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  1. Zhang J, Gopinath SCB
    3 Biotech, 2020 Feb;10(2):35.
    PMID: 31988829 DOI: 10.1007/s13205-019-2030-z
    Cortisol is a stress hormone released from the adrenal glands and is responsible for both hyperglycemia and hypertension during pregnancy. These factors make it mandatory to detect the levels of cortisol during pregnancy to identify and treat hypoglycemia and hypertension. In this study, cortisol levels were quantified with an aptamer-conjugated gold nanorod using an electrochemical interdigitated electrode sensor. The surface uniformity was analyzed by high-power microscopy and 3D-nanoprofiler imaging. The detection limit was determined to be 0.01 ng/mL, and a linear regression indicated that the sensitivity range was in the range of 0.01-0.1 ng/mL, based on a 3σ calculation. Moreover, the specificity of the aptamer was determined by a binding analysis against norepinephrine and progesterone, and it was clearly found that the aptamer specifically recognizes only cortisol. Further, the presence of cortisol was detected in the serum in a dose-dependent manner. This method is useful to detect and correlate multiple pregnancy-related diseases by quantifying the levels of cortisol.
    Matched MeSH terms: Hypertension
  2. Mohd Shahrir MS, Abdul Halim AG, Soehardy Z, Kong NCT
    APLAR Journal of Rheumatology, 2007;10(2):112-116.
    DOI: 10.1111/j.1479-8077.2007.00270.x
    Background and method: This clinical experience involved the treatment of resistant systemic lupus erythematosus (SLE) patients with CD20 monoclonal antibody. Five patients failed conventional therapy, two developed complications and one needed rituximab as an emergency measure. Four patients had lupus nephritis, three had autoimmune hemolytic anemia, two had immune thrombocytopenia and one had lupoid hepatitis. The patients were aged 14-49 years, (mean 28.63). Three were Malays, two Chinese, two Indian and one Turkish; six were females. Mean disease duration was 63.25 months and mean total rituximab dose received was 2812.50 mL. Results: Hemoglobin levels improved from 9.3 ± 5.7 to 13.1 ± 8.6 g/dL for two SLE patients with autoimmune hemolytic anemia after 34 weeks (P = 0.180). Platelet counts improved from 25 ± 17 to 198 ± 97 × 10 9/high powered field from 0 to 10 weeks for three SLE patients with immune thrombocytopenia (P = 0.109). In the lupus nephritis patients on rituximab, serum albumin improved from 24.5 ± 23.2 to 37.5 ± 31.8 mmol/L (n = 3) from week 0 to week 17 (P = 0.100). Urine protein creatinine ratio improved from 0.55 ± 0.23 to 0.08 ± 0.03 g/mmol creatinine (P = 0.068) from week 0 to week 13. C3 and C4 improved from 90.8 ± 36.5 to 120.7 ± 37.9 (P = 0.07) and 21.6 ± 10.1-27.3 ± 16.2 mg/dL (P = 0.27), respectively, and Systemic Lupus Erythematosus Activity Disease Index was reduced from 17.9 ± 11.2 to 6.3 ± 6.8 (P = 0.375) after 8 weeks. Two patients developed drug reactions to rituximab. Conclusion: All of the patients responded to rituximab on top of their conventional therapy. © 2007 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.
    Matched MeSH terms: Hypertension
  3. Mohd A, Gun SC, Das Gupta E, De'Souza B
    APLAR Journal of Rheumatology, 2006;9 Suppl 1:A89.
    Objective: To determine the epidemiological, clinical and laboratory features of the patients with gout, on follow up in Rheumatology Outpatient Clinic, Hospital Seremban.
    Methods: This was a retrospective study. Case notes of all our existing gout patients were reviewed, and data on demography, clinical features, associated conditions, and laboratory findings were noted.
    Results: 54 patients were studied, 48 (89%) were male and 6 (11%) were female at the ratio of M : F = 8:1, 30 (57%) of them had the onset of symptoms at their 3rd and 4th decades of life. The majority were the Malays 39 (72%), followed by the Indians 11 (20%) and the Chinese 4 (8%). Commonly associated conditions were hypertension in 37 (68.5%), obesity (BMI of 30 and above) in 36 (66.7%) and hyperlipidaemia in 36 (66.7%) of them. Mixed hyperlipidaemia (High TG and LDL cholesterol) were found in 19 (53%). Underlying history of diabetes mellitus 7 (13%), alcohol consumption 8 (15%), smoking habits 22 (40%) and family history of gout 18 (33%). Half of our patients 27 (50%) had at least 2 or more joints involvement. 28 (52%) of them had tophaceous gout. Among those with tophaceous gout, 18 (64%) had renal impairment with serum creatinine of .150mmol/l. 6 (31.5%) of the patients with renal impairment found to have renal calculi on ultrasonography.
    Conclusion: There was male predominance in our group of patients which was consistent with other reported epidemiological studies. Hypertension, mixed hyperlipidaemia and obesity were common associated conditions while diabetes mellitus, smoking and family history of gout were not. The majority of gout patients in our clinic were Malays and due to religious reasons, alcohol was not a common associated factor. Half of our patients had multiple joints involvement and more than half also had tophaceous gout. There was high incidence of renal impairment seen in patients with tophaceous gout. These could be due to delay in seeking medical treatment, present of renal calculi and possibly contributed by associated hypertension and diabetes mellitus.
