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ABSTRACT The objective of this study was to investigate the association between triglyceride to high‐density lipoprotein cholesterol ratio (TG/HDL‐c), triglyceride‐glucose index (TyG), and related parameters (TyG‐BMI, TyG‐WC) with prehypertension and hypertension over 45 years old. According to the blood pressure diagnosis, the enrolled individuals were divided into two groups, which were prehypertension and hypertension. In multivariate logistic regression analysis, after adjusting for confounders, the highest quartile groups of TG/HDL‐c, TyG, and related parameters showed a significantly increased risk of hypertension compared to the lowest quartile groups, and there was associated with hypertension when comparing the highest TG/HDL‐c to the lowest TG/HDL‐c and corresponding ORs were 1.416 (1.234, 1.625) and 1.029 (0.893, 1.187), respectively. Furthermore, when comparing the fourth quartile to the first quartile of TG/HDL‐c, TyG index, and related parameters, respectively, both corresponding ORs of hypertension were higher than prehypertension. Elevated TyG, TyG‐BMI, TyG‐WC index, and TG/HDL‐c ratio levels were associated with hypertension in individuals over 45 years. Moreover, the receiver operating characteristic curve was used to compare the predictive ability of each parameter in identifying people with hypertension suggested that the TyG‐WC index ([Area under the curve] AUC: 0.601 [CI: 0.588–0.615]), TyG‐BMI, and TyG were more significant than TG/HDL‐c in distinguishing hypertension. However, in the prehypertension population, the area under the ROC curve for TyG‐BMI (0.543 [CI: 0.530–0.556]) was better than that of other parameters. They have the potential to become cost‐effective monitors in the hierarchical management of hypertension. [ABSTRACT FROM AUTHOR]

Background: Uric acid as a prominent causal factor in the pathogenesis of hypertension is well recognized. Nevertheless, the influence of uric acid on the transition from prehypertension to hypertension within the Chinese population remains understudied. Methods: A cohort of 1,516 prehypertensive individuals, aged 35 to 84 years, underwent recruitment following a comprehensive health assessment in 2017 and subsequent re-evaluation in 2022. Baseline characteristics and relevant clinical data were collected. The analytical approach encompassed multiple logistic regression and propensity score matching. Results: Over 5 years, the cumulative incidence of hypertension amounted to 35.1%, with 33.9% in males and 37.3% in females, respectively. Notably, prehypertensive subjects concomitant with hyperuricemia exhibited a higher cumulative incidence of hypertension in comparison to the non-hyperuricemic counterparts (40.7% vs. 34.0%, p = 0.041). Multiple logistic regression unveiled a significant association between hyperuricemia and heightened hypertension risk (adjusted odds ratio [OR] = 1.44; 95% confidence interval [CI], 1.05–1.98; p = 0.022). Nonetheless, this association did not reach statistical significance when examining female subjects (adjusted OR = 1.10; 95% CI, 0.58–2.09; p = 0.781) or participants aged ≥ 60 years (adjusted OR = 1.07; 95% CI, 0.61–1.88; p = 0.814). Further validation through propensity score matching affirmed that subjects afflicted by hyperuricemia experienced a substantially elevated risk of transitioning from prehypertension to hypertension over the course of five years compared with the non-hyperuricemic counterparts (41.3% vs. 32.3%, p = 0.045), after adjusting for 12 covariates including age and gender. Hyperuricemia emerged as an independent risk factor predisposing individuals to the development of hypertension from a prehypertensive state. Conclusion: This observation prompted the formulation of a hypothesis suggesting that ameliorating elevated uric acid levels may potentially mitigate the progression from prehypertension to hypertension. [ABSTRACT FROM AUTHOR]

