Search

Background: Hypertension is prevalent in the pediatric population, with estimated rates between 2% and 5%, and its incidence is rising globally. This study offers a single-center analysis of hypertension in children. Methods: a retrospective chart review was conducted involving children aged 1 month to 13 years diagnosed with hypertension. Results: The study included a total of 129 children. Secondary hypertension was identified in 103 patients (79.8%), while primary hypertension was noted in 26 patients (20.2%). Primary hypertension was more common among pre-teen children (50.0%), whereas secondary hypertension predominantly affected those aged 1 to 5 years. Renal parenchymal disease emerged as the most frequent etiology of secondary hypertension, followed by endocrine disorders and vascular issues. No significant correlation was found between hypertension and obesity. The primary complications associated with hypertension in these children were cardiovascular, followed by neurological issues. A small proportion (14.7%) managed their hypertension solely through lifestyle modifications, while the majority required additional antihypertensive medications. At the final follow-up, 50% of the children demonstrated improved blood pressure readings. Conclusion: The findings indicate a higher prevalence of secondary hypertension compared to primary hypertension among the studied population. This study underscores the necessity for heightened awareness among pediatricians regarding the early identification and management of hypertension. Larger population-based studies are warranted to further investigate the prevalence, causes, and outcomes of hypertension in this region. [ABSTRACT FROM AUTHOR]

Sepsis and hypertension pose significant health risks, yet the optimal mean arterial pressure (MAP) target for resuscitation remains uncertain. This study investigates the association between average MAP (a-MAP) within the initial 24 h of intensive care unit admission and clinical outcomes in patients with sepsis and primary hypertension using the Medical Information Mart for Intensive Care (MIMIC) IV database. Multivariable Cox regression assessed the association between a-MAP and 30-day mortality. Kaplan–Meier and log-rank analyses constructed survival curves, while restricted cubic splines (RCS) illustrated the nonlinear relationship between a-MAP and 30-day mortality. Subgroup analyses ensured robustness. The study involved 8,810 patients. Adjusted hazard ratios for 30-day mortality in the T1 group (< 73 mmHg) and T3 group (≥ 80 mmHg) compared to the T2 group (73–80 mmHg) were 1.25 (95% CI 1.09–1.43, P = 0.001) and 1.44 (95% CI 1.25–1.66, P < 0.001), respectively. RCS revealed a U-shaped relationship (non-linearity: P < 0.001). Kaplan–Meier curves demonstrated significant differences (P < 0.0001). Subgroup analysis showed no significant interactions. Maintaining an a-MAP of 73 to 80 mmHg may be associated with a reduction in 30-day mortality. Further validation through prospective randomized controlled trials is warranted. [ABSTRACT FROM AUTHOR]

Abstract Sepsis and hypertension pose significant health risks, yet the optimal mean arterial pressure (MAP) target for resuscitation remains uncertain. This study investigates the association between average MAP (a-MAP) within the initial 24 h of intensive care unit admission and clinical outcomes in patients with sepsis and primary hypertension using the Medical Information Mart for Intensive Care (MIMIC) IV database. Multivariable Cox regression assessed the association between a-MAP and 30-day mortality. Kaplan–Meier and log-rank analyses constructed survival curves, while restricted cubic splines (RCS) illustrated the nonlinear relationship between a-MAP and 30-day mortality. Subgroup analyses ensured robustness. The study involved 8,810 patients. Adjusted hazard ratios for 30-day mortality in the T1 group (

The incidence of primary hypertension is on the rise in the pediatric population, with an approximate prevalence ranging from 3% to 5%. The most significant risk factors for the onset and development of primary hypertension are well-known, and some of them are preventable, including increased salt consumption and obesity. Connected with metabolic risk factors, elevated blood pressure in childhood is carried into adulthood. Primary hypertension is associated with attenuated vascular responses to various physiological stimuli in both peripheral microcirculation and systemic macrocirculation in adults and children. Endothelial dysfunction is one of the most important features of arterial hypertension, together with an increased level of oxidative stress – both determinants significantly contribute to all the pathophysiological changes observed in hypertension. Systemic arterial hypertension has emerged as a prevalent cardiovascular risk factor associated with substantial morbidity and mortality. Hence, the timely identification of individuals with elevated blood pressure and early-life blood pressure management could serve as a crucial strategy to mitigate the risk of cardiovascular disease and mortality in adulthood.

Abstract Background Time-restricted eating (TRE), a popular form of intermittent fasting, has shown benefits for improving metabolic diseases and cardiometabolic health. However, the effect of TRE in the regulation of blood pressure in primary hypertension remains unclear. Methods A 6-week randomized controlled trial was conducted, in which a total of 74 stage 1 primary hypertensive patients without high-risk were randomly assigned to Dietary Approaches to Stop Hypertension (DASH) group (n = 37) or DASH + TRE group (n = 37). Participants in the DASH + TRE group were instructed to consume their food within an 8-h window. Scientific research platform in We Chat application was used to track participants. The primary outcome was blood pressure. The secondary outcomes included body composition, cardiometabolic risk factors, inflammation-related parameters, urinary Na+ excretion, other clinical variables and safety outcomes. Results The reduction of systolic blood pressure and diastolic blood pressure were 5.595 ± 4.072 and 5.351 ± 5.643 mm Hg in the DASH group and 8.459 ± 4.260 and 9.459 ± 4.375 mm Hg in the DASH + TRE group. DASH + TRE group improved blood pressure diurnal rhythm. Subjects in DASH + TRE group had decreased extracellular water and increased urinary Na+ excretion. Furthermore, the decrease in blood pressure was associated with a reduction of extracellular water or increase in urinary Na+ excretion. In addition, safety outcomes such as nighttime hunger were also reported. Conclusion Our study demonstrated that 8-h TRE + DASH diet caused a greater decrease in blood pressure in stage 1 primary hypertensive patients than DASH diet. This study may provide novel insights into the benefits of lifestyle modification in the treatment of primary hypertension. Trial registration https://www.chictr.org.cn/ (ChiCTR2300069393, registered on March 15, 2023).

