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Population-Attributable Risk for Cardiovascular Disease Associated With #Hypertension in #Black Adults
The multivariable-adjusted HR associated with hypertension was 1.91 (95% CI, 1.48-2.46) for CVD, 2.41 (95% CI,1.59-3.66) for coronary heart disease, 1.52 (95% CI, 1.01-2.30) for heart failure, and 2.20 (95% CI, 1.44-3.36) for stroke. The prevalence of hypertension was 53.2% among non-Hispanic black individuals. The PAR associated with hypertension was 32.5% (95% CI, 20.5%-43.6%) for CVD, 42.7% (95% CI, 24.0%-58.4%) for coronary heart disease, 21.6% (95% CI, 0.6%-40.8%) for heart failure, and 38.9% (95% CI, 19.4%-55.6%) for stroke. The PAR was higher among those younger than 60 years (54.6% [95% CI, 37.2%-68.7%]) compared with those 60 years or older (32.0% [95% CI, 11.9%-48.1%]). No differences were present in subgroup analyses.
Conclusions and Relevance These findings suggest that a substantial proportion of CVD cases among black individuals are associated with hypertension. Interventions to maintain normal blood pressure throughout the life course may reduce the incidence of CVD in this population.
https://jamanetwork.com/journals/jamacardiology/article-abstract/2753609
Population-Attributable Risk for Cardiovascular Disease Associated With #Hypertension in #Black Adults
The multivariable-adjusted HR associated with hypertension was 1.91 (95% CI, 1.48-2.46) for CVD, 2.41 (95% CI,1.59-3.66) for coronary heart disease, 1.52 (95% CI, 1.01-2.30) for heart failure, and 2.20 (95% CI, 1.44-3.36) for stroke. The prevalence of hypertension was 53.2% among non-Hispanic black individuals. The PAR associated with hypertension was 32.5% (95% CI, 20.5%-43.6%) for CVD, 42.7% (95% CI, 24.0%-58.4%) for coronary heart disease, 21.6% (95% CI, 0.6%-40.8%) for heart failure, and 38.9% (95% CI, 19.4%-55.6%) for stroke. The PAR was higher among those younger than 60 years (54.6% [95% CI, 37.2%-68.7%]) compared with those 60 years or older (32.0% [95% CI, 11.9%-48.1%]). No differences were present in subgroup analyses.
Conclusions and Relevance These findings suggest that a substantial proportion of CVD cases among black individuals are associated with hypertension. Interventions to maintain normal blood pressure throughout the life course may reduce the incidence of CVD in this population.
https://jamanetwork.com/journals/jamacardiology/article-abstract/2753609
Jamanetwork
Population-Attributable Risk for Cardiovascular Disease Associated With Hypertension in Black Adults
This study assesses the population-attributable risk of cardiovascular disease associated with hypertension among black adults in the United States.
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Relationship between #obesity indices and #hypertension among middle-aged and elderly populations in Taiwan: A community-based, cross-sectional study
..The obesity indices included body mass index (BMI), body fat (BF) percentage and waist circumference (WC).
Of the 396 people recruited, 200 had HTN. The age-adjusted Pearson’s coefficients of BMI, BF percentage and WC were 0.23 (p<0.001), 0.14 (p=0.01) and 0.26 (p<0.001), respectively. Multiple logistic regression of the HTN-related obesity indices showed that the ORs of BMI, BF percentage and WC were 1.15 (95% CI 1.08 to 1.23, p<0.001), 1.07 (95% CI 1.03 to 1.11, p<0.001) and 1.06 (95% CI 1.03 to 1.08, p<0.001), respectively. The AUCs of BMI, BF percentage and WC were 0.626 (95% CI 0.572 to 0.681, p<0.001), 0.556 (95% CI 0.500 to 0.613, p=0.052) and 0.640 (95% CI 0.586 to 0.694, p<0.001), respectively.
Conclusions WC is a more reliable predictor of HTN than BMI or BF percentage. The effect of abdominal fat distribution on blood pressure is greater than that of total BF amount
https://bmjopen.bmj.com/content/9/10/e031660
Relationship between #obesity indices and #hypertension among middle-aged and elderly populations in Taiwan: A community-based, cross-sectional study
..The obesity indices included body mass index (BMI), body fat (BF) percentage and waist circumference (WC).
