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254. The impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study).

Author

Ostrowska, Aleksandra, Wojciechowska, Wiktoria, Rajzer, Marek, Weber, Thomas, Bursztyn, Michael, Persu, Alexandre, Stergiou, George, Kiełbasa, Grzegorz, Chrostowska, Marzena, Doumas, Michaelis, Parati, Gianfranco, Bilo, Grzegorz, Grassi, Guido, Mancia, Giuseppe, Januszewicz, Andrzej, and Kreutz, Reinhold

Subjects
*AMBULATORY blood pressure monitoring, *COVID-19 pandemic, *COVID-19 treatment, *BLOOD pressure, *PHENOTYPIC plasticity
Abstract

• The COVID-19 pandemic had a negative impact on hypertension management. • In the pre-pandemic period, unfavorable hypertension phenotypes improved during treatment. • Improvement of hypertension phenotypes was not observed during the pandemic. The COVID-19 pandemic had a major impact on medical care. This study evaluated the influence of the pandemic on blood pressure (BP) control and hypertension phenotypes as assessed by office and 24-hour ambulatory BP monitoring (ABPM). Data were collected from 33 centers including Excellence Centers of the European Society of Hypertension. Two groups of patients with treated hypertension were compared. Pandemic group: including participants who had ABPM twice - at visit 2 during the COVID-19 pandemic and visit 1 performed 9–15 months prior to visit 2. Pre-pandemic group: had ABPM at two visits, performed before the pandemic within 9–15 months interval. We determined the following hypertension phenotypes: masked hypertension, white coat hypertension, sustained controlled hypertension (SCH) and sustained uncontrolled hypertension (SUCH). We analyzed the prevalence of phenotypes and their changes between visits. Data of 1419 patients, 616 (43 %) in the pandemic group and 803 (57 %) in the pre-pandemic group, were analyzed. At baseline (visit 1), the prevalence of hypertension phenotypes did not differ between groups. In the pandemic group, the change in hypertension phenotypes between two visits was not significant (p = 0.08). In contrast, in the pre-pandemic group, the prevalence of SCH increased during follow-up (28.8 % vs 38.4 %, p < 0.01) while the prevalence of SUCH decreased (34.2 % vs 27.8 %, p < 0.01). In multivariable adjusted analysis, the only factor influencing negative changes of hypertension phenotypes was the COVID-19 pandemic period. These results indicate a negative impact of the COVID-19 pandemic on BP control assessed by hypertension phenotypes. [ABSTRACT FROM AUTHOR]

Published
2025
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255. The siesta in the elderly.

Author

Bursztyn, Michael and Ginsberg, Gary

Subjects
*NAPS (Sleep), *CARDIOVASCULAR diseases risk factors, *DISEASES in older people, *DISEASE risk factors
Abstract

Determines whether additional sleep period or nap practice of the elderly during the day increased the risks of cardiovascular, cerebrovascular and mortality events in Jerusalem, Israel. Percentage of nap or siesta practice; Meaning of increased creatinine level in siesta takers; Nap as an independent predictor of mortality.

Published
1999
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256. Nifedipine in the Treatment of Hypertension in Systemic Lupus Erythematosus.

Author

Bursztyn, Michael, Many, Amira, and Rosenthal, Talma

Subjects
HYPERTENSION, SYSTEMIC lupus erythematosus, DRUG side effects, NIFEDIPINE, KIDNEY diseases, ANTIHYPERTENSIVE agents, ADRENERGIC beta blockers
Abstract

Treatment of hypertension in systemic lupus erythematosus (SLE) may be complicated by unwanted immunologic vascular and renal side effects of drugs. The safety of long-acting nifedipine tablets was studied in 8 SLE hypertensive subjects for six months. Nifedipine reduced blood pressure from a mean 151.9 ±10/103.7 ± 8.6 mmHg to a mean of 130±14.1/87.5 ± 5 mmHg. There was no deterioration of renal function or of hematologic or immunologic indices during that period. We believe nifedipine is a safe and effective hypotensive drug in SLE, either alone or combined with beta blockers and diuretics. [ABSTRACT FROM AUTHOR]

Published
1987
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261. Twenty-four-hour ambulatory systolic blood pressure may be a better predictor of all-cause and cardiovascular mortality than clinic blood pressure.

Author

Bursztyn, Michael and Asayama, Kei

Subjects
CARDIOVASCULAR disease related mortality, HYPERTENSION risk factors, MORTALITY risk factors, HYPERTENSION epidemiology, HYPERTENSION, AMBULATORY blood pressure monitoring, BLOOD pressure, BLOOD pressure measurement, CARDIOVASCULAR diseases risk factors, DIABETES, DISEASE prevalence, DIAGNOSIS
Published
2019
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262. Hypertension in the Aging Patient Implications for the Selection of Drug Therapy

Author

Bursztyn, Michael, Gavras, Irene, and Gavras, Haralambos

Abstract

Although earlier debates had questioned the wisdom of treating hypertension in elderly patients, it is now becoming apparent that such treatment is warranted. Systolic hypertension, which prevails in this population, is more closely correlated to hypertensive complications than is diastolic blood pressure. Recent multicenter trials have demonstrated that in this age group, as in younger patients, control of hypertension can significantly decrease the rate of cardiovascular and cerebrovascular events. Many effective antihypertensive agents are available today, but elderly patients, because of their hemodynamic and biochemical characteristics, are particularly vulnerable to the common side effects of most drugs. However, the two newer classes of drugs (the angiotensin‐converting enzyme inhibitors and the calcium channel blockers) offer several advantages in terms of favorable hemodynamic and biochemical profiles, convenience of dosing, and maintenance of quality of life. These characteristics justify choosing these agents as first‐line therapy for hypertension.

Published
1989
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263. Mortality in the Jerusalem 70-year-olds longitudinal study: Does nifedipine have a role?

Author

Bursztyn, Michael, Ginsberg, Gary, Spilberg, Ofra, Maaravi, Yoram, and Stessman, Johanan

Abstract

Background: Short-acting nifedipine was found to be associated with increased mortality in elderly patients in some studies. Methods: We examined effects of long-acting nifedipine in a longitudinal study of Jerusalem 70 year olds (448 participants). Results: After follow-up of 6.5 years (1990--1996) 70 subjects died. We examined the effects of baseline variables on total mortality. Hypertensives had higher mortality than normotensives, 21.2% versus 13.8%, p = 0.01. Diuretic-treated patients (n = 72), mostly hypertensive (n = 71), had significantly higher mortality than non-diuretic-treated patients (n = 375), 45.5% versus 14.1%; p < 0.001. Although nifedipine-treated patients had a higher prevalence of coronary heart disease diagnosis than diuretic-treated patients (52% versus 35%), their relative risk of mortality was 0.8 (CI 0.4--1.4) of that of diuretic-treated patients. A multiple logistic regression model, including gender, systolic blood pressure, creatinine, cholesterol, diagnosis of congestive heart failure, cardiovascular arrest, diabetes, previous myocardial infarction, physical activity, nifedipine, other calcium channel and beta blockers and diuretics, found only serum creatinine and diuretic therapy associated with total mortality, p = 0.004 and p < 0.02, respectively. When interaction terms were added to account for drug combinations, diuretic therapy lost significance, but the combination of diuretics and beta blockers (probably representing a more severe form of hypertension) became significant, p = 0.03. Conclusion: Long acting nifedipine is not associated with increased mortality in elderly hypertensives. [ABSTRACT FROM AUTHOR]

Published
1999
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272. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Author

