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Hypertension has become a major public health problem in the last few decades. High blood pressure is a serious risk factor for premature cardiovascular disease and end organ damage including left-ventricular hypertrophy and congestive heart failure, which in-turn increases the risk of cardiovascular morbidity and mortality. While studies of hypertension have been performed worldwide in a variety of epidemiological settings such as diabetes, renal function, obesity and thyroid disorders, there is a need to identify appropriate treatment strategies Novel Strategies and Approaches in Hypertension introduces the reader to different aspects of hypertension treatment (environmental and occupational factors and different clinical settings that can trigger the disease). The book also covers special topics related to the use of new diagnostic biomarkers for hypertension patients, as well as endocrine and nutrition focused approaches to treat the condition. This reference book will be useful for medical professionals involved in the management and care of patients affected with hypertension.

This study aimed to examine the relationship of adherence with blood pressure (BP) control and its associated factors in hypertensive patients. This cross‐sectional nationwide BP screening study was conducted in Malaysia from May to October 2018. Participants with self‐declared hypertension completed the Hill‐Bone Compliance to High Blood Pressure Therapy Scale (Hill‐Bone CHBPTS) which assesses three important domains of patient behavior to hypertension management namely medication taking, appointment keeping and reduced salt intake. Lower scores indicate better compliance while higher scores indicate otherwise. Participant's body mass index and seated BP were measured based on standard measurement protocol. Determinants of adherence to treatment were analyzed using multiple linear regression. Out of 5167 screened subjects, 1705 were known hypertensives. Of these, 927 (54.4%) answered the Hill‐Bone CHBPTS and were entered into analysis. The mean age was 59.0 ± 13.2 years, 55.6% were female and 42.2% were Malays. The mean Hill‐Bone CHBPTS score was 20.4 ± 4.4 (range 14‐47), and 52.1% had good adherence. The mean systolic BP and diastolic BP were 136.4 ± 17.9 and 80.6 ± 11.6 mmHg, respectively. BP was controlled in 58.3% of those with good adherence compared to 50.2% in those with poor adherence (p = .014). Based on multiple linear regression analysis, female gender (β = −0.72, 95% confidence interval [CI] −1.30, −0.15, p = .014), older age (β = −0.05, 95% CI −0.07, −0.03, p < .001), and individuals with primary or lower educational level (β = −0.91, 95% CI −1.59, −0.23, p = .009) had better adherence to BP management. Interventional programs targeted at the less adherent groups are needed in order to improve their adherence and BP control.

Left ventricular hypertrophy (LVH) is often used as an indicator to assess hypertension‐mediated organ damage (HMOD), alongside hypertensive retinopathy (HR) and nephropathy. Assessment of HMOD is crucial when making decisions about treatment optimization. Despite longstanding debate over its reliability to detect LVH, it is common practice to perform an electrocardiogram (ECG) instead of directly assessing left ventricular mass with echocardiography. In this study, the presence of LVH was evaluated using both ECG and echocardiography among consecutive patients suspected of therapy‐resistant hypertension or secondary hypertension in the outpatient clinic of the Department of Internal Medicine at the Diakonessen Hospital, Utrecht, the Netherlands, between July 15, 2017, and July 31, 2020. The primary endpoints were the specificity and sensitivity of ECG as a diagnostic tool for LVH, with echocardiography serving as the reference method. Among the 329 participants, we identified 70 individuals (21.3%) with true LVH based on echocardiography. The ECG displayed a sensitivity of 47.9% and a specificity of 75.3%. Moreover, the area under the receiver operating characteristics curve was 0.604. In conclusion, ECG demonstrates limited value in identifying LVH. Considering the importance of accurately assessing HMOD for treatment optimization of hypertension, the role of ECG as a diagnostic tool for LVH is, therefore, questionable. Instead, we recommend employing standard echocardiography as a more reliable diagnostic.

