Patients diagnosed with hypertension (HT) are at high risk for end-organ damage. With changing living conditions and access to healthcare facilities worldwide, the rate of diagnosis in childhood is increasing. In this study, healthy children were compared with a group of pediatric patients diagnosed with hypertension. Cardiac findings in the hypertensive group were compared at presentation and at six months. We aimed to determine the discriminatory value of epicardial adipose tissue (EAT) measurements as an early imaging marker for cardiac involvement in children with HT compared to healthy children and to determine its prognostic feature for HT treatment response.

Fifty-nine primary hypertension patients and 76 control patients aged 0-18 years were compared. EAT values measured between the healthy group and the patient group and at the beginning of treatment and subsequent follow-ups in the patient group were evaluated with M-mode measurements.

There was no difference between the groups in terms of sex, and age. EAT was found to be significantly higher in the patient group than in the healthy group. There was a statistically significant difference between the EAT measurements evaluated before and after treatment in the patient group.

Hypertension is an important cause of morbidity and mortality. Using EAT measurements as a noninvasive parameter may provide information about early cardiac involvement due to HT. EAT is promising as an imaging marker that can be used in diagnosis and follow-up.

Noradrenergic activation in the central and peripheral nervous systems is a putative mechanism explaining the link between hypertension and affective disorders.

We investigated whether these stress-sensitive comorbidities may be dependent on basal noradrenergic activity and whether vascular responses to centrally acting stimuli vary according to noradrenergic activity.

We examined the relation of affective disorders and stress-mediated vascular responses to plasma concentrations of normetanephrine, a measure of noradrenergic activity, in subjects with primary hypertension (n = 100, mean ± s.d. age 43 ± 11 years, 54% male). The questionnaires Patient Health Questionnaire-9 (PHQ-9), 16-item Quick Inventory of Depressive Symptomatology-Self Report (QIDSSR-16) and Generalized Anxiety Disorder-7 (GAD-7) were used for evaluation of symptoms of depression and anxiety. Forearm blood flow (strain gauge plethysmography) was used to assess vascular responses to mental stress and to device-guided breathing (DGB), interventions that respectively increase or decrease noradrenergic activity in the prefrontal cortex and locus coeruleus.

Low mood and high anxiety were two- to threefold higher for hypertensive subjects in the highest compared with the lowest normetanephrine tertiles (each P < 0.005). Forearm vasodilator responses to mental stress and vasoconstrictor responses to DGB were attenuated in those with high compared with low normetanephrine (28.3 ± 21% v. 47.1 ± 30% increases for mental stress and 3.7 ± 21% v. 18.6 ± 15% decreases for DGB for highest versus lowest tertiles of normetanephrine, each P ≤ 0.01).

A hyperadrenergic state in hypertension is associated with mood disturbance and impaired stress-modulated vasomotor responses. This association may be mediated by chronic stress impinging on pathways regulating central arousal and peripheral sympathetic nerve activity.

The purpose of this study was to report on the prevalence of hypertension and anaemia, and types of medications prescribed to expectant mothers attending antenatal clinics at Intermediate Hospital Katutura in Windhoek, Namibia.

Millennium Development Goals 4 and 5 speak to reduction of child mortality and improvement of maternal health by 2015, respectively. Gestational hypertension is a major contributor to maternal and perinatal mortality and is reported to affect up to 10% of women world-wide. Prevalence of anaemia among pregnant women is reported higher in low- and middle-income countries than in developed countries.

This was a cross-sectional study involving the review of outpatient and clinic health records for patients attending antenatal clinics at Intermediate Hospital Katutura, Windhoek during October to November 2022. Data for patients on first antenatal clinic visit were obtained from facility antenatal clinic patient registers while that of follow-up patients were from patient health passports. All expectant mothers over 18 years of age who had provided written consent to participate, were included. Data collected were: age, body weight, haemoglobin concentration, blood pressure, gravida, number of babies delivered, pregnancy stage, comorbidities, and prescribed medications. The results were summarised using descriptive statistics. A p-value <0.05 is considered to be statistically significant.

354 records were included: 303 (85.6%) first visit, and 51 follow-up (14.4%). There was a significant correlation between systolic blood pressure (BP) and body weight (r = 0.31, p < 0.001). 13.5% of first-time visitors had haemoglobin levels lower than the normal range (11 g/dL). Difference in haemoglobin levels between trimesters 1 and 3 were significant (p < 0.001). Methyldopa was prescribed for all hypertensive expectant mothers. To reduce the incidences of anaemia and hypertension during pregnancy, women of childbearing age should be encouraged to attend antenatal visits earlier in pregnancy and to take measures for body weight reduction, respectively.

Post-traumatic stress disorder (PTSD) and hypertension are highly prevalent among Veterans. Cognitive dispersion, indicating within-person variability across neuropsychological measures at one time point, is associated with increased risk of dementia. We examined interactive effects of PTSD symptom severity and hypertension on cognitive dispersion among older Veterans.

We included 128 Vietnam-era Veterans from the Department of Defense-Alzheimer’s Disease Neuroimaging Initiative (DoD-ADNI) with a history of PTSD. Regression models examined interactions between PTSD symptom severity and hypertension on cognitive dispersion (defined as the intraindividual standard deviation across eight cognitive measures) adjusting for demographics and comorbid vascular risk factors.

There was an interaction between PTSD symptom severity and hypertension on cognitive dispersion (p = .026) but not on mean cognitive performance (p = .543). Greater PTSD symptom severity was associated with higher cognitive dispersion among those with hypertension (p = .002), but not among those without hypertension (p = .531). Results remained similar after adjusting for mean cognitive performance.