Zhou, Bin, Carrillo-Larco, Rodrigo M, Danaei, Goodarz, Riley, Leanne M, Paciorek, Christopher J, Stevens, Gretchen A, Gregg, Edward W, Bennett, James E, Solomon, Bethlehem, Singleton, Rosie K, Sophiea, Marisa K, Iurilli, Maria LC, Lhoste, Victor PF, Cowan, Melanie J, Savin, Stefan, Woodward, Mark, Balanova, Yulia, Cifkova, Renata, Damasceno, Albertino, Elliott, Paul, Farzadfar, Farshad, He, Jiang, Ikeda, Nayu, Kengne, Andre P, Khang, Young-Ho, Kim, Hyeon Chang, Laxmaiah, Avula, Lin, Hsien-Ho, Margozzini Maira, Paula, Miranda, J Jaime, Neuhauser, Hannelore, Sundström, Johan, Varghese, Cherian, Widyahening, Indah S, Zdrojewski, Tomasz, Abarca-Gómez, Leandra, Abdeen, Ziad A, Abdul Rahim, Hanan F, Abu-Rmeileh, Niveen M, Acosta-Cazares, Benjamin, Adams, Robert J, Aekplakorn, Wichai, Afsana, Kaosar, Afzal, Shoaib, Agdeppa, Imelda A, Aghazadeh-Attari, Javad, Aguilar-Salinas, Carlos A, Agyemang, Charles, Ahmad, Noor Ani, Ahmadi, Ali, Ahmadi, Naser, Ahmadi, Nastaran, Ahmadizar, Fariba, Ahmed, Soheir H, Ahrens, Wolfgang, Ajlouni, Kamel, Al-Raddadi, Rajaa, Alarouj, Monira, AlBuhairan, Fadia, AlDhukair, Shahla, Ali, Mohamed M, Alkandari, Abdullah, Alkerwi, Ala'a, Allin, Kristine, Aly, Eman, Amarapurkar, Deepak N, Amougou, Norbert, Amouyel, Philippe, Andersen, Lars Bo, Anderssen, Sigmund A, Anjana, Ranjit Mohan, Ansari-Moghaddam, Alireza, Ansong, Daniel, Aounallah-Skhiri, Hajer, Araújo, Joana, Ariansen, Inger, Aris, Tahir, Arku, Raphael E, Arlappa, Nimmathota, Aryal, Krishna K, Aspelund, Thor, Assah, Felix K, Assunção, Maria Cecília F, Auvinen, Juha, Avdićová, Mária, Azevedo, Ana, Azimi-Nezhad, Mohsen, Azizi, Fereidoun, Azmin, Mehrdad, Babu, Bontha V, Bahijri, Suhad, Balakrishna, Nagalla, Bamoshmoosh, Mohamed, Banach, Maciej, Banadinović, Maja, Bandosz, Piotr, Banegas, José R, Baran, Joanna, Barbagallo, Carlo M, Barceló, Alberto, Barkat, Amina, Barreto, Marta, Barros, Aluisio JD, Barros, Mauro Virgílio Gomes, Bartosiewicz, Anna, Basit, Abdul, Bastos, Joao Luiz D, Bata, Iqbal, Batieha, Anwar M, Batyrbek, Assembekov, Baur, Louise A, Beaglehole, Robert, Belavendra, Antonisamy, Ben Romdhane, Habiba, Benet, Mikhail, Benson, Lowell S, Berkinbayev, Salim, Bernabe-Ortiz, Antonio, Bernotiene, Gailute, Bettiol, Heloísa, Bezerra, Jorge, Bhagyalaxmi, Aroor, Bhargava, Santosh K, Bia, Daniel, Biasch, Katia, Bika Lele, Elysée Claude, Bikbov, Mukharram M, Bista, Bihungum, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B, Björkelund, Cecilia, Bloch, Katia V, Blokstra, Anneke, Bo, Simona, Bobak, Martin, Boeing, Heiner, Boggia, Jose G, Boissonnet, Carlos P, Bojesen, Stig E, Bongard, Vanina, Bonilla-Vargas, Alice, Bopp, Matthias, Borghs, Herman, Bovet, Pascal, Boyer, Christopher B, Braeckman, Lutgart, Brajkovich, Imperia, Branca, Francesco, Breckenkamp, Juergen, Brenner, Hermann, Brewster, Lizzy M, Briceño, Yajaira, Brito, Miguel, Bruno, Graziella, Bueno-de-Mesquita, H Bas, Bueno, Gloria, Bugge, Anna, Burns, Con, Bursztyn, Michael, Cabrera de León, Antonio, Cacciottolo, Joseph, Cameron, Christine, Can, Günay, Cândido, Ana Paula C, Capanzana, Mario V, Čapková, Naděžda, Capuano, Eduardo, Capuano, Vincenzo, Cardoso, Viviane C, Carlsson, Axel C, Carvalho, Joana, Casanueva, Felipe F, Censi, Laura, Cervantes-Loaiza, Marvin, Chadjigeorgiou, Charalambos A, Chamukuttan, Snehalatha, Chan, Angelique W, Chan, Queenie, Chaturvedi, Himanshu K, Chaturvedi, Nish, Chee, Miao Li, Chen, Chien-Jen, Chen, Fangfang, Chen, Huashuai, Chen, Shuohua, Chen, Zhengming, Cheng, Ching-Yu, Cheraghian, Bahman, Cherkaoui Dekkaki, Imane, Chetrit, Angela, Chien, Kuo-Liong, Chiolero, Arnaud, Chiou, Shu-Ti, Chirita-Emandi, Adela, Chirlaque, María-Dolores, Cho, Belong, Christensen, Kaare, Christofaro, Diego G, Chudek, Jerzy, Cinteza, Eliza, Claessens, Frank, Clarke, Janine, Clays, Els, Cohen, Emmanuel, Concin, Hans, Cooper, Cyrus, Coppinger, Tara C, Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Craig, Cora L, Crampin, Amelia C, Crujeiras, Ana B, Cruz, Juan J, Csilla, Semánová, Cui, Liufu, Cureau, Felipe V, Cuschieri, Sarah, D'Arrigo, Graziella, d'Orsi, Eleonora, Dallongeville, Jean, Dankner, Rachel, Dantoft, Thomas M, Dauchet, Luc, Davletov, Kairat, De Backer, Guy, De Bacquer, Dirk, De Curtis, Amalia, de Gaetano, Giovanni, De Henauw, Stefaan, de Oliveira, Paula Duarte, De Ridder, David, De Smedt, Delphine, Deepa, Mohan, Deev, Alexander D, DeGennaro, Vincent Jr, Delisle, Hélène, Demarest, Stefaan, Dennison, Elaine, Deschamps, Valérie, Dhimal, Meghnath, Di Castelnuovo, Augusto F, Dias-da-Costa, Juvenal Soares, Diaz, Alejandro, Dickerson, Ty T, Dika, Zivka, Djalalinia, Shirin, Do, Ha TP, Dobson, Annette J, Donfrancesco, Chiara, Donoso, Silvana P, Döring, Angela, Dorobantu, Maria, Dörr, Marcus, Doua, Kouamelan, Dragano, Nico, Drygas, Wojciech, Duante, Charmaine A, Duboz, Priscilla, Duda, Rosemary B, Dulskiene, Virginija, Dushpanova, Anar, Džakula, Aleksandar, Dzerve, Vilnis, Dziankowska-Zaborszczyk, Elzbieta, Eddie, Ricky, Eftekhar, Ebrahim, Eggertsen, Robert, Eghtesad, Sareh, Eiben, Gabriele, Ekelund, Ulf, El-Khateeb, Mohammad, El Ati, Jalila, Eldemire-Shearer, Denise, Eliasen, Marie, Elosua, Roberto, Erasmus, Rajiv T, Erbel, Raimund, Erem, Cihangir, Eriksen, Louise, Eriksson, Johan G, Escobedo-de la Peña, Jorge, Eslami, Saeid, Esmaeili, Ali, Evans, Alun, Faeh, David, Fakhretdinova, Albina A, Fall, Caroline H, Faramarzi, Elnaz, Farjam, Mojtaba, Fattahi, Mohammad Reza, Fawwad, Asher, Felix-Redondo, Francisco J, Felix, Stephan B, Ferguson, Trevor S, Fernandes, Romulo A, Fernández-Bergés, Daniel, Ferrante, Daniel, Ferrao, Thomas, Ferrari, Marika, Ferrario, Marco M, Ferreccio, Catterina, Ferreira, Haroldo S, Ferrer, Eldridge, Ferrieres, Jean, Figueiró, Thamara Hubler, Fink, Günther, Fischer, Krista, Foo, Leng Huat, Forsner, Maria, Fouad, Heba M, Francis, Damian K, Franco, Maria do Carmo, Frikke-Schmidt, Ruth, Frontera, Guillermo, Fuchs, Flavio D, Fuchs, Sandra C, Fujita, Yuki, Fumihiko, Matsuda, Furdela, Viktoriya, Furer, Ariel, Furusawa, Takuro, Gaciong, Zbigniew, Galbarczyk, Andrzej, Galenkamp, Henrike, Galvano, Fabio, Gao, Jingli, Gao, Pei, Garcia-de-la-Hera, Manoli, Garcia, Pablo, Gareta, Dickman, Garnett, Sarah P, Gaspoz, Jean-Michel, Gasull, Magda, Gazzinelli, Andrea, Gehring, Ulrike, Geleijnse, Johanna