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Pilz N, Picone DS, Patzak A, Opatz OS, Lindner T, Fesseler L, Heinz V, Bothe TL. Cuff-based blood pressure measurement: challenges and solutions. Blood Press 2024; 33:2402368. [PMID: 39291896 DOI: 10.1080/08037051.2024.2402368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 09/03/2024] [Accepted: 09/04/2024] [Indexed: 09/19/2024]
Abstract
OBJECTIVE Accurate measurement of arterial blood pressure (BP) is crucial for the diagnosis, monitoring, and treatment of hypertension. This narrative review highlights the challenges associated with conventional (cuff-based) BP measurement and potential solutions. This work covers each method of cuff-based BP measurement, as well as cuffless alternatives, but is primarily focused on ambulatory BP monitoring. RESULTS Manual BP measurement requires stringent training and standardized protocols which are often difficult to ensure in stressful and time-restricted clinical office blood pressure monitoring (OBPM) scenarios. Home Blood pressure monitoring (HBPM) can identify white-coat and masked hypertension but strongly depends on patient adherence to measurement techniques and procedure. The widespread use of nonvalidated automated HBPM devices raises further concerns about measurement accuracy. Ambulatory blood pressure measurement (ABPM) may be used in addition to OBPM. It is recommended to diagnose white-coat and masked hypertension as well as nocturnal BP and dipping, which are the BP values most predictive for major adverse cardiac events. Nonetheless, ABPM is limited by its non-continuous nature and susceptibility to measurement artefacts. This leads to poor overall reproducibility of ABPM results, especially regarding clinical parameters such as BP variability or dipping patterns. CONCLUSIONS Cuff-based BP measurement, despite some limitations, is vital for cardiovascular health assessment in clinical practice. Given the wide range of methodological limitations, the paradigm's potential for improvement is not yet fully realized. There are impactful and easily incorporated opportunities for innovation regarding the enhancement of measurement accuracy and reliability as well as the clinical interpretation of the retrieved data. There is a clear need for continued research and technological advancement to improve BP measurement as the premier tool for cardiovascular disease detection and management.
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Affiliation(s)
- N Pilz
- Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - D S Picone
- Sydney School of Health Sciences, University of Sydney, Sydney, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - A Patzak
- Institute of Translational Physiology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - O S Opatz
- Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T Lindner
- Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - L Fesseler
- Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - V Heinz
- Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T L Bothe
- Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Sydney School of Health Sciences, University of Sydney, Sydney, Australia
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Marinović Glavić M, Bilajac L, Bolješić M, Bubaš M, Capak K, Domislović M, Džakula A, Fuček M, Gellineo L, Jelaković A, Josipović J, Jukić T, Juraga D, Pećin I, Prelević V, Radunović D, Reiner Ž, Rukavina T, Šušnjara P, Vasiljev V, Vidranski V, Jelaković B. Assessment of Salt, Potassium, and Iodine Intake in the Croatian Adult Population Using 24 h Urinary Collection: The EH-UH 2 Study. Nutrients 2024; 16:2599. [PMID: 39203736 PMCID: PMC11356790 DOI: 10.3390/nu16162599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/02/2024] [Accepted: 08/03/2024] [Indexed: 09/03/2024] Open
Abstract
Cardiovascular diseases, which are the leading cause of death in Croatia, are linked to the high prevalence of hypertension. Both are associated with high salt intake, which was determined almost two decades ago when Croatian Action on Salt and Health (CRASH) was launched. The main objective of the present study was to evaluate salt, potassium, and iodine intake using a single 24 h urine sample in a random sample of the adult Croatian population and to analyse trends in salt consumption after the CRASH was intensively started. METHODS In this study, we analysed data on 1067 adult participants (mean age 57.12 (SD 13.9), men 35%). RESULTS Mean salt and potassium intakes were 8.6 g/day (IQR 6.2-11.2) and 2.8 g/day (IQR 2.1-3.5), respectively, with a sodium-to-potassium ratio of 2.6 (IQR 1.8-3.3). We detected a decrease of 17.6% (2 g/day less) in salt consumption compared with our previous salt-mapping study. However, only 13.7% and 8.9% met the WHO salt and potassium recommended targets of 5 g/day and 3.5 g/day, respectively. Salt intake was higher, and potassium ingestion was lower, in rural vs. urban regions and in continental vs. Mediterranean parts of Croatia. Moderate to severe iodine insufficiency was determined in only 3% of the adult participants. CONCLUSION In the last fifteen years, salt consumption has been significantly reduced in the Croatian adult population because of the intensive and broad CRASH program. However, salt intake is still too high, and potassium ingestion is too low. Salt reduction programs are the most cost-effective methods of cardiovascular disease prevention and merit greater consideration by the government and health policy makers.
