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Background In recent years, the prevalence of hypertension among the elderly in China has been consistently increasing. Current studies have found some association between hypertension and platelets, and platelet distribution width serves as the most sensitive measure of platelet activation, therefore, this study was conducted to explore the relationship between platelet distribution width and hypertension in elderly males and females. Objective To investigate the correlation of platelet distribution width with various hypertension subtypes in the elderly males and females. Methods A total of 600 elderly hypertensive and elderly non-hypertensive patients aged 65 years and above who were hospitalized in the Department of Cardiovascular Medicine, Hebei Provincial People's Hospital between 1 January 2020 and 24 April 2023 were consecutively enrolled and classified into 150 cases in the simple systolic hypertension (ISH) group, 150 cases in the simple diastolic hypertension (IDH) group, 150 cases in the systolic-diastolic hypertension (SDH) group, 150 cases in the normotensive group based on hypertension measurements. Basic data of patients were collected, including age, gender, BMI, systolic blood pressure, diastolic blood pressure, creatinine, uric acid, total cholesterol, triacylglycerol, high-density lipoprotein cholesterol (HDL-C) , low-density lipoprotein cholesterol (LDL-C) , fasting blood glucose, and platelet distribution width. Binary Logistic regression models were used to analyze the correlation between platelet distribution width and different hypertension subtypes. Results Binary Logistic regression analysis showed that age, uric acid, and platelet distribution width were influencing factors in the occurrence of ISH in males (P12.1-12.9 fL) was a risk factor for ISH (OR=8.893, 95%CI=2.731-28.955) , IDH (OR=5.265, 95%CI=1.758-15.768) , and SDH (OR=4.674, 95%CI=1.549-14.102) , while the quartile 4 of platelet distribution width (>12.9 fL) was a risk factor in the occurrence of SDH (OR=3.316, 95%CI=1.177-9.345) compared to quartile 1 of platelet distribution width (≤10.7 fL) ; in females, compared to quartile 1 of platelet distribution width (≤11.0 fL) , the quartile 3 of platelet distribution width (>12.4-13.2 fL) was a risk factor for ISH (OR=3.494, 95%CI=1.218-10.021) and SDH (OR=4.949, 95%CI=1.283-19.089) , quartile 4 of platelet distribution width (>13.2 fL) was a risk factor for ISH (OR=5.283, 95%CI=1.786-15.633) , IDH (OR=5.837, 95%CI=1.544-22.068) and SDH (OR=4.966, 95%CI=1.373-17.963) . Conclusion Among elderly males, platelet distribution width ≥12.1 fL is a risk factor for IDH and SDH. Among elderly women, platelet distribution width ≥12.4 fL is a risk factor for ISH and SDH, when platelet distribution width>13.2 fL, it is a risk factor for IDH.

BackgroundIsolated systolic hypertension (ISH) is common in older adults and is a risk factor for incident heart failure (HF). We examined the association of systolic-diastolic hypertension (SDH) with incident HF and other outcomes in older adults.MethodsIn the Cardiovascular Health Study (CHS), 5776 community-dwelling adults≥65years had data on baseline systolic and diastolic blood pressure (SBP and DBP). We excluded those with DBP

Abstract Background Vascular inflammation plays a key role in the progression of hypertension. Progranulin (PGRN), an anti-inflammatory growth factor, mediated inhibition of tumor necrosis factor-α (TNF-α), a pleiotropic cytokine, activity has been well-established. Despite the role of chronic low-grade inflammation in hypertension, serum levels of PGRN and PGRN/TNF-α ratio and, their association with systolic and diastolic blood pressure has not been determined in hypertensive patients till now. This study aims to find and correlate the serum levels of pro-inflammatory cytokine (TNF-α), anti-inflammatory growth factor (PGRN), and PGRN/TNF-α ratio with the blood pressure in systolic-diastolic hypertension (SDH) and isolated systolic hypertension (ISH) patients. Results A cross-sectional study was conducted on SDH patients (mean age, 52.95 ± 12.6 years; male/female (M/F) number = 15/10) and ISH patients (mean age, 55.80 ± 9.40 years; M/F number = 12/13) (n = 25 each). Twenty-five age and body mass index (BMI)-matched healthy subjects (mean age, 56.00 ± 8.55 years; male/female number = 11/14) were considered as control. All patients and healthy subjects were overweight (BMI, 25–30 kg/m2). Overnight fasting blood samples of subjects were taken and levels of PGRN and TNF-α were measured using ELISA diagnostic kits. PGRN and TNF-α levels were found significantly high, whereas PGRN/TNF ratio was found very low, in SDH and ISH patients as compared to healthy subjects. Reduced PGRN/TNF-α ratio and pulse pressure were found as independent predictors of SBP both in SDH and ISH patients. Conclusions Findings of elevated PGRN levels in response to raised TNF-α levels depict the counter regulation by PGRN to neutralize TNF-α. Findings of reduced PGRN/TNF ratio, and it being an independent predictor of SBP, ascertain the key role of imbalance in pro- and anti-inflammatory environment in hypertension. Thus, it strengthens the cross-link between the concept of immunity–adiposity–inflammation–blood pressure¸ a vicious network. Further, this cross-link of SBP and progranulin must be explored in longitudinal studies. New researches should be focused not only on impact of pro-inflammatory environment rather to find on a balance between pro- and anti-inflammatory status, so that new target sites could be explored for therapeutic management of hypertension.