Findings suggest, among older Veterans with PTSD, those with both hypertension and more severe PTSD symptoms may be at greater risk for cognitive difficulties. Further, cognitive dispersion may be a useful marker of subtle cognitive difficulties. Future research should examine these associations longitudinally and in a diverse sample.

To evaluate the relationship between the food environment in favelas and the presence of arterial hypertension and diabetes among women in the context of social vulnerability.

A cross-sectional and partially ecological population-based study was conducted in a Brazilian capital city. The healthiness and availability of ultra-processed foods in the food environment were assessed through retailer audits using the AUDITNOVA instrument. The presence of diabetes and arterial hypertension was evaluated based on self-reported prior medical diagnosis. Logistic regression models were applied using generalised estimating equations, adjusted for age, education, race/skin colour and poverty status.

1882 adult women of reproductive age (20–44 years).

It was found that 10·9 % of women were hypertensive and 3·2 % had diabetes. The likelihood of having diabetes and arterial hypertension decreases with higher levels of healthiness in the food environment (diabetes (OR: 0·25; 95 % CI: 0·07, 0·97)/arterial hypertension (OR: 0·45; 95 % CI: 0·24, 0·81)) and increases with greater availability of ultra-processed foods in their living area (diabetes (OR: 2·18; 95 % CI: 1·13, 4·21)/arterial hypertension (OR: 1·64; 95 % CI: 1·09, 2·47)).

These results suggest that characteristics of the consumer food environment have a significant effect on the occurrence of chronic diseases among socially vulnerable women, adding to the existing evidence in the literature and highlighting the need for integrated health care.

In response to increasing hypertension rates, South Africa implemented a regulation which set a maximum total sodium content for certain packaged food categories. We assess changes in reported sodium intake among 18-39 year old adults living in one township in the Western Cape as a result of the implementation of the regulation in 2016.

By linking one set of 24 hour dietary recall data to two versions of the South Africa Food Composition Database which reflect the pre-regulation and post-regulation periods, we calculated changes in sodium intake due to reformulation of food products, not behavior change. We statistically tested differences in mean consumption in this sample with paired t-tests.

Langa, Western Cape, South Africa

Surveyed participants were residents of Langa between 18-39 years old (n=2,148)

Before and after the implementation of the regulation there was a statistically significant decrease in the estimated sodium intake among adults of 189.4 mg (137.5, 241.4; p=0.00). Reported sodium from cured meat (such as Russians) and certain types of soup powder, cereals, and salted peanuts had a 9 to 33 percent lower calculated sodium consumption.

Our conclusions show that independent of any behavioral changes on the part of consumers, it is possible to lower sodium intake by using regulations to induce food manufacturers to lower the sodium levels in their products. As countries explore similar regulatory strategies, this work can add to that body of evidence to inform policies to improve the food system.

The China Rural Hypertension Control Project (CRHCP) is a nonphysician-led community-based hypertension intervention program that has demonstrated clear benefits in improving blood pressure (BP) control and reducing the incidence of cardiovascular disease events among hypertensive patients in rural areas of China. However, it is currently unclear whether the benefits of the CRHCP outweigh its costs, and whether promoting this project in China is justifiable from a perspective of healthcare system.

We employed a Markov model to forecast the anticipated 20-year costs and effectiveness of the CRHCP trial. Cost data for this study was gathered from public records or published papers, whereas clinical data was extracted from the CRHCP trial. Our primary outcome measure was the incremental cost-effectiveness ratio, expressed in Chinese Yuan (CNY) per quality-adjusted life-year (QALY), representing the additional cost per additional QALY gained.

Over a span of 20 years, the cost for a rural hypertensive individual in China who received intensive BP intervention by a nonphysician community healthcare provider would amount to 25,129 CNY, yielding an effectiveness of 8.19 QALY. In contrast, if usual care was provided, the cost would be 26,709 CNY with an effectiveness of 7.94 QALY. The CRHCP program demonstrated lower costs and greater effectiveness for rural hypertensive individuals in China.

Our study indicates that the implementation of the CRHCP program among rural hypertensive individuals in China resulted in increased effectiveness and reduced costs. From the perspective of Chinese healthcare system, the CRHCP program proves to be cost-saving within the current healthcare landscape.

This study aimed to investigate the effects of pain management according to the World Health Organization (WHO) analgesic ladder on pain severity, pain interference, and blood pressure (BP) in treated hypertensive patients with chronic musculoskeletal pain.

Pain management can affect BP control owing to the proposed mechanism by which persistent pain contributes to increased BP. However, there are inadequate studies investigating the benefit of pain management in controlling both pain and BP in hypertensive patients who have chronic pain.

In this cross-sectional study, demographic data and pain characteristics (resting pain score on the numerical pain rating scale, pain severity, and pain interference subscale of the Brief Pain Inventory) were collected via face-to-face interviews. BP was measured thrice on the same day. Data on pain medications taken in the previous 1 month were retrieved from the medical records. Participants were categorized into three groups following pain management patterns according to the WHO analgesic ladder: no, partial, and complete treatment. Multivariate logistic regression analysis (MLRA) was used to analyse the association between the variables and uncontrolled BP.

Among 210 participants, the mean (standard deviation) age was 68 (15.5) years, and 60.47% had uncontrolled BP. The resting pain score, pain severity, and pain interference subscale scores of the complete treatment group were significantly lower than that of the partial treatment group (P = 0.036, 0.026, and 0.044, respectively). The MLRA revealed that pain management patterns were associated with uncontrolled BP (adjusted odds ratio [AOR]: 6.75; 95% confidence interval [CI]: 2.71−16.78; P < 0.001) and resting pain scores (AOR: 1.17; 95% CI: 1.04−1.38; P = 0.048). Our findings suggest that pain management patterns adhering to the WHO analgesic ladder can reduce pain severity and pain interference and also control BP in hypertensive patients with chronic musculoskeletal pain.