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Background: Hypertension is a risk factor for cardiovascular events. Inflammation plays an important role in the development of essential hypertension. Studies assessing the association between complete blood count-based inflammatory scores (CBCIS) and hypertension are scarce. Therefore, this study aimed to determine the relationship between CBCIS and hypertension among individuals with and without human immunodeficiency virus (HIV). Method: This was a cross-sectional study among 344 participants at Serenje District Hospital and Serenje Urban Clinic. We used structured questionnaires to collect sociodemographic, clinical and laboratory characteristics. CBCIS included lymphocyte-monocyte ratio (LMR), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), derived neutrophil-lymphocyte ratio (d-NLR), and differential white blood cells. The primary outcome variable was hypertension defined as systolic and diastolic blood pressure higher than or equal to 140/90 mmHg. Logistic regression was used to estimate the association between hypertension and CBCIS in statistical package for social science (SPSS) version 22.0. Results: The participants had a median age of 32 years (interquartile range (IQR) 24–42) and 65.1% (n = 224) were female. The prevalence of hypertension was 10.5% (n = 36). Among those with hypertension, 55.6% (n = 20) were female and 44.4% (n = 16) were male. The CBCIS significantly associated with hypertension in people living with HIV (PLWH) was PLR (adjusted odds ratio (AOR) 0.98; 95% confidence interval (CI) 0.97–0.99, p = 0.01) while in people without HIV, AMC (AOR 15.40 95%CI 3.75–63.26), ANC (AOR 1.88 95%CI 1.05–3.36), WBC (AOR 0.52 95%CI 0.31–0.87) and PLR (AOR 0.98 95%CI 0.97–0.99) were the factors associated with hypertension. Compared to people without HIV, only WBC, ANC, NLR, and d-NLR were good predictors of hypertension among PLWH. Conclusion: Our study indicates a notable HIV-status driven association between CBCIS and hypertension, suggesting the use of CBICS as potential biomarkers for hypertension risk with substantial implications for early detection and preventive measures. [ABSTRACT FROM AUTHOR]

Introduction: An altered serum lipid profile and lipoprotein levels are major modifiable risk factors for hypertension. Apolipoprotein A1 and B100 (ApoA1 and ApoB100) are the chief structural proteins of High-density Lipoprotein Cholesterol (HDL-C) and Low-density Lipoprotein Cholesterol (LDL-C), respectively. The level of ApoB in the serum represents overall atherogenicity, whereas the level of ApoA1 can indicate total antiatherogenicity. Aim: To evaluate the serum levels of ApoA1 and ApoB in the first-degree relatives of individuals with essential hypertension. Materials and Methods: This cross-sectional observational study was conducted in the Clinical Biochemistry laboratory in association with the Department of General Medicine at SCB Medical College and Hospital, Cuttack, Odisha, India, from February 2018 to March 2019. It consisted of 165 participants: group I included hypertensive patients (n=55); group II included first-degree relatives of the above hypertensive patients (n=55); and group III included non hypertensive healthy age-matched controls (n=55). The waist-hip ratio, Blood Pressure (BP), fasting plasma glucose, serum cholesterol, triglycerides, HDL-C, LDL-C, ApoA1, ApoB, and the ApoB/ApoA1 ratio were all measured. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 25.0. Results: The mean age of subjects in groups I, II, and III was 49±8.3, 38±5.2, and 37±5.4 years, respectively, with males constituting 56% and females 44% of the total participants. The ApoA1 levels were lowest in group I (104.9±16.3 mg/dL) and highest in group III (117.4±7.3 mg/dL). The serum ApoB levels and the ratio of ApoB/ApoA1 were highest in group I (104.2±14.1; 1.1±0.64 mg/dL) and lowest in group III (60.9±18.2; 0.5±0.15 mg/dL). A highly significant negative correlation (r=-0.40, p<0.01) was found between Systolic Blood Pressure (SBP) and ApoA1. A significant correlation (r=0.26, p=0.04) was observed between SBP and the ApoB/ApoA1 ratio in group III. Conclusion: Serum ApoB levels and the ratio of ApoB/ ApoA1 were significantly elevated in the first-degree relatives of hypertensive patients, thus emphasising the importance of screening individuals with a positive family history of hypertension. [ABSTRACT FROM AUTHOR]

High fruit and vegetable diets are associated with reduced chronic kidney disease and cardiovascular disease but are infrequently used in hypertension treatment. Low acid diets are also associated with reduced chronic kidney disease and cardiovascular disease, and fruits and vegetables or oral sodium bicarbonate (NaHCO 3) lowers dietary acid. We randomized 153 hypertensive macroalbuminuric patients receiving pharmacologic chronic kidney disease and cardiovascular disease protection to get fruits and vegetables, oral NaHCO 3 , or Usual Care. We assessed the course of kidney disease progression and cardiovascular disease risk indices over five years. Chronic kidney disease progression was slower in participants receiving fruits and vegetables or oral NaHCO 3 than Usual Care [mean (SE)] [−1.08 (0.06) and −1.17 (0.07) vs. −1.94 (0.11) mL/min/1.73m2/ year, respectively, P 's<.001). Yet, systolic blood pressure was lower, and cardiovascular disease risk indices improved more in participants receiving fruits and vegetables than in those receiving NaHCO 3 or Usual Care. These cardiovascular benefits of fruits and vegetables were achieved despite lower doses of pharmacologic chronic kidney disease and cardiovascular disease protection. The trial supports fruits and vegetables as foundational hypertension treatment to reduce chronic kidney disease progression and cardiovascular disease risk. [ABSTRACT FROM AUTHOR]

To preclinically study the effectiveness of new antihypertensive drugs, various animal hypertension models are used. However, most of them do not correspond to primary hypertension, which develops in people with age. We used male Wistar rats of 4, 10, 12 and 18 months old. The animals were divided according to systolic blood pressure (SBP) into normotensive (SBP ≤ 114 mmHg) or hypertensive (SBP ≥ 115 mmHg). Within hypertensive animals, two cohorts were distinguished—with SBP below and above 125 mmHg. The animals received 100 µg/kg of taxifolin intraperitoneally for 7 days. A significant difference was shown between animals with SBP above and below 115 mmHg, as well as between cohorts of hypertensive animals with SBP above and below 125 mmHg within each age. The number of animals with elevated SBP increased with age both for clusters with an SBP above 115 mmHg and for cohorts with an SBP above 125 mmHg. Administration of taxifolin led to a significant decrease in the SBP only in hypertensive animals. A physiological model of age-related hypertension was obtained in male Wistar rats. It has been shown that hypertension develops and worsens with age. In preclinical studies, it should be taken into account that drugs may have different effects depending on the initial SBP of the animals. [ABSTRACT FROM AUTHOR]

Sialylation catalysed by sialyltransferase 7A (SIAT7A) plays a role in the development of cardiac hypertrophy. However, the regulatory mechanisms upstream of SIAT7A in this context remain poorly elucidated. Previous study demonstrated that KLF4 activates the SIAT7A gene in ischemic myocardium by binding to its promoter region. Nevertheless, the potential involvement of KLF4 in regulating SIAT7A expression in Ang II‐induced hypertrophic cardiomyocytes remains uncertain. This study seeks to deepen the underlying mechanisms of the KLF4 and SIAT7A interaction in the progression of Ang II‐induced cardiac hypertrophy. The results showed a concurrent increase in SIAT7A and KLF4 levels in hypertrophic myocardium of essential hypertension patients and in hypertrophic cardiomyocytes stimulated by Ang II. In vitro experiments revealed that reducing KLF4 levels led to a decrease in both SIAT7A synthesis and Sialyl‐Tn antigen expression, consequently inhibiting Ang II‐induced cardiomyocyte hypertrophy. Intriguingly, reducing SIAT7A levels also resulted in decreased KLF4 expression and suppression cardiomyocyte hypertrophy. Consistent with this, elevating SIAT7A levels increased KLF4 expression and exacerbated cardiomyocyte hypertrophy in both in vivo and in vitro experiments. Additionally, a time‐course analysis indicated that KLF4 expression preceded that of SIAT7A. Luciferase reporter assays further confirmed that modulating SIAT7A levels directly influenced the transcriptional activity of KLF4 in cardiomyocytes. In summary, KLF4 expression is upregulated in cardiomyocytes treated with Ang II, which subsequently induces the expression of SIAT7A. The elevated levels of SIAT7A, in turn, enhance the transcription of KLF4. These findings suggest a positive feedback loop between KLF4 and SIAT7A‐Sialyl‐Tn, ultimately promoting Ang II‐induced cardiac hypertrophy. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension is a prevalent and significant cause of mortality, contributing to 18% of deaths globally. The incidence of essential hypertension escalates with advancing age, and individuals exhibiting higher blood pressure in their youth face an elevated risk of subsequent hypertensive complications. Morphological and physiological alterations in the vasculature have been implicated in the development and persistence of hypertension. This condition elevates the risk of cerebral, cardiac, and renal events. The primary aim of this study was to measure the arterial stiffness index (SI) and reflection index (RI) in both hypertensive subjects and an age-matched control group of normotensive individuals. Methods: A cross-sectional study involving 200 subjects aged 30 to 60 years was conducted. Subjects were divided into four groups: Group 1 (control group of healthy individuals) and three hypertensive groups classified by the duration of their illness. Arterial stiffness was assessed using SI and RI, derived from digital volume pulse (DVP) recordings. DVP was measured using a finger pulse photoplethysmography device. The data were analyzed using analysis of variance (ANOVA), with statistical significance defined as P < 0.05 in relation to arterial stiffness indices and hypertension duration. Results: The study found a progressive increase in hypertension prevalence with advancing age and longer hypertension duration. Participants aged 40-49 years exhibited the highest prevalence across all groups. Group I, with normal blood pressure, showed the lowest RI (0.50 ± 0.08) and SI (6.12 ± 0.09). RI and SI increased significantly in Group II, further escalating in Group III. Group IV displayed a slight RI decrease but continued SI increase. ANOVA analysis revealed significant differences in RI and SI among the groups. Pearson correlation analysis showed strong positive correlations between both RI and SI values with the duration of hypertension. Conclusion: The study demonstrates a strong positive correlation between the two arterial stiffness indices, RI and SI, and the duration of hypertension. [ABSTRACT FROM AUTHOR]

