• Abdominal obesities
• High blood pressure
• Iran
• Obesity
• STEPS survey
• Uncontrolled hypertension

• Humans
• Iran/epidemiology
• Hypertension/epidemiology
• Female
• Male
• Middle Aged
• Obesity, Abdominal/epidemiology
• Obesity, Abdominal/complications
• Obesity/epidemiology
• Obesity/complications
• Adult
• Prevalence
• Aged
• Risk Factors
• Cross-Sectional Studies
• Body Mass Index

• Cardiovascular risk
• Characteristics
• Prospective study
• Uncontrolled hypertension

• Humans
• Hypertension/complications
• Male
• Female
• Middle Aged
• Cardiovascular Diseases/mortality
• Cardiovascular Diseases/etiology
• Risk Factors
• Antihypertensive Agents/therapeutic use
• Prospective Studies
• Blood Pressure
• Aged
• Albuminuria
• Adult

• Humans
• Hypertension/drug therapy
• Antihypertensive Agents/therapeutic use
• Drug Resistance
• Blood Pressure

• Anger
• Anxiety
• Blood pressure
• Ecological momentary assessment
• Race
• Sadness

• Healthy ageing
• Index of multiple deprivation
• Mediterranean dietary pattern
• Metabolic syndrome
• Metabolic syndrome prevalence
• Principal component analysis
• Socio-economic status
• Western dietary pattern

According to the World Health Organization (WHO), an estimated 1.28 billion adults aged 30–79 years worldwide have hypertension; and every year, hypertension takes 7.6 million lives. High intakes of salt and sugar (mainly fructose from added sugars) have been linked to the etiology of hypertension, and this may be particularly true for countries undergoing the nutrition transition, such as Lebanon. Salt-induced hypertension and fructose-induced hypertension are manifested in different mechanisms, including Inflammation, aldosterone-mineralocorticoid receptor pathway, aldosterone independent mineralocorticoid receptor pathway, renin-angiotensin system (RAS), sympathetic nervous system (SNS) activity, and genetic mechanisms. This review describes the evolution of hypertension and cardiovascular diseases (CVDs) in Lebanon and aims to elucidate potential mechanisms where salt and fructose work together to induce hypertension. These mechanisms increase salt absorption, decrease salt excretion, induce endogenous fructose production, activate fructose-insulin-salt interaction, and trigger oxidative stress, thus leading to hypertension. The review also provides an up-to-date appraisal of current intake levels of salt and fructose in Lebanon and their main food contributors. It identifies ongoing salt and sugar intake reduction strategies in Lebanon while acknowledging the country’s limited scope of regulation and legislation. Finally, the review concludes with proposed public health strategies and suggestions for future research, which can reduce the intake levels of salt and fructose levels and contribute to curbing the CVD epidemic in the country.

• diet
• fructose
• hypertension
• immunity
• lifestyle
• salt

Hypertension is an important public health concern that is claiming millions of lives worldwide. In sub-Saharan African countries, where some of the highest prevalence rates are being recorded, sufficient attention has not been given to its control.

The aim of this study was to determine the association and predictive potential of different anthropometric and bioelectrical impedance analysis (BIA) measures for hypertension.

A total of 812 individuals (204 men and 608 women) were enrolled, and their blood pressure measurement was determined. Direct anthropometric measures (weight, height, waist circumference (WC), and hip circumference) and derived anthropometric measures (body mass index, conicity index, abdominal volume index (AVI), and body adiposity index) were determined. BIA indices investigated included visceral fat level (VF), percentage body fat (%BF), resting metabolic rate (RMR), and skeletal muscle mass.

A prevalence of 31.28% was observed for hypertension in the total study population, with males having a slightly higher prevalence than females. Except for the skeletal muscle mass, all the other indices measured showed an increasing trend from normotension to prehypertension and hypertension. Age and visceral fat level showed the highest correlation with systolic blood pressure for both genders. Receiver operator characteristic analysis showed that age was the best predictor of hypertension in both genders, whereas, in predicting prehypertension, RMR was the best predictor in males, and WC was the best predictor in females. VF, WC, and AVI were other good predictors of hypertension in this study population. However, BMI and % BF had a low predictive value for hypertension.

The result of this study shows that within this study population in addition to age, measures of central obesity rather than general obesity are the likely drivers of the hypertension epidemic; thus, measures aimed at controlling central obesity may offer some therapeutic and preventive advantage.