Background: Vascular inflammation plays a key role in the progression of hypertension. Progranulin (PGRN), an anti-inflammatory growth factor, mediated inhibition of tumor necrosis factor-α (TNF-α), a pleiotropic cytokine, activity has been well-established. Despite the role of chronic low-grade inflammation in hypertension, serum levels of PGRN and PGRN/TNF-α ratio and, their association with systolic and diastolic blood pressure has not been determined in hypertensive patients till now. This study aims to find and correlate the serum levels of pro-inflammatory cytokine (TNF-α), anti-inflammatory growth factor (PGRN), and PGRN/TNF-α ratio with the blood pressure in systolic-diastolic hypertension (SDH) and isolated systolic hypertension (ISH) patients. Results: A cross-sectional study was conducted on SDH patients (mean age, 52.95 ± 12.6 years; male/female (M/F) number = 15/10) and ISH patients (mean age, 55.80 ± 9.40 years; M/F number = 12/13) (n = 25 each). Twenty-five age and body mass index (BMI)-matched healthy subjects (mean age, 56.00 ± 8.55 years; male/female number = 11/14) were considered as control. All patients and healthy subjects were overweight (BMI, 25–30 kg/m2). Overnight fasting blood samples of subjects were taken and levels of PGRN and TNF-α were measured using ELISA diagnostic kits. PGRN and TNF-α levels were found significantly high, whereas PGRN/TNF ratio was found very low, in SDH and ISH patients as compared to healthy subjects. Reduced PGRN/TNF-α ratio and pulse pressure were found as independent predictors of SBP both in SDH and ISH patients. Conclusions: Findings of elevated PGRN levels in response to raised TNF-α levels depict the counter regulation by PGRN to neutralize TNF-α. Findings of reduced PGRN/TNF ratio, and it being an independent predictor of SBP, ascertain the key role of imbalance in pro- and anti-inflammatory environment in hypertension. Thus, it strengthens the cross-link between the concept of immunity–adiposity–inflammation–blood pressure¸ a vicious network. Further, this cross-link of SBP and progranulin must be explored in longitudinal studies. New researches should be focused not only on impact of pro-inflammatory environment rather to find on a balance between pro- and anti-inflammatory status, so that new target sites could be explored for therapeutic management of hypertension. [ABSTRACT FROM AUTHOR]

Background: Ambulatory 24h - blood pressure measurement (ABPM) provides to assess exactly daily this parameter. According to World Health Organisation, ABPM is particularly helpful in patients with essential fluctuation of blood pressure during clinic visit, in patients with hipotonia and with antihypertensive drug-resistant arterial hypertension. ABPM is the best method useful in diagnosis of „white coat hypertension". Aim: The aim of the study was evaluation of frequency of various forms of arterial hypertension in type 2 diabetic patients with overweight detected with the use of ABPM. Material and method: The study comprised of subjects at the age 40-70 years. Group 1 (n=87) comprised of type 2 diabetic patients and the control group 2 (n=80) constitited patients without diabetes. During outpatient clinic visit 24h - ABPM was conducted. Occurrence of isolated systolic arterial hypertension, isolated diastolic hypertension and systolic-diastolic hypertension in two studied groups were diagnosed. Results. In 80% of type 2 diabetic patients (70 subjects) and in 64% of patients without diabetes arterial hypertension (51 subjects) was diagnosed. This parameter differed essential study groups (p=0.02). In half of all studied patients with de novo detected hypertension systolic - diastolic arterial hypertension was examined (35 subjects). In above 2/5 of these patients isolated systolic hypertension was examined. The higher percentage of patients with isolated systolic hypertension in type 2 diabetic patients was observed in comparison with control group (p=0.02). The higher percentage of patients with systolic-diastolic arterial hypertension in group 1 was observed than in the second group (p=0.03). The percentage of isolated diastolic hypertension didn't differ both studied groups (p>0.05). Conclusion. In 4/5 of type 2 diabetic patients arterial hypertension on the ground of ABPM system was detected. Systolic - diastolic hypertension was the predominant diagnosed arterial hypertension in type 2 diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Isolated systolic hypertension (ISH) is common in older adults and is a risk factor for incident heart failure (HF). We examined the association of systolic-diastolic hypertension (SDH) with incident HF and other outcomes in older adults., Methods: In the Cardiovascular Health Study (CHS), 5776 community-dwelling adults≥65years had data on baseline systolic and diastolic blood pressure (SBP and DBP). We excluded those with DBP<60mmHg (n=821), DBP≥90 and SBP<140mmHg (n=28), normal BP, taking anti-hypertensive drugs (n=1138), normal BP, not taking anti-hypertensive drugs, history of hypertension (n=193), and baseline HF (n=101). Of the remaining 3495, 1838 had ISH (SBP≥140 and DBP<90mmHg) and 240 had SDH (SBP≥140 and DBP≥90mmHg). The main outcome was centrally-adjudicated incident HF over 13years of follow-up., Results: Participants had a mean (±SD) age of 73 (±6)years, 57% were women, and 16% African American. Incident HF occurred in 25%, 22% and 11% of participants with ISH, SDH and no hypertension, respectively. Compared to no hypertension, multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for incident HF associated with ISH and SDH were 1.86 (1.51-2.30) and 1.73 (1.23-2.42), respectively. Cardiovascular mortality occurred in 22%, 24% and 9% of those with ISH, SDH and no hypertension, respectively with respective multivariable-adjusted HRs (95% CIs) of 1.88 (1.49-2.37) and 2.30 (1.64-3.24)., Conclusion: Among older adults with hypertension, both SDH and ISH have similar associations with incident HF and cardiovascular mortality., (Published by Elsevier B.V.)