Systolic vs diastolic blood pressure and the burden of hypertension

Tin, Lwin; Beevers, D. G.; Lip, Gregory Y.H.

doi:10.1038/sj.jhh.1001373

Cited by 50 publications

(42 citation statements)

References 28 publications

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“…They are uniformly recommended by the KSA and international agencies for hypertension as treatment guidelines (9)(10)(11). We fully agree with the remark of authors of studies that if IDH is not considered a separate entity, then the medical profession may deny treatment to many who require it (30,31). Not only treatment but also preventive and control measures targeting modifiable risk factors of IDH might be of greater public health importance (19) .…”

Section: Discussionsupporting

confidence: 59%

Isolated Diastolic Hypertension among Adults in Saudi Arabia: Prevalence, Risk Factors, Predictors and Treatment. Results of a National Survey

Saeed

Al-Hamdan

2016

Balkan Med J

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Background:In the past, diastolic hypertension was the main criterion for treatment, but currently, systolic pressure is the main criterion because it was thought that Isolated Diastolic Hypertension (IDH) is not associated with complications. Studies later revealed that IDH carries significant risks. Quantifying the magnitude and risk factors of IDH in the community is essential for all intervention strategies. Aims: This study aims to determine the prevalence, risk factors, predictors, treatment modalities and lifestyle practices of IDH adult patients in the Kingdom of Saudi Arabia (KSA). Study Design: Cross-sectional study. Methods: A community-based cross-sectional study using STEPwise approach among adults using a multistage, stratified, cluster random sample was carried out. Data were collected using questionnaires which included socio-demographics, blood pressure, biochemical, anthropometric measurements and lifestyle practices. Statistical analysis included calculating means and standard deviations, proportions, univariate and multiple logistic regression analysis. Results: Of a total 4562 subjects, 180 (3.95%) suffered from IDH, which was significantly related to age, gender, employment, smoking, diabetes mellitus, obesity and hypercholesterolemia. More than 93% were using some form of treatment, with 77.2% on prescribed drugs, 63% using diet, and 23% using exercise. Significant predictors of IDH were retirement and hypercholesterolemia. Conclusion: IDH is associated with some sociodemographic characteristics and co-morbidity. Given the risk of cardiovascular disease associated with IDH, the findings of this study emphasize the need for diagnosing the disease in middle-aged persons focusing on the modifiable risk factors of IDH.

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Section: Discussionsupporting

confidence: 59%

Isolated Diastolic Hypertension among Adults in Saudi Arabia: Prevalence, Risk Factors, Predictors and Treatment. Results of a National Survey

Saeed

Al-Hamdan

2016

Balkan Med J

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“…Systolic hypertension, due to hardening and loss of elasticity of the major arteries is an unavoidable consequence of aging and augmented by hypertension, in contrast to diastolic blood pressure which was thought to be a function of peripheral resistance. 18 Among the total hypertensive individuals in our study, only 38.7% were aware of the condition. This awareness level is more than that found in the Chennai study (32.8%) but less than that reported from other literature.…”

Section: Discussionmentioning

confidence: 66%

Hypertension: prevalence, awareness, treatment and control in a rural area of North Kerala, India

Suma¹,

Mayamol²,

Divakaran³

et al. 2017

Int J Community Med Public Health

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Background: High blood pressure is prevalent all over the world and is one of the major causes of cardiovascular morbidity and mortality. In considerable proportion of cases the disease tends to be asymptomatic for prolonged time, hence also labelled as “silent killer”. Awareness, treatment, and control of hypertension remain major challenges worldwide. The objective of this study was to determine the prevalence, awareness, treatment and control of hypertension in Northern Kerala. Methods: A community-based cross-sectional study among 687 subjects aged ≥20 years was conducted from March 2017 to July 2017. Data was collected by personal interviews, followed by anthropometric and blood pressure measurements. Diagnosis of hypertension was based on Joint National Committee (JNC) VIII guidelines. Results: The prevalence of hypertension (JNC VIII) was 48.2% with a 95% confidence interval ranging from 44.46% to 51.94%. Prevalence among males: 58.1% and females: 44.5%. Among the total hypertensives, 38.7% were aware. Of these, 94.5% taking treatment, 47.1% achieved adequate blood pressure control. Advancing age, current diabetic status, body mass index, and family history of hypertension were identified as risk factors for hypertension by multivariate logistic regression. Conclusions: High prevalence of hypertension was observed in the population. The low levels of awareness and control underscores the large gap between evidence and practice that needs to be bridged, for effective control of hypertension. This calls for plan to adopt preventive and control strategies and promote the health of the population.

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“…There is strong evidence that systolic hypertension is important in predicting cardiovascular or other health consequences including death. 30 For elderly patients several studies have alternatively suggested that increased pulse pressure may be more relevant to outcomes than systolic BP 31,32 although this may depend on the metric used for analyses. 33 We also observed that differences in pulse pressure were associated with ancestry, although these effects were not as strong (Supplementary Table S4).…”

Section: Admixture Effects Hypertension In Women R Kosoy Et Almentioning

confidence: 99%

Relationship between hypertension and admixture in post-menopausal African American and Hispanic American women

Kosoy

Nassir

et al. 2011

J Hum Hypertens

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To assess the relationship between ethnicity and hypertension using individual admixture and blood pressure measurements, we performed a cross-sectional study of African American and Hispanic American (HA) women enrolled in the Women's Health Initiative. The admixture odds ratio for systolic and diastolic hypertensive risk was determined using linear regression models in which the proportional measurements of European (EUR), sub-Saharan African (AFR) and Amerindian (AMI) admixture was analyzed using ancestry informative markers. In both African-American women (n ¼ 10 147) and HA women (n ¼ 4908) there was a significant positive association between hypertension and African admixture (Po10 À4 ). This relationship was observed for both systolic and diastolic hypertension examined as a continuous or dichotomous trait, and whether age, body mass index, years since menopause and a measurement of socioeconomic status were used as covariates. The odds ratio associated with AFR admixture in a dichotomous model of hypertension was 3.06 (95% confidence interval 2.72-3.45). AMI admixture was associated with lower odds of hypertension and appeared to be more protective, relative to EUR admixture. These data show that African admixture increases the risk for hypertension and provide additional support for evaluating therapeutic efficacy and conducting genetic analyses of hypertension in different ethnic groups.

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Systolic vs diastolic blood pressure and the burden of hypertension

Cited by 50 publications

References 28 publications

Isolated Diastolic Hypertension among Adults in Saudi Arabia: Prevalence, Risk Factors, Predictors and Treatment. Results of a National Survey

Isolated Diastolic Hypertension among Adults in Saudi Arabia: Prevalence, Risk Factors, Predictors and Treatment. Results of a National Survey

Hypertension: prevalence, awareness, treatment and control in a rural area of North Kerala, India

Relationship between hypertension and admixture in post-menopausal African American and Hispanic American women

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