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Hypertension in black

Samantha G Bromfield, Daichi Shimbo, John N Booth, Adolfo Correa, Gbenga Ogedegbe, April P Carson, Paul Muntner
Masked hypertension is associated with increased risk for cardiovascular disease. Identifying modifiable risk factors for masked hypertension could provide approaches to reduce its prevalence. Life's Simple 7 is a measure of cardiovascular health developed by the American Heart Association that includes body mass index, physical activity, diet, cigarette smoking, blood pressure (BP), cholesterol, and glucose. We examined the association between cardiovascular health and masked daytime hypertension in the Jackson Heart Study, an exclusively black cohort...
October 24, 2016: Hypertension
O M Aboyade, R Beauclair, O N Mbamalu, T R Puoane, G D Hughes
BACKGROUND: Various studies have shown that non-communicable diseases (NCDs) especially diabetes and hypertension are prevalent among older women living in South African urban areas, placing a heavy burden on the healthcare system. This study aimed to understand the health-seeking behaviour, healthcare practices and prevalence of traditional herbal medicine (THM) use among older women self-reporting NCDs from the Prospective Urban Rural Epidemiology study (PURE). METHOD: A homogenous purposive sampling of PURE participants was used to recruit women who were 50 years or older (n = 250)...
October 24, 2016: BMC Complementary and Alternative Medicine
Priya Muralidharan, Don Hayes, Stephen M Black, Heidi M Mansour
This systematic and comprehensive study reports for the first time on the successful rational design of advanced inhalable therapeutic dry powders containing dimethyl fumarate, a first-in-class Nrf2 activator drug to treat pulmonary inflammation, using particle engineering design technology for targeted delivery to the lungs as advanced spray dried (SD) one-component DPIs. In addition, two-component co-spray dried (co-SD) DMF:D-Man DPIs with high drug loading were successfully designed for targeted lung delivery as advanced DPIs using organic solution advanced spray drying in closed mode...
2016: Mol Syst Des Eng
Andrew C Patterson, Gerry Veenstra
OBJECTIVES: Intersectionality theory proposes that each combination of social categories derived from gender, race and nationality, such as immigrant White man or native-born Black woman, is associated with unique social experiences. We tested the potential of intersectionality theory for explicating racial inequalities in Canada by investigating whether Black-White health inequalities are conditioned by gender and immigrant status in a synergistic way. METHODS: Our dataset comprised 10 cycles (2001-2013) of the Canadian Community Health Survey...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
D Stott, M Bolten, D Paraschiv, I Papastefanou, J B Chambers, N A Kametas
OBJECTIVE: Pregnant hypertensive women who do not respond to labetalol but need vasodilatory therapy for blood pressure (BP) control rapidly progress to severe disease, which may be delayed by early recognition and individualised BP treatment. In this study, we sought to create prediction models at presentation, at 1 and 24 hours after commencement of treatment to identify patients who will not show a sustained response to labetalol and therefore need vasodilatory therapy. METHODS: The study population comprised of 134 women presenting with hypertension at a UK hospital...
October 20, 2016: Ultrasound in Obstetrics & Gynecology
Petra Rust, Cem Ekmekcioglu
Excessive dietary salt (sodium chloride) intake is associated with an increased risk for hypertension, which in turn is especially a major risk factor for stroke and other cardiovascular pathologies, but also kidney diseases. Besides, high salt intake or preference for salty food is discussed to be positive associated with stomach cancer, and according to recent studies probably also obesity risk. On the other hand a reduction of dietary salt intake leads to a considerable reduction in blood pressure, especially in hypertensive patients but to a lesser extent also in normotensives as several meta-analyses of interventional studies have shown...
October 19, 2016: Advances in Experimental Medicine and Biology
Matthew L Maciejewski, Xiaojuan Mi, Lesley H Curtis, Judy Ng, Samuel C Haffer, Bradley G Hammill
BACKGROUND: Despite the persistence of significant disparities, few evaluations examine disparities in laboratory testing by race/ethnicity, age, sex, Medicaid eligibility, and number of chronic conditions for Medicare fee-for-service beneficiaries' newly prescribed medications. In Medicare beneficiaries initiating diuretics or digoxin, this study examined disparities in guideline-appropriate baseline laboratory testing and abnormal laboratory values. METHODS AND RESULTS: To evaluate guideline-concordant testing for serum creatinine and serum potassium within 180 days before or 14 days after the index prescription fill date, we constructed retrospective cohorts from 10 states of 99 711 beneficiaries who had heart failure or hypertension initiating diuretic in 2011 and 8683 beneficiaries who had heart failure or atrial fibrillation initiating digoxin...