Background: Primary hypertension (HT) has a high mortality rate due to its atherosclerotic complications. Vitamin D (VD) deficiency has been reported to increase the development of non-dipper HT (ND-HT) and atherosclerosis, but there are also conflicting results. To our knowledge, there is no study investigating the relationship between VD and carotid artery intima-media thickness (C-IMT) in patients with HT. Therefore, we aimed to investigate the relationship between VD levels, ND-HT development, and C-IMT in patients with HT with no known cardiovascular disease (CVD). Methods: This study was conducted in 60 (63% female) patients with HT. Ambulatory blood pressure monitoring was performed using a portable digital recording device. C-IMT was measured using B-mode ultrasonography. Vitamin D levels were measured using elect roche milum inesc ence immunoassay. Those with C-IMT =0.750 mm were assumed to have subclinical atherosclerosis, and serum 25-(OH) D3 (VD) levels <20 ng/mL were VD deficient. Results: There was a significant negative linear relationship between VD levels and triglycerides (TG) and smoking, and a significant positive linear relationship between high-density lipoprotein cholesterol levels. Triglyceride levels were significantly (P = .015) higher in patients who were VD deficient compared to those who were VD sufficient. Patients with subclinical atherosclerosis were older (P = .002) than those without. Only patient age was positively associated with C-IMT (P < .001). There was no relationship between VD levels/VD deficiency and the presence of ND-HT and subclinical atherosclerosis. Conclusion: Our findings suggest that VD deficiency does not facilitate the development of ND-HT and subclinical atherosclerosis. [ABSTRACT FROM AUTHOR]

Context Patients with primary aldosteronism (PA) have higher cardiac comorbidities including more pronounced left ventricular hypertrophy than patients with essential hypertension. Objective Autonomous cortisol cosecretion (ACS) is a common subtype in PA associated with a worse metabolic profile. Hypothesis Autonomous cortisol cosecretion may affect myocardial parameters and result in a worse cardiac outcome compared to patients with PA and without ACS. Methods Three hundred and sixty-seven patients with PA undergoing 1 mg dexamethasone suppression test (DST) and echocardiography at baseline from 2 centers of the German Conn's Registry were included. Follow-up for up to 3.8 years was available in 192 patients. Results Patients with PA and ACS had higher NT-proBNP levels at baseline compared to patients with PA without ACS (114 vs 75.6 pg/mL, P =.02), but showed no difference in echocardiography values. NT-proBNP levels showed a significant positive correlation (r = 0.141, P =.011) with cortisol levels after DST at baseline. In response to therapy of PA, NT-proBNP levels decreased, but remained significantly higher in patients with ACS compared to patients without ACS. At follow-up, left ventricle end-diastolic dimension (LVEDD) decreased significantly only in patients without ACS. Left atrial diameter (LAD) decreased significantly in patients without ACS and in female patients with ACS but not in male patients. Left ventricular mass index (LVMI) significantly improved in female patients without ACS but remained unchanged in female patients with ACS as well as in male patients at follow-up. Conclusions In patients with PA, concomitant ACS is associated with a worse cardiac profile and only partial recovery even years after initiation of targeted PA therapy. [ABSTRACT FROM AUTHOR]

Aims To assess the relationship between the left ventricular remodeling parameters of cardiac magnetic resonance and NT-pro-BNP in patients with primary aldosteronism (PA). Methods Seventy-four PA and 39 essential hypertension patients were prospectively recruited and underwent cardiac magnetic resonance. Plasma NT-pro-BNP was measured before patients underwent cardiac magnetic resonance. Left ventricular remodeling parameters were defined as left ventricular function parameters, T1 mapping parameters, and strain parameters. Differences in continuous variables between two groups were analyzed using Student's t-test or Mann–Whitney U test. Differences in categorical variables between two groups were analyzed by chi-squared test. Spearman's correlation and linear regression were used to analyze the relationships between left ventricular remodeling parameters and plasma NT-Pro-BNP level. P<0.05 was considered as statistically significant. Results Patients with PA demonstrated higher NT-pro-BNP [86.0 (49.5, 145.5) vs. 45.0 (28.5, 73.5) pg/mL, P=0.001] and Native T1 (1227±41 vs. 1206±43 ms, P=0.015) level than essential hypertension patients. Compared to patients with normal NT-pro-BNP levels, those with abnormal levels demonstrated different left ventricular remodeling parameters. NT-pro-BNP level was independently related to native T1 (β=0.316, P=0.006), extracellular volume (β=0.419, P<0.001), short-axis global circumferential strain (β=0.429, P<0.001), four-chamber global longitudinal strain (β=0.332, P=0.002), and four-chamber global radial strain (β=-0.334, P=0.004) in patients after adjusting for baseline characteristics. Conclusions NT-pro-BNP level was related to left ventricular remodeling parameters derived from cardiac magnetic resonance in patients with PA. This result implies that clinicians should pay attention to NT-pro-BNP assessment in patients with PA in routine clinical assessment. [ABSTRACT FROM AUTHOR]

Effective antihypertensive therapy is essential for achieving optimal blood pressure (BP) control and reducing cardiovascular events. This double-blind, multicenter, randomized trial aimed to compare the antihypertensive efficacy and safety of a combination of amlodipine (AML) and candesartan cilexetil (CC) versus AML monotherapy in patients with essential hypertension (HTN). After a 4-week run-in period with AML 5 mg, patients whose HTN remained uncontrolled (diastolic BP [DBP]) ≥ 90 mmHg and < 120 mmHg) were randomized to receive either AML + CC or AML alone for 8 weeks. Efficacy was assessed by measuring changes in DBP and systolic BP (SBP). The primary safety measure was the incidence of adverse events (AEs). A total of 174 participants were included in the efficacy analysis. After 8 weeks, DBP decreased by -9.92 ± 0.86 mmHg in the AML + CC arm and - 2.08 ± 0.86 mmHg in the AML arm (p < 0.0001). SBP decreased by -14.27 ± 1.39 mmHg in the AML + CC arm versus - 2.77 ± 1.39 mmHg in the AML arm (p < 0.0001). AEs occurred in 11.24% of the AML + CC group and 5.62% of the AML group (p = 0.1773). AML + CC combination therapy demonstrated superior efficacy with good tolerance, making it a promising option for patients with inadequately controlled hypertension on amlodipine alone. [ABSTRACT FROM AUTHOR]

Background: Professional society guidelines are evidence-based recommendations intended to promote standardized care and improve health outcomes. Amid increased recognition of the role racism plays in shaping inequitable healthcare delivery, many researchers and practitioners have critiqued existing guidelines, particularly those that include race-based recommendations. Critiques highlight how racism influences the evidence that guidelines are based on and its interpretation. However, few have used a systematic methodology to examine race-based recommendations. This review examines hypertension guidelines, a condition affecting nearly half of all adults in the United States (US), to understand how guidelines reference and develop recommendations related to race. Methods: A systematic scoping review of all professional guidelines on the management of essential hypertension published between 1977 and 2022 to examine the use and meaning of race categories. Results: Of the 37 guidelines that met the inclusion criteria, we identified a total of 990 mentions of race categories. Black and African/African American were the predominant race categories referred to in guidelines (n = 409). Guideline authors used race in five key domains: describing the prevalence or etiology of hypertension; characterizing prior hypertension studies; describing hypertension interventions; social risk and social determinants of health; the complexity of race. Guideline authors largely used race categories as biological rather than social constructions. None of the guidelines discussed racism and the role it plays in perpetuating hypertension inequities. Discussion: Hypertension guidelines largely refer to race as a distinct and natural category rather than confront the longstanding history of racism within and beyond the medical system. Normalizing race as a biological rather than social construct fails to address racism as a key determinant driving inequities in cardiovascular health. These changes are necessary to produce meaningful structural solutions that advance equity in hypertension education, research, and care delivery. [ABSTRACT FROM AUTHOR]

The article discusses the increased risk of hypertension in cancer survivors, particularly adult survivors of childhood cancer, due to treatment-related factors such as chemotherapy and radiation therapy. It highlights the importance of recognizing and mitigating this risk, as hypertension is a common comorbidity among cancer survivors. The study by Nain et al. uses a composite score of social determinants of health (SDOH) to predict hypertension risk in cancer survivors, showing that adverse SDOH variables can significantly increase the risk of uncontrolled hypertension, especially in urban residents and older adults. The article emphasizes the complexity of SDOH and the need for nuanced analysis to understand individual-level risk factors beyond composite scores. [Extracted from the article]