Background: Prehypertension is a preclinical state of hypertension which leads to an increased likelihood of coronary heart disease, myocardial infarction, cerebrovascular disease as well as target organ damage. Addressing pre-hypertension through early lifestyle interventions is crucial to mitigating these detrimental effects and improving long-term health outcomes. So, the main objective of this study is to develop a lifestyle intervention program (LSIP) for the management of prehypertension using consensus building approach. Methods: It was a three round online modified Delphi study with 70 members panellists. All panellists had an experience of prehypertension either as patients (n = 30) or professionals (n = 40). Round 1 included initial recommendations developed from a previous systematic review and metanalysis, which were rated by panellists for their importance on a 5-point Likert scale. Panellists could also suggest additional items in the Round 1. Round 2 and 3 included all items from the Round 1 with new items suggested by the panellists. Data was analysed descriptively using SPSS version 29. All items receiving at least 70% of all respondents combined rating of 'Important' and 'Very Important' in Round 3 were included in the final set of recommendations. Results: Fifty-one panellists (80.9%) (patients = 25, professionals = 26) completed Round 3. Twenty-six recommendation items were included in the Round 1. Twenty new items were added in Round 2 with 46 total items in Round 2 and 3. Thirty-five of these items reached consensus in Round 3. The final set of recommendation comprised of 15 educational. 10 dietary, and 10 exercise recommendations. Conclusion: This modified Delphi study developed a comprehensive LSIP for the prevention of prehypertension, incorporating a holistic approach with educational, dietary, and exercise components aimed at the general population. Previously established standards of care (SOC) for managing prehypertension varied significantly and often provided fragmented guidance particularly on physical activity and education. This preventive model offers a novel and scalable approach for early intervention in prehypertension, potentially reducing reliance on medications and improving long-term health outcomes. [ABSTRACT FROM AUTHOR]

Background: Prehypertension is one of the common disorders during pregnancy. Reducing salt intake is among the best cost-effective interventions to reduce the risk of hypertension. The present study aimed to explore the effect of an educational intervention based on the Theory of Planned Behavior (TPB) on amount of salt consumed by prehypertensive pregnant women. Methods: The present quasi-experimental study was conducted in 2022 on 61 prehypertensive pregnant women visiting the Comprehensive Health Services Centers in Birjand, Iran. Pregnant women were selected through a convenience sampling method and randomly assigned to intervention and control groups. A blood pressure test and a 24-hour urine test were taken in 3 stages (before, immediately after, and one month after the intervention). A reliable and valid questionnaire based on the TPB was used to measure the cognitive variables. The intervention program included three training sessions based on the TPB held on an online platform (WhatsApp social network). Data were analyzed using repeated measures ANOVA and longitudinal marginal model with the GEE approach in SPSS19. The significance level for all statistical tests was set at p < 0 0.05. Results: After intervention, the mean score of perceived behavioral control (p = 0.02), intention (p = 0.004), and salt consumption behavior (p = 0.03) increased significantly in the intervention group, and the mean score of systolic blood pressure (p < 0.001) and diastolic blood pressure (P < 0.01) decreased significantly in this group. In the control group, a statistically significant difference was observed in the systolic and diastolic blood pressure of the subjects (p < 0.01). However, the score of attitude, subjective norms, perceived behavioral control, intention, salt consumption behavior and the daily salt intake did not show a statistically significant difference over time (P < 0.05). Conclusion: The present findings showed that the perceived behavioral control, intention, behavior, systolic and diastolic blood pressure can be modifiable variables to improve the amount of salt consumed by pre-hypertensive pregnant women. Therefore, we recommend that the present model be used to develop interventions to improve health indicators in pregnant women as a highly susceptible group in society. [ABSTRACT FROM AUTHOR]

The purpose of this interventional experimental study was to determine the effect of health education program on physical activity and blood pressure in middle-aged women with pre-hypertension in Kohdasht. Eighty middle-aged women with pre-hypertension were selected and divided into two groups randomly. After the one-month online training program for intervention group, by conducting an interview, the data was completed using questionnaire and it was analyzed using spss 27 software (significance level of 0.05). Before the intervention, there was no significant difference between the two groups. After 3 months of follow-up, a significant increase in attitude, perceived behavioral control and behavioral intention related to physical activity was observed in the intervention group compared to the control group (P <.05). Also, the average blood pressure in the intervention group was higher than the control group. Considering the effect of the online health education program based on the theory of planned behavior in improving the stages of changing physical activity and reducing blood pressure, the use of these developed models with an emphasis on modifying the subjective norm related to physical activity in the field of prevention is recommended for high blood pressure. [ABSTRACT FROM AUTHOR]