Background: Time-restricted eating (TRE), a popular form of intermittent fasting, has shown benefits for improving metabolic diseases and cardiometabolic health. However, the effect of TRE in the regulation of blood pressure in primary hypertension remains unclear. Methods: A 6-week randomized controlled trial was conducted, in which a total of 74 stage 1 primary hypertensive patients without high-risk were randomly assigned to Dietary Approaches to Stop Hypertension (DASH) group (n = 37) or DASH + TRE group (n = 37). Participants in the DASH + TRE group were instructed to consume their food within an 8-h window. Scientific research platform in We Chat application was used to track participants. The primary outcome was blood pressure. The secondary outcomes included body composition, cardiometabolic risk factors, inflammation-related parameters, urinary Na+ excretion, other clinical variables and safety outcomes. Results: The reduction of systolic blood pressure and diastolic blood pressure were 5.595 ± 4.072 and 5.351 ± 5.643 mm Hg in the DASH group and 8.459 ± 4.260 and 9.459 ± 4.375 mm Hg in the DASH + TRE group. DASH + TRE group improved blood pressure diurnal rhythm. Subjects in DASH + TRE group had decreased extracellular water and increased urinary Na+ excretion. Furthermore, the decrease in blood pressure was associated with a reduction of extracellular water or increase in urinary Na+ excretion. In addition, safety outcomes such as nighttime hunger were also reported. Conclusion: Our study demonstrated that 8-h TRE + DASH diet caused a greater decrease in blood pressure in stage 1 primary hypertensive patients than DASH diet. This study may provide novel insights into the benefits of lifestyle modification in the treatment of primary hypertension. Trial registration: https://www.chictr.org.cn/ (ChiCTR2300069393, registered on March 15, 2023). [ABSTRACT FROM AUTHOR]

Graphene, when electrified, generates far-infrared radiation within the wavelength range of 4 μm to 14 μm. This range closely aligns with the far-infrared band (3 μm to 15 μm), which produces unique physiological effects. Contraction and relaxation of vascular smooth muscle play a significant role in primary hypertension, involving the nitric oxide-soluble guanylate cyclase–cyclic guanosine monophosphate pathway and the renin–angiotensin–aldosterone system. This study utilized spontaneously hypertensive rats (SHRs) as an untr-HT to investigate the impact of far-infrared radiation at specific wavelengths generated by electrified graphene on vascular smooth muscle and blood pressure. After 7 weeks, the blood pressure of the untr-HT group rats decreased significantly with a notable reduction in the number of vascular wall cells and the thickness of the vascular wall, as well as a decreased ratio of vessel wall thickness to lumen diameter. Additionally, blood flow perfusion significantly increased, and the expression of F-actin in vascular smooth muscle myosin decreased significantly. Serum levels of angiotensin II (Ang-II) and endothelin 1 (ET-1) were significantly reduced, while nitric oxide synthase (eNOS) expression increased significantly. At the protein level, eNOS expression decreased significantly, while α-SMA expression increased significantly in aortic tissue. At the gene level, expressions of eNOS and α-SMA in aortic tissue significantly increased. Furthermore, the content of nitric oxide (NO) in the SHR's aortic tissue increased significantly. These findings confirm that graphene far-infrared radiation enhances microcirculation, regulates cytokines affecting vascular smooth muscle contraction, and modifies vascular morphology and smooth muscle phenotype, offering relief for primary hypertension. [ABSTRACT FROM AUTHOR]

The progress in research on the physiology of the cardiovascular system made in the last 100 years allowed for the development of the pathogenesis not only of secondary forms of hypertension but also of primary hypertension. The main determinants of blood pressure are described by the relationship between stroke volume, heart rate, peripheral resistance, and arterial stiffness. The theories developed by Guyton and Folkow describe the importance of the volume factor and total peripheral resistance. However, none of them fully presents the pathogenesis of essential hypertension. The multifactorial model of primary hypertension pathogenesis developed by Irving Page in the 1940s, called Page's mosaic, covers most of the pathophysiological phenomena observed in essential hypertension. The most important pathophysiological phenomena included in Page's mosaic form a network of interconnected "nodes". New discoveries both from experimental and clinical studies made in recent decades have allowed the original Page mosaic to be modified and the addition of new pathophysiological nodes. Most of the clinical studies confirming the validity of the multifactorial pathogenesis of primary hypertension concern adults. However, hypertension develops in childhood and is even perinatally programmed. Therefore, the next nodes in Page's mosaic should be age and perinatal factors. This article presents data from pediatric clinical trials describing the most important pathophysiological processes associated with the development of essential hypertension in children and adolescents. [ABSTRACT FROM AUTHOR]

AIM: To determine the dry eye (DE) rate and its relationship with disease stage in patients with primary hypertension. METHODS: A cross-sectional study included 432 patients with primary hypertension (with an equal number of patients in each group: 144 in stage I, II, and III hypertension) and 144 healthy subjects as a control group. The Ocular Surface Disease Index (OSDI) and Schirmer I test without anesthetics were conducted on all 576 subjects. Subjects with OSDI scores

Introduction: Endocrine hypertension (EHT) due to pheochromocytoma/paraganglioma (PPGL), Cushing's syndrome (CS), or primary aldosteronism (PA) is linked to a variety of metabolic alterations and comorbidities. Accordingly, patients with EHT and primary hypertension (PHT) are characterized by distinct metabolic profiles. However, it remains unclear whether the metabolomic differences relate solely to the disease-defining hormonal parameters. Therefore, our objective was to study the association of disease defining hormonal excess and concomitant adrenal steroids with metabolomic alterations in patients with EHT. Methods: Retrospective European multicenter study of 263 patients (mean age 49 years, 50% females; 58 PHT, 69 PPGL, 37 CS, 99 PA) in whom targeted metabolomic and adrenal steroid profiling was available. The association of 13 adrenal steroids with differences in 79 metabolites between PPGL, CS, PA and PHT was examined after correction for age, sex, BMI, and presence of diabetes mellitus. Results: After adjustment for BMI and diabetes mellitus significant association between adrenal steroids and metabolites - 18 in PPGL, 15 in CS, and 23 in PA - were revealed. In PPGL, the majority of metabolite associations were linked to catecholamine excess, whereas in PA, only one metabolite was associated with aldosterone. In contrast, cortisone (16 metabolites), cortisol (6 metabolites), and DHEA (8 metabolites) had the highest number of associated metabolites in PA. In CS, 18-hydroxycortisol significantly influenced 5 metabolites, cortisol affected 4, and cortisone, 11-deoxycortisol, and DHEA each were linked to 3 metabolites. Discussions: Our study indicates cortisol, cortisone, and catecholamine excess are significantly associated with metabolomic variances in EHT versus PHT patients. Notably, catecholamine excess is key to PPGL's metabolomic changes, whereas in PA, other non-defining adrenal steroids mainly account for metabolomic differences. In CS, cortisol, alongside other non-defining adrenal hormones, contributes to these differences, suggesting that metabolic disorders and cardiovascular morbidity in these conditions could also be affected by various adrenal steroids. [ABSTRACT FROM AUTHOR]