• diseased adults
• health-related
• healthy adults
• physical fitness
• water-based exercise

• Angiotensin II
• Dicrotic notch
• High frequency
• Hypertension
• Mechanics
• Mice
• Non-invasive
• Non-linear
• Plane wave imaging
• Pulse pressure
• Pulse wave velocity
• Ultrasound

• Animals
• Aorta, Abdominal/diagnostic imaging
• Blood Pressure
• Feasibility Studies
• Hypertension
• Mice
• Pulse Wave Analysis

• R01 HL135734 NHLBI NIH HHS

• Apparent treatment resistant hypertension
• Characteristics
• Independent predictor
• Korea
• Prevalence

• Adult
• Antihypertensive Agents/pharmacology
• Antihypertensive Agents/therapeutic use
• Blood Pressure
• Cross-Sectional Studies
• Drug Resistance
• Hospitals, General
• Humans
• Hypertension/diagnosis
• Hypertension/drug therapy
• Hypertension/epidemiology
• Prevalence
• Republic of Korea/epidemiology

• endothelial dysfunction
• hypertension
• resistance

• Antihypertensive Agents/pharmacology
• Antihypertensive Agents/therapeutic use
• Arginine/analogs & derivatives
• Blood Pressure/drug effects
• Humans
• Hypertension/drug therapy

• blood pressure
• hypertension awareness
• immigrant population
• taxi drivers

• Automobile Driving/statistics & numerical data
• Cross-Sectional Studies
• Humans
• Hypertension/diagnosis
• Hypertension/drug therapy
• Hypertension/epidemiology
• Male
• Middle Aged
• New York City/epidemiology
• Occupational Diseases/diagnosis
• Occupational Diseases/drug therapy
• Occupational Diseases/epidemiology
• Risk Factors

• U54 CA137788 NCI NIH HHS
• R21 NR019188 NINR NIH HHS
• P30 CA008748 NCI NIH HHS
• U54 CA132378 NCI NIH HHS
• U01 MD010648 NIMHD NIH HHS
• R24 MD008058 NIMHD NIH HHS
• R01 NR015265 NINR NIH HHS
• National Institute on Minority Health and Health Disparities
• National Institute of Nursing Research
• National Cancer Institute

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.

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.

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.

• Independent predictor
• Isolated systolic hypertension
• Progranulin
• Progranulin/tumor necrosis factor-α ratio
• Systolic blood pressure
• Systolic-diastolic hypertension
• Tumor necrosis factor-α

• Blood Pressure
• Brazil
• Humans
• Hypertension

This study investigated (i) whether compassion is associated with blood pressure or hypertension in adulthood and (ii) whether familial risk for hypertension modifies these associations.

The participants (N = 1112–1293) came from the prospective Young Finns Study. Parental hypertension was assessed in 1983–2007; participants’ blood pressure in 2001, 2007, and 2011; hypertension in 2007 and 2011 (participants were aged 30–49 years in 2007–2011); and compassion in 2001.

High compassion predicted lower levels of diastolic and systolic blood pressure in adulthood. Additionally, high compassion was related to lower risk for hypertension in adulthood among individuals with no familial risk for hypertension (independently of age, sex, participants’ and their parents’ socioeconomic factors, and participants’ health behaviors). Compassion was not related to hypertension in adulthood among individuals with familial risk for hypertension.

High compassion predicts lower diastolic and systolic blood pressure in adulthood. Moreover, high compassion may protect against hypertension among individuals without familial risk for hypertension. As our sample consisted of comparatively young participants, our findings provide novel implications for especially early-onset hypertension.

The online version of this article (10.1007/s12529-020-09886-5) contains supplementary material, which is available to authorized users.

• Blood pressure
• Compassion
• Familial risk
• Health behavior
• Hypertension
• Personality

• Adult
• Aged
• Ambulatory Care Facilities
• Antihypertensive Agents/therapeutic use
• Comorbidity
• Cross-Sectional Studies
• Drug Resistance
• Ethiopia/epidemiology
• Female
• Humans
• Hypertension/drug therapy
• Hypertension/epidemiology
• Male
• Middle Aged
• Obesity/epidemiology
• Prevalence
• Risk Factors

• hypertension
• risk factors

• Adolescent
• Adult
• Aged
• Antihypertensive Agents/pharmacology
• Antihypertensive Agents/therapeutic use
• Blood Pressure/drug effects
• Blood Pressure/physiology
• Blood Pressure Determination
• Cross-Sectional Studies
• Female
• France/epidemiology
• Humans
• Hypertension/diagnosis
• Hypertension/epidemiology
• Hypertension/etiology
• Hypertension/physiopathology
• Life Style
• Male
• Middle Aged
• Obesity/epidemiology
• Obesity/physiopathology
• Overweight/epidemiology
• Overweight/physiopathology
• Patient Compliance
• Prospective Studies
• Risk Factors
• Treatment Outcome
• Young Adult

• The Constances Cohort Study was supported and funded by the Caisse nationale d’assurance maladie (CNAM). The Constances Cohort Study is an “Infrastructure nationale en Biologie et Santé” and benefits from a grant from ANR (ANR-11-INBS-0002) and from the Ministry of Research. Constances is also partly funded by MSD, AstraZeneca and Lundbeck.

