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Hypertension, compounded by obesity, contributes to cardiovascular disease and mortality. Data describing hypertension prevalence in adults with short stature skeletal dysplasias are lacking, perhaps due to poor fit of typical adult blood pressure cuffs on rhizomelic or contracted upper extremities. Through health screening research, blood pressure was measured in short stature adults attending support group meetings and skeletal dysplasia clinics. Blood pressure was measured with a commercially available, narrower adult cuff on the upper and/or lower segment of the arm. Height, weight, age, gender, diagnosis, exercise, and medications were collected. Subjects were classified as normotensive, prehypertensive, or hypertensive for group analysis; no individual clinical diagnoses were made. In 403 short stature adults, 42% were hypertensive (systolic >140, diastolic >90 OR taking antihypertensive medications). For every BMI unit and 1 kg weight increase in males, there was a 9% and an 8% increase, respectively, in the odds of hypertension versus normotension. In females, the increase was 10% and 6%, respectively. In those with achondroplasia, the most common short stature dysplasia, males (n = 106) had 10% greater odds of hypertension versus normotension for every BMI unit and kilogram increase. In females with achondroplasia (n = 128), the odds of hypertension versus normotension was 8% greater for each BMI unit and 7% for each additional kilogram. These data suggest a high population prevalence of hypertension among short stature adults. Blood pressure must be monitored as part of routine medical care, and measuring at the forearm may be the only viable clinical option in rhizomelic short stature adults with elbow contractures.  相似文献   
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Body height has been recently related to the risk of coronary heart disease and metabolic risk factors. However, data are scarce regarding the relationship between body height and early‐stage atherosclerotic changes, especially in Chinese individuals. In this study, we aimed to comprehensively examine the associations of body height with early‐stage atherosclerosis and blood pressure in Chinese adults. Carotid‐femoral pulse wave velocity (cfPWV), carotid‐radial pulse wave velocity (crPWV), carotid artery‐dorsalis pedis pulse wave velocity (cdPWV), and body height were measured in 5098 men and women. All samples were obtained from a community‐based health examination survey in central China. After adjusting for sex, age, weight, fasting glucose level, lipid level, creatinine, and heart rate, low body heights were significantly associated with higher cfPWV, crPWV, and blood pressure (all P for trend <.01), whereas no significant association was found between body height and cdPWV. In addition, we found a significant interaction between prehypertension status and body height in relation to cfPWV, after adjusting for covariates (P for interaction = .0024). The associations were stronger in participants with prehypertension than in those with normal blood pressure. Compared to the group with the tallest stature and normal blood pressure, individuals in the group with the shortest stature and prehypertension had nearly a 2.5 m/s higher cfPWV. These results indicate that short body height was associated with an increased risk of early‐stage atherosclerosis in Chinese adults, independent of traditional cardiometabolic risk factors. Prehypertension might modify the association between body height and cfPWV.  相似文献   
4.
High blood pressure (BP) is associated with higher rates of cardiovascular events, even in stage I hypertension (HTN) and prehypertension (preHTN). Lower left ventricular (LV) systolic function, assessed by global longitudinal strain (GLS), has been demonstrated in individuals with HTN compared to individuals with normal BP, but a comparison of individuals with preHTN and stage I HTN was not described to date. The PREVER study includes two randomized double‐blind controlled trials, performed in volunteers with preHTN (PREVER‐prevention trial) or stage I HTN (PREVER‐treatment trial), aged 30‐70 years. A subsample of patients of both trials had GLS measured from 2D echocardiograms performed at baseline and after 18 months of follow‐up. We compared baseline data from both studies and, among stage I HTN patients, clinical and echocardiographic correlates of GLS were determined. Participants with preHTN (n = 91;53% female; 55 ± 9 yo) and stage I HTN (n = 105; 44% female; 55 ± 8 yo) had similar clinical parameters beyond the expected differences in BP levels. Participants with stage I HTN had lower GLS (−17.5 ± 2.5% vs −18.2 ± 2.4%, P = .03) compared with those with preHTN. In stage I HTN, lower GLS was associated with lower e'' and lower LV ejection fraction. In conclusion, patients in Stage I HTN may already express changes in GLS compared with individuals with preHTN, suggesting that even mildly difference in BP can be impact in subclinical systolic function.  相似文献   
5.