A decrease in IGF-1 is often linked to inflammation. Low systemic and local IGF-1 production and downregulation of IGF-1R expression may precede and predict PH development in children/adolescents. Leukocyte mRNA expression of IGF-1 and its receptor (IGF-1R) and plasma IGF-1 were measured in a group of 39 PH children/adolescents (29 boys and 10 girls) and 35 age-matched normotensive children (19 boys and 16 girls) using the RT-PCR and ELISA tests. The expression of the IGF-1R protein was assessed by flow cytometry. Plasma IGF-1 concentration was evaluated with ELISA. The expression of IGF-1 and IGF-1R and plasma concentrations of IGF-1 did not differ between groups. However, the PH children had a decreased percentage in IGF-1R-bearing lymphocytes (p = 0.02) and monocytes (p = 0.0003), as well as a low density of IGF-R in monocytes (p = 0.02). The IGF-1 expression was negatively correlated with pulse-wave velocity (PWV) (r = −0.49), systolic blood pressure (SBP) (−0.44), and carotid intima-media thickness (cIMT) (−0.43). The IGF-1R expression was negatively correlated with PWV (r = −0.42) and SBP (r = −0.41). Our results suggest that early subclinical hypertensive arterial injury is associated with lower activity of IGF-1-IGF-1R expression and loss of protective actions. [ABSTRACT FROM AUTHOR]

Abstract Moxibustion has been shown to have a potential antihypertensive effect, but its applicability for the primary care of hypertension is unclear. The authors conducted a multicenter randomized controlled trial (RCT) with patient preference arms to investigate the effect, safety, cost‐effectiveness, and compliance of moxibustion in community patients with hypertension. Patients with primary hypertension were enrolled from seven communities randomly or nonrandomly assigned to receive self‐administered moxibustion + the original hypertensive regimen or the original hypertensive regimen alone for 6 months. The authors mainly evaluated the effects of moxibustion on hypertensive outcomes and adverse events. As a result, a total of 160 and 240 patients were recruited into the randomized and nonrandomized arms, respectively, with 87.5% completing the follow‐up. At month 6, there was a significantly greater reduction in systolic blood pressure (SBP) (difference: −10.57 mmHg), a higher proportion of responders (82.2% vs. 53.7%; odds ratio 4.00), and better improvements in hypertensive symptoms and quality of life (QoL) in the moxibustion group than in the control group in the randomized population, but there was no significant between‐group difference in diastolic blood pressure (DBP). The nonrandomized findings showed the same effect direction for all outcomes, except for DBP. All moxibustion‐related adverse events were mild. In conclusion, moxibustion can reduce SBP and improve hypertensive symptoms and QoL in community patients with hypertension, with good safety and low cost, although its effect on DBP remains uncertain. The findings suggest that moxibustion may be an appropriate technique for community primary care of hypertension.

Background: Hypertension is prevalent in the pediatric population, with estimated rates between 2% and 5%, and its incidence is rising globally. This study offers a single-center analysis of hypertension in children. Methods: a retrospective chart review was conducted involving children aged 1 month to 13 years diagnosed with hypertension. Results: The study included a total of 129 children. Secondary hypertension was identified in 103 patients (79.8%), while primary hypertension was noted in 26 patients (20.2%). Primary hypertension was more common among pre-teen children (50.0%), whereas secondary hypertension predominantly affected those aged 1 to 5 years. Renal parenchymal disease emerged as the most frequent etiology of secondary hypertension, followed by endocrine disorders and vascular issues. No significant correlation was found between hypertension and obesity. The primary complications associated with hypertension in these children were cardiovascular, followed by neurological issues. A small proportion (14.7%) managed their hypertension solely through lifestyle modifications, while the majority required additional antihypertensive medications. At the final follow-up, 50% of the children demonstrated improved blood pressure readings. Conclusion: The findings indicate a higher prevalence of secondary hypertension compared to primary hypertension among the studied population. This study underscores the necessity for heightened awareness among pediatricians regarding the early identification and management of hypertension. Larger population-based studies are warranted to further investigate the prevalence, causes, and outcomes of hypertension in this region.

Objective To investigate the clinical significance of serum monocytes/ high-density lipoprotein cholesterol ratio ( MHR), (neutrophils + monocytes) / lymphocyte ratio ( NMLR), and calcium/ magnesium ratio (Ca / Mg) among patients with primary hypertension (PH) in Xining area of Qinghai Province. Methods A total of 528 subjects were enrolled, and they were divided into healthy control group (n = 179) and PH group (n = 349) according to blood pressure measurement results. According to the 2018 Chinese Guidelines for the management of hypertension, patients in the PH group were further divided into grade 1 PH group (n = 116), grade 2 PH group (n = 111) and grade 3 PH group ( n = 122). By using multivariate Logistic regression analysis, the independent risk factors of the disease were clarified in the PH group. Routine blood testing and biochemical detection were performed to measure the levels of MHR, NMLR and Ca / Mg. Spearman correlation analysis was employed to explore the correlation between MHR, NMLR, Ca / Mg levels and the classification of hypertension. Results Multivariate Logistic regression analysis showed that Ca / Mg and NMLR were independent risk factors for PH. Ca / Mg and NMLR in the PH group were significantly higher than those in the control group (P<0. 05). Compared with the grade 1 PH group, Ca / Mg and NMLR levels in the grade 3 PH group increased significantly (P<0. 05). Ca / Mg, NMLR and MHR levels were positively correlated with the classification of hypertension ( P < 0. 05). Conclusion NMLR, Ca / Mg and MHR levels are closely associated with the severity of PH. Monitoring NMLR and Ca / Mg is helpful for making early identification of high-risk PH patients and correspondingly providing clinical intervention. [ABSTRACT FROM AUTHOR]

Objective To investigate the predictive value of fragmented QRS complex and left ventricular hypertrophy for ventricular arrhythmia (VA) in patients with primary hypertension ( PH). Methods A total of 261 inpatients with PH were selected, and they all underwent routine electrocardiography, ambulatory electrocardiography (AECG), ambulatory blood pressure monitoring, echocardiography, and other examinations. Based on the results of AECG, the enrolled patients were divided into VA group (129 cases) and non-VA group (132 cases). Laboratory and examination results of general information and biochemical indicators were compared and analyzed between the two groups. Significant variables identified through univariate analysis were included in multivariate Logistic regression analysis to explore the relationship between fragmented QRS complex, left ventricular hypertrophy, and VA. Results In the VA group, the level of low-density lipoprotein cholesterol, positive rate of fragmented QRS complex, left ventricular posterior wall thickness, and left ventricular end-diastolic diameter were all higher than those in the non-VA group ( P < 0. 05). Logistic regression analysis revealed that fragmented QRS complex and left ventricular hypertrophy were independent risk factors for VA in patients with PH. ROC curve analysis indicated that the combination of fragmented QRS complex and left ventricular hypertrophy was superior to either of the individual indicator in predicting the risk of VA. Conclusion Fragmented QRS complex and left ventricular hypertrophy are independent risk factors for the occurrence of VA in patients with PH. The combination of the two is superior to either of the individual indicator in predicting the risk of VA. [ABSTRACT FROM AUTHOR]