October 18, 2016: Circulation. Cardiovascular Quality and Outcomes
Rakesh Malhotra, Kerri L Cavanaugh, William J Blot, T Alp Ikizler, Loren Lipworth, Edmond K Kabagambe
BACKGROUND: Whether polyunsaturated fatty acids (PUFA) are associated with end-stage renal disease (ESRD) in populations with a high burden of risk factors for kidney disease is unknown. We sought to determine whether PUFA intake is associated with ESRD. METHODS: We conducted a nested case-control study of ESRD within the Southern Community Cohort Study (SCCS), a prospective cohort of low-income blacks and whites in the southeastern US (2002-2009). Through 2012, 1,074 incident ESRD cases were identified by linkage with the United States Renal Data System and matched to 3,230 controls by age, sex and race...
October 18, 2016: BMC Nephrology
Hugo Huisman, Aletta Schutte, Johannes Van Rooyen, Carla Fourie, Ruan Kruger, Wayne Smith, Leandi Lammertyn, Leone Malan, Shani Botha, Carina Mels
OBJECTIVE: Tetrahydrobiopterin (BH4) is a cofactor for nitric oxide synthase (NOS) and may be a critical agent in endothelial function by improving nitric oxide (NO) mediated effects. It is reported that the NO synthesis capacity seems favourable in blacks despite their adverse cardiovascular profile. We therefore compared the concentrations of BH4, as well as blood pressure (BP) and arterial stiffness between black and white teachers. Furthermore, we tested the associations of BH4 with a product and inhibitor of NO synthesis, namely L-citrulline, and symmetric dimethylarginine (SDMA) respectively, in both ethnic groups...
September 2016: Journal of Hypertension
Lebo Gafane, Alta Schutte, Johannes Van Rooyen, Rudolph Schutte
OBJECTIVE: Hypertension, particularly in black populations is often accompanied by low renin levels, indicative of possible blood pressure (BP) dysregulation by the renin-angiotensin-system (RAS). The potential role of aldosterone in sympathetic nerve activation in the context of low renin warrants clarification. We therefore explored whether measures of sympathetic nerve activity (noradrenaline, 24-hour heart rate (HR) and % dipping in night-time HR) relate to renin, aldosterone and aldosterone-to-renin ratio (ARR) in low renin blacks and whites...
September 2016: Journal of Hypertension
Kristi Reynolds, Daichi Shimbo, C Barrett Bowling, Luqin Deng, Adam Bress, John Sim, Paul Muntner
OBJECTIVE: To identify risk factors for serious fall injuries following initiation of antihypertensive medication among older adults. DESIGN AND METHOD: We conducted a retrospective cohort study using a 5% random sample of people with Medicare health insurance, a government program for older US adults. The analysis was restricted to patients with a diagnosis of hypertension who initiated antihypertensive medication between 2007 and 2011. Initiation was defined by the first antihypertensive medication fill in this time period preceded by 365 days with no antihypertensive medication fills...
September 2016: Journal of Hypertension
Poghni Peri-Okonny, Colby Ayers, Naim Maalouf, Sandeep Das, James De Lemos, Jarett Berry, Aslan Turer, Ian Neeland, Philipp Scherer, Wanpen Vongpatanasin
OBJECTIVE: To examine the effect of body adiposity on relationship between leptin and incident hypertension in a multiethnic sample of US population. DESIGN AND METHOD: Participants were normotensive adults with BP ≤ 130/85 enrolled in Dallas Heart Study, a large, multiethnic population-based cohort. Incident hypertension was defined as systolic BP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or initiation of antihypertensive medications.Biomarkers were measured at baseline from fasting venous blood samples...
September 2016: Journal of Hypertension
William C Cushman
Beginning with the Veterans Administration (VA) Cooperative Hypertension Study of the 1960 s, blood pressure (BP) lowering with antihypertensive medications has been shown to reduce major cardiovascular (CV) outcomes, including coronary heart disease, stroke, heart failure (HF) and CV and all-cause mortality in randomized controlled CV outcome trials. Multiple drugs were usually required in these trials to lower BP in treated participants. Medication regimens in the early trials, including the VA trial, included a thiazide-type diuretic (TTD) as initial therapy...