    Matched MeSH terms: Hypertension
  4. Eashwary M, Hussein H
    APLAR Journal of Rheumatology, 2006;9 Suppl 1:A89.
    DOI: 10.1111/j.1479-8077.2006.00199_15.x
    Introduction: Gout is a clinical syndrome resulting from the deposition of monosodium urate monohydrate crystals. Recent studies have shown gout to be a significant metabolic disorder. However, there has been insufficient information on the clinical spectrum in the Malaysian population.
    Objective: This study is conducted to review the clinical characteristics of patients with gout.
    Study methods: In this cross-sectional study 52 patients with gout were recruited. The records of 13 patients from National University of Malaysia Hospital and 39 patients from Putrajaya Hospital, attending the rheumatology clinic between October and December 2005 were reviewed. Results: Gout was found predominantly among ethnic Malays 83%, and Chinese 17% in these centers. The male to female ratio was 12 :1. The peak age of onset of the disease was less than 40 years in 46% of the subjects. Primary gout in females was seen after menopause. 37% cases had a definitive hereditary incidence. At the first presentation 83% had acute monoarthritis and 17% acute polyarticular arthritis. Podagra was seen in 62%. Peripheral joints involvement was seen in 81% patients. Tophaceous gout was seen in 42%. In 85% cases the disease had a chronic polyarticular course, whereas in 15% the disease remained only at a single joint. In 10% cases, there was associated sero-negative arthritis. Associated disorders included hypertension (65%), diabetes mellitus (33%), dyslipidemia (56%), ischemic heart disease (23%), urate nephropathy (39%), uric acid nephrolithiasis (2%). In 88% of cases, there was associated hyperuricaemia. Most of the patients were overweight with body mass index 25-29 (39%) and obese with body mass index 30-70 (36%). Conclusions: Gout is not an unusual disorder in our centre. The age of onset of gout occurred much earlier with forty-six per cent of patients having their first attack of gout before the age of 40. Primary gout in females was seen after menopause. Majority of patients first presented with acute monoarthritis, of which sixty-two per cent presented with podagra. The incidence of tophi was high. Patients with gout should be screened for other associated disorders like diabetes mellitus, hypertension, dyslipidemia and obesity.
    Matched MeSH terms: Hypertension
  5. Azlin Baharudin, Hatta Sidi, Norzila Zakaria, Sharifah Ezat Wan Puteh
    ASEAN Journal of Psychiatry, 2007;8(2):51-63.
    MyJurnal
    Objective: This study aimed to determine the association between the personality traits and
    social factors with compliance to anti-hypertensive pharmachotherapy. Methods: This cross
    sectional study was conducted from 1st of June until 31st of December 2004, which involved
    Hospital Universiti Kebangsaan Malaysia Primary Polyclinic in Bandar Tasik Selatan,
    Cheras and Salak Polyclinic in Sepang, Selangor. A total of 200 patients who fulfilled all the inclusion criteria, were selected as respondents. This study used the Mini International Neuropsychiatric Interview (M.I.N.I) for the psychiatric diagnoses and personality characteristics were assessed by using Personality Assessment Schedule (PAS) Results: The prevalence rate of non-compliance was 38.5%. Paranoid personality trait (27.3%) was the most common type of personality traits that associated with non-compliance to the medications prescribed. The results of this study revealed a statistically significant difference between drug compliance and age, race, gender and the site where the study was conducted. No association was found between patients’ education level, occupation, income, marital status, family history of hypertension and personality traits and drug compliance. Conclusion: This study suggested that drug compliance among hypertensive patients was influenced by the presence of psychosocial factors. Hence, it is important for medical practitioners to understand these factors and administer treatment more individual.
    Matched MeSH terms: Hypertension
  6. Ngim CA, Abdul Rahman AR, Ibrahim A
    Acta Cardiol, 1999 Oct;54(5):277-82.
    PMID: 10596307
    BACKGROUND: Arterial stiffness, an aging process which is accelerated by hypertension, is emerging as a useful index of vascular health. There are evidences to suggest that hyperinsulinaemia may be an independent risk factor for coronary artery disease, besides its possible pathogenic role in essential hypertension. The main objectives of this study were to compare arterial stiffness between untreated hypertensives and normotensives and to investigate the relationship between fasting serum insulin and arterial stiffness.