Discrepancy in blood pressure (BP) control rate may be owed to different risk factors associated with elevated systolic and diastolic BP (SBP and DBP).

In a nationally representative survey of Korean population with BP measurements, a total of 5,100 participants with hypertension was included in the analyses. Three separate types of control rates were calculated: SBP, DBP, and (combined) S&DBP among all participants with hypertension and participants with treated hypertension, separately. Control rates were compared across sex and age groups. Multivariable logistic regression was used to identify demographic factors associated with SBP, DBP, and S&DBP control rates, separately.

In total, SBP, DBP, and S&DBP control rates were 63.0%, 63.7%, and 42.5% among all hypertension patients, and 77.5%, 87.4%, and 71.6% among treated hypertension patients. Men aged 40–49 years with hypertension and 30–39 years treated for hypertension had the highest SBP control rate (74.6% and 96.2%), which decreased by older age. Inversely, DBP control rate progressively increased with older age. SBP control rate among women with hypertension was the highest in 40–49 years (67.0%) but without linear trend by age group. Interestingly, both combined and DBP control rates were noticeably low among women aged 50–59 years. Women with body mass index ≥25 were at higher odds of having controlled SBP. Lower DBP control rate was observed in men with lower education level, higher household income, and heavy drinkers.

Separate examination of control rates demonstrated different sex- and age-differential trends, which would have been overlooked in combined control rates.

• Blood pressure
• Chronic disease
• Hypertension

• African American
• Hypertension
• Mineralocorticoid antagonist
• Sex-specific

• Aortic stiffness
• Blood pressure
• Cardiovascular disease
• Cognition
• Orthostatic hypotension
• Vascular hemodynamics

• Blood Pressure
• Cardiovascular Diseases/etiology
• Cardiovascular Diseases/prevention & control
• Cardiovascular Diseases/therapy
• Humans
• Hypertension/complications
• Hypertension/drug therapy
• Longitudinal Studies
• Pulse Wave Analysis
• Risk Factors
• Vascular Stiffness

• Renal denervation
• Resistant hypertension
• Sympathetic nervous system

• Animals
• Heart/physiology
• Humans
• Male
• Microvessels/cytology
• Microvessels/metabolism
• Myocardial Infarction/metabolism
• Myocytes, Cardiac/metabolism
• Neovascularization, Pathologic
• Neovascularization, Physiologic
• Rats
• Rats, Nude
• Rats, Sprague-Dawley
• Tissue Engineering/methods

• R01HL141570 NIH HHS
• R01 HL128362 NHLBI NIH HHS
• T32 EB001650 NIBIB NIH HHS
• DP2DK102258 NIH HHS
• R01HL093140 NIH HHS
• R01HL128362 NIH HHS
• P01GM081619 NIH HHS
• P01 GM081619 NIGMS NIH HHS
• R01 HL141570 NHLBI NIH HHS
• P01 HL094374 NHLBI NIH HHS
• P01HL094374 NIH HHS
• DP2 DK102258 NIDDK NIH HHS
• T32HL7312 NIH HHS
• T32 HL007312 NHLBI NIH HHS
• R01 HL093140 NHLBI NIH HHS
• R01 EY024158 NEI NIH HHS
• R01EY024158 NIH HHS

The current gold standard for the diagnosis of white-coat effect is by the 24-h ambulatory blood pressure monitoring (ABPM) which may not be readily available in every primary care setting. Previous studies had shown that deep breathing, through modulating the baroreceptor reflex sensitivity to vagal stimulation over 30 to 60 s, was useful in detection of the white-coat effect. The aim of our study was to evaluate the diagnostic accuracy of the deep breathing test (DBT) as compared with the gold standard of ABPM in the diagnosis of hypertension with white-coat effect in Chinese patients in primary care.

This cross sectional study recruited 178 consecutive, eligible, consented, hypertensive patients receiving treatment at a local public primary care Hypertension Clinic.

The diagnostic accuracy of the DBT in all recruited patients, patients not taking beta-adrenergic blockers and patients with different clinic SBP cut-off before the DBT by means of area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, positive and negative predictive values was evaluated.

