Altalhi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Objective:Our study aims to compare the effects of blood pressure variability (BPV) during ambulatory blood pressure measurement (ABPM) and visit-to-visit measurements to predict future cardiovascular complications among hypertensive patients.Methods:This is a retrospective case-control study of patients with hypertension over 10 years. All adult patients with at least one recorded ABPM, and at least three recorded visit measurements were included. Patients with incomplete ABPM readings, a history of a tested outcome, or the occurrence of any of the tested outcomes within the measurement period were excluded. The outcome was the development of any of the following: acute coronary syndrome (ACS), chronic ischemic heart disease (IHD), heart failure (HF), or stroke.Results:Of the 305 cases reviewed, 152 were included. The mean follow-up was 6.6±2.3 years. The mean age was 53.5±14.3 years. Eighty-two (53.9%) patients were male, while 70 (46.1%) were female. Risk factors included diabetes mellitus (53.9%), dyslipidemia (39.5%), obesity (16.4%), and smoking (8.6%). Comorbidities included stroke (2%), ACS (8.6%), IHD (20.4%), HF (2.6%), and renal failure (1.3%). One or more complications were seen in 22.4 % of the included patients. The variation of the daytime systolic ABP had been found to predict the future risk of developing IHD (OR=1.94; 95% CI=1.09–3.45; p=0.025). Moreover, IHD was associated with night-time systolic standard deviation (SD) in ABPM (OR=1.23; 95% CI=1.00–1.51; p=0.048). On the other side, ACS was found to be associated with systolic SD in visit-to-visit measurement (OR=1.10; 95% CI=1.01–1.21; p=0.04).Conclusion:Hypertensive patients with high variability of daytime and night-time SD in ABPM are more likely to have IHD. Whereas, having high variability in systolic SD in visit-to-visit measurements is associated with developing ACS.

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Purpose: This study aims to estimate the incidence of retinopathy of prematurity (ROP) and investigate its perinatal and neonatal risk factors in a tertiary hospital in Saudi Arabia. Methodology: This was a retrospective cohort study of premature infants admitted to a neonatal intensive care unit at a tertiary hospital in Jeddah, Saudi Arabia, from January 2016 to December 2017. Participants who met the screening criteria for ROP were included and followed up until spontaneous recovery or laser treatment. Results: A total of 119 infants screened, the incidence of ROP was 21.8% (26/119). A plus disease was diagnosed in 15.4% (4/26) of the ROP infants. For most, 80.7% (21/26) of the ROP regressed spontaneously, and 19.2% (5/26) required a laser intervention. The mean gestational age (GA) of infants diagnosed with ROP was 25.62 ± 1.58 weeks and the median birth weight (BW) 750 (interquartile range: 280) g. Lower GA, lower BW, prolonged oxygen therapy, and mechanical ventilation (MV) were significantly related to ROP disease and severity. Requiring resuscitation at birth, a lower Apgar score at 1-min, poor weight gain proportion at 6 weeks, and requiring a blood transfusion were significantly associated with ROP disease. Conclusion: Compared to other local studies, the incidence of ROP was lower in our population. Lower GA, low BW, prolonged oxygen therapy and MV, and poor weight gain at 6 weeks are well-documented risk factors. We recommend close monitoring of weight gain and oxygen therapy and modifying risk factors in preterm infants to lower the incidence and the severity of ROP.