Among developing countries, the prevalence of being underweight is rising when compared with the over-weight and obese population in young adults have been a major public concern that will shape the future of every individual's health. The present study aims to provide recent estimates of the prevalence of under-weight, overweight, and obese and its influencing factors and complications in younger adults. Among 1004, the overall prevalence rates of underweight, overweight and obese were found to be 18.8%, 12.3% and 3.7% respectively. The majority of the participants were newly diagnosed with prediabetes and prehypertension conditions, and nearly a quarter had a possible risk of developing thyroid and polycystic ovarian syndrome. Management of these health consequences decreases the progression of the risks that should be prevented [ABSTRACT FROM AUTHOR]

Background: Prehypertension during pregnancy is currently not considered as a high-risk pregnancy state in existing guidelines despite recent research correlating it with higher rates of morbidity and mortality in both the mother and the fetus. Studies on prehypertension have not been conducted in Africa despite high rates of poor neonatal outcomes. Aims: The study aimed to determine the association between late pregnancy prehypertension and adverse outcomes in newborns of women with late pregnancy prehypertension at Jinja Regional Referral Hospital. Methods and materials: Between September 2022 and January 2023, a hospital-based prospective cohort study including 300 pregnant women was conducted. Participants were divided according to third-trimester blood pressure, as determined by the JNC-8 criteria. Following hospital admission for labor and delivery, 150 normotensive women and 150 prehypertensive women were identified and followed until delivery, and their neonates were followed until death or hospital discharge. A p value of ≤ 0.05 was the threshold for statistical significance when comparing the groups using the relative risk, X2, and Mantel-Haenszel adjustment. Results: Composite adverse neonatal outcomes were more common in prehypertensive women compared to normotensive women (48.67% versus 32.67%), particularly Small-for-Gestation Age (SGA), stillbirth, and composite adverse neonatal outcomes had significantly higher likelihood, with aRRs of 1.63 (95% CI 1.10–2.42, p = 0.037), 9.0 (95% CI 1.15–70.16, p = 0.010), and 1.55 (95% CI 1.16–2.08, p < 0.001), respectively. By a linear model, birthweight decreased by 45.1 g for every 10 mmHg rise in systolic blood pressure (p = 0.041, Pearson correlation of -0.118). Conclusion and recommendations: Prehypertension in late pregnancy increased risks for adverse neonatal outcomes, thus a need to potentially lower pregnancy hypertension cut-off levels possibly through adopting the ACC/AHA blood pressure definitions for pregnant women. [ABSTRACT FROM AUTHOR]

This study was conducted to investigate the association between alcohol consumption in adolescence and the risk of hypertension or prehypertension development in early adulthood. This cohort study included adolescent participants aged 12–18 years from the 2000–2011 China Health and Nutrition Survey. Cox proportional risk regression models were used to analyze the associations of the frequency of alcohol consumption, alcohol intake, and type of alcohol with the risk of developing hypertension or prehypertension. Restricted cubic spline analysis was used to assess the dose–response relationships for alcohol intake and their hazard ratios (HRs). A total of 1556 participants were included in the final analysis. Among the overall population, 448 (30.81%) and 35 (34.31%) participants developed hypertension or prehypertension, respectively. Compared with no alcohol consumption, alcohol consumption ≥ 2 times/week and consumption of ≥2 types of alcohol were associated with an increased risk of hypertension and prehypertension, with HRs of 1.97 (95% confidence interval [CI] 1.17–3.34; p = 0.011) and 1.77 (95% CI 1.01–3.09; p = 0.046), respectively. Alcohol intake of > 96 mL/week was associated with an increased risk of hypertension and prehypertension, with HRs of 2.09 (95% CI 1.12–3.90; p = 0.020) and 2.07 (95% CI 1.11–3.84; p = 0.021), respectively. The restricted cubic spline analysis showed that the risk of developing high blood pressure or prehypertension tends to increase with increasing alcohol consumption. Heavy alcohol consumption in adolescence increased the risk of developing hypertension and prehypertension in early adulthood. [ABSTRACT FROM AUTHOR]

