy. [ABSTRACT FROM AUTHOR]

Intra-abdominal hypertension is an often underestimated risk factor for acute kidney injury (AKI). But the values of intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP), which are critical for the development of AKI in elderly patients after urgent abdominal surgery, are still not defined. Objective. To evaluate the relationship between IAP and APP and the development of acute kidney injury in geriatric patients after emergency abdominal surgery. Materials and methods. A prospective single-center study included 66 patients older than 60 years who underwent surgery for peritonitis and were transferred to the intensive care unit. Statistical processing was performed using the program "STATISTICA for Windows 13" (StatSoftInc., No. JPZ804I382130ARCN10-J). Results. Among the examined patients, 48 developed AKI (73%). The average values of IAP in patients with AKI and without AKI were 10.4 (7.4, 13.3) mm Hg and 6.7 (4.4; 9.6) mm Hg respectively (p<0.0001). APP in patients with AKI, respectively, was significantly lower (72 (61.5, 83.7)) than in patients without AKI (85.6 (74.5, 94.4; p<0.0001)). According to the results of logistic regression analysis, a relationship between high IAP values and the development of AKI was revealed: the odds ratio (OR) was 3.4 with the value of the criterion x2=32.4 (1<0.0001). The odds ratio between the reduction of APP and the development of AKI was 2.3 with the value of the criterion x2=13.4 (p=0.0002). ROC analysis showed that IAP>10.4 mm Hg. is the threshold level for the development of AKI with a sensitivity of 46% and a specificity of 90.5%, with an area under the AUC curve of 0.74 (p<0.001). APP<79.12 mm Hg is critical for the development of AKI, with a sensitivity of 66.4% and a specificity of 70%, with an area under the AUC curve of 0.68 (p<0.001). Conclusions. High values of IAP and reduction of APP are associated with the occurrence of acute kidney injury in elderly patients after emergency abdominal surgery. [ABSTRACT FROM AUTHOR]