Expert consensus on the management of hypertension in the young and middle‐aged Chinese population

Liu, Jing; Lu, Xiyi; Chen, Luyuan; Huo, Yong

doi:10.1111/ijcp.13426

Cited by 12 publications

(13 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Lower cut-off values of LAP in younger age subgroups may indicate that lipid over accumulation has a greater impact on hypertension risk in younger subjects than in older subjects. This finding is in accordance with data that showed that the pathophysiology of hypertension in young and middle-aged adults differs from that in elderly subjects and tends to be associated with metabolic disorders 19 . Whereas, the age-associated increase in large-artery stiffness is the main characteristic of arterial hypertension in elderly individuals 20 .…”

Section: Discussionsupporting

confidence: 93%

Age-adjusted cut-off values of lipid accumulation product (LAP) for predicting hypertension

Kaneva

Bojko

2021

Sci Rep

View full text Add to dashboard Cite

Among the many factors considered relevant to hypertension, obesity and metabolic disturbances play an important role in the development of this pathology. Therefore, lipid accumulation product (LAP), an index of visceral adiposity, is a simple and effective indicator of hypertension risk. To date, the reference and cut-off values for LAP have not been defined. The aim of the study was to determine the age-adjusted optimal cut-off values of LAP for the prediction of hypertension risk. This cross-sectional case–control study comprised 1960 subjects ranging from 20 to 64 years of age. The participants underwent anthropometric tests, blood pressure measurements, questionnaire surveys and laboratory examinations. The cut-off values of LAP were determined using receiver operating characteristic (ROC) curve analysis. According to our study results, LAP values in healthy subjects increased with age, whereas there was no effect of age on LAP values in patients with hypertension. These two findings determine the presence of age-adjusted cut-off values of LAP for diagnosing hypertension. Increasing age is associated with an increase in the cut-off values of LAP to detect hypertension. In conclusion, hypertension risk should be estimated using the age-adjusted cut-off values of LAP; otherwise, the risk of hypertension might be overestimated or underestimated.

show abstract

Section: Discussionsupporting

confidence: 93%

Age-adjusted cut-off values of lipid accumulation product (LAP) for predicting hypertension

Kaneva

Bojko

2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…There are unmet needs for providing healthcare professionals with a tailored hypertension management strategy in this special population. An expert consensus has been developed and published recently to meet the unmet needs [17].…”

Section: Discussionmentioning

confidence: 99%

Highlights of the 2018 Chinese hypertension guidelines

Liu

2020

Clin Hypertens

Self Cite

View full text Add to dashboard Cite

Background: Blood pressure (BP) are uncontrolled in over 80% hypertensive population in China, indicating a compelling need for a pragmatic hypertension management strategy. The 2018 Chinese hypertension guidelines issued in 2019, after 3 years revision. During the periods, the latest United States (US) and European guidelines successively published, bringing new thoughts, wisdoms and schemes on hypertension management. This review aims to summarize the highlights of the new Chinese guidelines. Main text: Despite the fact that the 2017 US hypertension guidelines changed hypertension definition from ≥140/90 mmHg to 130/80 mmHg, the Chinese hypertension guidelines did not follow suit, and maintained 140/ 90 mmHg as the cut-point of for diagnosis of hypertension. A combined, cardiovascular risks and BP levels-based antihypertensive treatment algorithm was introduced. Five classes of antihypertensive drugs, including β-blockers were recommended as initiation and maintenance of BP-lowering therapy. Initiating combination therapy, including single pill combination (SPC) was indicated in high-risk patients or those with grade 2 or 3 hypertension. For those with grade 1 hypertension (BP ≥ 140/90 mmHg), an initial low-dose antihypertensive drugs combination treatment could be considered. Conclusions: China has never stopped exploring the best strategy for improving hypertension control. Based on clinical evidence and expertise, the newest Chinese guidelines and expert consensus will be of help in guiding physicians and practitioners to provide better management of hypertension in China.

show abstract

“…The drugs used in NARRAS trial were in keeping with current guidelines and consensus recommendations ( 19 – 22 ). Long-acting CCBs, amlodipine or nifedipine GITS, both provide sustained 24-h BP control.…”

Section: Discussionmentioning

confidence: 99%

Dosing Time Matters? Nighttime vs. Daytime Administration of Nifedipine Gastrointestinal Therapeutic System (GITS) or Amlodipine on Non-dipper Hypertension: A Randomized Controlled Trial of NARRAS

Liu

Nie

et al. 2021

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

Background: Non-dipper hypertension is often characterized by a blunted decrease of nocturnal blood pressure (BP) and is associated with increased risk of target organ damage and cardiovascular (CV) events, while the optimal treatment strategy is yet to be established. This trial was designed to evaluate whether nocturnal BP reduction and arterial stiffness improvement differ from antihypertensive agents and time of administration.Methods: Young and middle-aged adults (18–65 years) with non-dipper hypertension were randomly assigned to nifedipine GITS (gastrointestinal therapeutic system) 30 mg or amlodipine besylate 5 mg once daily for 8 weeks, either taken in the morning or at night. Dose was doubled at 4-week if BP is not at goal. Twenty-four hour ambulatory BP monitoring (ABPM) and arterial stiffness were evaluated before and after 8 weeks of pharmacotherapy. The primary efficacy measure was the average nighttime systolic BP reduction.Results: A total of 98 non-dipper hypertensive patients (mean age 46.3 years) were randomized during Dec, 2016 and Dec, 2020, of whom 72 (73%) patients completed all ABPM and follow-up evaluations. Nighttime systolic BP significantly reduced at 8 weeks vs. baseline with nifedipine GITS or amlodipine, irrespective of dosing at nighttime (−9.9 vs −9.9 mmHg, P > 0.05) or daytime (−11.5 vs. −10.9 mmHg, P > 0.05). No difference was seen between these two agents, when combining the data of nighttime and daytime dosing together (−10.8 vs. −10.5 mmHg, respectively, P = 0.898). Daytime, 24-h systolic BP, diastolic BP at different time and pulse wave velocity reduced significantly and comparably, and recovery of dipping rhythm were similar among groups.Conclusion: Nighttime dosing of long-acting antihypertensive preparations, nifedipine GITS or amlodipine demonstrated similar effects on nocturnal BP reduction, dipping rhythm restoration and arterial elasticity improvement in younger subjects with non-dipper hypertension. These effects were comparable with morning dosing.

show abstract

Expert consensus on the management of hypertension in the young and middle‐aged Chinese population

Cited by 12 publications

References 66 publications

Age-adjusted cut-off values of lipid accumulation product (LAP) for predicting hypertension

Age-adjusted cut-off values of lipid accumulation product (LAP) for predicting hypertension

Highlights of the 2018 Chinese hypertension guidelines

Dosing Time Matters? Nighttime vs. Daytime Administration of Nifedipine Gastrointestinal Therapeutic System (GITS) or Amlodipine on Non-dipper Hypertension: A Randomized Controlled Trial of NARRAS

Contact Info

Product

Resources

About