The results for the ROC curves for systolic and diastolic BP changes after the DBT were statistically insignificant. The ROC curve was statistically significant for SBP change in patients not taking beta-adrenergic blockers and with pre-DBT clinic SBP ≥ 165 mmHg (ROC curve area of 0.719, 95% CI 0.53 to 0.91, p = 0.04). The corresponding sensitivity and specificity of the DBT were 40.9 and 90.9% respectively if SBP drop was > 30 mmHg.

The DBT, even though could not be clinically applied to all patients, was proven to be a potential screening and diagnostic test for white-coat effect in Chinese hypertensive patients with a pre-test SBP of ≥165 mmHg and who were not taking beta-adrenergic blockers.

This study was approved by Kowloon East Cluster/ Kowloon Central Cluster Research Ethics Committee/Institutional Review Board of Hospital Authority of Hong Kong under the registration KC/KE-16-0084/ER-3.

• Deep breathing test
• Hypertension
• Primary care
• White-coat effect

No studies that have measured the role of nursing care plans in patients with poorly controlled type 2 diabetes mellitus. Our objectives were firstly, to evaluate the effectiveness of implementing Standardized languages in Nursing Care Plans (SNCP) for improving A1C, blood pressure and low density lipoprotein cholesterol (ABC goals) in patients with poorly controlled type 2 diabetes mellitus at baseline (A1C ≥7%, blood pressure ≥ 130/80 mmHg, and low-density lipoprotein cholesterol≥100 mg/dl) compared with Usual Nursing Care (UNC). Secondly, to evaluate the factors associated with these goals.

A four-year prospective follow-up study among outpatients with type 2 diabetes mellitus: We analyzed outpatients of 31 primary health centers (Madrid, Spain), with at least two A1C values (at baseline and at the end of the study) who did not meet their ABC goals at baseline. A total of 1916 had A1C ≥7% (881 UNC versus 1035 SNCP). Two thousand four hundred seventy-one had systolic blood pressure ≥ 130 mmHg (1204 UNC versus 1267 SNCP). One thousand one hundred seventy had diastolic blood pressure ≥ 80 mmHg (618 UNC versus 552 SNCP); and 2473 had low-density lipoprotein cholesterol ≥100 mg/dl (1257 UNC versus 1216 SNCP). Data were collected from computerized clinical records; SNCP were identified using NANDA and NIC taxonomies.

More patients cared for using SNCP achieved in blood pressure goals compared with patients who received UNC (systolic blood pressure: 29.4% versus 28.7%, p = 0.699; diastolic blood pressure: 58.3% versus 53.2%, p = 0.08), but the differences did not reach statistical significance. For A1C and low-density lipoprotein cholesterol goals, there were no significant differences between the groups. Coronary artery disease was a significant predictor of blood pressure and low-density lipoprotein cholesterol goals.

In patients with poorly controlled type 2 diabetes mellitus, there is not enough evidence to support the use of SNCP instead of with UNC with the aim of helping patients to achieve their ABC goals. However, the use of SNCP is associated with a clear trend of a achievement of diastolic blood pressure goals.

• Diabetes mellitus type 2
• NANDA
• NIC
• Outcome assessment
• Patient care planning
• Prospective studies

• Adipose Tissue/cytology
• Blood Pressure
• Cholesterol/blood
• Exercise
• Female
• Health Status
• Humans
• Male
• Middle Aged
• Physical Fitness
• Time Factors
• Triglycerides/blood

• Coronary heart disease
• Risk factors
• Sudden cardiac death

• Coarctation of the aorta
• adult CHD
• hypertension
• register

• Coronary flow reserve
• Forearm minimum vascular resistance
• Renal denervation
• Treatment-resistant hypertension

• Blood pressure
• Hypertension
• Observational study
• Organ damage

• Antihypertensive Agents/adverse effects
• Antihypertensive Agents/therapeutic use
• Blood Pressure/drug effects
• Databases, Factual
• General Practice
• Hospitals, Community
• Humans
• Hypertension/diagnosis
• Hypertension/drug therapy
• Hypertension/epidemiology
• Hypertension/physiopathology
• Italy/epidemiology
• Outpatient Clinics, Hospital
• Prognosis
• Registries
• Risk Assessment
• Risk Factors
• Time Factors