Objective: To investigate the value of cardiac magnetic resonance imaging (CMRI) in the diagnosis of left ventricular remodeling in patients with primary aldosteronism (PA). Methods: 82 patients diagnosed as PA in Liaoning Jinqiu Hospital from October2017 to December 2022 were selected as the study group, another 82 patients with essential hypertension (EH) who visited our hospital in the same period were selected as the control group. The clinical data, the CMRI parameters, biochemical and hormonal indexes between the study group and the control group were compared. Patients in the study group were divided into PA with and without left ventricular remodeling subgroup (PA1 group, n=38) and PA without left ventricular remodeling subgroup (PA2 group, n=44), and the CMRI parameters of patients in PA1 group and PA2 group were compared. Multivariate Logistic regression was used to analyze the factors of left ventricular remodeling in patients with PA, and regression equation and ROC curve were established to evaluate the diagnostic efficacy of CMRI on left ventricular remodeling in patients with PA. Results: Serum K and renin activity in the study group were lower than those in the control group, while aldosterone was significantly higher than that in the control group (P＜0.05). The EDVi, ESVi, Massi, initial T1mapping value and ECV of the study group were higher than those of the control group, and the enhanced T1 mapping value was lower than that of the control group (P＜0.05). Multivariate Logistic regression analysis showed that ESVi, Massi, enhanced T1 mapping value and ECV are closely related to left ventricular remodeling in patients with PA (P＜0.05). The ROC analysis results showed that the AUC of ESVi, Massi, enhanced T1 mapping value, ECV indicators and their combined regression prediction models in diagnosing left ventricular remodeling in patients with PA were 0.623, 0.677, 0.736, 0.675 and 0.779 respectively, indicated a high diagnostic efficiency of the combined diagnosis. Conclusion: CMRI can quantitatively evaluate the left ventricular remodeling in patients with PA, and its diagnostic efficacy is high; it can provide reference for clinical treatment and monitoring progress. [ABSTRACT FROM AUTHOR]

Moxibustion has been shown to have a potential antihypertensive effect, but its applicability for the primary care of hypertension is unclear. The authors conducted a multicenter randomized controlled trial (RCT) with patient preference arms to investigate the effect, safety, cost‐effectiveness, and compliance of moxibustion in community patients with hypertension. Patients with primary hypertension were enrolled from seven communities randomly or nonrandomly assigned to receive self‐administered moxibustion + the original hypertensive regimen or the original hypertensive regimen alone for 6 months. The authors mainly evaluated the effects of moxibustion on hypertensive outcomes and adverse events. As a result, a total of 160 and 240 patients were recruited into the randomized and nonrandomized arms, respectively, with 87.5% completing the follow‐up. At month 6, there was a significantly greater reduction in systolic blood pressure (SBP) (difference: −10.57 mmHg), a higher proportion of responders (82.2% vs. 53.7%; odds ratio 4.00), and better improvements in hypertensive symptoms and quality of life (QoL) in the moxibustion group than in the control group in the randomized population, but there was no significant between‐group difference in diastolic blood pressure (DBP). The nonrandomized findings showed the same effect direction for all outcomes, except for DBP. All moxibustion‐related adverse events were mild. In conclusion, moxibustion can reduce SBP and improve hypertensive symptoms and QoL in community patients with hypertension, with good safety and low cost, although its effect on DBP remains uncertain. The findings suggest that moxibustion may be an appropriate technique for community primary care of hypertension. [ABSTRACT FROM AUTHOR]

ObjectivePrimary hypertension has been shown to affect cognitive functions in adults but evidence in the pediatric population remain scarce and equivocal. We aimed to compare cognitive functioning between children diagnosed with primary hypertension and normotensive controls, with a focus on the role of different blood pressure (BP) parameters and body mass.MethodsWe conducted a single-center, prospective, cross-sectional study of children and adolescents (6–17 years old) with primary hypertension and age- and sex-matched normotensive controls. All participants underwent office BP, ambulatory BP monitoring (ABPM), and central BP measurements using an oscillometric device. Neurocognitive assessment consisted of evaluation of (i) intelligence quotient (IQ), (ii) categorical and phonemic fluency, (iii) verbal memory (verbal-logical story recall), and (iv) non-verbal computerized cognitive assessment.ResultsThe study included a total of 59 patients with primary hypertension (14 ± 3 years) and 37 normotensive controls (14 ± 3 years). Participants in the primary hypertension group had a significantly higher body mass index z-score (BMIz: 2.1 ± 1.4 vs. 0.7 ± 0.9, p

IntroductionEndocrine hypertension (EHT) due to pheochromocytoma/paraganglioma (PPGL), Cushing’s syndrome (CS), or primary aldosteronism (PA) is linked to a variety of metabolic alterations and comorbidities. Accordingly, patients with EHT and primary hypertension (PHT) are characterized by distinct metabolic profiles. However, it remains unclear whether the metabolomic differences relate solely to the disease-defining hormonal parameters. Therefore, our objective was to study the association of disease defining hormonal excess and concomitant adrenal steroids with metabolomic alterations in patients with EHT.MethodsRetrospective European multicenter study of 263 patients (mean age 49 years, 50% females; 58 PHT, 69 PPGL, 37 CS, 99 PA) in whom targeted metabolomic and adrenal steroid profiling was available. The association of 13 adrenal steroids with differences in 79 metabolites between PPGL, CS, PA and PHT was examined after correction for age, sex, BMI, and presence of diabetes mellitus.ResultsAfter adjustment for BMI and diabetes mellitus significant association between adrenal steroids and metabolites – 18 in PPGL, 15 in CS, and 23 in PA – were revealed. In PPGL, the majority of metabolite associations were linked to catecholamine excess, whereas in PA, only one metabolite was associated with aldosterone. In contrast, cortisone (16 metabolites), cortisol (6 metabolites), and DHEA (8 metabolites) had the highest number of associated metabolites in PA. In CS, 18-hydroxycortisol significantly influenced 5 metabolites, cortisol affected 4, and cortisone, 11-deoxycortisol, and DHEA each were linked to 3 metabolites.DiscussionsOur study indicates cortisol, cortisone, and catecholamine excess are significantly associated with metabolomic variances in EHT versus PHT patients. Notably, catecholamine excess is key to PPGL’s metabolomic changes, whereas in PA, other non-defining adrenal steroids mainly account for metabolomic differences. In CS, cortisol, alongside other non-defining adrenal hormones, contributes to these differences, suggesting that metabolic disorders and cardiovascular morbidity in these conditions could also be affected by various adrenal steroids.