Currently, the best treatment strategy for patients with a high‐normal blood pressure (prehypertension) is not known. The authors aimed to determine whether pharmacological reduction of systolic blood pressure (SBP) to a normal level (<120 mm Hg) would prevent cardiac morbidity and mortality in prehypertensive patients. In this secondary analysis, the authors obtained the data from SPRINT from the National Heart, Lung, and Blood Institute data repository center. Among 9361 patients enrolled in SPRINT, 289 high‐risk (ASCVD risk = 24.8% ± 13.0 [10‐65]) prehypertensive patients without previous cardiovascular disease and not receiving any antihypertensive medications were enrolled. One hundred and forty‐eight of them were assigned to standard treatment which consisted of clinical follow‐up till SBP goes above 140 mm Hg and then staring medications to keep SBP <140 mm Hg. One hundred and forty‐one were assigned to the intensive treatment receiving pharmacological SBP reduction to <120 mm Hg upon enrollment. The primary composite outcome was myocardial infarction, and other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes. Throughout the 3.06 years of follow‐up, a primary outcome event was confirmed in three participants (0.74% per year) in the intensive‐treatment group and 8 (1.61% per year) in the standard‐treatment group (hazard ratio [HR], 0.19; P = .045). Rates of serious adverse events were not increased by intensive‐treatment (HR, 0.83; P = .506). Based on this secondary post hoc analysis, intensive SBP reduction may probably be beneficial for primary prevention of cardiovascular morbidity and mortality in high‐risk prehypertensive patients. This finding needs to be evaluated in a larger trial designed specifically to answer this question.  相似文献   
6.
目的 探讨高血压前期患者的心脏代谢异常风险因素.方法 以广州市2个独立社区居民高血压流行病学调查分析为基线资料,对高血压组(530例)、高血压前期组(562例)及理想血压组(557例)的心脏代谢风险因素进行病例对照研究.结果 高血压前期组的血压、年龄、体质指数(BMI)、腰围、尿酸、高敏C反应蛋白均明显高于理想血压组(P <0.05,P<0.01),而高密度脂蛋白胆固醇则均明显低于理想血压组(P<0.01);logistic回归结果显示:年龄和BMI是高血压前期患病的危险因素;高血压组有68.91%的患者合并至少一项代谢异常,有52.04%高血压前期患者合并至少一项代谢异常.结论 高血压前期患者已有心血管代谢异常风险因素的聚集.  相似文献   
7.
试论中医治未病理论在高血压前期防治中的运用   总被引:1,自引:0,他引:1  
高血压前期人群是高血压病的强大后备军,在高血压前期即有亚临床病变的改变,因此,对高血压前期的研究和干预有重要意义。高血压前期属中医"治未病"范畴中的第2层次内容,"先期干预"是基于治未病理论下高血压前期的处理原则,"见肝之病,当先实脾"是治法,中医药干预高血压前期是治未病理论在临床中具体运用的典范。  相似文献   
8.
邱蕾  钟晓妮  宋文丰  田考聪 《重庆医学》2012,41(16):1619-1622
目的分析重庆市中青年人高血压前期流行现状并探讨流行相关因素,为开展高血压的一级预防及对心、脑血管事件的防治工作提供基础资料和理论依据。方法根据重庆医科大学附属第一医院体检中心2010年体检数据,获得18~59岁中青年人有效样本20 000例,计算人群中高血压前期患病率,分析正常血压、高血压前期、高血压人群相关指标差异,并应用Logis-tic回归模型进行危险因素分析。结果 (1)有效样本20 000例中,高血压前期7 310例,其中,男4 968例,女2 342例。高血压前期患病率为36.55%。(2)与正常血压组相比,肥胖测量指标体质量指数(BMI)、腰围/身高比(WHtR)、腰围(WC),代谢指标总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、血糖,高血压前期组均高于血压正常组,而高密度脂蛋白胆固醇(HDL-C)较血压正常组低,差异具有统计学意义。(3)Logistic回归分析显示,年龄、BMI、WC、WHtR、总胆固醇、三酰甘油、血糖是男性高血压前期患病的危险因素,HDL-C是保护因素;年龄、BMI、WC、WHtR、总胆固醇、三酰甘油、血糖是女性高血压前期患病的危险因素。其中,BMI对男性高血压前期和女性高血压前期患病影响均达到了最大,优势比(OR)值分别为1.99(95%CI 1.80~2.20)、1.82(95%CI1.58~2.10)。结论超重和肥胖是高血压前期最重要的影响因子,同时也要重视高血压前期人群的血脂变化。  相似文献   
9.