Abstract Background Uric acid as a prominent causal factor in the pathogenesis of hypertension is well recognized. Nevertheless, the influence of uric acid on the transition from prehypertension to hypertension within the Chinese population remains understudied. Methods A cohort of 1,516 prehypertensive individuals, aged 35 to 84 years, underwent recruitment following a comprehensive health assessment in 2017 and subsequent re-evaluation in 2022. Baseline characteristics and relevant clinical data were collected. The analytical approach encompassed multiple logistic regression and propensity score matching. Results Over 5 years, the cumulative incidence of hypertension amounted to 35.1%, with 33.9% in males and 37.3% in females, respectively. Notably, prehypertensive subjects concomitant with hyperuricemia exhibited a higher cumulative incidence of hypertension in comparison to the non-hyperuricemic counterparts (40.7% vs. 34.0%, p = 0.041). Multiple logistic regression unveiled a significant association between hyperuricemia and heightened hypertension risk (adjusted odds ratio [OR] = 1.44; 95% confidence interval [CI], 1.05–1.98; p = 0.022). Nonetheless, this association did not reach statistical significance when examining female subjects (adjusted OR = 1.10; 95% CI, 0.58–2.09; p = 0.781) or participants aged ≥ 60 years (adjusted OR = 1.07; 95% CI, 0.61–1.88; p = 0.814). Further validation through propensity score matching affirmed that subjects afflicted by hyperuricemia experienced a substantially elevated risk of transitioning from prehypertension to hypertension over the course of five years compared with the non-hyperuricemic counterparts (41.3% vs. 32.3%, p = 0.045), after adjusting for 12 covariates including age and gender. Hyperuricemia emerged as an independent risk factor predisposing individuals to the development of hypertension from a prehypertensive state. Conclusion This observation prompted the formulation of a hypothesis suggesting that ameliorating elevated uric acid levels may potentially mitigate the progression from prehypertension to hypertension.

Abstract Background Prehypertension is one of the common disorders during pregnancy. Reducing salt intake is among the best cost-effective interventions to reduce the risk of hypertension. The present study aimed to explore the effect of an educational intervention based on the Theory of Planned Behavior (TPB) on amount of salt consumed by prehypertensive pregnant women. Methods The present quasi-experimental study was conducted in 2022 on 61 prehypertensive pregnant women visiting the Comprehensive Health Services Centers in Birjand, Iran. Pregnant women were selected through a convenience sampling method and randomly assigned to intervention and control groups. A blood pressure test and a 24-hour urine test were taken in 3 stages (before, immediately after, and one month after the intervention). A reliable and valid questionnaire based on the TPB was used to measure the cognitive variables. The intervention program included three training sessions based on the TPB held on an online platform (WhatsApp social network). Data were analyzed using repeated measures ANOVA and longitudinal marginal model with the GEE approach in SPSS19. The significance level for all statistical tests was set at p

Abstract Background Prehypertension during pregnancy is currently not considered as a high-risk pregnancy state in existing guidelines despite recent research correlating it with higher rates of morbidity and mortality in both the mother and the fetus. Studies on prehypertension have not been conducted in Africa despite high rates of poor neonatal outcomes. Aims The study aimed to determine the association between late pregnancy prehypertension and adverse outcomes in newborns of women with late pregnancy prehypertension at Jinja Regional Referral Hospital. Methods and materials Between September 2022 and January 2023, a hospital-based prospective cohort study including 300 pregnant women was conducted. Participants were divided according to third-trimester blood pressure, as determined by the JNC-8 criteria. Following hospital admission for labor and delivery, 150 normotensive women and 150 prehypertensive women were identified and followed until delivery, and their neonates were followed until death or hospital discharge. A p value of ≤ 0.05 was the threshold for statistical significance when comparing the groups using the relative risk, X2, and Mantel-Haenszel adjustment. Results Composite adverse neonatal outcomes were more common in prehypertensive women compared to normotensive women (48.67% versus 32.67%), particularly Small-for-Gestation Age (SGA), stillbirth, and composite adverse neonatal outcomes had significantly higher likelihood, with aRRs of 1.63 (95% CI 1.10–2.42, p = 0.037), 9.0 (95% CI 1.15–70.16, p = 0.010), and 1.55 (95% CI 1.16–2.08, p