We applied 24-h Holter monitoring to analyze the characteristics of arrhythmias and heart rate variability in Chinese patients with primary aldosteronism (PA) and compared them with age-, sex-, and blood pressure-matched primary hypertension (PH) patients. A total of 216 PA patients and 261 PH patients were enrolled. The nonstudy data were balanced using propensity score matching (PSM), and the risk variables for developing arrhythmias were then analyzed using logistic regression analysis. Before PSM, the proportion of PA patients with combined atrial premature beats and prolonged QT interval was higher than the corresponding proportion in the PH group. After PSM, the PA group had a larger percentage of transient atrial tachycardia and frequent atrial premature beats, and it had higher heart rate variability metrics. The proportion of unilateral PA combined with multiple ventricular premature beats was higher than that of bilateral PA. Older age, grade 3 hypertension, and hypokalemia were independent risk factors for the emergence of arrhythmias in PA patients. PA patients suffer from a greater prevalence of arrhythmias than well-matched PH patients.

A recent study conducted in China, called the SSaSS (Salt Substitute and Stroke Study), found that potassium-enriched salt significantly reduced the rates of strokes, major cardiovascular events, and death in older adults with a history of stroke. However, a follow-up analysis of the data focused on specific cardiovascular events such as acute coronary syndrome, heart failure, arrhythmia, and sudden death, and found that while the incidence rates of these events were lower in participants who used potassium-enriched salt, the differences were not statistically significant. The authors caution that more research is needed to determine the specific cardiovascular benefits of salt substitution. Nonetheless, the study provides hope for future studies to provide more definitive evidence. [Extracted from the article]

Graphene, when electrified, generates far-infrared radiation within the wavelength range of 4 μm to 14 μm. This range closely aligns with the far-infrared band (3 μm to 15 μm), which produces unique physiological effects. Contraction and relaxation of vascular smooth muscle play a significant role in primary hypertension, involving the nitric oxide-soluble guanylate cyclase–cyclic guanosine monophosphate pathway and the renin–angiotensin–aldosterone system. This study utilized spontaneously hypertensive rats (SHRs) as an untr-HT to investigate the impact of far-infrared radiation at specific wavelengths generated by electrified graphene on vascular smooth muscle and blood pressure. After 7 weeks, the blood pressure of the untr-HT group rats decreased significantly with a notable reduction in the number of vascular wall cells and the thickness of the vascular wall, as well as a decreased ratio of vessel wall thickness to lumen diameter. Additionally, blood flow perfusion significantly increased, and the expression of F-actin in vascular smooth muscle myosin decreased significantly. Serum levels of angiotensin II (Ang-II) and endothelin 1 (ET-1) were significantly reduced, while nitric oxide synthase (eNOS) expression increased significantly. At the protein level, eNOS expression decreased significantly, while α-SMA expression increased significantly in aortic tissue. At the gene level, expressions of eNOS and α-SMA in aortic tissue significantly increased. Furthermore, the content of nitric oxide (NO) in the SHR’s aortic tissue increased significantly. These findings confirm that graphene far-infrared radiation enhances microcirculation, regulates cytokines affecting vascular smooth muscle contraction, and modifies vascular morphology and smooth muscle phenotype, offering relief for primary hypertension.

Purpose of Review: To review recent evidence on childhood hypertension across Africa, identifying knowledge gaps, challenges and priorities, and highlight clinical perspectives in managing primary hypertension. Recent Findings: Only 15 of the 54 African countries reported on absolute blood pressure (BP) measures, elevated BP, pre- and/or hypertension. The reported hypertension prevalence ranged between 0.0 and 38.9%, while elevated BP and/or pre-hypertnesion ranged from 2.7 to 50.5%. Childhood BP nomograms are lacking across Africa and the rates of hypertension were based on guidelines developed in countries with the lowest to no number of children from African ancestry. The recent studies across Africa also showed little to no detail when reporting BP specific methodology. No recent data informing the use or effectiveness of antihypertensive agents in children and adolesents are available. Summary: Childhood hypertension is on the rise, while data from Africa remains vastly under-represented. Collaborative research, resources, and policies need to be strengthened in addressing the growing public health concern of childhood onset hypertension on this continent. [ABSTRACT FROM AUTHOR]

Copyright of ScienceRise: Medical Science is the property of PC TECHNOLOGY CENTER and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Primary hypertension is a disease that is being diagnosed with increasing frequency in pediatric patients, and many of them are found to have hypertension-mediated organ damage (HMOD), including arterial damage. The pathophysiology of primary hypertension and the formation of HMOD is multifactorial. One mechanism studied in recent years is the subclinical inflammation accompanying the elevation of blood pressure. Experimental studies, studies in adults and children, revealed the involvement of immune mechanisms in the formation of vascular lesions in the course of primary hypertension. The paper summarizes the current knowledge on this subject and points to possible therapeutic targets. Particular emphasis is placed on data from pediatric patients with primary hypertension, as a relation between arterial damage (early vascular aging) and immune system activation had already been found in children. The correct identification of immunological mechanisms may not only broaden our understanding of primary hypertension as a disease but also, more importantly, lead to the most effective methods of its treatment.

Abstract Objective To investigate the prevalence of hypertension in adolescents and children in the Taicang area and analyse related factors to provide a theoretical basis for the prevention and control of hypertension in this region. Methods A total of 1,000 students who were visited and surveyed in primary schools in the Taicang area in 2021 were selected for statistical testing using a cluster random sampling method, and a survey was conducted on their dietary habits. dietary habits, such as the consumption of meals that included protein-rich animal products, beans and dairy products, vegetables and fruits, salty foods and fried food, was taken into consideration, along with physical fitness indices, waist-to-height ratio and waist circumference. Results Of the 1,000 adolescents and children surveyed, 222 were classified into the hypertensive group and 778 into the normotensive group. There were 138 boys (a prevalence rate of 6.3%) and 84 girls (a prevalence rate of 4.1%) in the hypertensive group. The physical fitness indices of the hypertensive group were significantly higher than those of the normotensive group. Concerning dietary structure, the frequency of cereal intake between the two groups was comparable, while the hypertensive group’s intake of vegetables, fruits, beans and dairy products was significantly lower than that of the normotensive group. Finally, a logistic multivariate regression analysis of related factors was carried out, and it was concluded that waist-to-height ratio, waist circumference and salty and fried food intake were positively correlated with the prevalence of hypertension. Conclusion The prevalence of hypertension among adolescents and children in the Taicang area is high. Body weight and dietary structure can be used as reference indicators for the prevalence of hypertension in this age group.