Of the 396 people recruited, 200 had HTN. The age-adjusted Pearson’s coefficients of BMI, BF percentage and WC were 0.23 (p<0.001), 0.14 (p=0.01) and 0.26 (p<0.001), respectively. Multiple logistic regression of the HTN-related obesity indices showed that the ORs of BMI, BF percentage and WC were 1.15 (95% CI 1.08 to 1.23, p<0.001), 1.07 (95% CI 1.03 to 1.11, p<0.001) and 1.06 (95% CI 1.03 to 1.08, p<0.001), respectively. The AUCs of BMI, BF percentage and WC were 0.626 (95% CI 0.572 to 0.681, p<0.001), 0.556 (95% CI 0.500 to 0.613, p=0.052) and 0.640 (95% CI 0.586 to 0.694, p<0.001), respectively.
Conclusions WC is a more reliable predictor of HTN than BMI or BF percentage. The effect of abdominal fat distribution on blood pressure is greater than that of total BF amount
https://bmjopen.bmj.com/content/9/10/e031660
BMJ Open
Relationship between obesity indices and hypertension among middle-aged and elderly populations in Taiwan: a community-based, cross…
Objective Obesity and hypertension (HTN) have become increasingly prevalent in Taiwan. People with obesity are more likely to have HTN. In this study, we evaluated several anthropometric measurements for the prediction of HTN in middle-aged and elderly populations…
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Association of Isolated Diastolic #Hypertension as Defined by the 2017 ACC/AHA Blood Pressure Guideline With Incident Cardiovascular Outcomes
..the definition of hypertension was lowered from a blood pressure (BP) of greater than or equal to 140/90 to greater than or equal to 130/80 mm Hg. The new diastolic BP threshold of 80 mm Hg was recommended based on expert opinion and changes the definition of isolated diastolic hypertension (IDH).
atherosclerotic cardiovascular disease (ASCVD)
..Compared with normotensive ARIC participants, IDH by the 2017 ACC/AHA definition was not significantly associated with incident ASCVD (n = 1386 events; median follow-up, 25.2 years; hazard ratio [HR], 1.06 [95% CI, 0.89-1.26]), HF (n = 1396 events; HR, 0.91 [95% CI, 0.76-1.09]), or CKD (n = 2433 events; HR, 0.98 [95% CI, 0.65-1.11]). Results were also null for cardiovascular mortality in the 2 external cohorts (eg, HRs of IDH by the 2017 ACC/AHA definition were 1.17 [95% CI, 0.87-1.56] in the NHANES [n = 1012 events] and 1.02 [95% CI, 0.92-1.14] in CLUE II [n = 1497 events]).
Conclusions and Relevance In this analysis of US adults, the estimated prevalence of IDH was more common when defined by the 2017 ACC/AHA BP guideline compared with the JNC7 guideline. However, IDH was not significantly associated with increased risk for cardiovascular outcomes.
https://bit.ly/2O8suYu
Association of Isolated Diastolic #Hypertension as Defined by the 2017 ACC/AHA Blood Pressure Guideline With Incident Cardiovascular Outcomes
..the definition of hypertension was lowered from a blood pressure (BP) of greater than or equal to 140/90 to greater than or equal to 130/80 mm Hg. The new diastolic BP threshold of 80 mm Hg was recommended based on expert opinion and changes the definition of isolated diastolic hypertension (IDH).
atherosclerotic cardiovascular disease (ASCVD)
..Compared with normotensive ARIC participants, IDH by the 2017 ACC/AHA definition was not significantly associated with incident ASCVD (n = 1386 events; median follow-up, 25.2 years; hazard ratio [HR], 1.06 [95% CI, 0.89-1.26]), HF (n = 1396 events; HR, 0.91 [95% CI, 0.76-1.09]), or CKD (n = 2433 events; HR, 0.98 [95% CI, 0.65-1.11]). Results were also null for cardiovascular mortality in the 2 external cohorts (eg, HRs of IDH by the 2017 ACC/AHA definition were 1.17 [95% CI, 0.87-1.56] in the NHANES [n = 1012 events] and 1.02 [95% CI, 0.92-1.14] in CLUE II [n = 1497 events]).
Conclusions and Relevance In this analysis of US adults, the estimated prevalence of IDH was more common when defined by the 2017 ACC/AHA BP guideline compared with the JNC7 guideline. However, IDH was not significantly associated with increased risk for cardiovascular outcomes.
https://bit.ly/2O8suYu
Long #Working Hours and the Prevalence of Masked and Sustained #Hypertension
Previous studies on the effect of long working hours on blood pressure have shown inconsistent results. Mixed findings could be attributable to limitations related to blood pressure measurement and the lack of consideration of masked hypertension..
