Global burden of hypertension: analysis of worldwide data

Kearney, Patricia M.; Whelton, Megan; Reynolds, Kristi; Muntner, Paul; Whelton, Paul K.; He, Jiang

doi:10.1016/s0140-6736(05)17741-1

Cited by 5,546 publications

(2,993 citation statements)

References 42 publications

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“…In a prior study, worse GLS was associated with increased cerebral small vessel disease among older adults without prevalent cardiovascular disease (CVD) 6. However, cardiac strain has not been thoroughly evaluated in relation to cognition among aging adults who endure decades of vascular risk factor exposure 11, 12…”

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confidence: 99%

Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults

Kresge

Khan

Wagener

et al. 2018

JAHA

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BackgroundGlobal longitudinal strain (GLS), reflecting total shortening of the myocardium during the cardiac cycle, has emerged as a more precise myocardial function measure than left ventricular ejection fraction (LVEF). Longitudinal strain may be selectively affected in subclinical heart disease, even in the presence of normal LVEF. This study examines subclinical cardiac dysfunction, assessed by GLS and LVEF, and cognition among older adults.Methods and ResultsVanderbilt Memory and Aging Project participants who were free of clinical dementia, stroke, and heart failure (n=318, 73±7 years, 58% male) completed neuropsychological assessment and cardiac magnetic resonance to quantify GLS and LVEF. Linear regression models related GLS and LVEF to neuropsychological performances, adjusting for age, sex, race/ethnicity, education, Framingham Stroke Risk Profile, cognitive diagnosis, and APOE*ε4 status. Models were repeated with a cardiac×cognitive diagnosis interaction term. Compromised GLS (reflected by higher values) related to worse naming (β=−0.07, P=0.04), visuospatial immediate recall (β=−0.83, P=0.03), visuospatial delayed recall (β=−0.22, P=0.03), and verbal delayed recall (β=−0.11, P=0.007). LVEF did not relate to worse performance on any measure (P>0.18). No diagnostic interactions were observed.ConclusionsOur study results are among the first to suggest that compromised GLS relates to worse episodic memory and language performance among older adults who are free of clinical dementia, stroke, and heart failure. Subclinical cardiac dysfunction may correlate with cognitive health in late life, even when LVEF remains normal. The results add to growing evidence that GLS may be a more sensitive and preferred method for quantifying subclinical changes in cardiac function.

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confidence: 99%

Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults

Kresge

Khan

Wagener

et al. 2018

JAHA

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“…Hypertension (HTN) remains a public health burden affecting about one‐third of US adults and more than one billion individuals worldwide 1, 2. Response to antihypertensive treatment also varies among individuals with some individuals remaining resistant to certain therapies, and only about 50% of patients treated with antihypertensive therapies achieve blood pressure (BP) control 1, 3, 4, 5.…”

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confidence: 99%

Pharmacometabolomic Assessments of Atenolol and Hydrochlorothiazide Treatment Reveal Novel Drug Response Phenotypes

Rotroff

Shahin

Gurley

et al. 2015

CPT Pharmacometrics Syst. Pharmacol.

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Achieving hypertension (HTN) control and mitigating the adverse health effects associated with HTN continues to be a global challenge. Some individuals respond poorly to current HTN therapies, and mechanisms for response variation remain poorly understood. We used a nontargeted metabolomics approach (gas chromatography time‐of‐flight/mass spectrometry gas chromatography time‐of‐flight/mass spectrometry) measuring 489 metabolites to characterize metabolite signatures associated with treatment response to anti‐HTN drugs, atenolol (ATEN), and hydrochlorothiazide (HCTZ), in white and black participants with uncomplicated HTN enrolled in the Pharmacogenomic Evaluation of Antihypertensive Responses study. Metabolite profiles were significantly different between races, and metabolite responses associated with home diastolic blood pressure (HDBP) response were identified. Metabolite pathway analyses identified gluconeogenesis, plasmalogen synthesis, and tryptophan metabolism increases in white participants treated with HCTZ (P < 0.05). Furthermore, we developed predictive models from metabolite signatures of HDBP treatment response (P < 1 × 10−5). As part of a quantitative systems pharmacology approach, the metabolites identified herein may serve as biomarkers for improving treatment decisions and elucidating mechanisms driving HTN treatment responses.

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“…Computed tomography or magnetic resonance imaging were not essential for diagnosis of stroke, but were necessary for differentiating the subtypes of stroke (ischemic or hemorrhagic). Without imaging data, stroke was still diagnosed in the presence of specific signs and symptoms of focal disturbance of cerebral function and the subtype defined as “uncertain” (see the protocol the CSPPT1). …”

Section: Methodsmentioning

confidence: 99%

“…Hypertension has become a highly important public health challenge, affecting more than 1 billion adults worldwide 1. More important, most hypertensive patients have grade 1 hypertension (untreated systolic blood pressure [SBP] of 140–159 mm Hg and/or diastolic blood pressure [DBP] of 90–99 mm Hg) and no previous cardiovascular diseases 2.…”

Section: Introductionmentioning

confidence: 99%

Impact of Achieved Blood Pressure on First Stroke in Uncomplicated Grade 1 Hypertension

Sun

et al. 2017

JAHA

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BackgroundWe aimed to test the impact of achieved blood pressure (BP) on first stroke among patients with grade 1 hypertension and without cardiovascular diseases in the China Stroke Primary Prevention Trial.Methods and ResultsA total of 3187 patients with uncomplicated grade 1 hypertension were included. The risk of outcomes was assessed according to: (1) the proportion of visits in which BP was reduced to <140/90 mm Hg, and (2) the time‐averaged systolic BP (SBP) or diastolic BP levels during the study treatment period. The median antihypertensive treatment duration was 4.6 years. Only 1.5% of the participants discontinued the treatments because of adverse reaction. Overall, the risk of stroke decreased with the increase of the proportion of study visits with BP <140/90 mm Hg (for per 5% increase; hazard ratio, 0.92 [95% CI, 0.87–0.98]). Consistently, compared with patients with time‐averaged SBP ≥140 or diastolic BP ≥90 mm Hg, the risk of stroke was lower in patients with time‐averaged SBP of 120 to <140 mm Hg (1.1% versus 2.9%; hazard ratio, 0.39 [95% CI, 0.22–0.69]) or diastolic BP <90 mm Hg (1.5% versus 2.7%; hazard ratio, 0.41 [95% CI, 0.17–0.98]). The beneficial results were consistent across age (<60 versus ≥60 years), sex, baseline SBP (<150 versus 150 to <160 mm Hg), study treatment groups (enalapril or enalapril‐folic acid), and hypertension subtypes (isolated systolic hypertension or systolic‐diastolic hypertension). However, a time‐averaged SBP <120 mm Hg (versus 120–140 mm Hg) was associated with an increased risk for stroke. Similar results were observed for composite cardiovascular events or all‐cause death.ConclusionsAchieved BP <140/90 mm Hg was significantly associated with a decreased risk of stroke or all‐cause death in patients with uncomplicated grade 1 hypertension.

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Global burden of hypertension: analysis of worldwide data

Abstract: Hypertension is an important public-health challenge worldwide. Prevention, detection, treatment, and control of this condition should receive high priority.

Cited by 5,546 publications

References 42 publications

Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults

Subclinical Compromise in Cardiac Strain Relates to Lower Cognitive Performances in Older Adults

Pharmacometabolomic Assessments of Atenolol and Hydrochlorothiazide Treatment Reveal Novel Drug Response Phenotypes

Impact of Achieved Blood Pressure on First Stroke in Uncomplicated Grade 1 Hypertension

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