ObjectiveFosinopril and amlodipine are commonly prescribed as first-line pharmacotherapeutic agents for pediatric hypertension, but there is a lack of comparative studies regarding the efficacy of these two drugs. We aimed to evaluate and compare the efficacy of fosinopril and amlodipine monotherapy in pediatric primary hypertension.MethodsThis was a single-center, bidirectional observational study. A total of 175 children and adolescents with primary hypertension receiving antihypertensive monotherapy from July 2020 to February 2023 were enrolled. According to antihypertensive drugs, they were divided into the fosinopril group (n = 96) and the amlodipine group (n = 79). Subgroup analysis was performed to compare the efficacy of the two groups in terms of blood pressure (BP) control rates and reductions following a 4-week treatment.ResultsAfter 4 weeks of treatment, both groups achieved significant reductions in systolic BP (SBP) and diastolic BP (DBP) by more than 18 mmHg and 6 mmHg, respectively, with BP control rates of 61.5% in the fosinopril group and 59.5% in the amlodipine group, revealing no significant differences in the antihypertensive efficacy between the two groups except for DBP control rate (FDR adjusted P > 0.05). Further subsequent subgroup analyses revealed that the reductions in SBP and DBP in the fosinopril group were significantly greater than those in the amlodipine group in patients of females and hypo-HDL-cholesterolemia (FDR adjusted P 0.05).ConclusionsFosinopril and amlodipine monotherapy were both effective in pediatric primary hypertension during a short-term follow-up. Fosinopril may be particularly effective in reducing BP in hypertensive patients of females, central obesity, IR, and hypo-HDL-cholesterolemia. These findings indicate that optimizing antihypertensive medication selection based on the individualized characteristics of children with hypertension may improve the efficacy of antihypertensive treatment.

Aims Blood pressure control requires medication adherence and lifestyle modifications. Social cognitive theory suggests social support, psychological adaptation, and self-efficacy can reinforce lifestyle modifications. This study investigated if self-efficacy was a mediator between self-rated health status (SRHS), social support, depressive symptoms, anxiety, and self-care among patients with hypertension. Method and results This cross-sectional study recruited patients with primary hypertension by convenience sampling (N = 318) from an outpatient cardiology clinic. Data included participant characteristics and self-report scales for social support, SRHS, anxiety, depressive symptoms, Self-efficacy and self-care diet quality and weight management. We used path analysis to test the hypothesized model. The mean age of participants was 63.91 ± 11.80 years. Mean scale scores for social support and depressive symptoms were 54.23 ± 13.26 and 6.14 ± 3.14, respectively; SRHS was 66.91 ± 13.80, self-efficacy was 34.31 ± 11.62, self-care for diet quality and weight management were 36.50 ± 13.19 and 27.38 ± 8.64, respectively. Bootstrapping demonstrated self-efficacy was the mediator between social support and self-care for diet quality and weight management; depressive symptoms mediated the relationship between social support and self-efficacy. In addition, the variable of depressive symptoms was also a mediator between SRHS and self-efficacy. The final model showed SRHS, social support, depressive symptoms, and self-efficacy explained 28% of self-care. Conclusion Our findings suggest developing theory-based interventions for patients with hypertension that provide education and/or psychological support for increasing patients' self-efficacy and reducing depressive symptoms simultaneously to facilitate their long-term self-care behaviours. [ABSTRACT FROM AUTHOR]

Primary hypertension (PH) is the most common cause of arterial hypertension in adolescents; many of these patients present with isolated systolic hypertension (ISH). The study presents a case of a 16-year-old male adolescent with PH. The patient had ISH in both 24-hour-ambulatory and office measurements. Secondary causes and hypertension-mediated organ damage were excluded. Evaluation of the vascular phenotype revealed low central systolic blood pressure (109 mm Hg), high peripheral augmentation index (27 mm Hg), and high arterial elasticity. The boy was started on non-pharmacological treatment. The manuscript discusses up-to-date knowledge on the pathogenesis and evolution of ISH in young people. A diagnostic and therapeutic approach according to the European Society of Hypertension is presented. Adolescents with ISH require evaluation of the vascular phenotype. There is a need for further studies on the evolution and long-term outcome in young people with this form of arterial hypertension.

Objective: To investigate the prevalence of hypertension in adolescents and children in the Taicang area and analyse related factors to provide a theoretical basis for the prevention and control of hypertension in this region. Methods: A total of 1,000 students who were visited and surveyed in primary schools in the Taicang area in 2021 were selected for statistical testing using a cluster random sampling method, and a survey was conducted on their dietary habits. dietary habits, such as the consumption of meals that included protein-rich animal products, beans and dairy products, vegetables and fruits, salty foods and fried food, was taken into consideration, along with physical fitness indices, waist-to-height ratio and waist circumference. Results: Of the 1,000 adolescents and children surveyed, 222 were classified into the hypertensive group and 778 into the normotensive group. There were 138 boys (a prevalence rate of 6.3%) and 84 girls (a prevalence rate of 4.1%) in the hypertensive group. The physical fitness indices of the hypertensive group were significantly higher than those of the normotensive group. Concerning dietary structure, the frequency of cereal intake between the two groups was comparable, while the hypertensive group's intake of vegetables, fruits, beans and dairy products was significantly lower than that of the normotensive group. Finally, a logistic multivariate regression analysis of related factors was carried out, and it was concluded that waist-to-height ratio, waist circumference and salty and fried food intake were positively correlated with the prevalence of hypertension. Conclusion: The prevalence of hypertension among adolescents and children in the Taicang area is high. Body weight and dietary structure can be used as reference indicators for the prevalence of hypertension in this age group. [ABSTRACT FROM AUTHOR]

Primary hypertension is a disease that is being diagnosed with increasing frequency in pediatric patients, and many of them are found to have hypertension-mediated organ damage (HMOD), including arterial damage. The pathophysiology of primary hypertension and the formation of HMOD is multifactorial. One mechanism studied in recent years is the subclinical inflammation accompanying the elevation of blood pressure. Experimental studies, studies in adults and children, revealed the involvement of immune mechanisms in the formation of vascular lesions in the course of primary hypertension. The paper summarizes the current knowledge on this subject and points to possible therapeutic targets. Particular emphasis is placed on data from pediatric patients with primary hypertension, as a relation between arterial damage (early vascular aging) and immune system activation had already been found in children. The correct identification of immunological mechanisms may not only broaden our understanding of primary hypertension as a disease but also, more importantly, lead to the most effective methods of its treatment. [ABSTRACT FROM AUTHOR]

