Role of housing in blood pressure control: a review of evidence from the Smart Wellness Housing survey in Japan

Hypertension research 2024 update and perspectives: blood pressure management

This mini-review article presents a comprehensive update on recent advancements in blood pressure management, based on original research published between 2023 and 2024. As part of the "Hypertension Research 2024 Update and Perspectives", the review integrates insights from the JSH2024 Fukuoka Declaration, emphasizing the concept of "NEO-HYPERTENSION harmonized with society". The strategies proposed in this review aim to realize this concept by promoting lifelong blood pressure management, preemptive medicine, and leveraging digital health technologies. Key strategies include adherence to treatment guidelines, overcoming clinical inertia, and the utilization of new digital tools and novel antihypertensive agents. Additionally, the review explores the significance of multidisciplinary collaboration and non-pharmacological therapies, as well as the importance of setting individualized treatment goals tailored to patients' unique backgrounds. By aligning with the JSH's vision, this review offers a fresh perspective on contemporary clinical practices and future directions. These updates aim to contribute to improved patient outcomes and global health advancements in hypertension care.

Geo-demographic and socioeconomic determinants of diagnosed hypertension among urban dwellers in Ibadan, Nigeria: a community-based study

BACKGROUND

The relationship between diagnosed high blood pressure (HBP) and proximity to health facilities and noise sources is poorly understood. We investigated the associations between the number of persons diagnosed with HBP at different distance corridors of noise-generating sources (churches, mosques, bus stops, and road networks), and blood pressure monitoring outlets (healthcare facilities and pharmaceutical shops) in Ibadan, Nigeria. In addition, we investigated the likelihood of being diagnosed with HBP using distance from noise-generating sources, distance to blood pressure monitoring outlets, socio-demographic and clinical status of the participants.

METHODS

We investigated 13,531 adults from the African Rigorous Innovative Stroke Epidemiological Surveillance (ARISES) study in Ibadan. Using a Geographic Information System (GIS), the locations of healthcare facilities, pharmaceutical shops, bus stops, churches, and mosques were buffered at 100 m intervals, and coordinates of persons diagnosed with HBP were overlaid on the buffered features. The number of persons with diagnosed HBP living at every 100 m interval was estimated. Gender, occupation, marital status, educational status, type of housing, age, and income were used as predictor variables. Analysis was conducted using Spearman rank correlation and binary logistic regression at p < 0.05.

RESULTS

There was a significant inverse relationship between the number of persons diagnosed with HBP and distance from pharmaceutical shops (r=-0.818), churches (r=-0.818), mosques (r=-0.893) and major roads (r= -0.667). The odds of HBP were higher among the unemployed (AOR = 1.58, 95% CI: 1.11-2.24), currently married (AOR = 1.45, CI: 1.11-1.89), and previously married (1.75, CI: 1.29-2.38). The odds of diagnosed HBP increased with educational level and age group.

CONCLUSION

Proximity to noise sources, being unemployed and educational level were associated with diagnosed HBP. Reduction in noise generation, transmission, and exposure could reduce the burden of hypertension in urban settings.

Geo-Demographic and Socioeconomic Determinants of Diagnosed Hypertension among Urban Dwellers in Ibadan, Nigeria: A Community-based Study

Background

The relationship between diagnosed high blood pressure (HBP) and proximity to health facilities and noise sources is poorly understood. We investigated the relationship between proximity to noise sources, sociodemographic and economic factors, and diagnosed HBP in Ibadan, Nigeria.

Methods

We investigated 13,531 adults from the African Rigorous Innovative Stroke Epidemiological Surveillance (ARISES) study in Ibadan. Using a Geographic Information System (GIS), the locations of healthcare facilities, pharmaceutical shops, bus stops, churches, and mosques were buffered at 100m intervals, and coordinates of persons diagnosed with HBP were overlaid on the buffered features. The number of persons with diagnosed HBP living at every 100m interval was estimated. Gender, occupation, marital status, educational status, type of housing, age, and income were used as predictor variables. Analysis was conducted using Spearman rank correlation and binary logistic regression at p<0.05.