M, George, Ronnie, Ghanbari, Ali, Ghasemi, Erfan, Gheorghe-Fronea, Oana-Florentina, Ghimire, Anup, Gialluisi, Alessandro, Giampaoli, Simona, Gieger, Christian, Gill, Tiffany K, Giovannelli, Jonathan, Gironella, Glen, Giwercman, Aleksander, Gkiouras, Konstantinos, Goldberg, Marcel, Goldsmith, Rebecca A, Gomez, Luis F, Gomula, Aleksandra, Gonçalves, Helen, Gonçalves, Mauer, Gonçalves Cordeiro da Silva, Bruna, Gonzalez-Chica, David A, Gonzalez-Gross, Marcela, González-Rivas, Juan P, González-Villalpando, Clicerio, González-Villalpando, María-Elena, Gonzalez, Angel R, Gorbea, Mariano Bonet, Gottrand, Frederic, Graff-Iversen, Sidsel, Grafnetter, Dušan, Grajda, Aneta, Grammatikopoulou, Maria G, Gregor, Ronald D, Grodzicki, Tomasz, Grosso, Giuseppe, Gruden, Gabriella, Gu, Dongfeng, Guan, Ong Peng, Gudmundsson, Elias F, Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L, Gulliford, Martin C, Gunnlaugsdottir, Johanna, Gunter, Marc J, Gupta, Prakash C, Gupta, Rajeev, Gureje, Oye, Gurzkowska, Beata, Gutierrez, Laura, Gutzwiller, Felix, Ha, Seongjun, Hadaegh, Farzad, Haghshenas, Rosa, Hakimi, Hamid, Halkjær, Jytte, Hambleton, Ian R, Hamzeh, Behrooz, Hange, Dominique, Hanif, Abu AM, Hantunen, Sari, Hao, Jie, Hardman, Carla Menêses, Hari Kumar, Rachakulla, Hashemi-Shahri, Seyed Mohammad, Hata, Jun, Haugsgjerd, Teresa, Hayes, Alison J, He, Yuna, Heier, Margit, Hendriks, Marleen Elisabeth, Henrique, Rafael dos Santos, Henriques, Ana, Hernandez Cadena, Leticia, Herqutanto, Herrala, Sauli, Heshmat, Ramin, Hill, Allan G, Ho, Sai Yin, Ho, Suzanne C, Hobbs, Michael, Holdsworth, Michelle, Homayounfar, Reza, Horasan Dinc, Gonul, Horimoto, Andrea RVR, Hormiga, Claudia M, Horta, Bernardo L, Houti, Leila, Howitt, Christina, Htay, Thein Thein, Htet, Aung Soe, Htike, Maung Maung Than, Hu, Yonghua, Huerta, José María, Huhtaniemi, Ilpo Tapani, Huiart, Laetitia, Huisman, Martijn, Husseini, Abdullatif S, Huybrechts, Inge, Hwalla, Nahla, Iacoviello, Licia, Iannone, Anna G, Ibrahim, Mohsen M, Ibrahim Wong, Norazizah, Ikram, M Arfan, Iotova, Violeta, Irazola, Vilma E, Ishida, Takafumi, Isiguzo, Godsent C, Islam, Muhammad, Islam, Sheikh Mohammed Shariful, Iwasaki, Masanori, Jackson, Rod T, Jacobs, Jeremy M, Jaddou, Hashem Y, Jafar, Tazeen, James, Kenneth, Jamrozik, Konrad, Janszky, Imre, Janus, Edward, Jarvelin, Marjo-Riitta, Jasienska, Grazyna, Jelaković, Ana, Jelaković, Bojan, Jennings, Garry, Jha, Anjani Kumar, Jiang, Chao Qiang, Jimenez, Ramon O, Jöckel, Karl-Heinz, Joffres, Michel, Johansson, Mattias, Jokelainen, Jari J, Jonas, Jost B, Jørgensen, Torben, Joshi, Pradeep, Joukar, Farahnaz, Jóżwiak, Jacek, Juolevi, Anne, Jurak, Gregor, Jureša, Vesna, Kaaks, Rudolf, Kafatos, Anthony, Kajantie, Eero O, Kalmatayeva, Zhanna, Kalpourtzi, Natasa, Kalter-Leibovici, Ofra, Kampmann, Freja B, Kannan, Srinivasan, Karaglani, Eva, Kårhus, Line L, Karki, Khem B, Katibeh, Marzieh, Katz, Joanne, Kauhanen, Jussi, Kaur, Prabhdeep, Kavousi, Maryam, Kazakbaeva, Gyulli M, Keil, Ulrich, Keinan Boker, Lital, Keinänen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kemper, Han CG, Keramati, Maryam, Kerimkulova, Alina, Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khalili, Davood, Khaw, Kay-Tee, Kheiri, Bahareh, Kheradmand, Motahareh, Khosravi, Alireza, Kiechl-Kohlendorfer, Ursula, Kiechl, Stefan, Killewo, Japhet, Kim, Dong Wook, Kim, Jeongseon, Klakk, Heidi, Klimek, Magdalena, Klumbiene, Jurate, Knoflach, Michael, Kolle, Elin, Kolsteren, Patrick, Kontto, Jukka P, Korpelainen, Raija, Korrovits, Paul, Kos, Jelena, Koskinen, Seppo, Kouda, Katsuyasu, Kowlessur, Sudhir, Koziel, Slawomir, Kratenova, Jana, Kriaucioniene, Vilma, Kristensen, Peter Lund, Krokstad, Steiner, Kromhout, Daan, Kruger, Herculina S, Kubinova, Ruzena, Kuciene, Renata, Kujala, Urho M, Kulaga, Zbigniew, Kumar, R Krishna, Kurjata, Pawel, Kusuma, Yadlapalli S, Kutsenko, Vladimir, Kuulasmaa, Kari, Kyobutungi, Catherine, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Landrove, Orlando, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Latt, Tint Swe, Le Coroller, Gwenaëlle, Le Nguyen Bao, Khanh, Le, Tuyen D, Lee, Jeannette, Lee, Jeonghee, Lehmann, Nils, Lehtimäki, Terho, Lemogoum, Daniel, Levitt, Naomi S, Li, Yanping, Lilly, Christa L, Lim, Wei-Yen, Lima-Costa, M Fernanda, Lin, Xu, Lin, Yi-Ting, Lind, Lars, Lingam, Vijaya, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Lo, Wei-Cheng, Loit, Helle-Mai, Lopez-Garcia, Esther, Lopez, Tania, Lotufo, Paulo A, Lozano, José Eugenio, Lukačević Lovrenčić, Iva, Lukrafka, Janice L, Luksiene, Dalia, Lundqvist, Annamari, Lundqvist, Robert, Lunet, Nuno, Lustigová, Michala, Luszczki, Edyta, Ma, Guansheng, Ma, Jun, Machado-Coelho, George LL, Machado-Rodrigues, Aristides M, Macia, Enguerran, Macieira, Luisa M, Madar, Ahmed A, Maggi, Stefania, Magliano, Dianna J, Magriplis, Emmanuella, Mahasampath, Gowri, Maire, Bernard, Majer, Marjeta, Makdisse, Marcia, Malekzadeh, Fatemeh, Malekzadeh, Reza, Malhotra, Rahul, Mallikharjuna Rao, Kodavanti, Malyutina, Sofia K, Maniego, Lynell V, Manios, Yannis, Mann, Jim I, Mansour-Ghanaei, Fariborz, Manzato, Enzo, Marcil, Anie, Mårild, Staffan B, Marinović Glavić, Mihalea, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martorell, Reynaldo, Mascarenhas, Luis P, Matasin, Marija, Mathiesen, Ellisiv B, Mathur, Prashant, Matijasevich, Alicia, Matlosz, Piotr, Matsha, Tandi E, Mavrogianni, Christina, Mbanya, Jean Claude N, Mc Donald Posso, Anselmo J, McFarlane, Shelly R, McGarvey, Stephen T, McLachlan, Stela, McLean, Rachael M, McLean, Scott B, McNulty, Breige A, Mediene Benchekor, Sounnia, Medzioniene, Jurate, Mehdipour, Parinaz, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisinger, Christa, Mendoza Montano, Carlos, Menezes, Ana Maria B, Menon, Geetha R, Mereke, Alibek, Meshram, Indrapal I, Metspalu, Andres, Meyer, Haakon E, Mi, Jie, Michels, Nathalie, Mikkel, Kairit, Milkowska, Karolina, Miller, Jody C, Minderico, Cláudia S, Mini, GK, Mirjalili, Mohammad Reza, Mirrakhimov, Erkin, Mišigoj-Duraković, Marjeta, Modesti, Pietro A, Moghaddam, Sahar Saeedi, Mohajer, Bahram, Mohamed, Mostafa K, Mohamed, Shukri F, Mohammad, Kazem, Mohammadi, Mohammad Reza, Mohammadi, Zahra, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohan, Viswanathan, Mohanna, Salim, Mohd Yusoff, Muhammad Fadhli, Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Møllehave, Line T, Molnár, Dénes, Momenan, Amirabbas, Mondo, Charles K, Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K, Moon, Jin Soo, Moosazadeh, Mahmood, Moreira, Leila B, Morejon, Alain, Moreno, Luis A, Morgan, Karen, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mostafavi, Seyed-Ali, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Moura-dos-Santos, Marcos André, Mridha, Malay K, Msyamboza, Kelias P, Mu, Thet Thet, Muhihi, Alfa J, Muiesan, Maria L, Müller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Musa, Kamarul Imran, Musić Milanović, Sanja, Musil, Vera, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M, Najafi, Farid, Nakamura, Harunobu, Námešná, Jana, Nang, Ei Ei K, Nangia, Vinay B, Narake, Sameer, Ndiaye, Ndeye Coumba, Neal, William A, Nejatizadeh, Azim, Nenko, Ilona, Neovius, Martin, Nguyen, Chung T, Nguyen, Nguyen D, Nguyen, Quang V, Nguyen, Quang Ngoc, Nieto-Martínez, Ramfis E, Niiranen, Teemu J, Nikitin, Yury P, Ninomiya, Toshiharu, Nishtar, Sania, Njelekela, Marina A, Noale, Marianna, Noboa, Oscar A, Noorbala, Ahmad Ali, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Børge G, Noto, Davide, Nowak-Szczepanska, Natalia, Nsour, Mohannad Al, Nunes, Baltazar, O'Neill, Terence W, O'Reilly, Dermot, Ochimana, Caleb, Oda, Eiji, Odili, Augustine N, Oh, Kyungwon, Ohara, Kumiko, Ohtsuka, Ryutaro, Olié, Valérie, Olinto, Maria Teresa A, Oliveira, Isabel O, Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M, Ordunez, Pedro, Ornelas, Rui, Ortiz, Pedro J, Osmond, Clive, Ostojic, Sergej M, Ostovar, Afshin, Otero, Johanna A, Overvad, Kim, Owusu-Dabo, Ellis, Paccaud, Fred Michel, Padez, Cristina, Pahomova, Elena, Paiva, Karina Mary de, Pająk, Andrzej, Palli, Domenico, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Panza, Francesco, Paoli, Mariela, Papandreou, Dimitrios, Park, Soon-Woo, Park, Suyeon, Parnell, Winsome R, Parsaeian, Mahboubeh, Pasquet, Patrick, Patel, Nikhil D, Pavlyshyn, Halyna, Pećin, Ivan, Pednekar, Mangesh S, Pedro, João M, Peer, Nasheeta, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C, Peres, Karen GDA, Peres, Marco A, Peters, Annette, Petkeviciene, Janina, Peykari, Niloofar, Pham, Son Thai, Pichardo, Rafael N, Pigeot, Iris, Pikhart, Hynek, 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Killewo, Japhet, Kim, Dong Wook, Kim, Jeongseon, Klakk, Heidi, Klimek, Magdalena, Klumbiene, Jurate, Knoflach, Michael, Kolle, Elin, Kolsteren, Patrick, Kontto, Jukka P, Korpelainen, Raija, Korrovits, Paul, Kos, Jelena, Koskinen, Seppo, Kouda, Katsuyasu, Kowlessur, Sudhir, Koziel, Slawomir, Kratenova, Jana, Kriaucioniene, Vilma, Kristensen, Peter Lund, Krokstad, Steiner, Kromhout, Daan, Kruger, Herculina S, Kubinova, Ruzena, Kuciene, Renata, Kujala, Urho M, Kulaga, Zbigniew, Kumar, R Krishna, Kurjata, Pawel, Kusuma, Yadlapalli S, Kutsenko, Vladimir, Kuulasmaa, Kari, Kyobutungi, Catherine, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Landrove, Orlando, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Latt, Tint Swe, Le Coroller, Gwenaëlle, Le Nguyen Bao, Khanh, Le, Tuyen D, Lee, Jeannette, Lee, Jeonghee, Lehmann, Nils, Lehtimäki, Terho, Lemogoum, Daniel, Levitt, Naomi S, Li, Yanping, Lilly, Christa L, Lim, Wei-Yen, Lima-Costa, M Fernanda, Lin, Xu, Lin, Yi-Ting, Lind, Lars, Lingam, Vijaya, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Lo, Wei-Cheng, Loit, Helle-Mai, Lopez-Garcia, Esther, Lopez, Tania, Lotufo, Paulo A, Lozano, José Eugenio, Lukačević Lovrenčić, Iva, Lukrafka, Janice L, Luksiene, Dalia, Lundqvist, Annamari, Lundqvist, Robert, Lunet, Nuno, Lustigová, Michala, Luszczki, Edyta, Ma, Guansheng, Ma, Jun, Machado-Coelho, George LL, Machado-Rodrigues, Aristides M, Macia, Enguerran, Macieira, Luisa M, Madar, Ahmed A, Maggi, Stefania, Magliano, Dianna J, Magriplis, Emmanuella, Mahasampath, Gowri, Maire, Bernard, Majer, Marjeta, Makdisse, Marcia, Malekzadeh, Fatemeh, Malekzadeh, Reza, Malhotra, Rahul, Mallikharjuna Rao, Kodavanti, Malyutina, Sofia K, Maniego, Lynell V, Manios, Yannis, Mann, Jim I, Mansour-Ghanaei, Fariborz, Manzato, Enzo, Marcil, Anie, Mårild, Staffan B, Marinović Glavić, Mihalea, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martorell, Reynaldo, Mascarenhas, Luis P, Matasin, Marija, Mathiesen, Ellisiv B, Mathur, Prashant, Matijasevich, Alicia, Matlosz, Piotr, Matsha, Tandi E, Mavrogianni, Christina, Mbanya, Jean Claude N, Mc Donald Posso, Anselmo J, McFarlane, Shelly R, McGarvey, Stephen T, McLachlan, Stela, McLean, Rachael M, McLean, Scott B, McNulty, Breige A, Mediene Benchekor, Sounnia, Medzioniene, Jurate, Mehdipour, Parinaz, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisinger, Christa, Mendoza Montano, Carlos, Menezes, Ana Maria B, Menon, Geetha R, Mereke, Alibek, Meshram, Indrapal I, Metspalu, Andres, Meyer, Haakon E, Mi, Jie, Michels, Nathalie, Mikkel, Kairit, Milkowska, Karolina, Miller, Jody C, Minderico, Cláudia S, Mini, GK, Mirjalili, Mohammad Reza, Mirrakhimov, Erkin, Mišigoj-Duraković, Marjeta, Modesti, Pietro A, Moghaddam, Sahar Saeedi, Mohajer, Bahram, Mohamed, Mostafa K, Mohamed, Shukri F, Mohammad, Kazem, Mohammadi, Mohammad Reza, Mohammadi, Zahra, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohan, Viswanathan, Mohanna, Salim, Mohd Yusoff, Muhammad Fadhli, Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Møllehave, Line T, Molnár, Dénes, Momenan, Amirabbas, Mondo, Charles K, Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K, Moon, Jin Soo, Moosazadeh, Mahmood, Moreira, Leila B, Morejon, Alain, Moreno, Luis A, Morgan, Karen, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mostafavi, Seyed-Ali, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Moura-dos-Santos, Marcos André, Mridha, Malay K, Msyamboza, Kelias P, Mu, Thet Thet, Muhihi, Alfa J, Muiesan, Maria L, Müller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Musa, Kamarul Imran, Musić Milanović, Sanja, Musil, Vera, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M, Najafi, Farid, Nakamura, Harunobu, Námešná, Jana, Nang, Ei Ei K, Nangia, Vinay B, Narake, Sameer, Ndiaye, Ndeye Coumba, Neal, William A, Nejatizadeh, Azim, Nenko, Ilona, Neovius, Martin, Nguyen, Chung T, Nguyen, Nguyen D, Nguyen, Quang V, Nguyen, Quang Ngoc, Nieto-Martínez, Ramfis E, Niiranen, Teemu J, Nikitin, Yury P, Ninomiya, Toshiharu, Nishtar, Sania, Njelekela, Marina A, Noale, Marianna, Noboa, Oscar