Introduction: Primary hypertension (PHT) has long ceased to be an adult problem. It commonly affects children and adolescents and is becoming a severe health care problem in many countries. In contrast to secondary hypertension, which occurs mainly in younger children with kidney, cardiovascular, and endocrine disorders, PHT affects older children and adolescents. Potential causes of PHT include being overweight, particularly obese, sleep apnea, and increased sympathetic nervous system (SNS) activity. Vegetative system activity is an essential factor in children’s blood pressure (BP). Those with excessive sympathetic system activity have increased heart rate, BP, and other parameters characterizing the positive chronotropic effect. In turn, one of the factors stimulating the SNS is blood desaturation (DES). This study investigates the relationship between ambulatory BP and oxygen DES rates. Material and methods: The degree and number of DES episodes were assessed by finger pulse oximetry during 24-h ambulatory monitoring in 54 boys and girls with PHT. Their results were compared to 52 healthy children without PHT. Results: Several disturbances in blood saturation were found in children with PHT. They had more episodes of DES and profound hypoxia (< 90%), their blood DES was significantly lower, and their DES time was longer. Additionally, higher systolic BP and higher diastolic pressure loads were observed throughout the day and night in children with longer DES times (> 60 s), who also had more DES episodes and lower baseline and average blood saturation. Conclusions: Children with PHT show significant disturbances in blood oxygenation, leading to overactive SNS activity, which may be a crucial element in PHT pathogenesis in children. Introduction: Primary hypertension (PHT) has long ceased to be an adult problem. It commonly affects children and adolescents and is becoming a severe health care problem in many countries. In contrast to secondary hypertension, which occurs mainly in younger children with kidney, cardiovascular, and endocrine disorders, PHT affects older children and adolescents. Potential causes of PHT include being overweight, particularly obese, sleep apnea, and increased sympathetic nervous system (SNS) activity. Vegetative system activity is an essential factor in children’s blood pressure (BP). Those with excessive sympathetic system activity have increased heart rate, BP, and other parameters characterizing the positive chronotropic effect. In turn, one of the factors stimulating the SNS is blood desaturation (DES). This study investigates the relationship between ambulatory BP and oxygen DES rates. Material and methods: The degree and number of DES episodes were assessed by finger pulse oximetry during 24-h ambulatory monitoring in 54 boys and girls with PHT. Their results were compared to 52 healthy children without PHT. Results: Several disturbances in blood saturation were found in children with PHT. They had more episodes of DES and profound hypoxia (< 90%), their blood DES was significantly lower, and their DES time was longer. Additionally, higher systolic BP and higher diastolic pressure loads were observed throughout the day and night in children with longer DES times (> 60 s), who also had more DES episodes and lower baseline and average blood saturation. Conclusions: Children with PHT show significant disturbances in blood oxygenation, leading to overactive SNS activity, which may be a crucial element in PHT pathogenesis in children. [ABSTRACT FROM AUTHOR]

Objective To examine the serum level of free fatty acid (FFA) in children with primary hypertension and its value in the pathogenesis, prevention, and treatment of primary hypertension in children. Methods In this retrospective study, 34 children with primary hypertension who were treated for the first time in Children's Hospital Affiliated to Capital Institute of Pediatrics from January to June, 2021, were enrolled as the hypertension group, and 32 children with normal blood pressure who underwent physical examination during the same period were enrolled as the control group. The two groups were compared in terms of the levels of fasting serum FFA, fasting serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C). The multivariate logistic regression model was used to analyze the influence of FFA on the development of primary hypertension. Results Compared with the control group, the hypertension group had significantly higher body mass index (BMI), systolic blood pressure, and diastolic blood pressure (P<0.05), as well as significantly higher serum levels of FFA, TG, LDL-C, and non-HDL-C and a significantly lower serum level of HDL-C (P<0.05). Compared with the control group, the hypertension group had significantly higher rates of elevated serum FFA (>0.45 mmol/L for girls and >0.60 mmol/L for boys) (P<0.05) and abnormal blood lipid levels (abnormality in at least one index among serum TG, TC, LDL-C, HDL-C, and non-HDL-C) (P<0.05). A multivariate logistic regression equation was established based on age, sex, BMI, elevated serum FFA, and abnormal blood lipid levels, and the results showed that elevated serum FFA was an independent risk factor for primary hypertension in children (OR=17.560, 95%CI: 1.964-157.003, P<0.05). Conclusions There is a significant increase in serum FFA level in children with primary hypertension, and the increase in serum FFA can increase the risk of primary hypertension in children. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Low- and middle-income countries have a high prevalence of primary hypertension, but its treatment and control are often low. Heat-sensitive moxibustion (HSM), an innovative acupoint stimulation technique, may be effective for treating hypertension and thus used appropriately in primary healthcare. The objective of this study is to investigate whether HSM is effective and safe for the treatment of primary hypertension in the community. Methods This study is a multicenter, pragmatic, randomized controlled trial (RCT) with patient-preference arms. Four hundred patients with primary hypertension from seven communities will be enrolled. Initially, the communities will be randomly assigned into two study clusters, one using compulsory randomization and the other allowing treatment selection by patient preferences. Then, patients in the compulsory randomization cluster will be randomized to receive HSM plus their original antihypertensive regimen (HSM group) or only their original antihypertensive regimen (control group) for 6 months. Patients in the patient preference cluster may choose to receive HSM or control if they have a preference; otherwise, patients will be randomly assigned. The primary outcome is the change in systolic blood pressure from baseline; secondary outcomes include change in diastolic blood pressure, dosage of antihypertensive drugs, quality of life (QoL), severity of hypertensive symptoms, and incidence of cardiovascular events. Patient compliance with the HSM regimen, the cost-effectiveness ratio, and safety outcomes will also be evaluated. Outcome data will be collected at 6 monthly visits. Discussion This trial will provide important evidence regarding HSM as a technique for primary hypertension in primary healthcare settings. Given the randomization with patient preferences considered, the trial will also allow analyzing patient-preference effects and the comparison of randomized and nonrandomized samples, to improve the robustness and extrapolation of study conclusions. Trial registration ClinicalTrials.gov NCT04788563 . Registered on March 9, 2021.