Results

There was a significant inverse relationship between the number of persons diagnosed with HBP and distance from pharmaceutical shops (r=-0.818), churches (r=-0.818), mosques (r=-0.893) and major roads (r=-0.667). The odds of diagnosed HBP were higher among the unemployed (AOR=1.58, 95% CI: 1.11-2.24), currently married (AOR=1.45, CI: 1.11-1.89), and previously married (1.75, CI: 1.29-2.38). The odds of diagnosed HBP increased with educational level and age group.

Conclusion

Proximity to noise sources, being unemployed and educational level were associated with diagnosed HBP. Reduction in noise generation, transmission, and exposure could reduce the burden of hypertension in urban settings.

Home blood pressure-centered approach - from digital health to medical practice: HOPE Asia Network consensus statement 2023

Recent innovations in digital technology have enabled the simultaneous accumulation, and the linking and analysis of time-series big data relating to several factors that influence blood pressure (BP), including biological indicators, physical activity, and environmental information. Various approaches can be used to monitor BP: in the office/clinic; at home; 24-h ambulatory recording; or with wearable and cuffless devices. Of these, home BP monitoring is a reliable and convenient method, and is recommended for hypertension management by current national and international guidelines. This recommendation is based on evidence showing that home BP is an important predictor of cardiovascular, cerebrovascular and kidney disease in patients with hypertension. In addition, lifetime personalized health record (PHR)-based home BP with telemonitoring combined with co-interventions has been shown to lower BP more effectively than the traditional approach based on office BP. Thus, home BP represents a key metric for personalized anticipation medicine, from digital healthcare to digital medicine. This paper summarizes the latest evidence on home BP monitoring and proposes a Hypertension Cardiovascular Outcome Prevention and Evidence in Asia (HOPE Asia) Network consensus on a home BP-centered approach to the management of hypertension.

Digital hypertension towards to the anticipation medicine

"Digital Hypertension" is a new research field proposed by the Japanese Society of Hypertension that integrates digital technology into hypertension management and proactively promotes research activities. This novel approach includes the development of new technologies for better BP management, such as sensors for detecting environmental factors that affect BP, information processing, and machine learning. To facilitate "Digital Hypertension," a more sophisticated BP monitoring system capable of measuring an individual's BP more frequently in various situations would be required. With the use of these technologies, hypertension management could shift from the current "dots" management based on office BP readings during clinic visits to a "line" management system based on seamless home BP or individual BP data taken by a wearable BP monitoring device. DTx is the innovation to change hypertension management from "dots" to "line", completely achieved by wearable BP.

Effects of indoor temperature and its fluctuation on blood pressure and its variability

Cardiovascular diseases (CVDs) are the number one health threat globally. Adverse indoor thermal environments are associated with excess mortality caused by CVDs in the cold season. While many studies have focused on the impact of indoor temperature on CVDs, none has considered the fluctuation of indoor temperature. To quantify the effect of indoor temperature on blood pressure and the effect of indoor temperature fluctuation on blood pressure variability (BPV), 172 middle-aged and elderly people in areas that experience both hot summers and cold winters in China completed a household survey regarding their characteristics and living habits. A hierarchical linear model (HLM) was used to analyze the impact of indoor temperature on home blood pressure. A multiple linear model was used to analyze the effect of indoor temperature fluctuation on day-to-day home blood pressure variability. The results showed that there was a significant negative correlation between morning temperature below 18 °C and blood pressure, especially systolic blood pressure (SBP). At the same time, morning temperature fluctuations have an independent influence on BPV, and a deviation of morning temperature fluctuation greater than 1.1 °C significantly increased BPV. Morning temperature and its fluctuation threshold for the rise of SBP and its variability of middle-aged and elderly people were clarified, which can provide a basis for the design, operation, and evaluation of residential thermal environmental health performance for the middle-aged and elderly population in this area, thereby reducing the cardiovascular health risk of the corresponding population.