Background: The triglyceride-glucose (TyG) index is regarded as an independent predictor of cardiovascular disease consequences and a reliable surrogate measure of insulin resistance (IR). However, the correlation analysis between triglyceride glucose index and heart failure with preserved ejection fraction in patients with essential hypertension remains unknown. Methods: A single-center, retrospective study was conducted with patients diagnosed with essential hypertension at the First Affiliated Hospital of Xinjiang Medical University, from December 2018 to September 2020. Participants were selected based on specific inclusion and exclusion criteria, with their clinical data and laboratory tests collected. The study employed Spearman's correlation analysis, logistic regression models, restricted cubic spline plots, and receiver operating characteristic (ROC) curves to investigate the relationships between the TyG index and HFpEF. Results: Out of 1,602 enrolled hypertensive patients, 992 were included in the analysis after applying exclusion criteria. Patients were categorized into tertiles based on the TyG index, which showed that patients in the highest tertile had characteristics associated with a higher risk of HFpEF, including age, body mass index (BMI), systolic blood pressure (SBP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and left ventricular mass index (LVMI). A significant, independent association between the TyG index and HFpEF was confirmed, with an odds ratio (OR) of 5.127 (95% CI [3.894–6.856]). Furthermore, an S-shaped nonlinear relationship was observed between the TyG index and the incidence of HFpEF (nonlinear p < 0.001). TyG index (AUC: 0.824, 95% CI [0.795–0.854]), NT-proBNP (AUC: 0.840, 95% CI [0.816–0.864]), and LVMI (AUC: 0.847, 95% CI [0.820–0.875]) showed good predictive ability for HFpEF. In addition, the TyG+LVMI combination demonstrated the strongest predictive ability (AUC: 0.907, 95% CI [0.887–0.927]). Conclusion: The study underscores a significant association between IR, as indicated by the TyG index, and the development of HFpEF in hypertensive patients. It highlights the critical role of metabolic dysfunction in the pathophysiology of HFpEF, advocating for a broader perspective on cardiovascular risk management. [ABSTRACT FROM AUTHOR]

Background: Hypertension is prevalent in the pediatric population, with estimated rates between 2% and 5%, and its incidence is rising globally. This study offers a single-center analysis of hypertension in children. Methods: a retrospective chart review was conducted involving children aged 1 month to 13 years diagnosed with hypertension. Results: The study included a total of 129 children. Secondary hypertension was identified in 103 patients (79.8%), while primary hypertension was noted in 26 patients (20.2%). Primary hypertension was more common among pre-teen children (50.0%), whereas secondary hypertension predominantly affected those aged 1 to 5 years. Renal parenchymal disease emerged as the most frequent etiology of secondary hypertension, followed by endocrine disorders and vascular issues. No significant correlation was found between hypertension and obesity. The primary complications associated with hypertension in these children were cardiovascular, followed by neurological issues. A small proportion (14.7%) managed their hypertension solely through lifestyle modifications, while the majority required additional antihypertensive medications. At the final follow-up, 50% of the children demonstrated improved blood pressure readings. Conclusion: The findings indicate a higher prevalence of secondary hypertension compared to primary hypertension among the studied population. This study underscores the necessity for heightened awareness among pediatricians regarding the early identification and management of hypertension. Larger population-based studies are warranted to further investigate the prevalence, causes, and outcomes of hypertension in this region. [ABSTRACT FROM AUTHOR]

Despite the well-established significance of the CAC score as a cardiovascular risk marker, the timing of using CAC score in routine clinical practice remains unclear. We aim to develop a prediction model for patients visiting outpatient cardiology units, which can recommend whether CAC score screening is necessary. A prediction model using retrospective cross-sectional design was conducted. Patients who underwent CAC score screening were included. Eight candidate predictors were preselected, including age, gender, DM or primary hypertension, angina chest pain, LDL-C (≥130 mg/dl), presence of low HDL-C, triglyceride (≥150 mg/dl), and eGFR. The outcome of interest was the level of CAC score (CAC score 0, CAC score 1–99, CAC score ≥100). The model was developed using ordinal logistic regression, and model performance was evaluated in terms of discriminative ability and calibration. A total of 360 patients were recruited for analysis, comprising 136 with CAC score 0, 133 with CAC score 1–99, and 111 with CAC score ≥100. The final predictors identified were age, male gender, presence of hypertension or DM, and low HDL-C. The model demonstrated excellent discriminative ability (Ordinal C-statistics of 0.81) with visually good agreement on calibration plots. The implementation of this model (CAC-prob) has the potential to enhance precision in recommending CAC screening. However, external validation is necessary to assess its robustness in new patient cohorts. [ABSTRACT FROM AUTHOR]

Objective: Tafamidis-associated adverse events (AEs) were investigated retrospectively by data mining the US Food and Drug Administration Adverse Event Reporting System (FAERS) to inform clinical safety. Methods: Data were gathered from the FAERS database, which spans the second quarter of 2019 to the fourth quarter of 2023. A total number of 8532 reports of Tafamidis-related adverse events were detected after evaluating 8,432,351 data. Disproportionality analyses were used to quantify the signal and assess the significance of Tafamidis-associated AEs using four algorithms, including the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the multi-item gamma Poisson shrinker (MGPS) and the Bayesian confidence propagation neural network (BCPNN). Results: Among the 8532 reports of AEs with Tafamidis as the primary suspected drug, Tafamidis-induced AEs were identified as occurring in 27 system organ classes (SOC). A total of 207 Tafamidis-induced AEs were detected which simultaneously complied with the four algorithms. Our analysis also identified new adverse reactions including Hypoacusis, Deafness, and Essential hypertension. The median onset of adverse reactions associated with Tafamidis was 180 days (interquartile range [IQR] 51–419 days). Conclusion: Tafamidis is a drug that has shown favorable safety and tolerability results in clinical trials. However, a number of adverse reactions associated with Tafamidis have been identified through analysis of the FAERS database. In clinical applications, it is recommended to closely monitor patients' hearing while using Tafamidis. In addition, it is hoped that further experimental and clinical studies will be conducted in the future to understand the mechanism of occurrence between Tafamidis and adverse reactions such as primary hypertension, hyperlipidemia, and height reduction. [ABSTRACT FROM AUTHOR]

Introduction. Studies on the relationship between a family history of hypertension and left ventricular hypertrophy are sparse. We evaluated this relationship in patients with essential hypertension. Methods. A total of 1668 patients with essential hypertension were consecutively enrolled in the prospective Federal Medical Centre Abuja Hypertension Registry. First‐degree family history was defined by the presence of a known history of hypertension in any or both parents, siblings, and children. Echocardiographic left ventricular hypertrophy was diagnosed using the criteria of the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Results. The prevalence of a family history of hypertension, echocardiographic, and electrocardiographic left ventricular hypertrophy were 61.7%, 46.8%, and 30.8%, respectively. After multivariable adjustment, paternal history of hypertension [OR: 1.56, CI: 1.20–2.05, p = 0.001] was associated with an increased risk of echocardiographic left ventricular hypertrophy, while maternal history of hypertension [OR: 0.72, CI 0.58–0.91, p = 0.006] was associated with a reduced risk. Age ≥50 years (p = 0.026), duration of hypertension ≥1 year (p = 0.047), and heart failure (p < 0.001) were associated with an increased risk of left ventricular hypertrophy, while male sex (p < 0.001) was associated with a reduced risk. Conclusion. Our study showed that a paternal history of hypertension is associated with an increased left ventricular hypertrophy risk among patients with essential hypertension, while maternal history is protective. [ABSTRACT FROM AUTHOR]

Sepsis and hypertension pose significant health risks, yet the optimal mean arterial pressure (MAP) target for resuscitation remains uncertain. This study investigates the association between average MAP (a-MAP) within the initial 24 h of intensive care unit admission and clinical outcomes in patients with sepsis and primary hypertension using the Medical Information Mart for Intensive Care (MIMIC) IV database. Multivariable Cox regression assessed the association between a-MAP and 30-day mortality. Kaplan–Meier and log-rank analyses constructed survival curves, while restricted cubic splines (RCS) illustrated the nonlinear relationship between a-MAP and 30-day mortality. Subgroup analyses ensured robustness. The study involved 8,810 patients. Adjusted hazard ratios for 30-day mortality in the T1 group (< 73 mmHg) and T3 group (≥ 80 mmHg) compared to the T2 group (73–80 mmHg) were 1.25 (95% CI 1.09–1.43, P = 0.001) and 1.44 (95% CI 1.25–1.66, P < 0.001), respectively. RCS revealed a U-shaped relationship (non-linearity: P < 0.001). Kaplan–Meier curves demonstrated significant differences (P < 0.0001). Subgroup analysis showed no significant interactions. Maintaining an a-MAP of 73 to 80 mmHg may be associated with a reduction in 30-day mortality. Further validation through prospective randomized controlled trials is warranted. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association between the extent of nocturnal systolic blood pressure decline and left ventricular hypertrophy in patients with primary hypertension who were receiving antihypertensive drug therapy. Design: This was a cross-sectional hospital-based study from November 2020 to March 2021. Setting: The study was conducted at the Polyclinic of Korle Bu Teaching Hospital, Ghana. Participants: Outpatients ≥18 years old with primary hypertension who were receiving antihypertensive drug therapy. Interventions: Each participant underwent a 24-hour ambulatory blood pressure monitoring and a transthoracic echocardiogram. Main outcome measures: Left ventricular hypertrophy and the extent of mean systolic blood pressure decline during sleep. Results: 180 participants were recruited, comprising 110 (61.1%) females. The participants' mean (±SD) age was 57.6 ± 11.0 years. 80% had a non-dipping blood pressure pattern, and 43.9% had left ventricular hypertrophy. Uncontrolled office blood pressure was an independent predictor of left ventricular hypertrophy in these patients (AOR 2.010, 95% CI 1.048-3.855, p=0.036); however, a non-dipping nocturnal systolic blood pressure status was not (AOR 1.849, 95% CI 0.850-4.022, p=0.121). 61.1% had abnormal left ventricular geometry, with concentric hypertrophy being the predominant geometric pattern. Conclusion: Left ventricular hypertrophy and non-dipping nocturnal blood pressure were common in these hypertensive Ghanaian patients on antihypertensive therapy. Left ventricular hypertrophy was associated with uncontrolled office blood pressure but not the extent of nocturnal systolic blood pressure declines during a single 24-hour ambulatory blood pressure recording. [ABSTRACT FROM AUTHOR]

