2020 International Society of Hypertension Global Hypertension Practice Guidelines

Unger, Thomas; Borghi, Claudio; Charchar, Fadi J.; Khan, Nadia; Poulter, Neil; Prabhakaran, Dorairaj; Ramiréz, Agustín J.; Schlaich, Markus P.; Stergiou, George S.; Tomaszewski, Maciej; Wainford, Richard D; Williams, Bryan; Schutte, Aletta E.

doi:10.1161/hypertensionaha.120.15026

Cited by 2,653 publications

(2,914 citation statements)

References 137 publications

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“…We defined the case where at least one variable of lipid profile parameters is abnormal as Overall dyslipidemia, and when all variables of lipid profile parameters are abnormal as mixed dyslipidemia. According to the International Society of Hypertension [ 13 ], HTN definition is when systolic blood pressure (SBP) > 140 mmHg and Diastolic BP (DBP) > 90 mmHg. One of ADA [American Diabetes Association; 14] criteria for diabetes diagnosis is random BS > 200 mg/dL (>11.1 mmol/L) with hyperglycemia symptoms.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of cardiovascular Diseases Risk Factors Among Jordanians

Alsaud¹,

Tabbaa²,

Kasabri³

et al. 2020

Journal of the Saudi Heart Association

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Background and aims One of the most common causes of death worldwide is cardiovascular diseases (CVDs). This study evaluated the prevalence of CVDs risk factors (RFs) and their constellation electively among the Jordanian population and, assessing the most prevalent RF interplay with the rest of CVDs RFs as well as the impact of age and gender dimorphism on the frequencies of coexistence of multiple CVDs risk factors (RFs) among the Jordanian population. Methods and results In this observational multicenter study, a total of 1449 subjects were enrolled. The mean age (±SD) was 44.35 ± 14.46 years; 796 (54.9%) of them were females and 801 (55.28%) of the whole study pool had no family history of premature CVDs. Only 5.9% of the population did not have any of these RFs. The prevalence of CVDs MRFs within-affected subjects was as follows: there were 1081 (74.6%) subjects with overall dyslipidemia, 471 (32.51%) with obesity, 456 (31.47%) were smokers, and at the first diagnostic encounter 541 (37.47%) were with elevated blood pressure and, 310 (21.51%) were with elevated random blood sugar. The coexistence of ≥ two, ≥ three and, ≥ four RFs was observed in 75.7%, 44.4%, and 21.4% of the subjects, respectively. The constellation of multiple RFs was more frequent in men than that in women, where the presence of ≥ two RFs for men was at 86.18% vs. 67.09% for women. Similarly, the appearance of multiple RFs increases with age, starting from the existence of ≥ three, and four RFs respectively. Most notably the clustering of ≥ five RFs in the age group of 45–59 years showed the greatest frequency vs. any other age group. Conclusions CVDs risk factors (RFs) and clusters of them are extremely prevalent in the Jordanian population. Overall dyslipidemia is the most prevalent MRF and the most favors clustering with other CVDs RFs. Combined two RFs had the highest proportional frequency between all six RFs clusters. The constellation of at least two, three, and four CVDs RFs presented at almost three-fourth, half, and around one-fourth; respectively, Middle-aged males presented significantly higher rates of ≥ five RFs occurrences than females.

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Section: Methodsmentioning

confidence: 99%

Prevalence of cardiovascular Diseases Risk Factors Among Jordanians

Alsaud¹,

Tabbaa²,

Kasabri³

et al. 2020

Journal of the Saudi Heart Association

View full text Add to dashboard Cite

show abstract

“…The mean SBP and DBP from the right arm was calculated [ 46 ]. Hypertension was defined as SBP ≥ 140 mmHg and or DBP ≥ 90 mmHg [ 47 ]. We made use of the SphygmoCor XCEL device (AtCor Medical Pty.…”