Abstract

Background: Seven ideal health metrics were defined by AHA to monitor cardiovascular health. This study aimed to investigate the impact of ideal cardiovascular health behaviors and factors on the development of hypertension in prehypertensive subjects. Methods: Thirty-two thousand eight-hundred and eighty-seven participants with prehypertension were included in the study after excluding for preexisting stroke, myocardial infarction or malignancy. Cox proportional hazards regression was used to calculate hazard ratios and 95% confidence intervals [CI] for the development of hypertension. Results: During a follow-up of 52.2 months, 15?500 prehypertensive participants developed hypertension. The cumulative incidence of hypertension decreased with the number of ideal health metrics increased. It was 78.61%, 71.08%, 63.15%, 56.07% and 61.62% in prehypertensive individuals carrying ≤1, 2, 3, 4 and ≥5 ideal health behaviors or factors, respectively. After adjustment for age, gender, family history of hypertension, alcohol consumption, resting heart rate, plasma triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and high-sensitivity C-reactive protein, the risk ratios of incident hypertension in the subjects who carried 2, 3, 4, and ≥5 ideal health metrics were 0.833 (95%CI: 0.789–0.880), 0.710 (95%CI: 0.672–0.749), 0.604 (95%CI: 0.568–0.642), and 0.581 (95%CI: 0.524–0.643), respectively, in comparison to those with ≤1 ideal health metric. A similar trend was also observed in male and female populations. Poor health metrics, including body mass index, diet (salt intake), physical activity, total cholesterol, and smoking, were predictors for the development of hypertension in prehypertensive individuals. Conclusion: Ideal cardiovascular health behaviors and factors are protective factors to prevent the progression from prehypertension to hypertension.  相似文献   
10.
Background: Hypertension accounts for 7% of the annual global disease burden, despite great efforts to counter this trend. Thus, interventions targeted at prehypertension might lead to a breakthrough for hypertension prevention. This study focused on the prevalence of prehypertension among adults in Central China and the best indicator of prehypertension, which would provide the basis for future interventions. Methods: This cross-sectional study was conducted using multistage stratified random sampling in seven counties in Hubei Province. Data from 30,634 survey respondents were analyzed using logistic regression and receiver operating characteristic (ROC) curve statistical tests, for the prevalence of prehypertension and the predictive ability of body mass index (BMI), waist-to-height ratio (WHtR), and waist circumference (WC) for prehypertension. Results: The prevalence of prehypertension in adults was 42.2%. The following factors contributed to the risk of prehypertension: male sex, elder age, divorce/separation, drinking, heavy labor intensity, and high BMI (p < 0.05). Being a farmer and exercise exhibited positive associations with prehypertension (p < 0.05). Compared with BMI and WHtR, WC had a higher predictive value for prehypertension (area under ROC curve, AUC = 0.630, 95% confidence interval: 0.623–0.637, p < 0.0001), especially for men. The optimal cutoffs of WC for prehypertension were 79.95 cm in men and 76.85 cm in women. Conclusions: The prehypertension rate in adults was high in Central China. Significant factors related to hypertension were identified. More interventions targeting individuals with WC above the cutoff level are needed for timely awareness of prehypertension and early prevention of hypertension.  相似文献   
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