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Affiliation(s)
- Mihaela Marinović Glavić
- Department of Social Medicine and Epidemiology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (L.B.); (A.J.); (D.J.); (T.R.); (V.V.)
| | - Lovorka Bilajac
- Department of Social Medicine and Epidemiology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (L.B.); (A.J.); (D.J.); (T.R.); (V.V.)
- Department of Public Health, Faculty of Health Studies, University of Rijeka, 51000 Rijeka, Croatia
- Teaching Institute of Public Health Primorje—Gorski Kotar County, 51000 Rijeka, Croatia
| | - Marta Bolješić
- Department of Anatomy and Neuroscience, Faculty of Medicine, University of Osijek, 31000 Osijek, Croatia;
| | - Marija Bubaš
- Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (K.C.)
- Ministry of Health, 10000 Zagreb, Croatia
| | - Krunoslav Capak
- Croatian Institute of Public Health, 10000 Zagreb, Croatia; (M.B.); (K.C.)
| | - Marija Domislović
- Department for Nephrology, Hypertension, Dialysis and Transplantation University Hospital Centre, 10000 Zagreb, Croatia; (M.D.); (L.G.); (V.P.); (D.R.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (T.J.); (I.P.)
| | - Aleksandar Džakula
- Department of Social Medicine and Organization of Health Care, Andrija Štampar School of Public Health, University of Zagreb School of Medicine, 10000 Zagreb, Croatia;
| | - Mirjana Fuček
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Lana Gellineo
- Department for Nephrology, Hypertension, Dialysis and Transplantation University Hospital Centre, 10000 Zagreb, Croatia; (M.D.); (L.G.); (V.P.); (D.R.)
| | - Ana Jelaković
- Department of Social Medicine and Epidemiology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (L.B.); (A.J.); (D.J.); (T.R.); (V.V.)
- Department for Nephrology, Hypertension, Dialysis and Transplantation University Hospital Centre, 10000 Zagreb, Croatia; (M.D.); (L.G.); (V.P.); (D.R.)
| | - Josipa Josipović
- Department of Nephrology and Dialysis, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia;
- School of Medicine, Catholic University of Croatia, 10000 Zagreb, Croatia
| | - Tomislav Jukić
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (T.J.); (I.P.)
- Department of Oncology and Nuclear Medicine, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia
| | - Denis Juraga
- Department of Social Medicine and Epidemiology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (L.B.); (A.J.); (D.J.); (T.R.); (V.V.)
| | - Ivan Pećin
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (T.J.); (I.P.)
- Department for Metabolic Diseases, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Vladimir Prelević
- Department for Nephrology, Hypertension, Dialysis and Transplantation University Hospital Centre, 10000 Zagreb, Croatia; (M.D.); (L.G.); (V.P.); (D.R.)
- Clinic for Nephrology, Clinical Centre of Montenegro, 81000 Podgorica, Montenegro
| | - Danilo Radunović
- Department for Nephrology, Hypertension, Dialysis and Transplantation University Hospital Centre, 10000 Zagreb, Croatia; (M.D.); (L.G.); (V.P.); (D.R.)