A, Noorbala, Ahmad Ali, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Børge G, Noto, Davide, Nowak-Szczepanska, Natalia, Nsour, Mohannad Al, Nunes, Baltazar, O'Neill, Terence W, O'Reilly, Dermot, Ochimana, Caleb, Oda, Eiji, Odili, Augustine N, Oh, Kyungwon, Ohara, Kumiko, Ohtsuka, Ryutaro, Olié, Valérie, Olinto, Maria Teresa A, Oliveira, Isabel O, Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M, Ordunez, Pedro, Ornelas, Rui, Ortiz, Pedro J, Osmond, Clive, Ostojic, Sergej M, Ostovar, Afshin, Otero, Johanna A, Overvad, Kim, Owusu-Dabo, Ellis, Paccaud, Fred Michel, Padez, Cristina, Pahomova, Elena, Paiva, Karina Mary de, Pająk, Andrzej, Palli, Domenico, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Panza, Francesco, Paoli, Mariela, Papandreou, Dimitrios, Park, Soon-Woo, Park, Suyeon, Parnell, Winsome R, Parsaeian, Mahboubeh, Pasquet, Patrick, Patel, Nikhil D, Pavlyshyn, Halyna, Pećin, Ivan, Pednekar, Mangesh S, Pedro, João M, Peer, Nasheeta, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C, Peres, Karen GDA, Peres, Marco A, Peters, Annette, Petkeviciene, Janina, Peykari, Niloofar, Pham, Son Thai, Pichardo, Rafael N, Pigeot, Iris, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pitakaka, Freda, Piwonska, Aleksandra, Pizarro, Andreia n, Plans-Rubió, Pedro, Polašek, Ozren, Porta, Miquel, Poudyal, Anil, Pourfarzi, Farhad, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Price, Alison J, Price, Jacqueline F, Providencia, Rui, Puhakka, Soile E, Puiu, Maria, Punab, Margus, Qasrawi, Radwan F, Qorbani, Mostafa, Queiroz, Daniel, Quoc Bao, Tran, Radić, Ivana, Radisauskas, Ricardas, Rahimikazerooni, Salar, Rahman, Mahfuzar, Raitakari, Olli, Raj, Manu, Rakhimova, Ellina M, Ramachandra Rao, Sudha, Ramachandran, Ambady, Ramos, Elisabete, Rampal, Lekhraj, Rampal, Sanjay, Rangel Reina, Daniel A, Rarra, Vayia, Rech, Cassiano Ricardo, Redon, Josep, Reganit, Paul Ferdinand M, Regecová, Valéria, Revilla, Luis, Rezaianzadeh, Abbas, Ribeiro, Robespierre, Riboli, Elio, Richter, Adrian, Rigo, Fernando, Rinke de Wit, Tobias F, Ritti-Dias, Raphael M, Robitaille, Cynthia, Rodríguez-Artalejo, Fernando, Rodriguez-Perez, María del Cristo, Rodríguez-Villamizar, Laura A, Roggenbuck, Ulla, Rojas-Martinez, Rosalba, Romaguera, Dora, Romeo, Elisabetta L, Rosengren, Annika, Roy, Joel GR, Rubinstein, Adolfo, Ruidavets, Jean-Bernard, Ruiz-Betancourt, Blanca Sandra, Ruiz-Castell, Maria, Rusakova, Iuliia A, Russo, Paola, Rutkowski, Marcin, Sabanayagam, Charumathi, Sabbaghi, Hamideh, Sachdev, Harshpal S, Sadjadi, Alireza, Safarpour, Ali Reza, Safi, Sare, Safiri, Saeid, Saidi, Olfa, Sakarya, Sibel, Saki, Nader, Salanave, Benoit, Salazar Martinez, Eduardo, Salmerón, Diego, Salomaa, Veikko, Salonen, Jukka T, Salvetti, Massimo, Sánchez-Abanto, Jose, Sans, Susana, Santos, Diana A, Santos, Ina S, Santos, Lèlita C, Santos, Maria Paula, Santos, Rute, Saramies, Jouko L, Sardinha, Luis B, Sarganas, Giselle, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savvas, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D, Schargrodsky, Herman, Schipf, Sabine, Schmidt, Carsten O, Schnohr, Peter, Schöttker, Ben, Schramm, Sara, Schultsz, Constance, Schutte, Aletta E, Sebert, Sylvain, Sein, Aye Aye, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Servais, Jennifer, Shalnova, Svetlana A, Shamah-Levy, Teresa, Shamshirgaran, Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Shaw, Jonathan E, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M, Silva, Caroline Ramos de Moura, Silva, Diego Augusto Santos, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöström, Michael, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobngwi, Eugène, Söderberg, Stefan, Soemantri, Agustinus, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild IA, Sørgjerd, Elin P, Sorić, Maroje, Sossa Jérome, Charles, Soumaré, Aïcha, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Staessen, Jan A, Starc, Gregor, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stieber, Jutta, Stöckl, Doris, Stocks, Tanja, Stokwiszewski, Jakub, Stronks, Karien, Strufaldi, Maria Wany, Suka, Machi, Sun, Chien-An, Sung, Yn-Tz, Suriyawongpaisal, Paibul, Sy, Rody G, Syddall, Holly E, Sylva, René Charles, Szklo, Moyses, Tai, E Shyong, Tammesoo, Mari-Liis, Tamosiunas, Abdonas, Tan, Eng Joo, Tang, Xun, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarqui-Mamani, Carolina B, Taylor, Anne, Taylor, Julie, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thinggaard, Mikael, Thomas, Nihal, Thorand, Barbara, Thuesen, Betina H, Timmermans, Erik J, Tjandrarini, Dwi H, Tjonneland, Anne, Toft, Ulla, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Tormo, María José, Tornaritis, Michael J, Torrent, Maties, Torres-Collado, Laura, Touloumi, Giota, Traissac, Pierre, Triantafyllou, Areti, Trichopoulos, Dimitrios, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ulmer, Hanno, Uusitalo, Hannu MT, Valdivia, Gonzalo, Valvi, Damaskini, van Dam, Rob M, van den Born, Bert-Jan, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, van Zutphen, Elisabeth M, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Vasan, Senthil K, Vega, Tomas, Veidebaum, Toomas, Velasquez-Melendez, Gustavo, Veronesi, Giovanni, Verschuren, WM Monique, Verstraeten, Roosmarijn, Victora, Cesar G, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesus, Virtanen, Jyrki K, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vlasoff, Tiina, Vollenweider, Peter, Voutilainen, Ari, Wade, Alisha N, Walton, Janette, Wambiya, Elvis OA, Wan Bebakar, Wan Mohamad, Wan Mohamud, Wan Nazaimoon, Wanderley Júnior, Rildo de Souza, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nicholas, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Emmanuel A, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Tien Yin, Woo, Jean, Wu, Frederick C, Wu, Shouling, Wyszynska, Justyna, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, San-Lin, Younger-Coleman, Novie O, Yusoff, Ahmad Faudzi, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antonis, Zapata, Maria Elisa, Zaw, Ko Ko, Zejglicova, Kristyna, Zeljkovic Vrkic, Tajana, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhen, Shiqi, Zheng, Yingfeng, Zholdin, Bekbolat, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Zoghlami, Nada, Zuñiga Cisneros, Julio, and Ezzati, Majid