Section: Methodsmentioning

confidence: 99%

The Cardiotonic Steroid Marinobufagenin Is a Predictor of Increased Left Ventricular Mass in Obesity: The African-PREDICT Study

et al. 2020

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The endogenous Na+/K+-ATPase inhibitor, marinobufagenin (MBG), strongly associates with salt intake and a greater left ventricular mass index (LVMi) in humans and was shown to promote cardiac fibrosis and hypertrophy in animals. The adverse effects of MBG on cardiac remodeling may be exacerbated with obesity, due to an increased sensitivity of Na+/K+-ATPase to MBG. This study determined whether MBG is related to the change in LVMi over time in adults with a body mass index (BMI) ≥30 kg/m2 (obese) and <30 kg/m2 (non-obese). The study followed 275 healthy participants (aged 20–30 years) from the African-Prospective study on the Early Detection and Identification of Cardiovascular disease and Hypertension (African-PREDICT) study over 4.5 years. At baseline, we measured 24 h urine MBG excretion. MBG levels were positively associated with salt intake. LVMi was determined by two-dimensional echocardiography at baseline and after >4.5 years. With multivariate adjusted analyses in obese adults (N = 56), we found a positive association of follow-up LVMi (Adjusted (Adj.) R2 = 0.35; Std. β = 0.311; p = 0.007) and percentage change in LVMi (Adj. R2 = 0.40; Std. β = 0.336; p = 0.003) with baseline MBG excretion. No association of LVMi (Adj. R2 = 0.37; p = 0.85) or percentage change in LVMi (Adj. R2 = 0.19; p = 0.68) with MBG excretion was evident in normal weight adults (N = 123). These findings suggest that obese adults may be more sensitive to the adverse cardiac effects of MBG and provide new insight into the potential role of dietary salt, by way of MBG, in the pathogenesis of cardiac remodeling in obese individuals.

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“…A similar effect was found in a retrospective cohort of 118 NAFLD patients with paired liver biopsies, where the use of RAS inhibitors was associated with decreased fibrosis progression rate only in patients with T2DM[ 22 ]. Given these potential benefits, the high safety profile of the drugs, and the fact that RAS blockers are one of the main classes of drugs recommended as initial therapy by hypertension guidelines[ 120 , 121 ], we suggest that RAS blockers should be considered as first-line therapy in patients with NAFLD and hypertension, after assessing the potential contraindications.…”

Section: Management Of Liver Fibrosis In Nafldmentioning

confidence: 99%

Clinical assessment and management of liver fibrosis in non-alcoholic fatty liver disease

Campos-Murguía

Ruiz-Margáin

González-Regueiro

et al. 2020

WJG

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Non-alcoholic fatty liver disease (NAFLD) is among the most frequent etiologies of cirrhosis worldwide, and it is associated with features of metabolic syndrome; the key factor influencing its prognosis is the progression of liver fibrosis. This review aimed to propose a practical and stepwise approach to the evaluation and management of liver fibrosis in patients with NAFLD, analyzing the currently available literature. In the assessment of NAFLD patients, it is important to identify clinical, genetic, and environmental determinants of fibrosis development and its progression. To properly detect fibrosis, it is important to take into account the available methods and their supporting scientific evidence to guide the approach and the sequential selection of the best available biochemical scores, followed by a complementary imaging study (transient elastography, magnetic resonance elastography or acoustic radiation force impulse) and finally a liver biopsy, when needed. To help with the selection of the most appropriate method a Fagan′s nomogram analysis is provided in this review, describing the diagnostic yield of each method and their post-test probability of detecting liver fibrosis. Finally, treatment should always include diet and exercise, as well as controlling the components of the metabolic syndrome, +/- vitamin E, considering the presence of sleep apnea, and when available, allocate those patients with advanced fibrosis or high risk of progression into clinical trials. The final end of this approach should be to establish an opportune diagnosis and treatment of liver fibrosis in patients with NAFLD, aiming to decrease/stop its progression and improve their prognosis.

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2020 International Society of Hypertension Global Hypertension Practice Guidelines

Cited by 2,653 publications

References 137 publications

Prevalence of cardiovascular Diseases Risk Factors Among Jordanians

Prevalence of cardiovascular Diseases Risk Factors Among Jordanians

The Cardiotonic Steroid Marinobufagenin Is a Predictor of Increased Left Ventricular Mass in Obesity: The African-PREDICT Study

Clinical assessment and management of liver fibrosis in non-alcoholic fatty liver disease

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