- Clinic for Nephrology, Clinical Centre of Montenegro, 81000 Podgorica, Montenegro
| | - Željko Reiner
- Department for Metabolic Diseases, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
- Department of Cardiology and Congenital Diseases of Adults, Polish Mother’s Memorial Hospital Research Institute, 93-338 Lodz, Poland
| | - Tomislav Rukavina
- Department of Social Medicine and Epidemiology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (L.B.); (A.J.); (D.J.); (T.R.); (V.V.)
- Teaching Institute of Public Health Primorje—Gorski Kotar County, 51000 Rijeka, Croatia
| | - Petar Šušnjara
- Faculty of Kinesiology Osijek, Josip Juraj Strosssmayer, University of Osijek, 31000 Osijek, Croatia;
| | - Vanja Vasiljev
- Department of Social Medicine and Epidemiology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia; (L.B.); (A.J.); (D.J.); (T.R.); (V.V.)
| | - Valentina Vidranski
- Department of Clinical Chemistry, Sestre Milosrdnice University Hospital Centre, 10000 Zagreb, Croatia;
| | - Bojan Jelaković
- Department for Nephrology, Hypertension, Dialysis and Transplantation University Hospital Centre, 10000 Zagreb, Croatia; (M.D.); (L.G.); (V.P.); (D.R.)
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia; (T.J.); (I.P.)
- Croatian Hypertension League, 10000 Zagreb, Croatia
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Li J, Han LH, Feng R, Wu LH, Cai J, Zeng TY, Liu H, Wang L, Li JY, Zhan ZQ. Validation of the JAMR upper-arm pressure monitor B23 according to the AAMI/ESH/ISO Universal Standard (ISO 81060- 2:2018/AMD 1:2020). Blood Press Monit 2024:00126097-990000000-00120. [PMID: 39105269 DOI: 10.1097/mbp.0000000000000719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
The aim of this study was to evaluate the accuracy of the JAMR upper-arm blood pressure monitor B23 in the general population according to the AAMI/ESH/ISO Universal Standard (ISO 81060-2 : 2018/AMD 1 : 2020). The study recruited participants who met the criteria of the AAMI/ESH/ISO Universal Standard in terms of their number, sex, age, limb size, and blood pressure (BP) distribution. The study involved measuring BP, including both SBP and DBP, using both the test device and a standard mercury sphygmomanometer in sequential measurements. Of 90 participants, 85 qualified participants were analyzed. A total of 255 sets of comparison data (three sets for each subject) were obtained and analyzed. For the validation criterion 1, the mean ± SD of the differences between the JAMR B23 and mercury sphygmomanometer BP readings was -0.24 ± 6.52/-2.67 ± 5.6 mmHg (SBP/DBP). For criterion 2, the SD of the averaged BP (SBP/DBP) differences between the JAMR B23 and reference BP (SBP/DBP) per participant was 5.61/5.13 mmHg (the requirement was ≤6.95/6.43 mmHg by calculation). The JAMR B23 passed all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060-2 : 2018/AMD 1 : 2020) and can be recommended for clinical and self/home use in the general population.