Abstract

Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30–79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30–79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306–359) million women and 317 (292–344) million men in 1990 to 626 (584–668) million women and 652 (604–698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55–62) of women and 49% (46–52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43–51) of women and 38% (35–41) of

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280. Management of patients with hypertension and chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. On behalf of the European Society of Hypertension Working Group on Hypertension and the Kidney.

Author

Halimi, Jean-Michel, Sarafidis, Pantelis, Azizi, Michel, Bilo, Grzegorz, Burkard, Thilo, Bursztyn, Michael, Camafort, Miguel, Chapman, Neil, Cottone, Santina, de Backer, Tine, Deinum, Jaap, Delmotte, Philippe, Dorobantu, Maria, Doumas, Michalis, Dusing, Rainer, Duly-Bouhanick, Béatrice, Fauvel, Jean-Pierre, Fesler, Pierre, Gaciong, Zbigniew, and Gkaliagkousi, Eugenia

Subjects
*DISEASE risk factors, *MINERALOCORTICOID receptors, *CHRONIC kidney failure, *RENIN-angiotensin system, *PATIENT compliance
Abstract

Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed. Results Overall, 88 ESH-ECS representatives from 27 countries participated. According to the responders, renin-angiotensin system (RAS) blockers, calcium-channel blockers and thiazides were often added when these medications were lacking in CKD patients, but physicians were more prone to initiate RAS blockers (90% [interquartile range: 70–95%]) than MRA (20% [10–30%]), SGLT2i (30% [20–50%]) or (GLP1-RA (10% [5–15%]). Despite treatment optimisation, 30% of responders indicated that hypertension remained uncontrolled (30% (15–40%) vs 18% [10%–25%]) in CKD and CKD patients, respectively). Hyperkalemia was the most frequent barrier to initiate RAS blockers, and dosage reduction was considered in 45% of responders when kalaemia was 5.5–5.9 mmol/L. Conclusions RAS blockers are initiated in most ESH-ECS in CKD patients, but MRA and SGLT2i initiations are less frequent. Hyperkalemia was the main barrier for initiation or adequate dosing of RAS blockade, and RAS blockers' dosage reduction was the usual management. PLAIN LANGUAGE SUMMARY: What is the context? Hypertension is a strong independent risk factor for development of chronic kidney disease (CKD) and progression of CKD to ESKD. Improved adherence to the guidelines in the treatment of CKD is believed to provide further reduction of cardiorenal events. European Society of Hypertension Excellence Centres (ESH-ECs) have been developed in Europe to provide excellency regarding management of patients with hypertension and implement guidelines. Numerous deficits regarding general practitioner CKD screening, use of nephroprotective drugs and referral to nephrologists prior to referral to ESH-ECs have been reported. In contrast, real-life management of these patients among ESH-ECs is unknown. Before implementation of strategies to improve guideline adherence in Europe, we aimed to investigate how patients with CKD are managed among the ESH-ECs. What is the study about? In this study, a survey was conducted in 2023 by the ESH to assess management of CKD patients referred to ESH-ECs. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed among their centres. What are the results? RAAS blockers are initiated in 90% of ESH-ECs in CKD patients, but the initiation of MRA and SGLT2i is less frequently done. Hyperkalemia is the main barrier for initiation or adequate dosing of RAAS blockade, and its most reported management was RAAS blockers dosage reduction. These findings will be crucial to implement strategies in order to improve management of patients with CKD and guideline adherence among ESH-ECs. [ABSTRACT FROM AUTHOR]

Published
2024
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285. Birth Weight and Maternal Body Size as Determinants of Blood Pressure at Age 17: Results from the Jerusalem Perinatal Study Cohort.

Author

Dior, Uri P., Karavani, Gilad, Bursztyn, Michael, Paltiel, Ora, Calderon-Margalit, Ronit, Friedlander, Yechiel, Youssim, Iaroslav, Manor, Orly, and Hochner, Hagit

Subjects
*BLOOD pressure, *REGRESSION analysis, *BIRTH weight, *CHILD health services, *DESCRIPTIVE statistics, *BODY mass index, *BODY size, *LONGITUDINAL method, *ADOLESCENCE
Abstract

Objectives: To investigate the effect of birth weight (BW) and maternal pre-pregnancy BMI (mBMI) on blood pressure (BP) in adolescence. Methods: A Population-based cohort of 11,729 births in Jerusalem during 1974–1976, with archival data on maternal and birth characteristics was performed. Measurements at age 17 were assessed and linear regression models were used to evaluate the associations of birth characteristics with BP outcomes. Results: BW was inversely associated with both systolic (SBP) and diastolic (DBP) BP at age 17 (SBP: B = − 0.829, p = 0.002; DBP: B = − 0.397, p = 0.033). The interaction term between BW and weight at age 17 was significant for DBP (p = 0.017) and pulse pressure (p = 0.005). mBMI yielded significant positive associations with BP, independent of BW. Conclusions for Practice: Our findings indicate that there are at least two distinct pathways linking early life characteristics with subsequent BP: Intrauterine growth, as reflected by BW and other genetic or environmental factors, reflected by mBMI and maternal education, contribute to offspring adolescent BP. These results warrant replication in other birth cohorts and underline the need to explore specific mechanisms that account for these associations. [ABSTRACT FROM AUTHOR]

Published
2021
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286. Hypertension and Its Treatment at Age 90 Years: Is There an Association with 5-Year Mortality?