September 2016: Journal of Hypertension
Dean Picone, Martin Schultz, Petr Otahal, J Andrew Black, Nathan Dwyer, Alun Hughes, Fuyou Liang, Ronak Rajani, Phil Roberts-Thomson, Velandai Srikanth, Kenji Takazawa, James Sharman
OBJECTIVE: Accurate measurement of blood pressure (BP) is crucial for hypertension management. Accuracy of brachial cuff (BCUFF) devices to measure invasive (intra-arterial) BP at the brachial artery (BINV) and aorta (AINV) has never been systematically assessed. This study aimed to determine the: 1) relationship between BINV and AINV; 2) accuracy of BCUFF devices to estimate invasive BP and; 3) accuracy of BCUFF devices to classify BP thresholds. DESIGN AND METHOD: Three individual patient meta-analyses (by search of online databases and systematic review supplemented by measurements in a tertiary hospital cardiac catheterization laboratory) were performed to determine: 1) BINV versus AINV BP; 2) BCUFF versus BINV BP and AINV BP and; 3) BCUFF for BP classification versus invasive BP...
September 2016: Journal of Hypertension
Longjian Liu, Jessica Dow, Barbara Simon, Howard Eisen
OBJECTIVE: Multiple medication use in patients with hypertension (HTN) is a common clinical problem faced by both primary and specialists. Patients who remain to have higher BP in spite of the concurrent use of 3 antihypertensive agents of different classes are defined as resistant hypertension (RH). In the study we aimed to identify the prevalence of RH, and examined its association with mortality from all-cause and cardiovascular disease (CVD). DESIGN AND METHOD: Data from the U...
September 2016: Journal of Hypertension
Brian Rayner
Although the consequences of hypertension are universal, Blacks (African Americans or Indigenous Africans) have been the subject of a differential approach to causation, outcome and treatment. Blacks have a greater propensity to salt sensitivity and suppressed plasma renin suggesting a predisposition to Na retention by the kidney. As a result blood pressure (BP) response to diuretics and amlodipine is better than inhibitors of the renin-angiotensin-system in monotherapy. Target organ damage is more frequent and blood pressure (BP) is more difficult to control despite more intensive therapy...
September 2016: Journal of Hypertension
Aletta Schutte
Less than 100 years ago reports from studies in Kenya indicated that the prevalence of hypertension was exceptionally low in tribal areas that have undergone no changes possibly for centuries. In recent decades, however, the transition of populations in many African countries from traditional lifestyles to urbanised environments seems to have contributed to the significant escalation of hypertension and cardiovascular events in black populations. This is confirmed by reports from the World Health Organization indicating that the prevalence of hypertension is globally the highest on the African continent...
September 2016: Journal of Hypertension
Solomon Kadiri
Hypertension prevalence rates in most urbanized areas of Africa range from 20-30%, with a recent systematic review reporting 16.2% for sub-Saharan Africa. These rates are lower than those in the West but the age standardized rates are higher than in other regions of the world. The attendant morbidity and mortality are disproportionately high. For example, failure of nocturnal dipping and microalbuminuria, predictive of vascular disease, occur relatively early in the course of hypertension and predispose to early vascular disease...
September 2016: Journal of Hypertension
Agustin Ramirez
The presentation will focus on the different guidelines we have actually in hands (JNCHT 8, ESH / ESC, ISH) and compare them to the last Latin-American Society of Hypertension Guidelines to be published in this year.In this way, we will focus our attention in the socio-economic problem of the different countries in LA and the differences we have included in our Guidelines due to the actual needs in LA.Additionally we will specially mention the special populations from LA like andineans, people living over 500m from sea level, and the different black populations that are different from those described in North America...
September 2016: Journal of Hypertension
Nora T Oliver, Christine M Hartman, Jennifer R Kramer, Elizabeth Y Chiao
INTRODUCTION: Chronic HIV/hepatitis C virus (HCV) coinfection carries increased risk of cirrhosis, hepatocellular carcinoma, and death. Due to anti-inflammatory properties, 3-hydroxy-3methylglutaryl coenzyme A (HMG-CoA) inhibitors (statins) may be useful adjunctive therapy to reduce liver disease progression. METHODS: Clinical information was extracted from the Veterans Affairs HIV and HCV Clinical Case Registries (1999-2010). HIV-related variables included combination antiretroviral therapy era of diagnosis, CD4 cell count, and percentage time with undetectable HIV viral load...
October 23, 2016: AIDS
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