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Affiliation(s)
- Jing Li
- Department of Cardiology, Shenzhen Guangming District People's Hospital, Shenzhen, China
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4
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Turnbull N, Nghiep LK, Butsorn A, Khotprom A, Tudpor K. Machine learning models identify micronutrient intake as predictors of undiagnosed hypertension among rural community-dwelling older adults in Thailand: a cross-sectional study. Front Nutr 2024; 11:1411363. [PMID: 39081680 PMCID: PMC11286389 DOI: 10.3389/fnut.2024.1411363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/02/2024] [Indexed: 08/02/2024] Open
Abstract
Objective To develop a predictive model for undiagnosed hypertension (UHTN) in older adults based on five modifiable factors [eating behaviors, emotion, exercise, stopping smoking, and stopping drinking alcohol (3E2S) using machine learning (ML) algorithms. Methods The supervised ML models [random forest (RF), support vector machine (SVM), and extreme gradient boosting (XGB)] with SHapley Additive exPlanations (SHAP) prioritization and conventional statistics (χ2 and binary logistic regression) were employed to predict UHTN from 5,288 health records of older adults from ten primary care hospitals in Thailand. Results The χ2 analyses showed that age and eating behavior were the predicting features of UHTN occurrence. The binary logistic regression revealed that taking food supplements/vitamins, using seasoning powder, and eating bean products were related to normotensive and hypertensive classifications. The RF, XGB, and SVM accuracy were 0.90, 0.89, and 0.57, respectively. The SHAP identified the importance of salt intake and food/vitamin supplements. Vitamin B6, B12, and selenium in the UHTN were lower than in the normotensive group. Conclusion ML indicates that salt intake, soybean consumption, and food/vitamin supplements are primary factors for UHTN classification in older adults.
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Affiliation(s)
- Niruwan Turnbull
- Faculty of Public Health, Mahasarakham University, Maha Sarakham, Thailand
- Public Health and Environmental Policy in Southeast Asia Research Cluster (PHEP-SEA), Mahasarakham University, Maha Sarakham, Thailand
| | - Le Ke Nghiep
- Vinh Long Department of Health, Vinh Long, Vietnam
| | - Aree Butsorn
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani, Thailand
| | - Anuwat Khotprom
- Public Health and Environmental Policy in Southeast Asia Research Cluster (PHEP-SEA), Mahasarakham University, Maha Sarakham, Thailand
| | - Kukiat Tudpor
- Faculty of Public Health, Mahasarakham University, Maha Sarakham, Thailand
- Public Health and Environmental Policy in Southeast Asia Research Cluster (PHEP-SEA), Mahasarakham University, Maha Sarakham, Thailand
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Laxmi, Golmei P, Srivastava S, Kumar S. Single nucleotide polymorphism-based biomarker in primary hypertension. Eur J Pharmacol 2024; 972:176584. [PMID: 38621507 DOI: 10.1016/j.ejphar.2024.176584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/19/2024] [Accepted: 04/11/2024] [Indexed: 04/17/2024]
Abstract
Primary hypertension is a multiplex and multifactorial disease influenced by various strong components including genetics. Extensive research such as Genome-wide association studies and candidate gene studies have revealed various single nucleotide polymorphisms (SNPs) related to hypertension, providing insights into the genetic basis of the condition. This review summarizes the current status of SNP research in primary hypertension, including examples of hypertension-related SNPs, their location, function, and frequency in different populations. The potential clinical implications of SNP research for primary hypertension management are also discussed, including disease risk prediction, personalized medicine, mechanistic understanding, and lifestyle modifications. Furthermore, this review highlights emerging technologies and methodologies that have the potential to revolutionize the vast understanding of the basis of genetics in primary hypertension. Gene editing holds the potential to target and correct any kind of genetic mutations that contribute to the development of hypertension or modify genes involved in blood pressure regulation to prevent or treat the condition. Advances in computational biology and machine learning enable researchers to analyze large datasets and identify complex genetic interactions contributing to hypertension risk. In conclusion, SNP research in primary hypertension is rapidly evolving with emerging technologies and methodologies that have the potential to transform the knowledge about genetic basis related to the condition. These advances hold promise for personalized prevention and treatment strategies tailored to an individual's genetic profile ultimately improving patient outcomes and reducing healthcare costs.
