| 1. |
- Beaney, Thomas, et al.
(författare)
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May measurement month 2019 : The global blood pressure screening campaign of the international society of hypertension
- 2020
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Ingår i: Hypertension. - 0194-911X. ; 76:2, s. 333-341
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Tidskriftsartikel (refereegranskat)abstract
- Elevated blood pressure remains the single biggest risk factor contributing to the global burden of disease and mortality. May Measurement Month is an annual global screening campaign aiming to improve awareness of blood pressure at the individual and population level. Adults (≥18 years) recruited through opportunistic sampling were screened at sites in 92 countries during May 2019. Ideally, 3 blood pressure readings were measured for each participant, and data on lifestyle factors and comorbidities were collected. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, or a diastolic blood pressure ≥90 mm Hg (mean of the second and third readings) or taking antihypertensive medication. When necessary, multiple imputation was used to estimate participants' mean blood pressure. Mixed-effects models were used to evaluate associations between blood pressure and participant characteristics. Of 1 508 130 screenees 482 273 (32.0%) had never had a blood pressure measurement before and 513 337 (34.0%) had hypertension, of whom 58.7% were aware, and 54.7% were on antihypertensive medication. Of those on medication, 57.8% were controlled to <140/90 mm Hg, and 28.9% to <130/80 mm Hg. Of all those with hypertension, 31.7% were controlled to <140/90 mm Hg, and 350 825 (23.3%) participants had untreated or inadequately treated hypertension. Of those taking antihypertensive medication, half were taking only a single drug, and 25% reported using aspirin inappropriately. This survey is the largest ever synchronized and standardized contemporary compilation of global blood pressure data. This campaign is needed as a temporary substitute for systematic blood pressure screening in many countries worldwide.
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| 2. |
- Charchar, Fadi J., et al.
(författare)
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Lifestyle management of hypertension : International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension
- 2024
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Ingår i: Journal of Hypertension. - : Wolters Kluwer. - 0263-6352 .- 1473-5598. ; 42:1, s. 23-49
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Tidskriftsartikel (refereegranskat)abstract
- Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.
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| 3. |
- Lin, Queran, et al.
(författare)
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Hypertension in stroke survivors and associations with national premature stroke mortality : data for 2·5 million participants from multinational screening campaigns
- 2022
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Ingår i: The Lancet Global Health. - 2214-109X. ; 10:8, s. 1141-1149
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Tidskriftsartikel (refereegranskat)abstract
- Background: Blood pressure control has a pivotal role in reducing the incidence and recurrence of stroke. May Measurement Month (MMM), which was initiated in 2017 by the International Society of Hypertension, is the largest global blood pressure screening campaign. We aim to compare MMM participants with and without a previous history of stroke and to investigate associations between national-level estimates of blood pressure management from MMM and premature stroke mortality. Methods: In this annual, global, cross-sectional survey, more than 2·5 million volunteers (≥18 years) from 92 countries were screened in May, 2017, and May, 2018. Three seated blood pressure readings and demographic, lifestyle, and cardiovascular disease data were collected. Associations between risk factors and stroke history were analysed with mixed-effects logistic regression, and associations between national-level estimates of blood pressure management and premature stroke mortality based on Global Burden of Disease data were investigated with linear regression. Findings: 2 222 399 (88·4%) of 2 515 365 participants had recorded data on a history of stroke, of whom 62 639 (2·8%) reported a previous stroke. Participants with a history of stroke had higher rates of hypertension (77·0% vs 32·9%, p<0·0001) and of treated (90·2% vs 57·0%, p<0·0001) and controlled (55·9% vs 32·4%, p<0·0001) hypertension than those without a history of stroke. A third of participants with a history of stroke had either untreated hypertension or treated but uncontrolled hypertension (blood pressure ≥140/90 mm Hg). Strong positive associations were found between national premature stroke mortality and mean systolic blood pressure (84·3 [95% CI 38·8 to 129·9] years of life lost [YLL] per 100 000 people per mm Hg increase) and the percentage of participants with raised blood pressure (49·1 [22·6 to 75·6] YLL per 100 000 people per 1% increase). Strong negative associations were found between national premature stroke mortality and the percentage of participants with hypertension on treatment (−21·0 [−33·0 to −8·9] YLL per 100 000 people per 1% increase) and with controlled blood pressure (−31·6 [−43·8 to −19·4] YLL per 100 000 people per 1% increase). Interpretation: Blood pressure control remains suboptimal worldwide among people with a history of stroke. National estimates of blood pressure management reflect national premature stroke mortality sufficiently to prompt policy makers to promote blood pressure screening and management. Funding: International Society of Hypertension and Servier Pharmaceuticals.
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| 4. |
- Macchi, Chiara, et al.
(författare)
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Leptin, Resistin, and Proprotein Convertase Subtilisin/Kexin Type 9 - The Role of STAT3
- 2020
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Ingår i: The American journal of pathology. - : Elsevier BV. - 1525-2191 .- 0002-9440. ; 190:11, s. 2226-2236
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Tidskriftsartikel (refereegranskat)abstract
- In a condition of dysfunctional visceral fat depots, as in the case of obesity, alterations in adipokines levels may be detrimental for the cardiovascular system. The proinflammatory leptin and resistin adipokines have been described as possible links between obesity and atherosclerosis. The present study was aimed at evaluating whether proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of low-density lipoprotein metabolism, is induced by leptin and resistin through the involvement of the inflammatory pathway of signal transducer and activator of transcript 3 (STAT3). In HepG2 cells, leptin and resistin upregulated PCSK9 gene and protein expression as well as the phosphorylation of STAT3. Upon STAT3 silencing, leptin and resistin lost their ability to activate PCSK9. The knock-down of STAT3 did not affect the expression of leptin and resistin receptors as well as that of PCSK9. The analysis of human PCSK9 promoter region showed that the two adipokines raise PCSK9 promoter activity via the involvement of sterol regulatory element motif. In healthy male, a positive association between circulating leptin and PCSK9 levels was found only when BMI was < 25 kg/m2. In conclusion, our study identified STAT3 as one of the molecular regulators of leptin- and resistin-mediated transcriptional induction of PCSK9.
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| 7. |
- Poulter, Neil R., et al.
(författare)
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May Measurement Month : results of 12 national blood pressure screening programmes between 2017 and 2019
- 2022
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Ingår i: European Heart Journal, Supplement. - : Oxford University Press (OUP). - 1520-765X .- 1554-2815. ; 24:Sf, s. 1-5
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Tidskriftsartikel (refereegranskat)abstract
- The frst May Measurement Month (MMM) campaign, a global blood pressure (BP) screening programme, began in 2017 as an initiative of the International Society of Hypertension.1 Two subsequent annual campaigns have also been completed in consecutive years2,3 and having had to defer activities due to the COVID-19 pandemic in 2020 the fourth campaign was run in 2021, the results of which are currently in press. Since its initiation in 2017, volunteers from more than 100 countries have participated. The aims of MMM have remained consistent from the start-to raise awareness of the importance of the measurement of BP at the individual and population level and to provide a temporary pragmatic solution to the shortfall in BP screening programmes in countries around the world.
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