Abstract Although the relationship between hypertension and hyperuricemia is widely recognized, there is still a relative lack of research on prehypertensive individuals and the individual associations of systolic and diastolic blood pressure with the risk of hyperuricemia. From 2011 to 2016, we conducted a study on 53,323 individuals at Wuhu City Hospital in China. Based on initial blood pressure readings, participants were categorized into normal, prehypertension, or hypertension groups. We used Cox regression to analyze the associations with baseline factors. In subgroup analyses, systolic and diastolic pressures were treated as continuous variables, and their relationship with the risk of hyperuricemia was examined using restricted cubic spline analysis. The risk increased in the prehypertension and hypertension groups compared to the normal blood pressure group, with hazard ratios of 1.192 and 1.350, respectively. For each unit increase in blood pressure, the risk of hyperuricemia rose by 0.8% (systolic) and 0.9% (diastolic), especially when blood pressure levels exceeded 115/78 mmHg. Additionally, we observed that factors such as gender, alcohol consumption habits, obesity, and dyslipidemia might further influence this association. These findings emphasize the importance of early risk assessment and intervention in these patient populations in clinical practice.

Abstract Background The distinction between normal and high blood pressure remains a debated topic, with varying guidelines on when to start medication. Contemporary guidelines advocate for the initiation of antihypertensive therapy in individuals who present with high-normal blood pressure, particularly those exhibiting elevated 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores. Despite these recommendations, there is a notable lack of direct evidence supporting the efficacy of treating high-normal blood pressure to prevent major adverse cardiovascular events (MACE). Methods The PRINT-TAHA9 trial, a unicentric, randomized, open-label, controlled, parallel clinical study, seeks to explore the effects of intensive blood pressure control on MACE in participants with high-normal blood pressure. We will enroll 1620 adults aged 18 years and above with a systolic blood pressure range of 130–140 mmHg, diastolic blood pressure under 90 mmHg, and atherosclerotic cardiovascular disease (ASCVD) risk score exceeding 7.5%. The study will be executed in five distinct phases, with each phase enrolling between 300 and 400 participants. Participants will be randomly assigned to either the treatment group receiving antihypertensive medication (amlodipine/valsartan) and a low-salt/low-fat diet or to the control group receiving a similar diet. Follow-up visits are scheduled every 6 months over a 3-year period to monitor blood pressure, evaluate medication adherence, document any adverse events, and adjust the intervention as necessary. Cox proportional hazards regression analysis will be employed to examine the disparities between the two arms. Discussion Despite guidelines promoting early treatment of elevated blood pressure, the debate continues due to insufficient evidence that such interventions significantly reduce the occurrence of MACE. This trial seeks to address this critical evidence gap. Trial registration The PRINT-TAHA9 trial was registered in October 2019 with the Iranian Registry of Clinical Trials (IRCT.ir) under the registration number IRCT20191002044961N1. https://irct.behdasht.gov.ir/trial/43092 .

Abstract No consensus has emerged among different guidelines concerning how many blood pressure (BP) measurements should be performed at office visits in the diagnosis of hypertension. The purpose of this study was to examine the compatibility of various multiple average office BP measurements and 24‐h BP monitoring (ABPM) in patients followed up in the posthoc analysis of the Cappadocia hypertension cohort. A total 1158 office BP measurements by 207 patients were examined. The results were then classified as G1 (average of the 1st and 2nd BP), G2 (average of the 2nd and 3rd), G3 (average of the 2nd, 3rd, and 4th), G4 (average of the 2nd, 3rd, 4th, and 5th), and G5 (average of all five measurements). Compatibility between the average values in the groups and concomitant 24‐h ABPM data was examined. While a significant difference was observed between daytime 24‐h ABPM SBP and G1 (p = .002), no difference was found in the other groups. Office DBP approached the daytime 24‐h ABPM values as the number of measurements in the five groups increased, although average office DBP data in all groups were higher than daytime 24‐h ABPM DBP (p = .000 for all). In light of our study results, we recommend that three office BP measurements be performed and that the average of the 2nd and 3rd measurements be used for SBP, while in terms of DBP, we recommend that as many measurements as possible be taken without the 1st value being included in the average.

