The Association Between Daily Physical Activity and Risk of Hypertension in Middle-Aged and Older Adults:A Nationwide Cohort Study in China

Physical activity (PA) plays a key role in the treatment of hypertension, and moderate to vigorous PA has been documented to lower the risk of developing hypertension. However, dose-response relationships between PA and hypertension are not consistent, and little is known about this relationship within the Chinese middle-aged and older people. We investigated the relationship between PA and hypertension within this population using China Health and Nutrition Survey 1991-2015 data. Physical activity was expressed in terms of the metabolic equivalent task (MET) and participants were divided into groups according to quartiles, namely, Q1 (< 32.97 METs-h/w), Q2 (32.97-60.38 METs-h/ w), Q3 (60.38-98.95 METs-h/w), and Q4 (> 98.95 METs-h/w). Compared with the Q1 group, the odds ratio of risk with hypertension (95% CIs) after adjusting for confounding factors were 0.63 (0.35, 1.12), 0.49 (0.28, 0.86), and 0.62 (0.35, 1.09) for those in Q2, Q3, and Q4, respectively. Restricted cubic spline functions were used and a U-shaped relationship between physical activity and hypertension risk was found, indicative of an optimal level of physical activity, which was found to be 112 METs-h/w. Our data suggest maintenance of optimal levels of total daily physical activity may be important for preventing hypertension in Chinese adults over the age of 40.

Association of cardiometabolic multimorbidity with all-cause and cardiovascular disease mortality among Chinese hypertensive patients

BACKGROUND Hypertension usually clusters with multiple comorbidities.However,the association between cardiometabolic multimorbidity(CMM)and mortality in hypertensive patients is unclear.This study aimed to investigate the association between CMM and all-cause and cardiovascular disease(CVD)mortality in Chinese patients with hypertension.METHODS The data used in this study were from the China National Survey for Determinants of Detection and Treatment Status of Hypertensive Patients with Multiple Risk Factors(CONSIDER),which comprised 5006 participants aged 19–91 years.CMM was defined as the presence of one or more of the following morbidities:diabetes mellitus,dyslipidemia,chronic kidney disease,coronary heart disease,and stroke.Cox proportional hazard models were used to calculate the hazard ratios(HR)with 95%CI to determine the association between the number of CMMs and both all-cause and CVD mortality.RESULTS Among 5006 participants[mean age:58.6±10.4 years,50%women(2509 participants)],76.4%of participants had at least one comorbidity.The mortality rate was 4.57,4.76,8.48,and 16.04 deaths per 1000 person-years in hypertensive patients without any comorbidity and with one,two,and three or more morbidities,respectively.In the fully adjusted model,hypertensive participants with two cardiometabolic diseases(HR=1.52,95%CI:1.09–2.13)and those with three or more cardiometabolic diseases(HR=2.44,95%CI:1.71–3.48)had a significantly elevated risk of all-cause mortality.The findings were similar for CVD mortality but with a greater increase in risk magnitude.CONCLUSIONS In this study,three-fourths of hypertensive patients had CMM.Clustering with two or more comorbidities was associated with a significant increase in the risk of all-cause and cardiovascular mortality among hypertensive patients,suggesting more intensive treatment and control in this high-risk patient group.

Evaluation of the effects of health education interventions for hypertensive patients based on the health belief model

BACKGROUND Hypertension is a major risk factor for cardiovascular disease and stroke,and its prevalence is increasing worldwide.Health education interventions based on the health belief model(HBM)can improve the knowledge,attitudes,and behaviors of patients with hypertension and help them control their blood pressure.AIM To evaluate the effects of health education interventions based on the HBM in patients with hypertension in China.METHODS Between 2021 and 2023,140 patients with hypertension were randomly assigned to either the intervention or control group.The intervention group received health education based on the HBM,including lectures,brochures,videos,and counseling sessions,whereas the control group received routine care.Outcomes were measured at baseline,three months,and six months after the intervention and included blood pressure,medication adherence,self-efficacy,and perceived benefits,barriers,susceptibility,and severity.RESULTS The intervention group had significantly lower systolic blood pressure[mean difference(MD):-8.2 mmHg,P<0.001]and diastolic blood pressure(MD:-5.1 mmHg,P=0.002)compared to the control group at six months.The intervention group also had higher medication adherence(MD:1.8,P<0.001),self-efficacy(MD:12.4,P<0.001),perceived benefits(MD:3.2,P<0.001),lower perceived barriers(MD:-2.6,P=0.001),higher perceived susceptibility(MD:2.8,P=0.002),and higher perceived severity(MD:3.1,P<0.001)than the control group at six months.CONCLUSION Health education interventions based on the HBM effectively improve blood pressure control and health beliefs in patients with hypertension and should be implemented in clinical practice and community settings.