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Affiliation(s)
- Laxmi
- Department of Pharmacology, Delhi Institute of Pharmaceutical Sciences and Research, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, M B Road, New Delhi, 110017, India
| | - Pougang Golmei
- Department of Pharmacology, Delhi Institute of Pharmaceutical Sciences and Research, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, M B Road, New Delhi, 110017, India
| | - Shriyansh Srivastava
- Department of Pharmacology, Delhi Institute of Pharmaceutical Sciences and Research, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, M B Road, New Delhi, 110017, India
| | - Sachin Kumar
- Department of Pharmacology, Delhi Institute of Pharmaceutical Sciences and Research, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, M B Road, New Delhi, 110017, India.
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Sharma JR, Fokkens H, Laubscher R, Apalata TR, Nomatshila SC, Alomatu SY, Strijdom H, Johnson R. No Association Between AGT Gene Polymorphisms with Hypertension in a South African Population. Diabetes Metab Syndr Obes 2024; 17:1853-1865. [PMID: 38706806 PMCID: PMC11069114 DOI: 10.2147/dmso.s452272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/16/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose Hypertension is a leading cause of cardiovascular-related morbidity and mortality worldwide, with a prevalence increasing at an alarming rate in both middle- and low-income countries. Various environmental and genetic factors have been attributed to play a significant role in the increasing prevalence of hypertension. Single nucleotide polymorphisms (SNPs) in the angiotensinogen (AGT) gene are reported to have a significant association with hypertension; however, there are limited studies done on South African populations. Therefore, this case-control study aimed to investigate the association between AGT SNPs (rs2004776, rs3789678, rs5051 and rs7079) with hypertension in a study population of isiXhosa-speaking participants from the Eastern Cape Province in South Africa. Materials and Methods The SNPs were genotyped in 250 hypertensive cases and 237 normotensive controls, using TaqMan genotyping assays. Results For the SNP rs2004776, the frequency of CC genotype (18.4%) and C allele (44%) in hypertensive cases showed no significant differences (p = 0.52, χ2 = 1.32), when compared to the normotensive control group (CC: 19.8% and C allele: 43%). Similar results were obtained for the genotypic and allelic frequencies between hypertensive cases and normotensive controls for rs3789678 (p = 0.88, χ2=0.26) and rs5051 (p = 0.57, χ2=1.12), and rs7079 (p = 0.33, χ2=2.23). These findings demonstrate that there were no significant associations between the SNPs rs2004776, rs3789678, rs7079, rs5051 with hypertension in our study population. Conclusion These findings suggest that AGT gene polymorphisms are not associated with the development of hypertension in the studied population. The present study represents the first genetic report to investigate the AGT gene polymorphisms with hypertension in an isiXhosa-speaking South African population.
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Affiliation(s)
- Jyoti Rajan Sharma
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa
| | - Hannah Fokkens
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa
- Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Ria Laubscher
- Biostatistics Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Teke Ruffin Apalata
- Department of Laboratory-Medicine and Pathology, Faculty of Health Sciences, Walter Sisulu University and National Health Laboratory Services, Mthatha, South Africa
| | - Sibusiso Cyprian Nomatshila
- Department of Public Health, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha, South Africa
| | - Samuel Yao Alomatu
- Department of Internal Medicine, Nelson Mandela Central Hospital and Walter Sisulu University, Mthatha, South Africa
| | - Hans Strijdom
- Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rabia Johnson
- Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa
- Centre for Cardiometabolic Research in Africa, Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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7
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Peniston S, Sivaramakrishnan D, Holloway A. Undiagnosed and uncontrolled hypertension in rural African adults: a scoping review protocol of primary health care interventions. BMJ Open 2024; 14:e081937. [PMID: 38589263 PMCID: PMC11015176 DOI: 10.1136/bmjopen-2023-081937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/04/2024] [Indexed: 04/10/2024] Open
Abstract