Recent years have witnessed a rise in the popularity of information integration without sharing of raw data. By leveraging and incorporating summary information from external sources, internal studies can achieve enhanced estimation efficiency and prediction accuracy. However, a noteworthy challenge in utilizing summary-level information is accommodating the inherent heterogeneity across diverse data sources. In this study, we delve into the issue of prior probability shift between two cohorts, wherein the difference of two data distributions depends on the outcome. We introduce a novel semi-parametric constrained optimization-based approach to integrate information within this framework, which has not been extensively explored in existing literature. Our proposed method tackles the prior probability shift by introducing the outcome-dependent selection function and effectively addresses the estimation uncertainty associated with summary information from the external source. Our approach facilitates valid inference even in the absence of a known variance-covariance estimate from the external source. Through extensive simulation studies, we observe the superiority of our method over existing ones, showcasing minimal estimation bias and reduced variance for both binary and continuous outcomes. We further demonstrate the utility of our method through its application in investigating risk factors related to essential hypertension, where the reduced estimation variability is observed after integrating summary information from an external data. [ABSTRACT FROM AUTHOR]

The extent to which the association between hypertension and chronic pain in observational studies is either causally linked or influenced by other shared risk factors has not been substantially addressed. In the present study, Mendelian randomization (MR) was employed to examine the potential causal relationship between hypertension and risk of chronic pain. The study data were derived from the pooled dataset of the genome-wide association study (GWAS), enabling the evaluation of the causal effects of hypertension on various types of chronic pain including chronic headache as well as chest, abdominal, joint, back, limb, and multisite chronic pain. We performed a bidirectional two-sample MR analysis using random effect inverse variance weighting (IVW), MR-Egger, weighted median, and weighted mode, quantified by odds ratio (OR). Genetically predicted essential hypertension was associated with an increased risk of chronic headache (OR = 1.007, 95% CI : 1.003–1.011, P = 0.002) and limb pain (OR = 1.219, 95% CI : 1.033–1.439, P = 0.019). No potential causal associations were identified between chronic pain and essential hypertension in the reverse direction MR (P > 0.05). In addition, there was no potential causal association between secondary hypertension and chronic pain (P > 0.05). This study provided genetic evidence that a unidirectional causal relationship exists between essential hypertension and the increased risks of chronic headache and limb pain, and no causal relationship was found between secondary hypertension and chronic pain. These findings offer theoretical underpinnings for future research on managing hypertension and chronic pain. [ABSTRACT FROM AUTHOR]

Previous studies found that histamine H2 receptor antagonists (H2RAs) had blood pressure lowering and cardioprotective effects, but the impact of H2RAs on the survival outcomes of critically ill patients with essential hypertension is still unclear. The aim of this study was to investigate the association of H2RAs exposure with all‐cause mortality in patients with essential hypertension based on Medical Information Mart for Intensive Care III database. A total of 17,739 patients were included, involving 8482 H2RAs users and 9257 non‐H2RAs users. Propensity score matching (PSM) was performed to improve balance between 2 groups that were exposed to H2RAs or not. Kaplan–Meier survival curves were used to compare the cumulative survival rates and multivariable Cox regression models were performed to evaluate the association between H2RAs exposure and all‐cause mortality. After 1:1 PSM, 4416 pairs of patients were enrolled. The results revealed potentially significant association between H2RAs exposure and decreased 30‐day, 90‐day, and 1‐year mortalities in multivariate analyses (HR = 0.783, 95% CI: 0.696‐0.882 for 30‐day; HR = 0.860, 95% CI: 0.778‐0.950 for 90‐day; and HR = 0.883, 95% CI: 0.811‐0.961 for 1‐year mortality, respectively). Covariate effect analyses showed that the use of H2RAs was more beneficial in essential hypertension patients with age ≥ 60, BMI ≥ 25 kg/m2, coronary arteriosclerosis, stroke, and acute kidney failure, respectively. In conclusion, H2RAs exposure was related to lower mortalities in critically ill patients with essential hypertension, which provided novel potential strategy for the use of H2RAs in essential hypertension patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether angiotensin II type 1 receptor (AGTR1 A1166C) gene polymorphism was associated with the effectiveness of valsartan monotherapy in Chinese patients with essential hypertension. Methods: This retrospective analysis included 198 patients (⩾18 years of age) who received valsartan monotherapy (80 mg/day) for newly developed essential hypertension at the authors’ center between January 1, 2020 and December 31, 2023. Genotyping for AGTR1 A1166C gene polymorphism was done by polymerase chain reaction (PCR)-melting curve analysis of genomic DNA from peripheral blood samples. A dominant genetic model for AGTR1 A1166C (AA genotype versus AC + CC genotype) was used. Multivariate regression analysis of baseline variables and AGTR1 polymorphism was conducted to identify predictors of target blood pressure attainment (

Background Hypertension is a common chronic non-communicable disease in clinical practice, and its prevalence is on the rise globally due to population aging and changes in human lifestyles. Prolonged high blood pressure can lead to damage to various target organs such as the heart, brain, kidneys, and retina, severely threatening human health and being a major cause of global disease burden. The left ventricle, as the primary target of end-organ damage, its structural changes are also the pathological basis for the development of many cardiovascular diseases. Objective This study aims to explore the relationship between the atherogenic index of plasma (AIP) and serum lipoprotein-associated phospholipase A2 (Lp-PLA2) levels and left ventricular hypertrophy (LVH) in patients with primary hypertension. Methods A total of 167 patients with primary hypertension who visited the Department of Cardiovascular Medicine at the Second Affiliated Hospital of Zhengzhou University from October 2021 to June 2023 were enrolled in this study. Baseline data of the patients were collected, and fasting venous blood biochemical markers were measured. Echocardiograms were conducted within 24 hours of admission to calculate left ventricular mass (LVM) and left ventricular mass index (LVMI). Patients were divided into non-left ventricular hypertrophy (NLVH) group (87 patients) and LVH group (80 patients) based on LVMI. Pearson correlation test and Spearman rank correlation analysis were used to investigate the correlation between serum Lp-PLA2 level, AIP and echocardiographic parameters. Multivariate Logistic regression analysis was used to explore the influencing factors of LVH in hypertensive patients. Receiver operating characteristic (ROC) curve was plotted to explore the diagnostic value of serum Lp-PLA2 level and AIP in hypertensive patients with LVH, and the area under ROC curve (AUC) was calculated. Results Patients in the LVH group had higher age, duration of hypertension, levels of N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), left ventricular posterior wall thickness (LVWPT), interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDd), left atrial end-systolic diameter (LAESd), Lp-PLA2 levels, AIP, LVM, and LVMI compared to the NLVH group (P

Objectives: Individuals with obstructive sleep apnea (OSA) suffer from a multitude of concurrent morbidities including cardiovascular disease (CVD). Limited data exists comparing long term cardiovascular disease (CVD) clinical outcomes for patients treated with surgical intervention versus continuous positive airway pressure (CPAP). The purpose of this study was to compare CVD outcomes at multiple time points comparing those treated with sleep surgery versus CPAP alone. Methods: A research database was used to assess outcomes: death, myocardial infarction, atrial fibrillation, heart failure, essential hypertension, and pulmonary hypertension at 5, 8, and 20 years for patients with OSA treated with surgical interventions (upper airway stimulation [UAS], uvulopalatopharyngoplasty [UPPP], and tonsillectomy) or CPAP alone. Subjects were identified using ICD and CPT codes and analyses were conducted with and without propensity score matching for age, sex, race, BMI, myocardial infarction (MI), essential hypertension, pulmonary hypertension, atrial fibrillation, and heart failure. Results: All surgical interventions demonstrated benefit over CPAP alone at most time points for most surgical interventions. At 8 years, for all sleep surgeries (UAS or UPPP or tonsillectomy) (n = 6627) versus treatment with CPAP alone (n = 6627), matched subjects demonstrated decreased risk (odds ratios) and superior survival (hazard ratios and log ranks tests) for death (OR = 0.49 [0.39, 0.62] P ≤.0001, HR = 0.29 [0.23, 0.37], χ2 = 109.58 P ≤.0001), myocardial infarction (OR = 0.67 [0.54, 0.84] P =.0005*, HR = 0.48 [0.38, 0.60], χ2 = 42.40 P ≤.0001), atrial fibrillation (OR = 0.70 [0.59, 0.83] P ≤.0001, HR = 0.54 [0.45, 0.64], χ2 = 51.53 P ≤.0001), heart failure (OR = 0.55 [0.47, 0.64] P ≤.0001, HR = 0.41 [0.35, 0.47], χ2 = 137.416 P ≤.0001), essential hypertension (OR = 0.88 [0.82, 0.94] P =.0002, HR = 0.78 [0.74, 0.82], χ2 = 76.38 P ≤.0001), and pulmonary hypertension (OR = 0.51 [0.40, 0.65] P ≤.0001, HR = 0.38 [0.29, 0.48], χ2 = 60.67 P ≤.0001) where P ≤.00037 indicated statistical significance*. Conclusion: This investigation suggests surgical management of obstructive sleep apnea may contribute to the mitigation of long-term clinical CVD morbidity. [ABSTRACT FROM AUTHOR]