Ambulatory blood pressure was defined as the mean of the next readings recorded every 15 minutes during daytime working hours. Masked hypertension was defined as clinic blood pressure < 140/90 mm Hg and ambulatory blood pressure ≥135/85 mm Hg. Sustained hypertension was defined as clinic blood pressure ≥140/90 mm Hg and ambulatory blood pressure ≥135/85 mm Hg or being treated hypertension. Long working hours were associated with the prevalence of masked hypertension (prevalence ratio 49+=1.70 [95% CI, 1.09–2.64]), after adjustment for sociodemographics, lifestyle-related risk factors, diabetes mellitus, family history of cardiovascular disease, and job strain.
The association with sustained hypertension was of a comparable magnitude (prevalence ratio 49+=1.66 [95% CI, 1.15–2.50]). Results suggest that long working hours are an independent risk factor for masked and sustained hypertension. Workplace strategies targeting long working hours could be effective in reducing the clinical and public health burden of hypertension.
https://bit.ly/2w9qBVc
Previous studies on the effect of long working hours on blood pressure have shown inconsistent results. Mixed findings could be attributable to limitations related to blood pressure measurement and the lack of consideration of masked hypertension..
Ambulatory blood pressure was defined as the mean of the next readings recorded every 15 minutes during daytime working hours. Masked hypertension was defined as clinic blood pressure < 140/90 mm Hg and ambulatory blood pressure ≥135/85 mm Hg. Sustained hypertension was defined as clinic blood pressure ≥140/90 mm Hg and ambulatory blood pressure ≥135/85 mm Hg or being treated hypertension. Long working hours were associated with the prevalence of masked hypertension (prevalence ratio 49+=1.70 [95% CI, 1.09–2.64]), after adjustment for sociodemographics, lifestyle-related risk factors, diabetes mellitus, family history of cardiovascular disease, and job strain.
The association with sustained hypertension was of a comparable magnitude (prevalence ratio 49+=1.66 [95% CI, 1.15–2.50]). Results suggest that long working hours are an independent risk factor for masked and sustained hypertension. Workplace strategies targeting long working hours could be effective in reducing the clinical and public health burden of hypertension.
https://bit.ly/2w9qBVc
www.ahajournals.org
Long Working Hours and the Prevalence of Masked and Sustained Hypertension | Hypertension
Previous studies on the effect of long working hours on blood pressure have shown inconsistent results. Mixed findings could be attributable to limitations related to blood pressure measurement and...
Evaluation of a Common Prescribing Cascade of Calcium Channel Blockers and Diuretics in Older Adults With #Hypertension
https://2medical.news/2020/03/08/evaluation-of-a-common-prescribing-cascade-of-calcium-channel-blockers-and-diuretics-in-older-adults-with-hypertension/
Calcium channel blockers (CCBs) are commonly prescribed agents for hypertension that can cause peripheral edema. A prescribing cascade occurs when the edema is misinterpreted as a new medical condition and a diuretic is subsequently prescribed to treat the edema. The extent to which this prescribing cascade occurs at a population level is not well understood.. ..Individuals who were newly dispensed a CCB had a higher …
https://2medical.news/2020/03/08/evaluation-of-a-common-prescribing-cascade-of-calcium-channel-blockers-and-diuretics-in-older-adults-with-hypertension/
Calcium channel blockers (CCBs) are commonly prescribed agents for hypertension that can cause peripheral edema. A prescribing cascade occurs when the edema is misinterpreted as a new medical condition and a diuretic is subsequently prescribed to treat the edema. The extent to which this prescribing cascade occurs at a population level is not well understood.. ..Individuals who were newly dispensed a CCB had a higher …
Open Access Oral #glucocorticoids and incidence of #hypertension in people with chronic inflammatory diseases: a population-based cohort study
https://2medical.news/2020/03/30/open-access-oral-glucocorticoids-and-incidence-of-hypertension-in-people-with-chronic-inflammatory-diseases-a-population-based-cohort-study/
..Among 71 642 patients in the cohort, 24 896 (34.8%) developed hypertension during a median follow-up of 6.6 years. The incidence rate of hypertension was 46.7 (95% confidence interval [CI] 46.0–47.3) per 1000 person-years. Incidence rates increased with higher cumulative glucocorticoid prednisolone-equivalent dose, from 44.4 per 1000 person-years in periods of nonuse to 45.3 per 1000 person-years for periods with between > 0.0 and 959.9 …