Abstract Background The incidence of hypertension (HTN) as a worldwide health problem is rising rapidly. Early identification and management of pre-HTN before HTN development can help reduce its related complications. We evaluated the relationship between liver enzymes levels and pre-HTN/HTN in the Azar cohort population. Method This cross-sectional study was based on data from the large Azar cohort study and a total of 14,184 participants were included. Pre-HTN and HTN were defined based on the American Heart Association guideline. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) levels were measured by Pars Azmoon kits. The relationship between pre-HTN/HTN and liver enzyme levels was evaluated by logistic regression. Results Of 14,184 participants, 5.7% and 39.6% had pre-HTN and HTN, respectively. In the adjusted model, AST levels of 19–23 IU/l were associated with an elevated risk of pre-HTN (OR [95% CI]: 1.24 [1.04–1.48]). A dose-response increase was seen in pre-HTN in relation to ALT, with the highest OR in the third tertile (1.34 [1.09–1.63]). The odds of pre-HTN also increased with GGT in the third tertile (1.25[1.03–1.52]). In addition, the odds of HTN increased with increased levels of AST, ALT, ALP, and GGT, such that the highest ORs were recorded in the third tertile (OR 1.22 [1.09–1.37], 1.51 [1.35–1.70], 1.19 [1.07–1.34], and 1.68 [1.49–1.89], respectively). Among these enzymes, GGT had the highest OR regarding HTN. Conclusion This study indicates that AST, ALT, ALP and GGT levels were associated with pre-HTN (except for ALP) and HTN, independent of known risk factors. Hence, it may be possible to use liver enzymes to predict the incidence of pre-HTN and HTN, empowering primary care providers to make the necessary interventions promptly.

Background: The distinction between normal and high blood pressure remains a debated topic, with varying guidelines on when to start medication. Contemporary guidelines advocate for the initiation of antihypertensive therapy in individuals who present with high-normal blood pressure, particularly those exhibiting elevated 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores. Despite these recommendations, there is a notable lack of direct evidence supporting the efficacy of treating high-normal blood pressure to prevent major adverse cardiovascular events (MACE). Methods: The PRINT-TAHA9 trial, a unicentric, randomized, open-label, controlled, parallel clinical study, seeks to explore the effects of intensive blood pressure control on MACE in participants with high-normal blood pressure. We will enroll 1620 adults aged 18 years and above with a systolic blood pressure range of 130–140 mmHg, diastolic blood pressure under 90 mmHg, and atherosclerotic cardiovascular disease (ASCVD) risk score exceeding 7.5%. The study will be executed in five distinct phases, with each phase enrolling between 300 and 400 participants. Participants will be randomly assigned to either the treatment group receiving antihypertensive medication (amlodipine/valsartan) and a low-salt/low-fat diet or to the control group receiving a similar diet. Follow-up visits are scheduled every 6 months over a 3-year period to monitor blood pressure, evaluate medication adherence, document any adverse events, and adjust the intervention as necessary. Cox proportional hazards regression analysis will be employed to examine the disparities between the two arms. Discussion: Despite guidelines promoting early treatment of elevated blood pressure, the debate continues due to insufficient evidence that such interventions significantly reduce the occurrence of MACE. This trial seeks to address this critical evidence gap. Trial registration: The PRINT-TAHA9 trial was registered in October 2019 with the Iranian Registry of Clinical Trials (IRCT.ir) under the registration number IRCT20191002044961N1. https://irct.behdasht.gov.ir/trial/43092. [ABSTRACT FROM AUTHOR]

BACKGROUND Limited data are published on the relationship of the Chinese visceral adiposity index (CVAI) with prehypertension progression or regression. Therefore, we investigated this association through the China Health and Retirement Longitudinal Study. METHODS Participants with prehypertension were assigned to two groups according to baseline CVAI, and after 4 years of follow-up, their blood pressure was analyzed for deterioration or improvement. We constructed logistic regression models for assessing the association of CVAI with the progression or regression of prehypertension. A restricted cubic spline (RCS) model was utilized for determining the dose–response association. Subgroup analysis and sensitivity analysis were also conducted. RESULTS The study included 2,057 participants with prehypertension. During the follow-up, 695 participants progressed to hypertension, 561 participants regressed to normotension, and 801 participants remained as prehypertensive. An association was observed between a high CVAI value and a higher incidence of progression to hypertension and between a high CVAI value and a lower incidence of regression to normotension (OR = 1.66 and 0.58, 95% CI: 1.35–2.05 and 0.47–0.73, respectively). The RCS model exhibited a linear association between CVAI and prehypertension progression and regression (all P for non-linear > 0.05). The results of the subgroup and sensitivity analyses agreed with those of the primary analysis. CONCLUSIONS A significant association was noted between CVAI and prehypertension progression and regression. Thus, as part of the hypertension prevention strategy, monitoring CVAI is crucial in individuals with prehypertension. [ABSTRACT FROM AUTHOR]