Background: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are widely used medications for treating essential hypertension, but there is limited research comparing their effectiveness. To address this gap, a recent meta-analysis was conducted to evaluate and compare the efficacy of these two drug classes in decreasing blood pressure (BP) among patients with essential hypertension. Objective: Evaluating of comparative efficacy of ACEIs versus ARBs in reducing BP in essential hypertension. Methods: An extensive literature search for randomized controlled trials (RCTs) following PRISMA guidelines (2020), with inclusion criteria of age ≥18 years, with either gender and diagnosed of essential hypertension and receiving ACEIs or ARBs for at least 4 weeks. Patients with secondary hypertension, malignancy, symptomatic cardiovascular system (CVS) disease, hepatic involvement, and studies with Fimasartan and Allisartan were excluded. For this study, all RCTs that reported changes in mean systolic BP (SBP) and diastolic BP (DBP) before and after administration of the drugs were gathered. Standardized mean difference (SMD) was calculated using RevMan 5.4.1 software. The significance level was set at a P < 0.05. Results: A total of 28 RCTs (n = 9778) were included in our study. Both groups reduce SBP and DBP from the baseline values. Pooled analyses of studies showed that ARBs were superior to ACEIs with SMD = 0.179 in the random-effect model, 95% confidence interval (CI) (0.0975–0.260), P < 0.001, and in the fixed-effect model, SMD = 0.207, 95% CI (0.167–0.248), P < 0.001 in the mean reduction of SBP. Furthermore, for a mean reduction in DBP, ARBs were superior to ACEIs with SMD = 0.329 in the random-effect model, 95% CI (0.161–0.496), P < 0.001, and in the fixed-effect model, SMD = 0.317, 95% CI (0.276–0.357), P < 0.001. Our study included 28 RCTs with a combined sample size of 9778 participants. Both ACEIs and ARBs were found to effectively reduce SBP and DBP from their baseline values. However, our pooled analysis of the studies revealed that ARBs were more effective than ACEIs in reducing mean SBP, with an SMD of 0.179 in the random-effect model and 0.207 in the fixed-effect model. The 95% CIs for these estimates were (0.0975–0.260) and (0.167–0.248), respectively, with P < 0.001. Similarly, for a mean reduction in DBP, ARBs were found to be superior to ACEIs with a SMD of 0.329 in the random-effect model and 0.317 in the fixed-effect model, with 95% CIs of (0.161–0.496) and (0.276–0.357), respectively, and a P < 0.001. Conclusion: ARBs are more efficacious as compared to ACEIs in essential hypertension. [ABSTRACT FROM AUTHOR]

BACKGROUND Elevated soluble stimulating factor 2 (sST2) level is observed in cardiovascular diseases, such as heart failure and acute coronary syndrome, which reflects myocardial fibrosis and hypertrophy, indicating adverse clinical outcomes. However, the association between sST2 and hypertensive heart disease are less understood. This study aimed to determine the relationship of sST2 with left ventricular hypertrophy (LVH) and geometric remodeling in essential hypertension (EH). METHODS We enrolled 483 patients (aged 18–80 years; 51.35% female). sST2 measurements and echocardiographic analyses were performed. RESULTS Stepwise multiple linear regression analysis showed significant associations among sST2, left ventricular (LV) mass, and LV mass index. The prevalence of LVH and concentric hypertrophy (CH) increased with higher sST2 grade levels (P for trend < 0.05). Logistic regression analysis suggested that the highest tertile of sST2 was significantly associated with increased LVH risk, compared with the lowest tertile (multivariate-adjusted odds ratio [OR] of highest group: 6.61; P  < 0.001). Similar results were observed in the left ventricular geometric remodeling; the highest tertile of sST2 was significantly associated with increased CH risk (multivariate-adjusted OR of highest group: 5.80; P  < 0.001). The receiver operating characteristic analysis results revealed that sST2 had potential predictive value for LVH (area under the curve [AUC]: 0.752, 95% confidence interval [CI]: 0.704–0.800) and CH (AUC: 0.750, 95% CI: 0.699–0.802) in patients with EH. CONCLUSIONS High sST2 level is strongly related to LVH and CH in patients with EH and can be used as a biomarker for the diagnosis and risk assessment of hypertensive heart disease. CLINICAL TRIALS REGISTRATION Trial Number ChiCTR2400082764 [ABSTRACT FROM AUTHOR]

Background: Essential hypertension, a prevalent cardiovascular condition, poses a significant health burden worldwide. Based on the latest American clinical guidelines, half of adults in the United States have hypertension. Of these, only about a half are treated and about a quarter are adequately controlled for hypertension. Given its impact on morbidity and mortality, ensuring effective management of high blood pressure is crucial to reduce associated risks and improve patient outcomes. Objective: This review aims to provide a comprehensive and up-to-date summary of the latest cardiology guidelines and evidence-based research on essential hypertension, with a focus on guiding outpatient clinical practice. Methods: The review evaluates both non-pharmacological approaches and pharmacological interventions to offer clinicians practical insights. Notably, it emphasizes the importance of individualized treatment plans tailored to patients' specific risk profiles and comorbidities. Results: By consolidating the latest advancements in hypertension management, this review provides clinicians with an up-to-date reference, offering a nuanced understanding of treatment goals and strategies. Conclusion: Through the incorporation of evidence-based recommendations, healthcare practitioners can optimize patient care, mitigate potential complications, and improve overall outcomes in essential hypertension. [ABSTRACT FROM AUTHOR]

Abstract It remained debates on metabolic‐related disorders in patients with primary aldosteronism (PA) and essential hypertension (EH). A systematic review and meta‐analysis was conducted to explore the prevalence of metabolic syndrome (MS) and the related indicators in PA and EH. PubMed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials from their commencement to December 2023 were searched for eligible studies. The meta‐analysis was performed by Review Manager 5.3 and STATA 15.1 software. A total of 12 studies were included, revealing that there was no significant difference between PA and EH in the prevalence of MS (1.27[0.92, 1.76], p = 0.14) with higher heterogeneity (I2 = 68%, p = 0.0002), while it became significant different (1.45[1.17, 1.81], p = 0.0008) and lower heterogeneity (I2 = 26%, p = 0.19) in patients who were overweight or obese by subgroup analysis. Higher systolic blood pressure (2.99[0.67, 5.31], p = 0.01; I2 = 43%, p = 0.06) and diastolic blood pressure (2.10[0.82, 3.38], p = 0.001; I2 = 36%, p = 0.11) with lower heterogeneity, and lower triglyceride in PA group with higher heterogeneity (‐0.23[‐0.37, ‐0.09], p = 0.001; I2 = 76%, p

Saad Mohammad Alsaad,1,2,&ast; Fahad Alajlan,2,&ast; Reema Alserhani,3 Nouf Alhussaini,3 Najoud Alali,3 Saud Abdullah Alatawi3 1Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia; 3College of Medicine, King Saud University, Riyadh, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Fahad Alajlan, Department of Family and Community Medicine, King Saud University Medical City, Saudi Arabia, Email Fahadajl64@gmail.comBackground: Continuity of care is one of the main principles of family medicine, described as a relationship with a single provider that extends beyond a single illness episode. This retrospective study, conducted at King Saud University Family Medicine Center in Riyadh, Saudi Arabia, aimed to investigate the impact of having a regular primary care provider on clinical outcomes and preventive service delivery for patients with diabetes and/or hypertension.Methods: The study, spanning 2017 to 2019, included 400 patients diagnosed with diabetes and/or hypertension for at least six months before the 6-month pre-attachment period to regular family medicine physicians in 2018. Data before and after attachment for at least six months were compared using electronic health records.Results: The mean age of the patients was 60.9, with a predominant female representation (66.8%) and 90.7% Saudis. Results indicated a significant improvement in glycated hemoglobin (HbA1c) levels (p = 0.005) and systolic blood pressure (p = 0.014) post-attachment. Preventive service delivery saw notable enhancements, with increased colon cancer screening (p = 0.03), breast cancer screening (p < 0.001), and retinal screening (p < 0.001) post-attachment.Conclusion: This study’s findings underscore the importance of continuity of care in chronic disease management and provide valuable and promising insights into the Saudi healthcare context, aligning with the Saudi Ministry of Health’s vision for universal access to regular primary care providers.Keywords: continuity of patient care, primary health care, diabetes mellitus, essential hypertension, healthcare quality