https://2medical.news/2020/03/30/open-access-oral-glucocorticoids-and-incidence-of-hypertension-in-people-with-chronic-inflammatory-diseases-a-population-based-cohort-study/
..Among 71 642 patients in the cohort, 24 896 (34.8%) developed hypertension during a median follow-up of 6.6 years. The incidence rate of hypertension was 46.7 (95% confidence interval [CI] 46.0–47.3) per 1000 person-years. Incidence rates increased with higher cumulative glucocorticoid prednisolone-equivalent dose, from 44.4 per 1000 person-years in periods of nonuse to 45.3 per 1000 person-years for periods with between > 0.0 and 959.9 …
EMA advises continued use of medicines for #hypertension, heart or #kidney disease during COVID-19 pandemic
https://2medical.news/2020/04/02/ema-advises-continued-use-of-medicines-for-hypertension-heart-or-kidney-disease-during-covid-19-pandemic/
EMA is aware of recent media reports and publications which question whether some medicines, for instance angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs, or sartan medicines), could worsen coronavirus disease (COVID-19). ACE inhibitors and ARBs are most commonly used for treating patients with high blood pressure, heart failure or kidney disease. It is important that patients do not interrupt their treatment with …
https://2medical.news/2020/04/02/ema-advises-continued-use-of-medicines-for-hypertension-heart-or-kidney-disease-during-covid-19-pandemic/
EMA is aware of recent media reports and publications which question whether some medicines, for instance angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs, or sartan medicines), could worsen coronavirus disease (COVID-19). ACE inhibitors and ARBs are most commonly used for treating patients with high blood pressure, heart failure or kidney disease. It is important that patients do not interrupt their treatment with …
Joint Effects of #Body Mass Index and Waist Circumference on the Incidence of #Hypertension in a Community-Based Chinese Population
https://2medical.news/2020/04/04/joint-effects-of-body-mass-index-and-waist-circumference-on-the-incidence-of-hypertension-in-a-community-based-chinese-population/
.. During 2.3 years of follow-up, 19.1% (n = 97) of the men and 13.6% (n = 158) of the women developed incident hypertension. The adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for obesity (BMI ≥30) were 3.49 (1.59–7.66) and 2.60 (1.48–4.55) for men and women, respectively. A 1-point increase in BMI was associated with 8% (OR = 1.08, 95% CI: 1.00–1.17) and 10% …
https://2medical.news/2020/04/04/joint-effects-of-body-mass-index-and-waist-circumference-on-the-incidence-of-hypertension-in-a-community-based-chinese-population/
.. During 2.3 years of follow-up, 19.1% (n = 97) of the men and 13.6% (n = 158) of the women developed incident hypertension. The adjusted odds ratios (ORs) (95% confidence intervals [CIs]) for obesity (BMI ≥30) were 3.49 (1.59–7.66) and 2.60 (1.48–4.55) for men and women, respectively. A 1-point increase in BMI was associated with 8% (OR = 1.08, 95% CI: 1.00–1.17) and 10% …
Discrimination and #Hypertension Risk Among African Americans in the Jackson Heart Study
https://2medical.news/2020/07/04/discrimination-and-hypertension-risk-among-african-americans-in-the-jackson-heart-study/
African Americans have a higher risk of hypertension compared with other racial or ethnic groups in the United States. One possible explanation for this disparity is discrimination. Few studies have examined the association between discrimination and incidence of hypertension. We examined whether everyday discrimination, lifetime discrimination, and stress from discrimination were associated with incident hypertension and whether these associations differed by gender, age, discrimination attribution, …
https://2medical.news/2020/07/04/discrimination-and-hypertension-risk-among-african-americans-in-the-jackson-heart-study/
African Americans have a higher risk of hypertension compared with other racial or ethnic groups in the United States. One possible explanation for this disparity is discrimination. Few studies have examined the association between discrimination and incidence of hypertension. We examined whether everyday discrimination, lifetime discrimination, and stress from discrimination were associated with incident hypertension and whether these associations differed by gender, age, discrimination attribution, …