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The occurrence of hypertension is influenced by combined actions of genetic and environmental factors. Among environmental factors, high salt intake is considered as one of the most important and critical dietary factors. High salt intake is closely related to the incidence and mortality of cardiac and cerebrovascular events, as well as ventricular hypertrophy, renal damage, and other target organ damages. The existing data show that the daily sodium salt intake of Chinese population is significantly higher than that of European and American populations, and it generally exceeds the standard. Therefore, sodium and potassium intake in patients with hypertension should be actively assessed to carry out targeted treatment, which is an important strategy in blood pressure management. According to the characteristics of high prevalence of hypertension, high sodium salt intake, and low blood pressure control rate in China, Chinese Medical Association Hypertension Professional Committee believes that it is necessary to promote salt restriction and formulate the assessment of salt intake and clinical process of blood pressure management according to the current status of sodium intake., (©2019 Wiley Periodicals, Inc.)

Objective. To understand the prevalence of hypertension in the population without awareness of hypertension in a rural area, a cross-sectional study was carried out. Methods. Blood pressures were measured in residents over 60 years during the National Basic Public Health Service project carrying on in a rural town of Shandong province. Combined with detail information of the hypertension disease history, the status of prevalence of hypertension was calculated. Basic information and clinical laboratory examinations were analyzed with Student' t or t' or chi-square test for univariate analysis. Multinomial logistic analysis was used in exploring multiple variables. Results. According to the individual history and blood pressure levels, the awareness rate of hypertension in the population over 60 years old was 50.3% (1285/2554, 95% CI: 48.3–52.3%). The prevalence of hypertension was 55.1% (1270/2304, 95% CI: 53.1–57.2%) in the population without awareness of hypertension, in which the proportion of stage 1 hypertension was 58.8% (747/1270), stage 2 hypertension was 28.9% (367/1270), and stage 3 hypertension was 12.3% (156/1270). The prevalence of hypertension in men was 54.4% (611/1124, 95% CI: 51.4–57.3%), which was almost the same as that in women (55.8%, 659/1180, 95% CI: 53.0–58.7%) (X2 = 0.515, P = 0.473). The prevalence of hypertension increased with age (X2trend = 11.848, P = 0.001). Age, BMI, total cholesterol, triglyceride, and drinking rate were positively correlated with the prevalence of hypertension, that is, the higher the level of these factors, the higher the prevalence of hypertension; on the contrary, LDL and smoking rate might be negatively correlated with the prevalence of hypertension, which means, the higher the prevalence of hypertension, the lower the level of these two indicators. Binary and multinominal logistic results showed that age, BMI, and drinking had stronger effects on the higher blood pressure level. Conclusions. The awareness rate of hypertension among the elderly in a rural area needs to be further improved. In the prevention and control of hypertension, close attention should be paid to the group of elder, high BMI index, high levels of total cholesterol and triglyceride, and drinking habits. [ABSTRACT FROM AUTHOR]

Objective: Emerging evidence shows that high blood pressure (BP) level even below 140/90 mmHg during pregnancy is associated with increased risk for maternal and infant complications. The meta-analysis evaluated the associations between prehypertension (BP 120-139/80-89 mmHg) during pregnancy and the risk of small for gestational age (SGA), as well as the impact of prehypertension on birth weight (BW).Methods: Databases (PubMed, Embase, and Cochrane Library) were searched for cohort studies with data on prehypertension in pregnancy and adverse obstetrical outcomes, including SGA and/or BW. The relative risks (RRs) of SGA and weighted mean differences (WMD) in BW were calculated and reported with 95% confidence intervals (95% CIs). We calculated pooled RRs using fixed- and random-effects models.Results: A total of 143,835 participants from five cohort studies were included. Prehypertension in pregnancy increased the risk of SGA (RR 1.59, 95%CI 1.44 to 1.76, p < .00001) and lowered BW (WMD -13.71, 95% CI -83.28 to 55.87, p = .70) compared with optimal BP (<120/80 mmHg). In subgroup analyses, for prehypertension in late pregnancy, the risk of SGA was significantly higher than for optimal BP (RR 1.60, 95% CI 1.44 to 1.78).Conclusion: BP within the range of 120-139/80-89 mmHg during pregnancy, as previously defined as prehypertension, particularly in late pregnancy, was associated with a 59% increase in the risk of having an SGA birth. [ABSTRACT FROM AUTHOR]

The optimal systolic blood pressure (SBP) treatment target in elderly people is full of challenge, and non-adherence is one major cause of uncontrolled BP. The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial is a multi-center, randomized controlled trial that aims to examine whether an intensive treatment (110 ≤ SBP < 130 mmHg) will provide more benefits in lowering cardiovascular events than a mild treatment (130 ≤ SBP < 150 mmHg) among people aged 60–80 years. From January 10, 2017 to December 31, 2017, 8511 patients with primary hypertension were recruited at 42 clinical centers throughout China and randomly assigned to the intensive or standard treatment in 1:1 ratio, in which clinical sites are considered as a stratification factor in randomization. Participants will be followed for an average of four years. All participants used the same validated home BP device and all centers used the same validated office BP device which can automatically upload the readings to a data center. The hospitals were randomly classified as the smartphone-based App center or usual care center in 1:1 ratio for the secondary purpose to study the effect of App management on BP control. In this trial, mean age of participants was 66.2 ± 4.8 years, 24.1% were in the range of 70–80 years, and 65% were at high-risk with the 10-year Framingham risk score ≥ 15%. In conclusion, STEP will provide evidence not only to address appropriate target of BP control among hypertensive patients aged 60–80 years, but also to assess an effective model of App management for hypertension. Trial Registration number: ClinicalTrials. gov. Unique identifier: NCT03015311. [ABSTRACT FROM AUTHOR]