Abstract Endothelial dysfunction is acknowledged as a marker for subclinical target organ damage (STOD) in hypertension, though its therapeutic potential has not yet been clarified. This study assessed whether early endothelial function improvement (EEFI) reduced STOD in patients with essential hypertension (EH). We conducted a retrospective cohort analysis of 456 EH patients initially free from STOD. Endothelial function was assessed using brachial artery flow-mediated dilation (FMD), with values ≤ 7.1% indicating dysfunction. Patients were initially categorized by endothelial status (dysfunction: n = 180, normal: n = 276), and further divided into improved or unimproved groups based on changes within three months post-enrollment. During a median follow-up of 25 months, 177 patients developed STOD. The incidence of STOD was significantly higher in patients with initial dysfunction compared to those with normal function. Kaplan–Meier analysis indicated that the improved group had a lower cumulative incidence of STOD compared to the unimproved group (p

Background. Essential hypertension (EH) is a complex, multifactorial and polygenic disease. Despite effective measures for control and modification of traditional risk factors, a significant amount of risk remains. The aim of the study was to evaluate changes in clinical parameters and to analyze the relationship of cholecalciferol, parathyroid hormone with anthropometric, metabolic parameters in patients with EH. Materials and methods. One hundred subjects with EH and target organ damage (stage 2), moderate, high, very high cardiovascular risk were enrolled in case-control study. Control group consisted of 60 healthy subjects matched for sex and age. Pearson’s test was used to determine the relationship between parameters in case of categorical variables; analysis of variance (ANOVA) when one of the variables is categorical and the other is numerical (interval); non-parametric Kruskal-Wallis test in case of abnormal array distribution. Results. Development and course of EH is characterized by clinical, hemodynamic, metabolic abnormalities that are nonlinearly exacerbated with the severity of hypertension. Correlation analysis showed a direct relationship between body weight and waist-to-hip ratio (r = 0.76–0.88; р

Background: Obesity is widely recognized for its role in predisposing individuals to a spectrum of chronic health conditions. Emerging preliminary evidence points to the potential benefits of low-frequency transcutaneous electrical nerve stimulation (Lo-TENS) in enhancing various health outcomes among those with obesity and associated disorders. Objective: This systematic review was designed to assess the effectiveness of Lo- TENS for managing obesity and its related chronic diseases. Methods: For this systematic review, we included randomized controlled trials that evaluated the impact of Lo-TENS on individuals with obesity and its associated chronic diseases. Results: Eight trials encompassing 671 participants and spanning three unique populations: essential hypertension (EH), type 2 diabetes mellitus (T2DM), and obesity were deemed eligible for inclusion in this review. Compared to baseline measurements, Lo-TENS demonstrated a tendency to positively affect blood pressure in individuals with EH and metabolic parameters in those with T2DM. Nonetheless, the efficacy of Lo-TENS in treating obesity is not yet clear when contrasted with a no-intervention control group. When compared with other intervention modalities, three of the trials reported less favorable results. Conclusions: Although Lo-TENS did not consistently surpass other treatments or yield substantial improvements, it generally provided greater benefits than the majority of placebo controls. This suggests that Lo-TENS could potentially serve as a beneficial adjunctive therapy in the management of obesity and its associated conditions. However, given the limited number of trials assessed, the elevated risk of bias within these studies, and the scarce evidence currently available, it is too early to reach definitive conclusions. Caution should be exercised when interpreting the current findings. There is an imperative for further high-quality research to thoroughly investigate and substantiate the efficacy of Lo-TENS in relation to obesity and its related disorders. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship between rs1410996 polymorphism of CFH gene and essential hypertension (EH) in the Yunnan Han population. Methods: rs1410996 of CFH gene was genotyped based on the collected clinical phenotypes of the EH patients (n = 520) and healthy people (n = 494). Results: On the genotype model and dominance model, there was no relationship between rs1410996 of CFH gene and EH after adjustment (P > 0.05). On the dominance model of male EH patients, the pulse pressure (PP) level of CC genotype carriers was higher than that of (CT + TT) genotype carriers after adjustment (P < 0.05). Conclusion: rs1410996 of CFH gene has no correlation with the genetic susceptibility to EH in the Yunnan Han population, but it is related to the PP level in male patients. [ABSTRACT FROM AUTHOR]

Objective To investigate the correlation of serum apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) and homocysteine (Hcy) levels with hypertension complicating coronary heart disease (CHD) . Methods We selected 156 cases including patients with essential hypertension (EH), hypertensives with CHD who had undergone coronary CT or coronary angiography (CAG), and healthy physical examinees. They were divided into four groups: EH group (n = 61), EH accompanied with stable angina pectoris (SAP) group (EH+SAP group, n = 29), EH complicating acute coronary syndrome (ACS) group (EH+ACS group, n = 32), and healthy physical examinees (control group, n = 34). We detected blood lipids and Hcy levels of the enrolled subjects in each group, and evaluated the changes of ApoA1, ApoB and Hcy levels in patients with single, double and multi-vessel lesions. The Gensini scores of patients with hypertension complicating CHD were calculated according to coronary CT or CAG results. The correlation of serum ApoA1, ApoB and Hcy levels with hypertension complicating CHD was explored by Logistic regression analysis. Results There were no statistically significant differences in age, sex, BMI, smoking history and drinking history among the four groups (all P>0. 05). The levels of ApoB and Hcy in the EH+SAP group and the EH+ACS group were all higher than those in the EH group and the control group (P< 0. 05), while the level of ApoA1 was the opposite. Binary multivariate Logistic regression analysis showed that ApoA1, ApoB and Hcy were all risk factors for hypertension complicating CHD. The higher the Gensini score and the number of diseased vessels were, the lower the level of ApoA1 was, indicating a negative correlation between them; the higher the Gensini score and the number of diseased vessels were, the higher the levels of ApoB and Hcy were, indicating a positive correlation between them, and the differences were all statistically significant (all P<0. 05). Conclusion ApoA1, ApoB and Hcy could be used as risk factors for hypertension complicating CHD, and could predict the severity of coronary artery disease to a certain extent. They could provide references for the prevention and treatment of the disease together with low- and high-density lipoprotein, and other traditional indexes of blood lipids. [ABSTRACT FROM AUTHOR]

Purpose: Hospitalized hypertensive patients rely on blood pressure medication, yet there is limited research on the sole use of amlodipine, despite its proven efficacy in protecting target organs and reducing mortality. This study aims to identify key indicators influencing the efficacy of amlodipine, thereby enhancing treatment outcomes. Patients and Methods: In this multicenter retrospective study, 870 hospitalized patients with primary hypertension exclusively received amlodipine for the first 5 days after admission, and their medical records contained comprehensive blood pressure records. They were categorized into success (n=479) and failure (n=391) groups based on average blood pressure control efficacy. Predictive models were constructed using six machine learning algorithms. Evaluation metrics encompassed the area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). SHapley Additive exPlanations (SHAP) analysis assessed feature contributions to efficacy. Results: All six machine learning models demonstrated superior predictive performance. Following variable reduction, the model predicting amlodipine efficacy was reconstructed using these algorithms, with the light gradient boosting machine (LightGBM) model achieving the highest overall performance (AUC = 0.803). Notably, amlodipine showed enhanced efficacy in patients with low platelet distribution width (PDW) values, as well as high hematocrit (HCT) and thrombin time (TT) values. Conclusion: This study utilized machine learning to predict amlodipine's effectiveness in hypertension treatment, pinpointing key factors: HCT, PDW, and TT levels. Lower PDW, along with higher HCT and TT, correlated with enhanced treatment outcomes. This facilitates personalized treatment, particularly for hospitalized hypertensive patients undergoing amlodipine monotherapy. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to find an association of epicardial adiposity and albuminuria patients with essential hypertension. Methods: The Observational study was conducted in the Department of Medicine, SGRDIMSR, Vallah, Sri Amritsar from April 2021 to July 2022. In this study, 100 patients aged 18-60 years having essential hypertension were enrolled. Patients were divided into 2 groups depending upon UACR i.e albuminuria(>30mg/dl) and albuminuria(<30mg/dl) coming to medicine opd or getting admitted in SGRDIMSR fulfilling the inclusion criteria after giving written and informed consent. Results: Out of 100 patients, majority of the patients (64%) belonged to 51-60 age group followed by 41-50 years (15%), 31-40 years (13%), and 21-30 years (8%) age group. Mean age of the patients was 49.96±11.35 years. 51% were males and 49% were females. 46% of patients had BMI 23-24.9 followed by >25 (32%), 18.5-22.9 (19%), and <18.5 (3%). Mean BMI of the patients was 24.54±3.27. Stage I hypertension was present in 66% of the patients, while stage II was present in 34% of patients. Left Ventricular Hypertrophy (LVH) was present in 84% of patients and absent in 16% of patients. 78% patients had serum albumin levels 3.5- 5.5 mg/dl and 22% patients had serum albumin levels <3.5 mg/dl. Mean albumin levels were 4.0130±0.54747 mg/dl. Conclusion: From this study it can be concluded that epicardial adipose tissue thickness and albuminuria was significantly associated with Hypertension. The relation of UACR levels with left ventricular hypertrophy and LVMI was found statistically significant. Similarly, the relation of epicardial adipose tissue thickness and serum albumin levels were significantly associated. [ABSTRACT FROM AUTHOR]