Background: The incidence of hypertension (HTN) as a worldwide health problem is rising rapidly. Early identification and management of pre-HTN before HTN development can help reduce its related complications. We evaluated the relationship between liver enzymes levels and pre-HTN/HTN in the Azar cohort population. Method: This cross-sectional study was based on data from the large Azar cohort study and a total of 14,184 participants were included. Pre-HTN and HTN were defined based on the American Heart Association guideline. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) levels were measured by Pars Azmoon kits. The relationship between pre-HTN/HTN and liver enzyme levels was evaluated by logistic regression. Results: Of 14,184 participants, 5.7% and 39.6% had pre-HTN and HTN, respectively. In the adjusted model, AST levels of 19–23 IU/l were associated with an elevated risk of pre-HTN (OR [95% CI]: 1.24 [1.04–1.48]). A dose-response increase was seen in pre-HTN in relation to ALT, with the highest OR in the third tertile (1.34 [1.09–1.63]). The odds of pre-HTN also increased with GGT in the third tertile (1.25[1.03–1.52]). In addition, the odds of HTN increased with increased levels of AST, ALT, ALP, and GGT, such that the highest ORs were recorded in the third tertile (OR 1.22 [1.09–1.37], 1.51 [1.35–1.70], 1.19 [1.07–1.34], and 1.68 [1.49–1.89], respectively). Among these enzymes, GGT had the highest OR regarding HTN. Conclusion: This study indicates that AST, ALT, ALP and GGT levels were associated with pre-HTN (except for ALP) and HTN, independent of known risk factors. Hence, it may be possible to use liver enzymes to predict the incidence of pre-HTN and HTN, empowering primary care providers to make the necessary interventions promptly. [ABSTRACT FROM AUTHOR]

No consensus has emerged among different guidelines concerning how many blood pressure (BP) measurements should be performed at office visits in the diagnosis of hypertension. The purpose of this study was to examine the compatibility of various multiple average office BP measurements and 24‐h BP monitoring (ABPM) in patients followed up in the posthoc analysis of the Cappadocia hypertension cohort. A total 1158 office BP measurements by 207 patients were examined. The results were then classified as G1 (average of the 1st and 2nd BP), G2 (average of the 2nd and 3rd), G3 (average of the 2nd, 3rd, and 4th), G4 (average of the 2nd, 3rd, 4th, and 5th), and G5 (average of all five measurements). Compatibility between the average values in the groups and concomitant 24‐h ABPM data was examined. While a significant difference was observed between daytime 24‐h ABPM SBP and G1 (p =.002), no difference was found in the other groups. Office DBP approached the daytime 24‐h ABPM values as the number of measurements in the five groups increased, although average office DBP data in all groups were higher than daytime 24‐h ABPM DBP (p =.000 for all). In light of our study results, we recommend that three office BP measurements be performed and that the average of the 2nd and 3rd measurements be used for SBP, while in terms of DBP, we recommend that as many measurements as possible be taken without the 1st value being included in the average. [ABSTRACT FROM AUTHOR]