Background Primary hypertension is one of the most well-known risk factors for cardiovascular disease. Currently, there is still no ideal indicator for left ventricular end-diastolic pressure. Methods 73 hypertension patients and 37 healthy people were enrolled in this study. Each member was examined with conventional echocardiography including multiple indicators such as Peak mitral valve flow velocity (E, A), E/A, left atrial volume index (LAVl), tissue Doppler (PW-TDI) peak velocities during early and late diastolic mitral valve flow (e ‘), E/e ‘, and GLS. We have collected clinical data from all enrolled members. The above cardiac ultrasound indicators were obtained before the antihypertensive treatment, one month and three months after treatment. Results Left ventricular end-diastolic pressure (LVEDP) was positively correlated and negatively correlated with GLS (r = 0.638, P

Introduction: It is estimated that hypertension (HTN) increases the risk at least twofold for cardiovascular diseases including coronary artery diseases, congestive heart failure/stroke (ischemic and hemorrhagic), renal failure, and peripheral arterial disease. In wide consensus, HTN is considered Vyanabala Vaishamya by recent Ayurvedic scholars. The aim of the study was to evaluate the effect of an Ayurvedic formulation and Nidana Parivarjana in the management of Vyanabala Vaishamya with special reference to Stage 1 primary HTN as per 8th JNC criteria. Methods: The present study was a randomized, interventional, two-arm, open-level, 30-day clinical trial on Vyanabala Vaishamya (primary HTN). Twenty-five patients in Group A were administered Ayurvedic formulation and 25 patients in Group B were administered Ayurvedic formulation along with Nidana Parivarjana (avoidance of causative factors) decided as per Ayurveda principles. Results: Ayurvedic formulation alone lowered systolic blood pressure (BP) mean from 150.087 (standard deviation [SD] ± 6.331) to 142.478 (SD ± 6.842) and diastolic BP mean from 93.609 (SD ± 3.539) to 89.522 (SD ± 3.566), while Ayurvedic formulation with Nidana Parivarjana lowered systolic BP mean from 151.000 (SD ± 5.800) to 136.174 (SD ± 5.449) and diastolic BP mean from 93.652 (SD ± 3.406) to 85.435 (SD ± 3.678). Although the reductions in BPs of both the groups were statistically highly significantly (P < 0.001), Ayurvedic formulation with Nidana Parivarjana was more effective in lowering the BPs than Ayurvedic formulation alone as found on intergroup comparison (P < 0.001). Conclusion: Ayurvedic formulation with Nidana Parivarjana was more effective in primary HTN than Ayurvedic formulation alone. It also proved that Nidana Parivarjana has a significant role in the management of Vyanabala Vaishamya, i.e., primary HTN.

Introduction. Patients with arterial hypertension have a higher rate of morning blood pressure surge (MBPS) than non-hypertensive patients. MBPS increases the risk of stroke, myocardial infarction, sudden cardiac death, arterial stiffness, left ventricular hypertrophy, carotid atherosclerosis, and vascular inflammation. The prevalence and predictors of MBPS may vary significantly between geographic regions. The objective of the study was to determine the incidence of MBPS and associated factors in patients with primary hypertension. Material and methods. A cross-sectional descriptive study was conducted in patients ≥35 years old, diagnosed with primary arterial hypertension, and hospitalized in the Department of Cardiology of Thanh Vu Hospital, Bac Lieu, Vietnam, between March 2019 and May 2020. Results. Among 126 hypertensive patients, 80 had MBPS (63.5%): 66 had systolic MBPS (52.4%), 65 had diastolic MBPS (51.6%), and 51 had both systolic and diastolic MBPS (40.5%). Nocturnal hypertension, left ventricular hypertrophy, and stroke were statistically associated with MBPS. Conclusions. Since there is a high prevalence of MBPS, associated with multiple complications in patients with grade 2 or 3 hypertension, 24-hour ambulatory blood pressure measurement must be used in clinical practice in this group of patients, to ensure the timely detection and treatment of MBPS.

Objective To observe the changes of ANP levels in the peripheral blood of patients with essential hypertension in Yunnan, and to explore the relationship between it and the pathogenesis of essential hypertension. Methods We selected 44 patients with essential hypertension diagnosed in the cardiology department of our hospital from June to September 2019 and set them as the case group. We also selected 44 healthy patients from the physical examination center of our hospital as the healthy control group. The ELISA method was used to detect the ANP level in the peripheral blood of the subjects. Results The level of ANP in the peripheral blood of patients with essential hypertension was significantly lower than that of normal people ( P < 0.05)；the occurrence of hypertension was used as the dependent variable and the serum ANP was used as the independent variable for logistic regression analysis. The results showed that ANP The partial regression coefficient with hypertension was 0.071, and the P value was 0.002 (P < 0.05). It was statistically significant; the person correlation analysis was used to analyze ANP and SBP/DBP, and the results showed that the correlation coefficient between ANP and SBP was -0.374. The P value is 0.000 (P < 0.05)；the correlation coefficient between ANP and DBP is - 0.331, and the P value is 0.002（P < 0.05), both of which are statistically significant, but compared to DBP, the correlation between ANP and SBP is more significant. Conclusions The low concentration of ANP in peripheral blood is closely related to the increase of blood pressure; NPR-C ligand ANP is involved in the pathogenesis of essential hypertension; ANP affects the changes in the level of SBP/DBP, and has a more significant impact on SBP. [ABSTRACT FROM AUTHOR]

Objective To compare the clinical value of different voltage criteria of 12-lead routine ECG in diagnosing left ventricular hypertrophy (LVH) related to primary hypertension, and to explore a method for improving the diagnostic efficiency of ECG. Methods A total of 161 patients with primary hypertension admitted to our hospital were selected. They all underwent examinations of echocardiography and 12-lead routine ECG, and these results were comparatively analyzed. According to the left ventricular mass index (LVMI), these patients were divided into LVH positive group (67 cases) and LVH negative group (94 cases). The sensitivity, specificity and Youden index of Sokolow, Cornell and Peguero-Lo Presti criteria, and the combined regimen were calculated based on ECG data, and compared between the genders. Results The values of left ventricular mass and LVMI in the LVH positive group are significantly higher than those in the LVH negative group with statistically significant differences (P < 0. 01). The sensitivity of Peguero-Lo Presti criterion is higher than that of the other two criteria, but the specificity is lower. Compared with single diagnostic criterion, the sensitivity of the combined regimen is the highest while its specificity is the lowest. Either in male or female patients, the Youden index of the combined regimen is the highest, followed by the index of Peguero-Lo Presti criterion, and the other two criteria. Conclusion Peguero-Lo Presti criterion is more recommended in diagnosing LVH with single diagnostic criterion. The combined regimen of the three criteria helps to increase the detection rate of LVH by ECG, which provides certain clinical application value. [ABSTRACT FROM AUTHOR]