Acute increases of blood pressure values are common causes of patients’ presentation to emergency departments, and their management represents a clinical challenge. They are usually described as ‘hypertensive crises’, ‘hypertensive urgencies’, terms that should be abandoned because they are misleading and inappropriate according to a recent task force of the European Society of Cardiology, which recommended to focus only on ‘hypertensive emergencies’. The latter can be esasily identified by using the B rain, A rteries, R etina, K idney, and/or H eart (BARKH) strategy as herein described. Although current guidelines recommendations/suggestions for treatment of these patients are not evidence-based, owing to the lack of randomized clinical trials, improved understanding of the underlying pathophysiology has changed the approach to management of the patients presenting with hypertensive emergencies in recent years. Starting from these premises and a systematic review of the available studies graded by their quality, using the AHA class of recommendation/level of evidence grading, whenever possible, we herein present a novel a streamlined symptoms- and evidence-based algorithm for the assessment and management of patients with hypertensive emergencies.

It is well known that cardiovascular events occur more frequently in the morning as blood pressure (BP) levels have been shown to increase during the period from night to early morning. In recent years, clinical research using ambulatory blood pressure monitoring (ABPM) or home BP monitoring has clarified that morning BP and BP surge are more closely related to the cardiovascular risk than clinical BP. This practical manual from field leading expert, Dr. Kazuomi Kario, reviews recent evidence on ?morning? and ?nocturnal? hypertension and the IT technologies physicians can use to support patients in home monitoring BP. Guidance on management via antihypertensive drugs is also discussed and with the aim of promoting ?perfect 24 hour BP control?.

This study aimed to compare the changes in physical activity (PA), chronic disease, and mental health indicators of Koreans before and after the COVID-19 outbreak, using raw data from more than 400,000 representative samples from the 2019–2020 Community Health Survey by the Korea Centers for Disease Control and Prevention, and to explore the correlations among them. We used two-way ANOVA to analyze changes and differences in PA and obesity levels. We assessed the influence of gender and recurrent PA using chi-square tests for mental health status and chronic disease. Finally, we performed a correlation analysis to determine the relationships among PA days, mental health, and chronic disease. The results showed that, compared to the levels before the COVID-19 period, moderate-intensity (Days: 1.415~1.217; Time: 114.688~107.321) and high-intensity (Days: 0.798~0.671; Time: 112.866~106.110) PA significantly decreased in Koreans during the COVID-19 period, while low-intensity (Time: 60.305~61.735) PA increased. Before and during the COVID-19 period, men (18,436 (8.1%)~16,124 (7.0%)) performed PA more regularly than women (13,207 (5.8%)~9382 (4.1%)). Compared to the number of regular PA participants before the COVID-19 period, regular PA participants (male, female) decreased from 31,643 (13.8%) to 25,506 (11.1%) during the COVID-19 period. Compared with the levels before the COVID-19 period, the experience rates of stress (3.1%~2.6%), depression (0.8%~0.6%), HBP (3.0%~2.2%), and diabetes (1.2%~0.9%) significantly changed under different levels of conventional PA intervention. In addition, the obesity rate during the COVID-19 period (23.957) was higher than it was before COVID-19 (23.477). During the COVID-19 period, the PA of Koreans was greatly restricted, but low-intensity PA was maintained and increased. PA is an effective activity for maintaining mental health and for preventing and reducing chronic diseases. Recommendations for appropriate intensity or a combination of high-, moderate-, and low-intensity PA should be based on the health status of Koreans to help them maintain mental health and to reduce the risk of chronic diseases during COVID-19 social distancing.