    METHODS: A cross-sectional observational study was designed. Forty normotensive (median age 47 +/- 6 yrs.) and twenty untreated hypertensive Malay men (median age 50 +/- 7 yrs.) without clinical evidence of cardiovascular complications were selected. Pulse wave velocity measured using the automated Complior machine was used as an index of arterial stiffness. Other measurements obtained were blood pressure, body mass index, fasting insulin, cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glucose and creatinine level.

    RESULTS: The blood pressure and pulse wave velocity (PWV) were significantly higher in the hypertensives compared to the normotensives (blood pressure 169/100 mm Hg +/- 14/7 vs. 120/80 mm Hg +/- 10/4, p < 0.001; PWV 11.69 m/s +/- 1.12 vs. 8.83 m/s +/- 1.35, p < 0.001). Other variables such as body mass index, fasting insulin, cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and haematocrit were comparable among the two groups. Within each group, there was a significant positive correlation between pulse wave velocity and systolic blood pressure (r = 0.76, p < 0.001 in normotensives; r = 0.73, p < 0.001 in hypertensives) and mean arterial pressure (r = 0.74, p < 0.001 in normotensives; r = 0.73, p < 0.001 in hypertensives). No correlation was noted between pulse wave velocity and diastolic blood pressure, age, body mass index, fasting insulin level, cholesterol, HDL-cholesterol, LDL-cholesterol or triglyceride levels.

    CONCLUSION: Arterial stiffness as determined by PWV is increased in newly diagnosed untreated hypertensive subjects even before clinically evident cardiovascular disease. However, arterial stiffness is not correlated with the fasting insulin level in normotensives and newly diagnosed hypertensives.

