The association between hypertension and other cardiovascular risk factors among non-diabetic Saudis adults-A cross sectional study

The Association of the Metabolic Score for Insulin Resistance (METS-IR) with Prehypertension in Normoglycemic Individuals

Background

Insulin resistance is a critical first step in the development of many chronic diseases such as diabetes, hypertension, and coronary artery disease (CAD). Early recognition of changes in insulin sensitivity and subsequent glycolipid dysregulation is paramount in reversing the progression of these diseases. Since the prevalence of insulin resistance is relatively high, there is a demand for a simple, easy, and inexpensive method for its detection.

Objectives

To assess the association of metabolic score for insulin resistance (METS-IR) with prehypertension (preHTN) in normoglycemic individuals.

Methods

A cross-sectional study included two groups with normal blood glucose levels (age and sex matched, 179 adults each) with and without preHTN. Those with a history of hypertension, diabetes, CAD, or on chronic drug treatment were excluded from the study. Metabolic score for insulin resistance was calculated as Ln [(2 × FPG (mg/dL) + fasting TG (mg/dL)] × BMI (kg/m²)/Ln [HDL-c (mg/dL)].

Results

The METS-IR score was significantly higher in those with preHTN (P < 0.001). One-way ANOVA showed significant differences in BMI, TG, and HDL-c according to METS-IR quartiles. Cox regression analysis showed that METS-IR is a single independent predictor of preHTN (OR = 1.3, 95% CI 1.20, 1.34).

Conclusions

Metabolic score for insulin resistance is significantly associated with and an independent predictor of prehypertension in euglycemic people.

Assessing the Risk of Hypertension in Chronic, Elderly Patients during the COVID-19 Pandemic: A Prospective Study

BACKGROUND

This study considers care management for older chronic patients during and after the COVID-19 pandemic.

AIMS

To identify groups of variables at previous time points as a basis for deriving efficient classification models during and after a pandemic situation and to quantify the effect of each variable within the model to predict levels of worsening risk in diastolic and systolic arterial hypertension (AHT).

MATERIAL AND METHODS

In this prospective longitudinal study, data were collected at three time points: before, during, and after the COVID-19 pandemic period.

RESULTS

The study included 148 patients with an average age of 81.6 years. During the study period, mean systolic blood pressure among this population rose by 5 mmHg to 128.8 mmHg; the number of patients with systolic blood pressure > 140 mmHg rose by 45.3%; among those with diastolic blood pressure > 90, the number rose by 41.2%; mean triglycerides levels rose to 152.6 mg/dL; cholesterol levels rose to 147 mg/dL; and LDL cholesterol rose to 112.2 mg/dL. Meanwhile, mean levels of HDL cholesterol decreased to 46.5 mg/dL. Binary-response logistic regression models were constructed to identify the most relevant variables for predicting AHT risk during and after the pandemic. The heart rate (OR = 1.79; 95% CI: 1.22-2.72) and body mass index (OR = 1.75; 95% CI: 1.08-2.94) variables were significant at the population level (p < 0.05) for diastolic and systolic AHT in the pandemic period risk models. The body mass index variable was also significant for diastolic AHT in the post-pandemic period risk model (OR = 1.97; 95% CI: 1.32-2.94), whilst the triglycerides variable was significant in the systolic AHT post-pandemic period risk model (OR = 1.49; 95% CI: 1.01-1.86).

CONCLUSIONS

Bad control of arterial hypertension in older patients with chronic disease is associated with elevated levels of LDL cholesterol, total cholesterol, systolic blood pressure, heart rate and triglycerides, and lower levels of HDL cholesterol.

Patient journey for hypertension and dyslipidemia in Saudi Arabia: highlighting the evidence gaps

BACKGROUND

In recent years, Saudi Arabia has witnessed staggering rates of hypertension and dyslipidemia-related cardiovascular (CV) deaths, overburdening the healthcare ecosystem of the country. Appropriate public health interventions can be devised through quantitative mapping of evidence. Identification of potential data gaps can prioritize future research needs and develop a 'best-fit' framework for patient-centric management of hypertension and dyslipidemia.

METHODS

This review quantified data gaps in the prevalence and key epidemiological touchpoints of the patient journey including awareness, screening, diagnosis, treatment, adherence, and control in patients with hypertension and dyslipidemia in Saudi Arabia. Studies published in English between January 2010 and December 2021 were identified through a structured search on MEDLINE, Embase, BIOSIS, and PubMed databases. An unstructured search on public and government websites, including Saudi Ministry of Health, without date limits was carried out to fill data gaps. After exclusion of studies based on predefined criteria, a total of 14 studies on hypertension and 12 studies and one anecdotal evidence for dyslipidemia were included in the final analyses.