INTRODUCTION Non-communicable diseases cause 74% of global deaths, with cardiovascular diseases as the major contributor. Hypertension, a primary risk factor for cardiovascular disease, is highly prevalent in Africa. Diagnosis, treatment and control rates are notably limited in rural areas. This limitation results in increased risks of premature mortality and complications such as stroke due to socioeconomic, cultural and geographical challenges. Progress in African countries enhancing hypertension services through primary health care interventions exists. However, a comprehensive review of all primary health care interventions addressing undiagnosed and uncontrolled hypertension in rural African settings is lacking. This scoping review aims to categorise primary health care interventions targeting undiagnosed and uncontrolled hypertension in rural African adults. Intervention components will be mapped to the four stages outlined in the hypertension care cascade to develop a pilot intervention logic model for rural African adults with hypertension. METHOD AND ANALYSIS The scoping review protocol will adhere to the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Studies considered for inclusion will include any intervention delivered by any healthcare provider in a rural African primary care setting targeting any stage of hypertension care. Eight databases will be searched without date restrictions, supplemented by grey literature and reference list searches. A two-stage screening process (title/abstract and full text) will determine evidence source eligibility. All eligible sources of evidence will be extracted, charted and evaluated using the Template for Intervention Description and Replication checklist. A pilot logic model categorising and mapping interventions to the four stages of the hypertension care cascade will be visually presented and analysed using narrative synthesis. ETHICS AND DISSEMINATION No primary data will be collected; therefore, ethics approval is not required. Findings will be disseminated to local health authorities in Ghana and other African Regions and through national and international conferences and publications in peer-reviewed journals.
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Affiliation(s)
- Sandra Peniston
- Nursing Studies, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
- Scottish Collaboration for Public Health Research and Policy, The University of Edinburgh, Edinburgh, UK
- School of Nursing, Faculty of Health, York University, Toronto, ON, Canada
| | - Divya Sivaramakrishnan
- Nursing Studies, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
- Scottish Collaboration for Public Health Research and Policy, The University of Edinburgh, Edinburgh, UK
| | - Aisha Holloway
- Nursing Studies, School of Health in Social Science, The University of Edinburgh, Edinburgh, UK
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8
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McCalla G, Brown PD, Nwokocha C. Cadmium induces microcytosis and anisocytosis without anaemia in hypertensive rats. Biometals 2024; 37:519-526. [PMID: 38184813 DOI: 10.1007/s10534-023-00567-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024]
Abstract
Dietary cadmium (Cd2+) intake is implicated in the pathogenesis of hypertension and anaemia, but there is a paucity of information on the haematological changes in hypertensive conditions. This study, therefore, aims to evaluate the effects of Cd2+ on blood pressure (BP) and haematological indices in the Sprague-Dawley rat model. Three cohorts (n = 10 each) of control and Cd2+-fed male Sprague-Dawley rats were selected. Cd2+-exposed rats received 2.5 or 5 mg/kg b.w. cadmium chloride via gavage thrice-weekly for eight weeks, while control animals received tap water. BP and flow were measured non-invasively from rat tails twice-weekly using a CODA machine, while weights were measured thrice-weekly. Haematological indices were assessed using the Cell-Dyn Emerald Haematology Analyzer. Data were reported as mean ± SEM, and statistically analyzed using One-Way Analysis of Variance. Bonferroni post hoc test was used for multiple comparisons. Cd2+-exposure induced hypertension by significantly (p < 0.05) elevating systolic, diastolic, and mean arterial BPs, pulse pressure, and heart rate (HR), and increased (p < 0.05) blood flow. Mean cell volume (MCV) and haemoglobin (MCH) were significantly (p < 0.05) reduced, and red cell distribution width (RDW) significantly (p < 0.01) increased by exposure to 5 mg/kg b.w. Cd2+. Haemoglobin concentration (MCHC), haematocrit, haemoglobin, red blood cell, platelet, mean platelet volume, and white blood cell counts were unaffected by Cd2+-exposure. Cd2+ induced hypertension, microcytosis, hypochromicity, and anisocytosis without anaemia, which may be precursor to microcytic anaemia and coronary artery disease. This study is important in Cd2+-exposed environments and warrants further investigations.
