Current Hypertension Reviews - Current Issue

A previous meta-analysis reported the positive effects of statin therapy on endothelial function. However, the obtained result had several limitations that necessitated updating the information in this field. Therefore, a systematic and meta-analysis review was conducted to determine whether statin therapy could improve endothelial function, as assessed by flow-mediated dilation (FMD).

MEDLINE, SciVerse Scopus, and Clarivate Analytics Web of Science were searched to identify randomized placebo-controlled trials assessing the impact of statin therapy on FMD. A random-effects model was used for meta-analysis to calculate the mean difference in weight. Meta-regression and subgroup analyses were used to identify sources of heterogeneity. In addition, nonlinear dose-response, quality of evidence, influence analysis, and publication bias evaluation were assessed using standard methods.

Thirty-five trials (41 arms) involving 2178 participants were included in the meta-analysis study. Statin treatment significantly improved FMD [weighted mean difference (WMD): 1.7%, 95% CI: 1.3-2.2, p < 0.001). However, significant heterogeneity was observed (I²=97.9%, p < 0.001). The results of the subgroup analysis showed that health status can contribute to heterogeneity. Non-linear dose-response analysis revealed the most significant improvement in FMD with atorvastatin at a dose of 20 mg/day and simvastatin at 80 mg/day.

Statin therapy significantly improved endothelial function, as assessed by FMD. These changes are clinically significant, but their use should be approached with caution.

The proportion of people with hypertension is increasing, and those affected are relatively younger. Worldwide, it is estimated that people with high blood pressure are more than 1.5 billion people. In Vietnam, from 2002 to 2008, according to a national survey on hypertension and its risk factors within the prevention and control of cardiovascular disease program, the prevalence of hypertension was 25.1%. This is alarming because high blood pressure can cause serious complications, including death.

The study aimed to explore the blood pressure characteristics and hypertension prevalence in adults in a northern delta province of Vietnam, and describe some risk factors in hypertensive subjects screened through the program.

This was a cross-sectional study collecting data from people aged 18 years or older in 10 cantons and the city of Nam Dinh from July 15^th to July 31^st, 2020. Using semi-automatic OMRON sphygmomanometers, sitting blood pressure was measured three times according to standardized methods specified by the Ministry of Health and two National Vascular Societies.

Blood pressure screening of 183,632 adults included 84,438 males, which accounted for 45.98%, with an average age of 60.36 ± 13.18 years. The estimated prevalence of hypertension was 27.20% (95% CI: 27.00% - 27.41%). The older the age, the higher the rate of hypertension in both sexes; the prevalence of hypertension over 65 years was 45.36%. Hypertension grade 1 accounted for 17.14%, followed by hypertension at grade 2 at 6.69%, and grade 3 at 1.15%; notably, the percentage of prehypertension accounted for 49.64%. The percentage of treated hypertension in Nam Dinh province was 56.85%, but the percentage of uncontrolled hypertension was 85.63%.

The prevalence of hypertension in Nam Dinh province was relatively high (27.20%), although the number of treated patients was also high (56.85%); moreover, the proportion of uncontrolled hypertension remained extremely high (85.63%). Local campaigns and suitable interventions are required to detect hypertension in the early stages and increase awareness for treatment in the population.

The representatives of mathematical concepts and indices allied to the Golden Ratio (GR) have been shown in the human body in superimposed human hands, phalangeal lengths of the digits, human ears, and the cardiovascular system. Recently, it has been demonstrated that the systolic blood pressure (SBP) to diastolic blood pressure (DBP) ratio measured by ambulatory blood pressure monitoring (ABPM) is close to GR. Accordingly, we aimed to evaluate the ratios between the SBP, DBP, and PP in normotensive and hypertensive patients who were on medical treatment or not, to assess the existence of golden proportions in 24-hour ambulatory blood pressure monitoring results.

Five hundred and twenty-nine patients who underwent ABPM were retrospectively enrolled in the study population. The ABPM was programmed to measure blood pressure every 30 min during the daytime and 60 min night time. Based on the ABPM results, patients were classified as hypertensive (SBP/DBP≥130/80 mmHg) and normotensive (SBP/DBP<130/80 mmHg), depending on ESC/ESH 2018 guidelines. They were also divided into two subgroups: medicated and nonmedicated. Systolic to diastolic blood pressure ratio (SBP/DBP) and diastolic blood pressure to pulse pressure (DBP/PP) were calculated in the usual fashion in all study populations and subgroups.

After the exclusion of 133 patients who did not fulfill the inclusion criteria, 396 patients were included in the statistical analysis. Mean SBP/DBP ratios were 1.66±0.15 in all the study population, 1.63±0.11 in normotensive without medication, 1.66±0.13 in normotensive with medications, 1.62±0.15 in hypertensive without medication, and 1.76±0.20 with medications.

We have documented that SBP to DBP ratios of untreated patients, irrespective of having normal or high blood pressure, run close around the GR. However, SBP to DBP ratios of patients having antihypertensive treatment are far from the GR.

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