Objective Previous studies focusing on primary aldosteronism (PA) and thyroid diseases were controversial. Hence, this study aimed to examine associations between thyroid function, thyroid diseases, and PA and its subtypes. Design and Methods This was a cross-sectional study, which enrolled 1023 patients with PA and 6138 patients with essential hypertension (EH) admitted to Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region from August 2011 to June 2022. All patients with PA were accurately classified into aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) by adrenal vein sampling (AVS). Multivariate logistic regression analysis was used to assess the relationship of thyroid function, thyroid nodules, and PA and its subtypes. Results A total of 7161 patients (327 APA and 696 IHA, and 6138 EH) were included with a mean age of 48.20 ± 8.83 years. PA patients and PA subtypes showed lower FT4, FT3, TT4, TT3, and prevalence of positive TPOAb, meanwhile higher prevalence of thyroid nodules than EH patients (PA: 56.10%, IHA: 56.90%, APA: 54.80%, and EH: 48.90%, respectively). PA (adjusted OR: 1.290, 95% CI: 1.035-1.607, P =.02) and its subtype (IHA) (adjusted OR: 1.316, 95% CI: 1.005-1.724, P =.04) were significantly associated with thyroid nodules. Compared to patients with lower plasma aldosterone concentration (PAC) levels (<12 ng/dL), patients with PAC levels ≥ 12 ng/dL presented a higher prevalence of thyroid nodules. Conclusions PA patients had lower thyroid function and higher prevalence of thyroid nodules compared to EH patients. Therefore, the screening of thyroid function and thyroid nodules may be indispensable for PA patients. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases are the leading cause of morbidity and mortality in developed countries and are becoming increasingly significant in developing nations. Many cardiovascular risk factors originate early in life, even prenatally. Elevated blood pressure and hypertension are gaining attention in paediatrics due to their rising prevalence and impact on early cardiovascular risk in adulthood. Along with non-modifiable risk factors for hypertension, several modifiable factors can be addressed through primordial and primary prevention, emphasising lifestyle modifications. When these measures fail and elevated blood pressure develops, early detection is crucial (secondary prevention). Regular blood pressure measurement, a simple and non-invasive procedure, should be a standard practice in paediatric clinical settings. Diagnosing elevated blood pressure and hypertension should adhere to recommended guidelines. Lifestyle modifications are the first-line therapy for primary hypertension in children; if a secondary cause is identified, targeted treatment can be implemented, but a healthy lifestyle remains essential. The early detection and treatment of high-risk blood pressure enable timely interventions to prevent complications (tertiary prevention). Collectively, these preventive measures aim to reduce the incidence of cardiovascular disease in adulthood. Furthermore, quaternary prevention seeks to avoid unnecessary or harmful medical interventions including unwarranted examinations and pharmacotherapy. This underscores the importance of accurate diagnosis and treatment of elevated blood pressure and hypertension and emphasises the need for primordial and primary prevention to minimise unnecessary clinical interventions. [ABSTRACT FROM AUTHOR]

Endothelium plays a fundamental role in the cardiovascular system, forming an interface between blood and adjacent tissues by regulating the vascular tone through the synthesis of nitric oxide, prostaglandins and other relaxing factors. Endothelial dysfunction is characterized by vasoconstriction, cell proliferation and shifting toward a proinflammatory and prothrombic state. In hypertension endothelial dysfunction may be involved in the initiation and development of vascular inflammation, vascular remodeling, and atherosclerosis and is independently associated with increased cardiovascular risk. Different conditions such as impaired vascular shear stress, inflammation and oxidative stress, activation of the renin angiotensin system have been described as important pathophysiological mechanisms involved in the development of endothelial dysfunction. The release of extracellular vesicles by neighboring cells in the vascular wall has emerged as an important regulator of endothelial function and with potential antihypertensive properties and beneficial effects by counteracting the hypertension mediated organ damage. Furthermore, macrovesicles are emerging as an innovative therapeutic approach for vascular protection, allowing the delivery of bioactive molecules, such as miRNA and drugs interacting with the renin angiotensin system. [ABSTRACT FROM AUTHOR]

Almost one-half of adults have hypertension, and blood pressure is poorly controlled in a third of patients despite the use of multiple drugs, likely because of mechanisms that are not affected by current treatments. Hypertension is linked to oxidative stress; however, common antioxidants are ineffective. Hypertension is associated with inactivation of key intrinsic mitochondrial antioxidant, superoxide dismutase 2 (SOD2), due to hyperacetylation, but the role of specific SOD2 lysine residues has not been defined. Hypertension is associated with SOD2 acetylation at lysine 68, and we suggested that deacetylation mimetic mutation of K68 to arginine in SOD2 inhibits vascular oxidative stress and attenuates hypertension. To test this hypothesis, we have developed a new deacetylation mimetic SOD2-K68R mice. We performed in vivo studies in SOD2-K68R mice using angiotensin II (ANG II) model of vascular dysfunction and hypertension. ANG II infusion in wild-type mice induced vascular inflammation and oxidative stress and increased blood pressure to 160 mmHg. SOD2-K68R mutation completely prevented increase in mitochondrial superoxide, abrogated vascular oxidative stress, preserved endothelial nitric oxide production, protected vasorelaxation, and attenuated ANG II-induced hypertension. ANG II and cytokines contribute to vascular oxidative stress and hypertension. Treatment of wild-type aortas with ANG II and cytokines in organoid culture increased mitochondrial superoxide twofold, which was completely prevented in aortas isolated from SOD2-K68R mice. These data support the important role of SOD2-K68 acetylation in vascular oxidative stress and pathogenesis of hypertension. We conclude that strategies to reduce SOD2 acetylation may have therapeutic potential in the treatment of vascular dysfunction and hypertension. NEW & NOTEWORTHY: Essential hypertension is associated with hyperacetylation of key mitochondrial antioxidant SOD2; however, the pathophysiological role of SOD2 acetylation has not been defined. Our animal study of angiotensin II hypertension model shows that deacetylation mimetic SOD2-K68R mutation prevents pathogenic increase in vascular mitochondrial superoxide, abrogates vascular oxidative stress, preserves endothelial nitric oxide, protects endothelial-dependent vasorelaxation, and attenuates hypertension. These data support the important role of SOD2-K68 acetylation in vascular oxidative stress and the pathogenesis of hypertension. [ABSTRACT FROM AUTHOR]

It remained debates on metabolic‐related disorders in patients with primary aldosteronism (PA) and essential hypertension (EH). A systematic review and meta‐analysis was conducted to explore the prevalence of metabolic syndrome (MS) and the related indicators in PA and EH. PubMed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials from their commencement to December 2023 were searched for eligible studies. The meta‐analysis was performed by Review Manager 5.3 and STATA 15.1 software. A total of 12 studies were included, revealing that there was no significant difference between PA and EH in the prevalence of MS (1.27[0.92, 1.76], p = 0.14) with higher heterogeneity (I2 = 68%, p = 0.0002), while it became significant different (1.45[1.17, 1.81], p = 0.0008) and lower heterogeneity (I2 = 26%, p = 0.19) in patients who were overweight or obese by subgroup analysis. Higher systolic blood pressure (2.99[0.67, 5.31], p = 0.01; I2 = 43%, p = 0.06) and diastolic blood pressure (2.10[0.82, 3.38], p = 0.001; I2 = 36%, p = 0.11) with lower heterogeneity, and lower triglyceride in PA group with higher heterogeneity (‐0.23[‐0.37, ‐0.09], p = 0.001; I2 = 76%, p < 0.0001) were observed. No significant difference was found in other indicators. This study showed a higher prevalence of MS in patients who were overweight or obese with PA. However, it was not the same in these patients who were in normal weight. More researches were needed to explore the relationship between PA and metabolism of glucose and lipid. [ABSTRACT FROM AUTHOR]

This article presents a study conducted in Singapore that assessed the self-care profiles of patients with essential hypertension. The study used a questionnaire-based instrument called the Hypertension Self-Care Profile (HTN-SCP) to evaluate patients' self-care behaviors and their level of self-efficacy, motivation, and behavior modifications in controlling their blood pressure. The study found that higher HTN-SCP scores were associated with better self-care behaviors, such as medication adherence, regular monitoring of weight and blood pressure, and proactive dietary measures. The results suggest that the HTN-SCP scores can help identify deficiencies in self-care behavior and guide targeted interventions for patients with essential hypertension. The study also provides demographic and lifestyle data of the patients, highlighting factors associated with self-care scores. However, the study acknowledges limitations such as potential selection bias and self-reporting of certain behaviors. [Extracted from the article]