Cardiovascular health awareness,risk perception,behavioural intention and INTERHEART risk stratification among middle-aged adults in Malaysia

Objective:To investigate the interrelationship between cardiovascular health awareness,risk perception,behavioural intention,and INTERHEART risk stratification in a middle-aged adult population in Malaysia.Methods:A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023.Participants completed validated questionnaires assessing cardiovascular health awareness,risk perception of cardiovascular diseases,behavioural intention towards adopting healthy habits,and INTERHEART risk stratification score(IHRS)based on established risk factors.A total of 602 respondents were included in the final analysis.Data were analysed with independent t-test/one-way ANOVA or Mann-Whitney/Kruskal-Wallis to test the differences,Pearson correlation or linear regression test to analyze the association of independent and dependent variables.Results:There was a significant positive correlation between medical knowledge related to cardiovascular disease(CVD)and knowledge related to CVD risk prevention,risk perception,behavioural intention and IHRS(P<0.05,Pearson correlation).Notably,individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention,risk perception,and behavioural intention.Males,laborers,active/former smokers,individuals with lower household income and educational levels,those involved in occupations not related to the healthcare sector,and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge,risk perception,and poorer behavioural intention regarding cardiovascular health(P<0.05,one-way ANOVA).While educational level,smoking status,awareness about CVD poster,self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention,risk perception,behavioral intention and/or IHRS(P<0.05,linear regression).Conclusions:These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk.Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.

Associated Factors to Poor Blood Pressure Control in Hypertensives Followed Up at the Campus University Hospital of Lome (Togo)

Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the campus university hospital of Lome (Togo) and to search for the associated factors. Methodology: The study was cross-sectional, descriptive and analytical, carried out from February (2022) to August 2022 in 260 hypertensive patients aged 22 years old, followed up (on an) as an outpatient for at least 3 months at the Lome University Hospital campus. A univariate then multivariate analysis were conducted in order to highlight the most common factors significantly linked to uncontrolled. Results: The mean age of hypertensives was 56.4 ± 12.7 years, the sex ratio (M/F) was 0.59. Prevalence of uncontrolled blood pressure was 42%. Associated Factors to poor blood pressure control in our study were age > 60 years (OR = 1.6 CI [1.17 - 2.50]), low socio-economic level (OR = 2.2 CI [1.96 - 4.33]), high cardiovascular risk level (OR = 3.1 CI [2.18 - 4.52]), non-adherence to regular blood pressure monitoring (OR = 3.3 CI [2.21 - 5.55]), low compliance to treatment (OR = 4.1 CI [2.33 - 6.76]) and a chronic renal failure (OR = 2.1 CI [1.21 - 3.10]). Conclusion: Nearly half of the hypertensives in our study had poorly controlled blood pressure by antihypertensive treatment medication. The factors of this poor control were age > 60 years, low socio-economic level, high or very high level of cardiovascular risk, low compliance to treatment, and renal failure.

Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the Cardiology Department of Kati University Hospital

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

Screening for Peripheral Artery Disease (PAD) in Hypertensive Black Patients: Ankle-Brachial Index in a Senegalese Primary Care Setting

