Hypertension and cardiovascular risk in young adult life: insights from CAVI

Leeson, Paul

doi:10.1093/eurheartj/suw061

Cited by 10 publications

(6 citation statements)

References 39 publications

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“…This suggest poor attitude and practice of preventive measures among younger hypertensive patients. Their potential surprise and stigma due to relatively early diagnosis, belief in its reversibility, and perception of bleak future health status, may all contribute to inconsistencies in initial adoption of preventive measures 42 . Unfortunately, long-term inconsistencies in self-management may contribute to early onset of cardiovascular complications and high disease burden 42 .…”

Section: Discussionmentioning

confidence: 99%

Reported self-management of hypertension among adult hypertensive patients in a developing country: a cross-sectional study in a Nigerian tertiary hospital

Omoronyia¹,

Okesiji²,

Uwalaka³

et al. 2021

Afr H. Sci.

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Background: Sustained control of blood pressure, is dependent on degree of self-management, which includes self-inte- gration, self-regulation, self-monitoring and adherence to regimen. We assessed the pattern of self-management of hyper- tension among adult hypertensive patients in a developing country. Methods: Cross-sectional study design and convenience sampling, was used to recruit adult hypertensive patients, attending Lagos State University Teaching Hospital, Lagos, Nigeria. Interviewer-administered questionnaire was used to obtain data on self-management components. SPSS version 21.0 was used to analyze data, with p-value set at 0.05. Result: One hundred and seven (107) respondents, had mean age of 49.0 ± 12.0 years. Mean value for self-management was 3.15 ± 0.55, comprising self-integration (3.06 ± 0.36), self-regulation (3.32 ± 0.63), self-monitoring (3.29 ± 0.84) and adherence to regimen (3.15 ± 0.55). Most components of self-management, had high levels of mean score. Respondents that were less than 40 years, compared with those that were more than 40 years, had greater mean values for self-integration (3.37 vs 3.05), but significantly lesser values for all other components (p < 0.05). Conclusion: Young hypertensives had poor levels of most components of self-management. There is urgent need for health educational programs on self-management of hypertension among young people in sub-Saharan Africa. Keywords: Hypertension; self-management; self-integration; self-regulation; adherence; Nigeria.

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Section: Discussionmentioning

confidence: 99%

Reported self-management of hypertension among adult hypertensive patients in a developing country: a cross-sectional study in a Nigerian tertiary hospital

Omoronyia¹,

Okesiji²,

Uwalaka³

et al. 2021

Afr H. Sci.

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“…15,16 While several studies have evaluated TI and its consequences in terms of glucose control in people with T2DM, [11][12][13] only a few studies have reported TI for blood pressure management in people with hypertension, 17,18 and there is lack of data on TI for blood pressure and lipid control simultaneously in incident T2DM. There is emerging global evidence on the cardiometabolic risk factor burden in people with hypertension 19 and dyslipidaemia, 20 and particularly on the increasing proportions of younger adults aged <50 years being less likely to be taking antihypertensive therapy (AHT), 19,21 resulting in significantly higher lifetime cardiovascular and mortality risk compared to older people with hypertension. 22 While a few studies have discussed the effect of hypertension 23 and dyslipidaemia 24,25 management as a cause of cardiovascular risk control failure, we are not aware of any population-level study that has evaluated the treatment patterns, delay in therapy initiation when needed, and associated medium-term impact on SBP and lipid control from the time of diagnosis of diabetes.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic inertia in the management of dyslipidaemia and hypertension in incident type 2 diabetes and the resulting risk factor burden: Real‐world evidence from primary care

Ling

Montvida

Khunti

et al. 2021

Diabetes Obesity Metabolism

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Objective: To investigate trends in the prevalence of hypertension and dyslipidaemia in incident type 2 diabetes (T2DM), time to antihypertensive (AHT) and lipid-lowering therapy (LLT), and the association with systolic blood pressure (SBP) and lipid control.Research Design and Methods: Using The Health Improvement Network UK primary care database, 254 925 people with incident T2DM and existing dyslipidaemia or hypertension were identified. Among those without atherosclerotic cardiovascular disease (ASCVD) history and not on AHT or LLT at diagnosis, the adjusted median months to initiating an AHT or an LLT, and the probabilities of high SBP or lipid levels over 2 years in people initiating therapy within or after 1 year were evaluated according to high and low ASCVD risk status.Results: At diabetes diagnosis, 66% and 66% had dyslipidaemia and hypertension, respectively. During 2005 to 2016, dyslipidaemia prevalence increased by 10% in people aged <60 years, while hypertension prevalence remained stable in all age groups. Among those with high ASCVD risk status in the age groups 18 to 39, 40 to 49, and 50 to 59 years, the median number of months to initiation of therapy were 20.4

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“…Traditional biomarkers used to risk stratify patients for treatment, such as left ventricular hypertrophy, tend to be less sensitive for identification of those at risk at younger ages, due to relatively shorter durations of exposure. 4,5 Left ventricular hypertrophy develops because blood pressure elevation increases afterload and left ventricular wall stress. However, gross changes in left ventricular morphology sufficient to reach criteria for the diagnosis of left ventricular hypertrophy are not often observed until severe disease is established.…”

Section: Introductionmentioning

confidence: 99%

Left atrial strain predicts cardiovascular response to exercise in young adults with suboptimal blood pressure

et al. 2021

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Aims: To investigate the left ventricular response to exercise in young adults with hypertension, and identify whether this response can be predicted from changes in left atrial function at rest. Methods: A total of 127 adults aged 18-40 years who completed clinical blood pressure assessment and echocardiography phenotyping at rest and during cardiopulmonary exercise testing, were included. Measurements were compared between participants with suboptimal blood pressure ≥120/80mm Hg (n = 68) and optimal blood pressure <120/80mm Hg (n = 59). Left ventricular systolic function during exercise was obtained from an apical four chamber view, while resting left atrial function was assessed from apical four and two chamber views.Results: Participants with suboptimal blood pressure had higher left ventricular mass (p = 0.031) and reduced mitral E velocity (p = 0.02) at rest but no other cardiac differences. During exercise, their rise in left ventricular ejection fraction was reduced (p = 0.001) and they had higher left ventricular end diastolic and systolic volumes (p = 0.001 and p = 0.001, respectively). Resting cardiac size predicted left ventricular volumes during exercise but only left atrial booster pump function predicted the left ventricular ejection fraction response ( = .29, p = 0.011). This association persisted after adjustment for age, sex, body mass index, and mean arterial pressure. Conclusion:Young adults with suboptimal blood pressure have a reduced left ventricular systolic response to exercise, which can be predicted by their left atrial booster pump function at rest. Echocardiographic measures of left atrial function may provide an early marker of functionally relevant, subclinical, cardiac remodelling in young adults with hypertension.

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Hypertension and cardiovascular risk in young adult life: insights from CAVI

Cited by 10 publications

References 39 publications

Reported self-management of hypertension among adult hypertensive patients in a developing country: a cross-sectional study in a Nigerian tertiary hospital

Reported self-management of hypertension among adult hypertensive patients in a developing country: a cross-sectional study in a Nigerian tertiary hospital

Therapeutic inertia in the management of dyslipidaemia and hypertension in incident type 2 diabetes and the resulting risk factor burden: Real‐world evidence from primary care

Left atrial strain predicts cardiovascular response to exercise in young adults with suboptimal blood pressure

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