Author

Stessman, Jochanan, Bursztyn, Michael, Gershinsky, Yoni, Hammerman-Rozenberg, Aliza, and Jacobs, Jeremy M.

Subjects
*ANTIHYPERTENSIVE agents, *BLOOD pressure, *COMPARATIVE studies, *CONFIDENCE intervals, *HYPERTENSION, *LONGITUDINAL method, *SCIENTIFIC observation, *INDEPENDENT living, *PROPORTIONAL hazards models, *DESCRIPTIVE statistics, *OLD age, *PROGNOSIS
Abstract

Objective To determine the association between hypertension at age 90 years, treatment, and 5-year mortality. Design A prospective observational study of a representative community-dwelling birth cohort (born 1920–1921) by the Jerusalem Longitudinal Study (1990–2015). Setting Home-assessment. Participants 480 subjects aged 90, examined 2010–2011. Measurements and Main Outcome: Hypertension was defined as treatment with antihypertensive medication, and/or sitting blood pressure (BP) > 140 mmHg systolic or >90 mmHg diastolic. Subjects were categorized as normotensive (NORMO), untreated hypertensive (NonTx-HTN), and treated hypertensive (Tx-HTN); assessment included activities of daily living (ADL), handgrip strength, and all-cause mortality (2010–2015). Results NORMO, NonTx-HTN, and Tx-HTN prevalence was 12.3% (59/480), 12.7% (61/480), and 75% (360/480). Tx-HTN had higher rates of low education, depression, low physical activity, chronic heart failure, ischemic heart disease, chronic kidney disease. Five-year survival was lowest among Tx-HTN and highest among NonTx-HTN versus NORMO among all subjects (51%, 72%, 61%; P = .01), and subgroups with ADL independence (64%, 91%, 74%; n = 265, P = .01), ADL dependence (37%, 55%, 48%; n = 194, P = .36), high grip strength (66%, 85%, 83%; n = 227, P = .04), low grip strength (38%, 60%, 61%; n = 149, P = .06), low comorbidity (64%, 84%, 70%; n = 219, P = .13), and high comorbidity (42%, 60%, 54%; n = 257, P = .12). Unadjusted mortality hazards ratios (HR) were higher for Tx-HTN [HR 1.38; 95% confidence interval (CI) 0.89–2.15] versus NonTx-HTN (HR 0.7; 95% CI 0.37–1.31) compared to NORMO (HR 1.0). After adjusting for medical and functional covariates, adjusted HRs were higher for Tx-HTN (HR 1.39; 95% CI 0.83–2.33) versus NonTx-HTN (HR 0.67; 95% CI 0.31–1.45) compared to NORMO (HR 1.0). Findings were consistent in subsets according to ADL status, grip strength, and comorbidity. Conclusions Untreated hypertension at age 90 years was not associated with increased mortality risk among community-dwelling elderly, irrespective of comorbidity, functional status, or muscle strength. [ABSTRACT FROM AUTHOR]

Published
2017
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287. Morning blood pressure surge and markers of cardiovascular alterations in untreated middle-aged hypertensive subjects.

Author

Pręgowska-Chwała, Barbara, Prejbisz, Aleksander, Kabat, Marek, Puciłowska, Bogna, Paschalis-Purtak, Katarzyna, Florczak, Elżbieta, Klisiewicz, Anna, Kuśmierczyk-Droszcz, Beata, Hanus, Katarzyna, Bursztyn, Michael, and Januszewicz, Andrzej

Abstract

The purpose of the study was to evaluate the degree of morning blood pressure surge (MBPS) and its relationship with markers of cardiovascular alterations in untreated middle-aged hypertensives. We studied 241 patients (mean age, 36.6 ± 10.7 years). Subjects with higher sleep-through MBPS (st-MBPS) were older ( P = .003), had higher carotid intima-media thickness (cIMT) ( P = .05) and lower E/A ratio ( P = .01) than those with lower MBPS. Subjects with higher prewakening MBPS (pw-MBPS) had significantly higher deceleration time ( P = .01) compared with those with lower pw-MBPS. St-MBPS correlated significantly with age, cIMT values, 24-hour systolic and diastolic BP, and systolic BP night-time fall. The significant correlations between pw-MBPS and cIMT values, deceleration time, 24-hour diastolic BP and systolic BP night-time fall were observed. A relationship between MBPS and cardiovascular alterations was observed both in dippers and nondippers, although in non-dippers, it was less pronounced. The results may imply a possible link between MBPS and markers of cardiovascular alterations in untreated hypertensive subjects. [ABSTRACT FROM AUTHOR]

Published
2016
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288. The new Mayo Clinic equation for estimating glomerular filtration rate.

Author

Maaravi, Yoram, Bursztyn, Michael, and Stessman, Jochanan

Subjects
*LETTERS to the editor, *KIDNEY diseases, *KIDNEY disease diagnosis, *CREATININE, *GLOMERULAR filtration rate, *REFERENCE values, *PREDICTIVE tests
Abstract

Presents a letter to the editor in response to the inaccuracy of Modification of Diet in Renal Disease equation in healthy people and development of a new equation for estimating glomerular filtration rate when the diagnosis of chronic kidney disease is unknown.

Published
2005
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290. Erectile Dysfunction in Obese Men.

Author

Bursztyn, Michael

Subjects
*LETTERS to the editor, *IMPOTENCE
Abstract

Presents a letter to the editor in response to the article "Effect of lifestyle changes on erectile dysfunction in obese men: a randomized controlled trial," by Katherine Esposito and colleagues.

Published
2004
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295. Abstract 574.

Author

Ariel, Ilana, Skarzinski, Galina, Kossovsky, Tally, Belzer, Vitali, Knigin, David, Kha'maisi, Mogher, Abassi, Zaid, and Bursztyn, Michael

Abstract

We observed alpha-smooth muscle actin (αSMA) expression in rat endovascular trophoblasts (EVasT) and investigated the spatial and temporal expression of smooth muscle (SM) proteins and their potential function in remodeled spiral artery. Rat placentas were examined from gestational day 13 to term, and were immunostained for cytokeratin, αSMA, α heavy chain of SM myosin, myocardin (marker of SM differentiation) and endothelin receptors A and B (ETA, ETB: BQ-123 and BQ-788, respectively). Transverse sections of the modified spiral artery were studied ex vivo for endothelin-1-induced contraction. EVasT expressed SM proteins co-localizing with cytokeratin, confirming their trophoblastic origin, Thin fibers, consistent with actin fibers, were observed by transmission electron microscopy, in the cellular localization of αSMA in EVasT.Functional experiments revealed that addition of 10-7M endothelin-1 ex vivo reduced vascular lumen cross section area by 10.1+/-0.9% compared with control. This effect was reduced to only 1.1+/-4.9% in the presence of ETA antagonist, and to 5.34.1% by ETB antagonist, p<0.001.The expression of proteins involved in SM differentiation, regulation of function and contraction, along with the expression of the endothelin system, suggest that some vascular tone is potentially maintained by endothelin-1 in the rat remodeled spiral artery despite replacement of SM cells by trophoblasts. Endothelin-induced contraction of the modified spiral artery ex vivo is mediated via its receptors, suggesting its role in situations of dysregulation of the vasoactive systems. [ABSTRACT FROM AUTHOR]

Published
2014

296. Abstract 429.

Author

Bursztyn, Michael, Därr, Roland, Pamporaki, Christina, Peitzsch, Mirko, and Eisenhofer, Graeme