Background: Peripheral artery disease (PAD) poses a significant health concern, particularly in Sub-Saharan Africa, where its prevalence is increasing. [1] Despite its significance, there is limited understanding of PAD among hypertensive patients in this region, highlighting a critical gap in knowledge. This study aimed to investigate the prevalence of PAD and associated factors in black hypertensive patients. Methods: A descriptive and analytical cross-sectional study was conducted over two years at a primary care center in Senegal using their ankle-brachial index (ABI) database. Data collection was strictly retrospective, and sociodemographic characteristics and clinical parameters were retrieved from the local patient database. We included all hypertensive patients who had benefited from an ABI. Statistical analysis was performed using the SPSS 18.0 software program. Results: Among the 220 hypertensive patients enrolled, PAD prevalence was 35%. Significant associations were observed between PAD occurrence and older age (>75 years, p = 0.008) and triple therapy (p = 0.015). Multivariate analysis confirmed age >75 years as a strong predictor of PAD in hypertensive patients (p = 0.01, OR = 4.6). Furthermore, PAD prevalence increased with the severity of hypertension (p = 0.03), emphasizing the need for targeted screening strategies in this population. Conclusion: Despite its limits, this study underscores the urgent need for improved access to healthcare services and tailored screening programs. The findings highlight the growing burden of PAD in Sub-Saharan Africa and the essential role of early detection and intervention, particularly in high-risk populations such as hypertensive individuals. Collaborative efforts involving healthcare providers, policymakers, and community stakeholders are crucial to implement effective interventions and reduce the impact of PAD on population health outcomes.

Blood Pressure Profile and Glycemic Control of Type 2 Diabetics and Hypertensives at the Yalgado Ouedraogo University Hospital: A Review of 116 Cases

Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.

Assessment of the Level of Knowledge about Chronic Renal Failure in 271 Hypertensive Patients in Brazzaville

Background and Objectives: Chronic kidney disease (CKD) is now a global public health problem. In low- and middle-income countries such as the Congo, access to dialysis is low and inequitable. The prevention of CKD involves raising awareness among patients at risk, such as those suffering from arterial hypertension (AH), by improving their knowledge of CKD. The objectives of our work were to determine the level of knowledge about CKD among hypertensive patients and to identify the factors associated with a low level of knowledge. Methodology: We conducted a 3-month descriptive and analytical cross-sectional study from 1 August to 30 October 2023 in 3 large public hospitals in Brazzaville (capital of the Republic of Congo). We included: hypertensive patients aged 18 and over who had freely consented to participate in our study and were able to answer the questions on the survey form. Patients with known hypertension who had been followed for less than 3 years and those with known chronic renal failure were not included. Results: The mean age was 58.4 ± 14.4 years (29 - 88 years). There were 121 men and 150 women (sex ratio = 0.8). All the patients were educated;37.2% with a higher level of education and 13.6% with primary education. 24 patients (9%) had a good level of knowledge about CKD and 153 (56%) had poor knowledge. A good level of knowledge was associated with the duration of hypertension, intellectual level and the existence of associated heart disease. Conclusion: Our study reveals a significant lack of knowledge about chronic kidney disease among hypertensive patients in Brazzaville.

Underlying anti-hypertensive mechanism of the Mizuhopecten yessoensis derived peptide NCW in spontaneously hypertensive rats via widely targeted kidney metabolomics

The angiotensin-converting enzyme(ACE)inhibitory peptide NCW derived from Mizuhopecten yessoensis has been demonstrated to have significant in vivo anti-hypertensive effects,however,its anti-hypertensive mechanism is still not fully clarified.This study established a UPLC-Q-TRAP-MS/MS-based widely targeted kidney metabolomics approach to explore the changes of kidney metabolic profiles and to clarify the antihypertensive mechanism of peptide NCW in spontaneously hypertensive rats(SHRs).Multivariate statistical analysis indicated that the kidney metabolic profiles were clearly separated between the SHR-NCW and SHRUntreated groups.A total of 85 metabolites were differentially regulated,and 16 metabolites were identified as potential kidney biomarkers,e.g.,3-hydroxybutyrate,malonic acid,deoxycytidine,and L-aspartic acid.The peptide NCW might regulate kidney metabolic disorder of SHRs to alleviate hypertension by suppressing inflammation and improving nitric oxide production under the regulation of linoleic acid metabolism,folate related pathways,synthesis and degradation of ketone bodies,pyrimidine metabolism,β-alanine metabolism,and retinal metabolism.

Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development.However,there is a huge gap between mental health service resources and mental health service needs.Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people.Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible.AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors.METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects.The general condition Questionnaire,Eysenck Personality Questionnaire,Symptom Checklist-90,General Health Questionnaire,and Smart Medical Service Use Intention Questionnaire were used to collect data.Pearson’s correlation was used to analyze the correlation between the participants’willingness to use smart medical services and their personality characteristics,psychological symptoms,and mental health.RESULTS The results revealed that the mental health of young and middle-aged people was poor,and some had psycho-logical problems such as anxiety,depression,and physical discomfort.Familiarity,acceptance,and usage of smart healthcare in this population are at a medium level,and these levels correlate with psychological characteristics.Acceptance was positively correlated with E,and negatively correlated with P,anxiety,fear,anxiety/insomnia,and social dysfunction.The degree of use was negatively correlated with P,obsessive-compulsive symptoms,depression,anxiety,hostility,paranoia,and somatic symptoms.CONCLUSION The familiarity,acceptance,and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.

Abnormal Umbilical Doppler: Incidence and Neonatal Outcomes among Hypertensive Disorders in Pregnancy at KCMC: A Hospital-Based Prospective Cohort Study

Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.

Risk Prediction Model for Hypertensive Disorders of Pregnancy Based on Routine Laboratory Indicators and Risk Factors: A Retrospective Analysis

Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.

Relationship between longitudinal changes in lipid composition and ischemic stroke among hypertensive patients

BACKGROUND Dyslipidemia was strongly linked to stroke,however the relationship between dyslipidemia and its components and ischemic stroke remained unexplained.AIM To investigate the link between longitudinal changes in lipid profiles and dyslipidemia and ischemic stroke in a hypertensive population.METHODS Between 2013 and 2014,6094 hypertension individuals were included in this,and ischemic stroke cases were documented to the end of 2018.Longitudinal changes of lipid were stratified into four groups:(1)Normal was transformed into normal group;(2)Abnormal was transformed into normal group;(3)Normal was transformed into abnormal group;and(4)Abnormal was transformed into abnormal group.To examine the link between longitudinal changes in dyslipidemia along with its components and the risk of ischemic stroke,we utilized multivariate Cox proportional hazards models with hazard ratio(HR)and 95%CI.RESULTS The average age of the participants was 62.32 years±13.00 years,with 329 women making up 54.0%of the sample.Over the course of a mean follow-up of 4.8 years,143 ischemic strokes happened.When normal was transformed into normal group was used as a reference,after full adjustments,the HR for dyslipidemia and ischemic stroke among abnormal was transformed into normal group,normal was transformed into abnormal group and abnormal was transformed into abnormal Wei CC et al.Dyslipidemia changed and ischemic stroke WJCC https://www.wjgnet.com 2 February 6,2025 Volume 13 Issue 4 group were 1.089(95%CI:0.598-1.982;P=0.779),2.369(95%CI:1.424-3.941;P<0.001)and 1.448(95%CI:1.002-2.298;P=0.047)(P for trend was 0.233),respectively.CONCLUSION In individuals with hypertension,longitudinal shifts from normal to abnormal in dyslipidemia-particularly in total and low-density lipoprotein cholesterol-were significantly associated with the risk of ischemic stroke.

Altered spontaneous brain activity patterns in hypertensive retinopathy using fractional amplitude of low-frequency fluctuations:a functional magnetic resonance imaging study

AIM:To study functional brain abnormalities in patients with hypertensive retinopathy(HR)and to discuss the pathophysiological mechanisms of HR by fractional amplitude of low-frequency fluctuations(fALFFs)method.METHODS:Twenty HR patients and 20 healthy controls(HCs)were respectively recruited.The age,gender,and educational background characteristics of the two groups were similar.After functional magnetic resonance imaging(fMRI)scanning,the subjects’spontaneous brain activity was evaluated with the fALFF method.Receiver operating characteristic(ROC)curve analysis was used to classify the data.Further,we used Pearson’s correlation analysis to explore the relationship between fALFF values in specific brain regions and clinical behaviors in patients with HR.RESULTS:The brain areas of the HR group with lower fALFF values than HCs were the right orbital part of the middle frontal gyrus(RO-MFG)and right lingual gyrus.In contrast,the values of fALFFs in the left middle temporal gyrus(MTG),left superior temporal pole(STP),left middle frontal gyrus(MFG),left superior marginal gyrus(SMG),left superior parietal lobule(SPL),and right supplementary motor area(SMA)were higher in the HR group.The results of a t-test showed that the average values of fALFFs were statistically significantly different in the HR group and HC group(P<0.001).The fALFF values of the left middle frontal gyrus in HR patients were positively correlated with anxiety scores(r=0.9232;P<0.0001)and depression scores(r=0.9682;P<0.0001).CONCLUSION:fALFF values in multiple brain regions of HR patients are abnormal,suggesting that these brain regions in HR patients may be dysfunctional,which may help to reveal the pathophysiological mechanisms of HR.