RESULTS

The prevalence of hypertension was reported to be 14.0%-41.8% while that for dyslipidemia was 12.5%-62.0%. The screening rate for hypertension was 100.0% as revealed by the nationwide surveys. Among hypertensive patients, only 27.6%-61.1% patients were aware of their condition, 42.2% patients underwent diagnosis, 27.9%-78.9% patients received antihypertensive treatment, 22.5% patients adhered to treatment medication, while blood pressure (BP) control was achieved in 27.0%-45.0% patients. Likewise, among patients with dyslipidemia, 10.5%-47.3% patients were aware of their condition, 34.6% patients were screened, and 17.8% underwent diagnosis. Although high treatment rates ranging from 40.0%-94.0% were reported, medication adherence recorded was 45.0%-77.4% among the treated patients. The overall low control rates ranged from 28.0%-41.5%.

CONCLUSIONS

The study findings highlight evidence gaps along key touchpoints of patient journey. Reinforcing the efforts for high-quality evidence-based research at a national level may pave a path for better resource utilization and provide guidance to practice and amend health policies for patients, healthcare practitioners (HCPs), and healthcare policy makers for better patient outcomes in Saudi Arabia.

The effect of prehypertension and hypertension on the incidence of cardiovascular disease: A population-based cohort study in Kharameh, a city in the South of Iran

Background and Aim

Prehypertension and hypertension are important risk factors for cardiovascular diseases. This study was carried out to evaluate the effect of prehypertension and hypertension on the development of cardiovascular diseases.

Methods

This prospective cohort study was performed on 9442 people aged 40-70 in Kharameh, southern Iran. Individuals were divided into three groups: normal blood pressure (N = 5009), prehypertension (N = 2166), and hypertension (N = 2267). In this study, demographic data, disease histories, behavioral habits, and biological parameters were studied. At first, the incidence density was calculated. Then Firth's Cox regression models were used to investigate the association between prehypertension and hypertension with the incidence of cardiovascular diseases.

Results

The incidence density in the three groups of individuals with normal blood pressure, prehypertension, and hypertension was 1.33, 2.02, and 3.29 cases per 100,000 person-days, respectively. The results of multiple Firth's Cox regression by controlling all factors showed that the risk of occurrence of cardiovascular disease in people with prehypertension was 1.33 times (hazard ratio [HR] = 1.32, 95% confidence interval [CI]: 1.01-1.73, p = 0.03) and those with hypertension were 1.85 times higher (HR = 1.77, 95% CI: 1.38-2.29, p < 0.0001) than the individuals with normal blood.

Conclusion

Prehypertension and hypertension have played an independent role in the risk for developing cardiovascular diseases. Therefore, early detection of individuals with these factors and control of other risk factors in them can contribute to reducing the occurrence of cardiovascular diseases.

Association of some biochemical parameters and blood pressure among males with hypertension in the camps of Nineveh province-Iraq

BACKGROUND

Hypertension is a significant public health problem that affects people all over the world. Various epidemiologic researches have been conducted to reveal the relationship between hypertension and several biochemical markers. The goal of this project was to investigate the electrolytes, glucose, total protein, and lipid profile in people with normal and high blood pressure.

MATERIALS AND METHODS

Between 2020 and 2022, a case-control study was done. Two hundred and eighteen males, age ranging from 30 to 70, took part in the study. The conventional flame photometric method was used to evaluate serum electrolytes, whereas kits from Biolab Company's kits were used to quantify serum calcium, serum glucose, and lipid profile.

RESULTS

When compared to normotension males, hypertension males had considerably greater salt, chloride, and potassium levels in their blood, but no significant variations in calcium levels. When compared to normotension males, hypertension individuals had considerably higher mean glucose, total cholesterol, low, and high-density lipoprotein cholesterol, and triglycerides. Many amino acids were identified in the blood of male hypertension patients, consisting of leucine, aspartic acid, glutamic acid, asparagine, serine, histidine, glycine, arginine, alanine, methionine, valine, and phenylalanine.

CONCLUSIONS

In this group, hypertension males have a different lipid and electrolyte profile than normotensive males.