Abstract

Absence of the normal 10% reduction of ambulatory blood pressure (ABP) from day to night is associated with morbidity and mortality. The cause of this reduction (or its absence) is not completely understood. We studied excretion of norepinephrine (NE) and epinephrine (EPI) on the same day ABP monitoring was performed in 37 healthy volunteers aged 52±7years, with body mass index (BMI) 25±4 Kg/m2, and 24-hour ABP 130±11/82±9 mmHg. Overall SBP decreased from day to night 134±13 to 117±10 mmHg, diastolic blood pressure (DBP) from 86±9 to 72±8 mmHg, and heart rate (HR) from 80±10 to 70±9 beats per minute (bpm). Urinary NE and EPI excretion decreased (p<0.005) from 19±10 to 10±6 μmol/mol creatinine, and from 4±2 to 0.8±0.4 μmol/mol creatinine, respectively. Awake or asleep SBP was not correlated to the corresponding NE excretion (r=-0.2, and 0.19). We defined SBP dippers (n=22) as those with a night/day ratio (NDR) of <0.9. There were no differences in age, gender, BMI, 24-hour ABP, daytime DBP, sleep ABP, daytime or sleep HR, or daytime or overnight NE or EPI excretion. On the other hand awake SBP 129±11 mmHg was lower, p<0.05, and NDR DBP 0.89±0.05, NDR HR 0.90±0.05, and NDR NE 0.66±2.7, were significantly higher p<0.05, in the non-dippers (n=15) , than in dippers 138±17mmHg, 0.81±0.05, 0.86±0.8, 0.49±0.18, respectively. In a stepwise multiple regression analysis model with SBP NDR as the dependent variable, awake SBP, p=0.0008, and NDR NE p=0.03, were significant predictors, whereas age and BMI were excluded from the model. In conclusion although day and night blood pressure and urinary NE are not related, the nocturnal decrease of SBP is closely related to the degree of reduction in sympathetic activity as reflected by urinary NE excretion on the same day. [ABSTRACT FROM AUTHOR]

Published
2013

297. High Prevalence of Hypertension in Ethiopian and Non-Ethiopian HIV-Infected Adults.

Author

Korem, Maya, Wallach, Tali, Bursztyn, Michael, Maayan, Shlomo, and Olshtain-Pops, Karen

Subjects
*CARDIOVASCULAR disease diagnosis, *HYPERTENSION risk factors, *AIDS, *BLOOD pressure, *CHI-squared test, *HIV, *HIV-positive persons, *HYPERTENSION, *T-test (Statistics), *VIRAL load, *CONTROL groups, *DISEASE prevalence, *CROSS-sectional method, *RETROSPECTIVE studies, *DATA analysis software
Abstract

Objectives. Prevalence of hypertension has not been studied in the Ethiopian HIV-infected population, which represents 60% of the patients in our AIDS unit. Our aim was to identify risk factors and characterize the prevalence of hypertension in the population monitored at our unit. Methods. A retrospective chart review categorized subjects according to their blood pressure levels. Hypertension prevalence was determined and stratified according to variables perceived to contribute to elevated blood pressure. Results. The prevalence of hypertension in our study population was significantly higher compared to the general population (53% versus 20%, P<0.0001) and was associated with known risk factors and not with patients’ viral load and CD4 levels. Ethiopian HIV-infected adults had a prominently higher rate of blood pressure rise over time as compared to non-Ethiopians (P=0.016). Conclusions. The high prevalence of hypertension in this cohort and the rapid increase in blood pressure in Ethiopians are alarming. We could not attribute high prevalence to HIV-related factors and we presume it is part of the metabolic syndrome. The lifelong cardiovascular risk associated with HIV infection mandates hypertension screening and close monitoring in this population. [ABSTRACT FROM AUTHOR]

Published
2018
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298. Abstract 62.

Author

Bursztyn, Michael and Ben-Dov, Iddo

Abstract

We analyzed 2168 ambulatory BP monitoring (ABPM) tracings of untreated patients from our clinical service database for the prevalence, associations and outcome of salt sensitivity (SS), as approximated from monitoring indices. SS was considered low (SSL) in patients with both mean arterial pressure (MAP) dipping >10% and 24h heart rate (HR) <70 bpm; high (SSH) in patients with MAP dipping 10% and 24h HR ≥70 bpm; and intermediate (SSI) in patients with other combinations of MAP dipping and 24h HR. Associations with demographic and monitoring variables were evaluated by ANOVA, multivariate general linear models and survival analyses. SSH was predicted for 11% (123/1116) of men and 16% (168/1012) of women (χ2 P<0.0001). Diabetes was more common among SSH men 6.5% (8/123) vs. 3.8% (6/168) in women, P=0.004. Positive linear trends (all P<0.05) were noted between SS and body mass index, clinic BP, 24h ambulatory BP, awake and sleep ambulatory HR and awake and sleep ambulatory BP variability. A negative trend existed with HR dipping (P<0.05). Adjustment for multiple variables abolished the linear associations of SS with clinic BP, ambulatory BP variability and HR dipping. Kaplan-Meier analyses revealed increased mortality in association with SS in men but not in women (Figure). With pooled SSL/SSI as reference, adjusted Cox proportional hazards ratios for all-cause mortality were 1.85 (95%CI 1.03-3.35) among SSH men and 1.03 (0.50-2.13) in women. In conclusion, to the extent that ABPM-derived estimation of SS is feasible, analysis of our ABPM database suggests increased mortality in SS men but not in women in whom SS was more common. [ABSTRACT FROM AUTHOR]

Published
2012

299. Abstract 285.

Author

Bursztyn, Michael and Gavish, Benjamin

Abstract

The ratio between the heart period (T) and the time constant (τ), characterizing the arterial pressure decay during the diastole, is a known ventriculo-arterial coupling factor, which is constant in mammals. Previously we have shown T/τ can be determined using standard ambulatory blood pressure(BP) monitoring (ABPM) records and when increased ,predicts all-cause mortality. Here we evaluated the association between increased T/τ and risk-related variation in some continuous clinical and demographic characteristics. We analyzed ABPM records of 2823 hypertensive patients (age 56±16, 54% women, 58% medicated and 9% with diabetes). T/τ was determined using its model expression, as the ratio between T coefficient of variation (SD/mean) and ln(SBP/DBP) variability (SD), where SBP and DBP are the systolic and diastolic BP and T (in sec) is 60/heart rate (HR). One-way ANOVA was applied to T/τ (dependent variable) using as a factor one of the following characteristics after grouping at constant intervals: age [in 5-yr intervals], body mass index (BMI) [5 kg/m2], mean SBP, DBP and pulse pressure (PP) [5 mmHg]; the corresponding dipping [5%], and hear rate (HR) [5 bpm]. End groups with size<50 were eliminated. T, τ and T/τ were 0.88±0.13 sec, 1.18±0.48 sec and 0.88±0.42, respectively. T/τ was greater than 0.9, 1.0 and 1.1, respectively, for 37%, 29% and 16% of the patients (1048, 829 and 647 of 2823). T/τ variation with the tested factors was monotonous and highly significant (p<10-6 for all). T/τ increased with older age, higher BMI, SBP, PP, and lower DBP, HR, and their dipping: T/τ was greater than 1.03 for age>77 yr; >1.06 for BMI>32 kg/m2; >1.06 for (mean) SBP>162 mmHg; >1.07 for DBP<68 mmHg; >1.07 for HR<57 beat/min; >1.05, >0.96 and >1.11 for SBP- DBP- and HR dipping smaller than 2.5%, 2.5% and 7.5%, respectively. The finding that T/τ values greater than a relatively narrow threshold (1.05±0.04) corresponds to risk factors level, and tendency tendency of the tested characteristics supports the view that T/τ that deviates from sucha threshold may signify autonomic cardiovascular dysregulation. [ABSTRACT FROM AUTHOR]

Published
2012

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