Atypical cervical spondylotic radiculopathy resulting in a hypertensive emergency during cervical extension: A case report and review of literature

BACKGROUND Extensive research revealed the absence of reports documenting hypertensive emergencies precipitated by changes in the cervical spine posture.CASE SUMMARY We here present a 57-year-old woman diagnosed as having cervical spondylotic radiculopathy(CSR)who was scheduled for anterior cervical decompression and fusion.During post-anesthetic positioning,a sudden hypertensive surge was observed when the patient was in a supine position with the neck being slightly extended.This surge was promptly reversed through cervical flexion and head elevation.This event however required an alternate surgical approach for recovery—posterior laminoplasty and endoscopy-assisted nucleus pulposus removal.Following the 6-month outpatient follow-up period,cervical flexion and extension activities substantially improved in the patient without any episodes of increase in acute blood pressure.CONCLUSION Maintaining a safe hypotensive posture and performing rapid,thorough deco-mpression surgery may serve as effective interventions for patients presenting symptoms similar to those of CSR accompanied by hypertensive emergencies(HE).This would mitigate the underlying causes of these HEs.

Cerebral arterial blood flow,attention,and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage

BACKGROUND Intracerebral hemorrhage mainly occurs in middle-aged and elderly patients with hypertension,and surgery is currently the main treatment for hypertensive cerebral hemorrhage,but the bleeding caused by surgery will cause damage to the patient's nerve cells,resulting in cognitive and motor dysfunction,resulting in a decline in the patient's quality of life.AIM To investigate associations between cerebral arterial blood flow and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage.METHODS Eighty-nine patients with depression after acute hypertensive cerebral hemorrhage who were admitted to our hospital between January 2019 and July 2021 were selected as the observation group,while 100 patients without depression who had acute hypertensive cerebral hemorrhage were selected as the control group.The attention span of the patients was assessed using the Paddle Pin Test while executive function was assessed using the Wisconsin Card Sorting Test(WCST)and cognitive function was assessed using the Montreal Cognitive Assessment Scale(MoCA).The Hamilton Depression Rating Scale(HAMD-24)was used to evaluate the severity of depression of involved patients.Cerebral arterial blood flow was measured in both groups.RESULTS The MoCA score,net scores I,II,III,IV,and the total net score of the scratch test in the observation group were significantly lower than those in the control group(P<0.05).Concurrently,the total number of responses,number of incorrect responses,number of persistent errors,and number of completed responses of the first classification in the WCST test were significantly higher in the observation group than those in the control group(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery was significantly lower in the observation group than in the control group(P<0.05).The basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery were positively correlated with the net and total net scores of each part of the Paddle Pin test and the MoCA score(P<0.05),and negatively correlated with each part of the WCST test(P<0.05).In the observation group,the post-treatment improvement was more prominent in the Paddle Pin test,WCST test,HAMD-24 score,and MoCA score compared with those in the pre-treatment period(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery significantly improved in the observation group after treatment(P<0.05).CONCLUSION Impaired attention,and executive and cognitive functions are correlated with cerebral artery blood flow in patients with depression after acute hypertensive cerebral hemorrhage and warrant further study.