Methodological issues are pointed to as the main sources of inconsistencies in studies about the association between job strain and blood pressure (BP)/hypertension. Our aim was to analyze the relationship between job strain and the whole BP distribution, as well as potential differences by gender, age, and use of antihypertensives. Additionally, we addressed issues relating to the operationalization of the exposure and outcome variables that influence the study of their inter-relations. We evaluated the baseline date of 12,038 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) (2008–2010), a multicenter cohort study of 35–74-year-old civil servants. Job strain was assessed by the Demand-Control-Support Questionnaire. The distribution of casual BP by categories of job strain was compared by a combination of exploratory techniques. Participants were classified into three subgroups (normotensives, medicated hypertensives, and unmedicated hypertensives), and analyses were stratified by gender and age. The relationship between job strain and casual BP varied along the whole outcome distribution. Hypertensive participants had greater differences in casual BP by job strain category, especially medicated hypertensives. Differences in casual BP were also greater for systolic than for diastolic BP and for older participants. No differences were encountered by gender. The exclusion of participants susceptible to misclassification for the exposure and outcome variables increased the differences observed between the categories of low and high job strain. In conclusion, the relationship between job strain and casual BP varied along the whole outcome distribution and by use of antihypertensive drugs, age, and BP parameter evaluated. Misclassification for exposure and outcome variables should be considered in analyses of this topic.

• demand-control model
• hypertension
• job stress
• method
• psychosocial factor

• Blood pressure
• Diabetes
• Plasma lipid profile
• Probiotics

• Adult
• Cardiovascular Diseases/complications
• Cardiovascular Diseases/drug therapy
• Diabetes Mellitus, Type 2/complications
• Dietary Supplements
• Humans
• Probiotics/therapeutic use
• Risk Factors
• Treatment Outcome

• Pakistan
• Prevalence
• Resistant hypertension

• cost-effectiveness
• diabetes complications
• glycaemic control
• type 2 diabetes

• Blood Glucose
• Diabetes Complications/prevention & control
• Diabetes Mellitus, Type 2/complications
• Diabetes Mellitus, Type 2/drug therapy
• Diabetes Mellitus, Type 2/metabolism
• Disease Management
• England
• Humans
• Hypoglycemic Agents/therapeutic use
• Obesity/complications
• Obesity/metabolism
• Obesity/therapy
• Quality Improvement
• United Kingdom
• Weight Reduction Programs

• Hypertension
• Randomized controlled trial
• Veterans

• Adolescent
• Adult
• Black or African American
• Age Factors
• Aged
• Antihypertensive Agents/administration & dosage
• Antihypertensive Agents/therapeutic use
• Behavior Therapy/methods
• Blood Pressure Monitoring, Ambulatory
• Disease Management
• Exercise
• Female
• Health Behavior
• Humans
• Hypertension/drug therapy
• Hypertension/therapy
• Male
• Medication Therapy Management/organization & administration
• Middle Aged
• Patient Care Team/organization & administration
• Research Design
• Sex Factors
• United States
• United States Department of Veterans Affairs
• Young Adult

• I01 HX000537 HSRD VA
• RCS 08-027 HSRD VA

• association
• body mass index
• body weight
• hypertension
• obesity

Sudden cardiac death (SCD) is a leading cause of death in the United States and often occurs without previous cardiac symptoms. Lifetime risk for SCD and the influence of established risk factors on lifetime risks for SCD have not been estimated previously.

We followed Framingham Heart Study participants who were free of cardiovascular disease before their earliest examination. SCD was defined as death attributed to coronary heart disease within 1 hour of symptom onset without another probable cause of death, as adjudicated by a panel of 3 physicians. Lifetime risk for SCD was estimated to 85 years of age for men and women, with death attributed to other causes as the competing risk, and stratified by risk factor levels. We followed 2294 men and 2785 women for 160 396 person‐years; 375 experienced SCD. At 45 years of age, lifetime risks were 10.9% (95% CI, 9.4–12.5) for men and 2.8% (95% CI, 2.1–3.5) for women. Greater aggregate burden of established risk factors was associated with a higher lifetime risk for SCD. Categorizing men and women solely by blood pressure levels resulted in a clear stratification of lifetime risk curves.

We present the first lifetime risk estimates for SCD. Greater aggregate risk factor burden, or blood pressure level alone, is associated with higher lifetime risks for SCD. This high risk of premature death attributed to SCD (approximately 1 in 9 men and 1 in 30 women) should serve as a motivator of public health efforts in preventing and responding to SCD.

• death
• epidemiology
• risk factors
• sudden

• Aged
• Aged, 80 and over
• Antihypertensive Agents/therapeutic use
• Blood Pressure
• Cardiovascular Diseases/epidemiology
• Death, Sudden, Cardiac/epidemiology
• Female
• Humans
• Hypertension/drug therapy
• Hypertension/epidemiology
• Independent Living
• Male
• Middle Aged
• Risk Factors
• United States/epidemiology

• R21 HL085375 NHLBI NIH HHS
• UL1 TR001422 NCATS NIH HHS