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Endothelial dysfunction is acknowledged as a marker for subclinical target organ damage (STOD) in hypertension, though its therapeutic potential has not yet been clarified. This study assessed whether early endothelial function improvement (EEFI) reduced STOD in patients with essential hypertension (EH). We conducted a retrospective cohort analysis of 456 EH patients initially free from STOD. Endothelial function was assessed using brachial artery flow-mediated dilation (FMD), with values ≤ 7.1% indicating dysfunction. Patients were initially categorized by endothelial status (dysfunction: n = 180, normal: n = 276), and further divided into improved or unimproved groups based on changes within three months post-enrollment. During a median follow-up of 25 months, 177 patients developed STOD. The incidence of STOD was significantly higher in patients with initial dysfunction compared to those with normal function. Kaplan–Meier analysis indicated that the improved group had a lower cumulative incidence of STOD compared to the unimproved group (p < 0.05). Multivariable Cox regression confirmed EEFI as an independent protective factor against STOD in EH patients (p < 0.05), regardless of their baseline endothelial status, especially in those under 65 years old, non-smokers, and with low-density lipoprotein cholesterol levels ≤ 3.4 mmol/L. In conclusion, EEFI significantly reduces STOD incidence in EH patients, particularly in specific subgroups, emphasizing the need for early intervention in endothelial function to prevent STOD. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course. Background: Amlodipine, a calcium channel blocker, and atenolol, a beta blocker, are commonly used as a fixed drug combination (FDC) to treat hypertension. Intentional or non-intentional overdose of amlodipine-atenolol results in hypotension and myocardial depression with a high risk of mortality. This report describes a 64-year-old man with an overdose of amlodipine-atenolol, presenting as an emergency with hypotension, bradycardia, and severe metabolic acidosis. He was successfully treated with intravenous calcium chloride infusion, hyperinsulinemia euglycemia therapy (HIE), and continuous veno-venous hemodialysis (CVVHD). Case Report: A 64-year-old man was diagnosed with essential hypertension 1 week prior to the admission. He had been prescribed 1 FDC tablet of amlodipine and atenolol (5+50 mg) per day; however, he took 1 table of the FDC per day for 3 days and then took 3-4 tablets each day during the next 4 days. He was brought to the hospital with hypotension, bradycardia, and severe metabolic acidosis and was diagnosed with amlodipine-atenolol overdose. He was treated with intravenous calcium chloride infusion, HIE, and CVVHD. His hemodynamics started to improve after administering these therapies for 6 h. Inotropes were gradually tapered off and stopped. He was extubated on day 5 and recovered completely. Conclusions: This report shows the serious effects amlodipine-atenolol overdose and the challenges of emergency patient management. An overdose of FDC of amlodipine and atenolol can cause cardiovascular collapse and severe metabolic acidosis. Timely and aggressive management with intravenous calcium infusion, HIE, and CVVHD is essential. [ABSTRACT FROM AUTHOR]

Background and aims: H-type hypertension is essential hypertension combined with high homocysteine, and both synergistically increase the risk of cardiovascular and cerebrovascular events. The aim of this study was to investigate the risk factors of H-type hypertension in Tibetan plateau population and correlation with MTHFR C677T gene. Methods and results: A multi-stage cluster random sampling method was used to select the research subjects in Tibet Autonomous Region from June 2020 to November 2021. Among Tibetans, the incidence of H-type hypertension accounted for 84.31% of hypertensive patients. The logistic regression analysis demonstrated that age, uric acid (UA), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) were risk factors for the prevalence of H-type hypertension, the OR (95% CI) was 1.083(1.073–1.094), 1.002(1.001–1.004), 1.240(1.050–1.464) and 2.274(1.432–3.611), respectively. MTHFR C677T TT genotype patients with H-type hypertension OR (95% CI) was 1.629(1.004–2.643). Based on this, a nomogram model was established, and the reliability of the model was proved by area under ROC curve, Brier score and average absolute error. The model's results indicate that for every five years of age, the score increases by 6 points; for a 2mmol/L increase in TG, the score increases by 5.5 points; for a 1mmol/L increase in LDL-C, the score increases by 10 points; and individuals with the TT genotype receive 8 points. The higher the score, the greater the risk of disease. Conclusion: The MTHFR C677T TT genotype is a risk locus for Tibetan patients with H-type hypertension, with age, TG, and LDL-C were identified as risk factors for the disease. [ABSTRACT FROM AUTHOR]

Background/Aim: Chronic kidney disease (CKD) has seen a rapid increase worldwide in recent decades, now recognised as a global health issue of the 21st century. Optimal, continuous control of hypertension represents a crucial part of treatment capable of slowing the progression of CKD. The aim of this study was to demonstrate that optimal regulation blood pressure control in patients with essential and secondary hypertension, along with CKD, slows the progression of CKD. Methods: The research was conducted at the University Clinical Centre of the Republic of Srpska, Banja Luka, Internal Clinic Nephrology Department. A retrospective-prospective study was blind for patients and lasted for 24 months. It included 97 patients, aged 18 and above, of both genders, hypertensive, in the 3rd or 4th stage of CKD (creatinine clearance of 15-59 mL/min). Assess the outcome of CKD, a "complex (undesirable) clinical outcome" was taken - one of three fundamental clinically undesirable events: double increase in serum creatinine values at the end of 24 months, onset of terminal renal insufficiency, or patient death. Patients were classified into three groups: I group - 30 patients with essential hypertension and CKD with optimally regulated blood pressure; II group - 32 patients with secondary hypertension and CKD with optimally regulated blood pressure; III control group - 35 patients with hypertension of various causes and CKD who did not achieve target blood pressure values. Blood pressure control was measured from month 0 to month 24 - once a month. Laboratory tests were taken every 3 months (red blood cells, haemoglobin, glycaemia, cholesterol, urea, creatinine, uric acid, sodium, potassium in serum and urine). Results: There was a highly statistically significant difference in glomerular filtration rate in the first group compared to the third group and in the second group compared to the third group. No statistically significant difference in glomerular filtration rate between the first and second groups was observed, where good blood pressure regulation was achieved. Conclusion: Optimal blood pressure control in the examined groups, regardless of the cause of CKD, was responsible for slowing the progression of CKD compared to the group with unregulated blood pressure. [ABSTRACT FROM AUTHOR]

The Ja-Kids Longitudinal Study (JA-Kids) aims to improve the health and development of Jamaican children by identifying social, demographic, environmental and clinical factors that help or hinder these processes. As clinical indicators relied on maternal reporting, we aim to evaluate the quality of the self-reported data. Women were recruited across Jamaica during pregnancy or at delivery from July 1–30 September 2011. Indicators were compared between women recruited while pregnant and at delivery to understand possible differences between the sub-populations. Variables reported more than once between pregnancy and delivery were assessed to evaluate level of agreement (reliability). Clinical indicators from the literature were contrasted with study findings to determine how maternal reporting align with published prevalence (validity). Intra-class correlation and the kappa (κ) statistic were used to assess reliability while chi-squared, Fisher's-exact or students-t were used to compare differences over time; p values ≤0.05 were considered statistically significant. Women recruited during pregnancy (n = 3970) were younger, less parous and possibly more socially disadvantaged than those recruited at delivery (n = 5803). Socio-demographic and selected clinical indicators showed good to moderate (0.421 < κ < 0.681) reporting consistency between pregnancy and delivery for previous C-section (κ = 0.681), pre-existing diabetes mellitus (κ = 0.616) and prior twin gestations (0.580). Most conditions however showed only fair agreement (0.21 < κ < 0.40) including previous gestational hypertension (κ = 0.387), asthma (κ = 0.365), premature rupture of membranes (κ = 0.324), eclampsia (κ = 0.257) and essential hypertension (κ = 0.213). Infectious conditions had poor reliability. Prevalence rates for most conditions, except sickle cell disease, were lower than the published literature. Complications and outcomes which were well defined for women were better reported than those requiring clinical judgment (e.g. prior C-section versus specific hypertensive disorders of pregnancy). NCDs with only episodic acute effects were not well reported, e.g. asthma, hypertension and sickle cell disease. Maternal reporting of pregnancy complications needs to be interpreted with caution. [ABSTRACT FROM AUTHOR]

Background: Understanding the impact of aortic regurgitation (AR) on hypertensive patients' hearts is important. Purpose: To assess left ventricular (LV) strain and structure in hypertensive patients and investigate the relationship with AR severity. Study Type: Retrospective. Population: 263 hypertensive patients (99 with AR) and 62 controls, with cardiac MRI data. Field Strength/Sequence: Balanced steady‐state free precession (bSSFP) sequence at 3.0T. Assessment: AR was classified as mild, moderate, or severe based on echocardiographic findings. LV geometry was classified as normal, concentric remodeling, eccentric hypertrophy, or concentric hypertrophy based on MRI assessment of LV mass/volume ratio and LV Mass index (LVMI). LV global radial peak strain (GRPS), global circumferential peak strain (GCPS), and global longitudinal peak strain (GLPS) were obtained by post‐processing bSSFP cine datasets using commercial software. Statistical Tests: ANOVA, Kruskal–Wallis test, Spearman's correlation coefficients (r), chi‐square test, and multivariable linear regression analysis. A P value <0.05 was considered statistically significant. Results: Hypertensive patients with AR had significantly lower LV myocardial strain and higher LVMI than the group without AR (GRPS 26.25 ± 12.23 vs. 34.53 ± 9.85, GCPS −17.4 ± 5.84 vs. −20.57 ± 3.57, GLPS −9.86 ± 4.08 vs. −12.95 ± 2.94, LVMI 90.56 ± 38.56 vs.58.84 ± 17.55). Of the 99 patients with AR, 56 had mild AR, 26 had moderate AR and 17 had severe AR. The degree of AR was significantly negatively correlated to the absolute values of LV GRPS, GCPS and GLPS (r = −0.284 – −0.416). LV eccentric hypertrophy increased significantly with AR severity (no AR 21.3%, mild AR 42.9%, moderate AR 73.1%, severe AR 82.4%). In multivariable analysis, the degree of AR was an independent factor affecting LV global strain and LVMI even after considering confounding factors (β values for global myocardial strain were −0.431 to −0.484, for LVMI was 0.646). Data Conclusion: Increasing AR severity leads to decreased cardiac function and worse ventricular geometric phenotypes in hypertensive patients. Level of Evidence: 4 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]