The authors aimed to investigate the association between outdoor light at night (LAN) intensity and blood pressure. The study included 13 507 participants aged 45 and above from the 2011–2012 China Health and Retirement Longitudinal Study baseline survey. Blood pressure measurements were obtained by averaging the last two readings recorded (three measurements with an interval of 45–60 s between each measurement) during the survey. Outdoor LAN intensity was assessed using Defense Meteorological Satellite Program data. The study categorized participants based on quartiles of outdoor LAN intensity and employed statistical methods like linear regression, restricted cubic splines, and logistic models to analyze the connections. After adjusting for potential confounding factors, higher levels of outdoor LAN intensity were associated with increase in systolic blood pressure (0.592 mmHg/interquartile range [IQR], 95% confidence interval [CI]: 0.027,1.157), diastolic blood pressure (0.853 mmHg/IQR, 95% CI: 0.525,1.180) and mean arterial pressure (0.766 mmHg/IQR, 95% CI: 0.385,1.147). Interestingly, the relationship between LAN intensity and odds of hypertension followed a non‐linear pattern, resembling a reverse “L” shape on cubic splines. Participants with the highest quartile of outdoor LAN intensity had 1.31‐fold increased odds of hypertension (95% CI: 1.08–1.58) compared to the lowest quartile. Additionally, there was an observable trend of rising odds for high‐normal blood pressure with higher levels of LAN intensity in the crude model, but no statistically significant differences were observed after adjusting for confounding factors. In conclusion, this study underscores a significant connection between outdoor LAN intensity and the prevalence of hypertension.

In early 1944, with the outcome of World War II by no means certain, many in the United States felt that FDR, as wartime Commander-in-Chief, was an indispensable part of prosecuting the war to a victorious conclusion. Yet although only 62, Roosevelt was mortally ill with congestive heart disease - a fact that was carefully shielded from the American public prior to the election of 1944. In a media environment where we get more details about politicians' health than we sometimes prefer, it is hard to imagine how a paper as authoriative as The New York Times could describe FDR's death as \"sudden and unexpected\" on its front page. Dr. Hugh Evans looks at the issue of Roosevelt's health not only from a medical ethics perspective, but also with a keen eye for the political and media considerations that led to the decision to run and not disclose the extent of Roosevelt's illness.

To study the Sustained Low Efficiency Dialysis (SLED) in the treatment of end-stage renal disease with refractory heart failure and the clinical curative effect of refractory hypertension. choose department of Nephrology, third People's Hospital of Gansu Province of 54 cases of end-stage renal disease with refractory heart failure. The patients with intractable hypertension were randomly divided into control group and observation group, with 27 cases in each group. The control group was treated with Intermittent HemoDialysis (IHD), the observation group was treated with SLED for 2 weeks. The levels of Scr, mean arterial pressure (MAP), BUN, heart rate (HR), CRP, IL-1β, TNF-α, TP, Alb and Hb in the observation group were better than those in the control group, and Closer to normal. The continuous low-efficiency and slow approach is better than the intermittent approach for hemodialysis in the treatment of end-stage renal disease complicated by refractory heart failure and refractory hypertension, which has a better treatment and prognostic effect, and can be promoted in clinical treatment.

The rate of hypertension and obesity is increasing in Vietnamese society. This study aimed to focus on assessing the relationship between anthropometric indexes (body mass index (BMI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR)) and high blood pressure to determine which is the best predictor for high blood pressure among adults over 18 years in Vietnam. A cross-sectional study of 1636 people was conducted. People who were over 18 years old, healthy or had hyperlipidemia and on the treatment were recruited. Patients with cancer, heart disease, diabetes, kidney disease, and hypertension were excluded. Information on demographics, smoking and drinking habits, weight, height, waist circumference, and blood pressure was collected. Areas under receiver operating characteristic curves (AUCs) were examined to determine the predictability of anthropometric indicators for high blood pressure in men and women. Logistic regression analysis, stratified by gender, was performed to examine the association between anthropometric indexes and high blood pressure. In this study, the percentage of people with high blood pressure was 10.51%. The AUC for the WHtR was significantly greater than for the BMI for both genders. Logistic regression demonstrated that only WHtR had a significant positive association with high blood pressure among women. The optimal WHtR cut-off value for predicting high blood pressure in men and women were 0.47 and 0.50, respectively. Among the indicators analyzed in this study, WHtR was the best for the predicting of the presence of high blood pressure, in both men and women. However, WHtR could only explain the changes of high blood pressure in women.