Background Thyroid-related hormones act to regulate metabolic pathways and blood pressure (BP). However, the relationship of TSH and peripheral thyroid hormones and the role of the hypothalamic-pituitary-thyroid axis on hypertension development is not fully understood. We assessed sex-specific associations of thyroid-related hormones with BP and hypertension in Hispanic/Latino adults followed for 6 years. Methods We studied 1789 adults, ages 45 to 74, free of diabetes at baseline from a subcohort of the Hispanic Community Health Study/Study of Latinos. We assessed TSH, free T4 (FT4), T3, and various indicators of thyroid axis. Using multivariable linear and Poisson regression adjusted for survey design and confounding variables, we estimated a priori sex-specific associations of thyroid-related hormones with changes in BP and hypertension development. Results In men and women, TSH and TSH/FT4 ratios were associated with changes in diastolic BP and T3 with changes in pulse pressure and the development of hypertension from prehypertension. In men, a 1-SD increase in TSH [incident rate ratio (IRR) = 1.42; 95% confidence interval (CI): 1.15, 1.75] and TSH/FT4 ratio (IRR = 1.20; 95% CI: 1.07, 1.35) were positively associated with the development of hypertension from prehypertension while the TSH/FT4 ratio (IRR = 0.85; 95% CI:.72, 1.00) was protective in women. We observed sex-specific differences in associations of the T3/FT4 ratio and indices of pituitary sensitivity to thyroid hormones with changes in pulse pressure and hypertension development. Conclusion Thyroid-related hormones are associated with sex-specific changes in BP and hypertension among Hispanic/Latino adults consistent with selected studies conducted in other populations. Mechanisms underlying associations of pituitary sensitivity to thyroid hormones with BP and hypertension development warrant further study. [ABSTRACT FROM AUTHOR]

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Background: The number of prehypertension patients will always be higher than hypertension patients; this is supported by the prevalence of prehypertension being 48.40% according to JNC 7, and hypertension being 34.10% according to Basic Health Research in 2018. Coffee consumption and sleep quality were risk factors that are closely related to the lifestyle of students, this is also reinforced by the number of 24-hour coffee outlets that are open around Universitas Airlangga. Purpose: This aim of this study is to analyze the relationship between coffee consumption and sleep quality on the incidence of prehypertension in final year Universitas Airlangga students. Methods: This type of research is a quantitative study with a cross-sectional study design and uses the Chi-square test. The samples consisted of 146 people, which were taken using a simple random sampling method. Data collection was carried out through an online questionnaire. This study involved coffee consumption and sleep quality as independent variables and the incidence of prehypertension in final year Universitas Airlangga students as the dependent variable. Results: There is a correlation between coffee consumption (p=0.00) and sleep quality (p=0.01) with prehypertension in final year Universitas Airlangga students. Coffee consumption has a 2,47 times greater risk and sleep quality has a 2,09 times greater risk of prehypertension in final year Universitas Airlangga students. Conclusion: Poor coffee consumption and sleep quality are related with prehypertension in final year Universitas Airlangga students.

Context: Teaching is regarded as one of the most stressful occupations, making them more vulnerable to cardiovascular diseases, especially hypertension. Aims and Objectives: We explored this study to estimate the prevalence of pre-hypertension and hypertension and its risk factors among school teachers. Settings and Design: This cross-sectional study was conducted for one year among 400 school teachers working in primary and secondary schools in southern Andhra Pradesh. Materials and Methods: Cluster sampling technique was used for sampling, where each school was considered as a cluster. A validated proforma with a questionnaire developed based on the WHO STEPS manual was used to collect data on socio-demographic details, blood pressure recordings, anthropometric measurements, and other related factors. Statistical Analysis: Odds ratio, the Chi-square test, and regression analysis was used to test the significance, where p < 0.05 was considered significant. Results: Among 400 subjects, 52.3% had normal blood pressure, 32.0% had pre-hypertension, and 15.7% had hypertension, with a total of pre-hypertension/ hypertension 47.7%. Prevalence of pre-hypertension/hypertension was significantly higher among the males (47.6%) [UOR: 2.4 (1.6-3.6)], the age group of 40 years and above (39.8%) [UOR: 4.6 (2.8-7.6)], and married subjects (90.1%) [UOR: 3.2 (1.8-5.6)]. Those who perceived moderate/severe stress at work (32.5%) [UOR: 3.9 (2.3-6.6)], teaching work of 11 years and above (59.7%) [UOR: 4.0 (2.7-6.2)], inadequate intake of fruits/vegetables (81.7%) [UOR: 1.6 (1.0-2.6)], adding extra salt to food (56.0%) [UOR: 2.0 (1.4-2.9)], and those who were overweight/obese (67.5%) [UOR: 3.4 (2.2-5.1)] had a higher prevalence. Conclusions: The prevalence of pre-hypertension and hypertension was considerably high among school teachers, and several factors were significantly associated with hypertension. Coordinated efforts in early diagnosis, control, and prevention of hypertension among teachers are the need of the hour.