Outcome of COVID-19 infection in patients on antihypertensives:A cross-sectional study

BACKGROUND Patients with coronavirus disease 2019(COVID-19)infection frequently have hypertension as a co-morbidity,which is linked to adverse outcomes.Antihypertensives may affect the outcome of COVID-19 infection.AIM To assess the effects of antihypertensive agents on the outcomes of COVID-19 infection.METHODS A total of 260 patients were included,and their demographic data and clinical profile were documented.The patients were categorized into nonhypertensive,angiotensin-converting enzyme inhibitor/angiotensin receptor blocker(ACEI/ARB),calcium channel blocker(CCB),a combination of ACEI/ARB and CCB,and beta-blocker groups.Biochemical,hematological,and inflammatory markers were measured.The severity of infection,intensive care unit(ICU)intervention,and outcome were recorded.RESULTS The mean age of patients was approximately 60-years-old in all groups,except the nonhypertensive group.Men were predominant in all groups.Fever was the most common presenting symptom.Acute respiratory distress syndrome was the most common complication,and was mostly found in the CCB group.Critical cases,ICU intervention,and mortality were also higher in the CCB group.Multivariable logistic regression analysis revealed that age,duration of antihypertensive therapy,erythrocyte sedimentation rate,high-sensitivity C-reactive protein,and interleukin 6 were significantly associated with mortality.The duration of antihypertensive therapy exhibited a sensitivity of 70.8%and specificity of 55.7%,with a cut-off value of 4.5 years and an area under the curve of 0.670(0.574-0.767;95%confidence interval)for COVID-19 outcome.CONCLUSION The type of antihypertensive medication has no impact on the clinical sequence or mortality of patients with COVID-19 infection.However,the duration of antihypertensive therapy is associated with poor outcomes.

Study on the association of multimorbidity with sleep and diet in young and middle-aged adults in Chongqing region,China

Background:The prevalence of multimorbidity is increasing,with a notable shift towards younger age groups.Methods:Convenience sampling was employed to select 15,988 young and middle-aged adults in Chongqing as the study population.The Apriori algorithm was used to identify the multimorbidity patterns within this population,while an unordered binary logistic regression model was applied to assess the association between sleep,diet and the risk of multimorbidity.Results:The study population had an average age of 39.2±10.1 years.Apriori association rules revealed that the most prevalent binary chronic disease multimorbidity pattern was dyslipidaemia+hypertension(14.78%),while the most common ternary chronic disease multimorbidity pattern was diabetes+dyslipidaemia+hypertension(9.66%).The logistic regression analysis revealed that a lower rating of sleep quality was associated with an elevated risk of multimorbidity(odds ratio(OR)=1.17,95%confidence interval(CI):1.01,1.36).Individuals who adhere to a meat-based diet(OR=1.45,95%CI:1.25,1.68)and those with elevated salt intake(OR=1.22,95%CI:1.01,1.47)were also observed to have an increased risk of multimorbidity.Additionally,a greater likelihood of multimorbidity was observed among those following a spicy diet(OR=1.3,95%CI:1.11,1.52)and consuming more oil(OR=1.16,95%CI:1.01,1.33).Conclusion:A poor sleep quality and a dietary preference for meat-based,salt,spicy and oils were found to be associated with an increased risk of multimorbidity progression among young and middle-aged populations.It is recommended that young and middle-aged adults should pay attention not only to sleep duration but also to sleep quality and improve dietary habits to reduce the likelihood of multimorbidity.

Analysis of the Effect of Family-Centered Empowerment Model(FCEM)Health Education Through WeChat on Medication Compliance and Blood Pressure of Elderly Hypertensive Patients in Rural Areas

Objective: To validate the effectiveness of a Family-Centered Empowerment Model (FCEM) health education through WeChat on medication compliance and blood pressure among elderly hypertensive patients in rural areas. Methods: One hundred and two rural elderly hypertensive patients aged 65-80 years were selected and randomly divided into an experimental and control group of 51 each. The control group implemented conventional health education, and the experimental group implemented FCEM health education through WeChat platform for 4 consecutive weeks. The Therapeutic Adherence Scale for Hypertensive Patients (TASHP) scores and blood pressure measurements were compared between and within the two groups. Results: After the intervention, there were significant differences in medication compliance and blood pressure between the two groups (P < 0.001). In the control group, before and after the intervention, there was a significant difference in medication compliance (P < 0.001), but no significant difference in blood pressure (P > 0.05). In the experimental group, there were significant differences in medication compliance and blood pressure before and after the intervention (P < 0.001). Conclusion: The FCEM health education through an online social platform significantly improved medication compliance and led to effective blood pressure control in rural elderly hypertensive patients. Therefore, as an effective, safe, and economical model, it is also necessary to explore its effectiveness in improving health problems in other chronic diseases and other age groups.