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Affiliation(s)
- Garsha McCalla
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica.
| | - Paul D Brown
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Chukwuemeka Nwokocha
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica
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Delmotte L, Desebbe O, Alexander B, Kouz K, Coeckelenbergh S, Schoettker P, Turgay T, Joosten A. Smartphone-Based versus Non-Invasive Automatic Oscillometric Brachial Cuff Blood Pressure Measurements: A Prospective Method Comparison Volunteer Study. J Pers Med 2023; 14:15. [PMID: 38276230 PMCID: PMC10817276 DOI: 10.3390/jpm14010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/06/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction: Mobile health diagnostics have demonstrated effectiveness in detecting and managing chronic diseases. This method comparison study aims to assess the accuracy and precision of the previously evaluated OptiBP™ technology over a four-week study period. This device uses optical signals recorded by placing a patient's fingertip on a smartphone's camera to estimate blood pressure (BP). Methods: In adult participants without cardiac arrhythmias and minimal interarm blood pressure difference (systolic arterial pressure (SAP) < 15 mmHg or diastolic arterial pressure (DAP) < 10 mmHg), three pairs of 30 s BP measurements with the OptiBP™ (test method) were simultaneously compared using three pairs of measurements with the non-invasive oscillometric brachial cuff (reference method) on the opposite arm over a period of four consecutive weeks at a rate of two measurements per week (one in the morning and one in the afternoon). The agreement of BP values between the two technologies was analyzed using Bland-Altman and error grid analyses. The performance of the smartphone application was investigated using the International Organization for Standardization (ISO) definitions, which require the bias ± standard deviation (SD) between two technologies to be lower than 5 ± 8 mmHg. Results: Among the 65 eligible volunteers, 53 participants had adequate OptiBP™ BP values. In 12 patients, no OptiBP™ BP could be measured due to inadequate signals. Only nine participants had known chronic arterial hypertension and 76% of those patients were treated. The mean bias ± SD between both technologies was -1.4 mmHg ± 10.1 mmHg for systolic arterial pressure (SAP), 0.2 mmHg ± 6.5 mmHg for diastolic arterial pressure (DAP) and -0.5 mmHg ± 6.9 mmHg for mean arterial pressure (MAP). Error grid analyses indicated that 100% of the pairs of BP measurements were located in zones A (no risk) and B (low risk). Conclusions: In a cohort of volunteers, we observed an acceptable agreement between BP values obtained with the OptiBPTM and those obtained with the reference method over a four-week period. The OptiBPTM fulfills the ISO standards for MAP and DAP (but not SAP). The error grid analyses showed that 100% measurements were located in risk zones A and B. Despite the need for some technological improvements, this application may become an important tool to measure BP in the future.
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Affiliation(s)
- Lila Delmotte
- Department of Anesthesiology, Erasme University Hospital, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium; (L.D.); (T.T.)
| | - Olivier Desebbe
- Department of Anesthesiology & Perioperative Medicine, Sauvegarde Clinic, Ramsay Santé, 69009 Lyon, France;
| | - Brenton Alexander
- Department of Anesthesiology, University of California San Diego, La Jolla, CA 92103, USA;
| | - Karim Kouz
- Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Sean Coeckelenbergh
- Department of Anesthesiology, Université Paris-Saclay, Paul Brousse Hospital, Assistance Publique Hôpitaux de Paris (APHP), 94800 Villejuif, France
- Outcomes Research Consortium, Cleveland, OH 44195, USA
| | - Patrick Schoettker
- Biospectal SA, 1003 Lausanne, Switzerland;
- Department of Anesthesiology, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Tuna Turgay
- Department of Anesthesiology, Erasme University Hospital, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium; (L.D.); (T.T.)
| | - Alexandre Joosten
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
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