    Matched MeSH terms: Hypertension/diagnosis*; Hypertension/physiopathology
  7. Mahdy ZA, Siraj HH, Khaza'ai H, Mutalib MS, Azwar MH, Wahab MA, et al.
    Acta Medica (Hradec Kralove), 2013;56(3):104-9.
    PMID: 24592747
    In view of the high anti-oxidative potential oftocotrienol, the role of the tocotrienol-rich fraction (TRF) of palm oil in preventing pregnancy induced hypertension (PIH) was explored in a randomized double-blind placebo-controlled clinical trial in an urban teaching hospital. Healthy primigravidae were randomized to receive either oral TRF 100 mg daily or placebo, from early second trimester until delivery. Out of 299 women, 151 were randomized into the TRF arm and 148 into the placebo arm. A total of 15 (5.0%) developed PIH. Although there was no statistically significant difference in the incidence of PIH (4/151 or 2.6% in the TRF arm vs. 11/148 or 7.4% in the placebo arm, p = 0.058) between the two arms, there was a tendency towards a lower incidence of PIH in the TRF arm compared to the placebo arm. With TRF supplementation, the relative risk (RR) of PIH was 0.36 (95% CI 0.12-1.09). In conclusion, although TRF from palm oil does not statistically significantly reduce the risk of development of PIH in the population studied, the 64% reduction in incidence of PIH is substantial. The findings warrant further clinical trials, particularly in high risk populations.
    Matched MeSH terms: Hypertension, Pregnancy-Induced/epidemiology; Hypertension, Pregnancy-Induced/prevention & control*
  8. Wahab NA, Chien BH, Omar MR, Aziz AA, Mustafa N, Sukor N, et al.
    Acta Med Indones, 2021 Jan;53(1):77-81.
    PMID: 33818409
    Co-occurrence of cyanotic congenital heart disease (CCHD) and phaeochromocytoma (PCC) and paraganglioma (PGL) are rare, although some cases have been reported. We report a case of left paraganglioma in a 20-year-old lady with an underlying CCHD who underwent palliative Glenn shunt, subsequently developed polycythaemia and cavernous sinus thrombosis presented with palpitation, sweating, headache and hypertension of 3-months duration at the age of 17. The abdominal CT scan revealed an enhancing left paraaortic mass measuring 5.2 cm x 4.4 cm x 3.8 cm. A 24-hour urine catecholamine demonstrated raised noradrenaline level to six times upper limit of normal and hence diagnosis of left sympathetic (sPGL) was made. In view of the delayed diagnosis and significant morbidity associated with her condition, surgical treatment is no longer an option. Therefore, vigilant screening and early treatment of PCC-PGL in patients with CCHD are crucial in order to avoid significant morbidity and ensure a good quality of life.
    Matched MeSH terms: Hypertension
  9. Hutchinson PJ, Kolias AG, Tajsic T, Adeleye A, Aklilu AT, Apriawan T, et al.
    Acta Neurochir (Wien), 2019 Jul;161(7):1261-1274.
    PMID: 31134383 DOI: 10.1007/s00701-019-03936-y
    BACKGROUND: Two randomised trials assessing the effectiveness of decompressive craniectomy (DC) following traumatic brain injury (TBI) were published in recent years: DECRA in 2011 and RESCUEicp in 2016. As the results have generated debate amongst clinicians and researchers working in the field of TBI worldwide, it was felt necessary to provide general guidance on the use of DC following TBI and identify areas of ongoing uncertainty via a consensus-based approach.

    METHODS: The International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury took place in Cambridge, UK, on the 28th and 29th September 2017. The meeting was jointly organised by the World Federation of Neurosurgical Societies (WFNS), AO/Global Neuro and the NIHR Global Health Research Group on Neurotrauma. Discussions and voting were organised around six pre-specified themes: (1) primary DC for mass lesions, (2) secondary DC for intracranial hypertension, (3) peri-operative care, (4) surgical technique, (5) cranial reconstruction and (6) DC in low- and middle-income countries.

    RESULTS: The invited participants discussed existing published evidence and proposed consensus statements. Statements required an agreement threshold of more than 70% by blinded voting for approval.

    CONCLUSIONS: In this manuscript, we present the final consensus-based recommendations. We have also identified areas of uncertainty, where further research is required, including the role of primary DC, the role of hinge craniotomy and the optimal timing and material for skull reconstruction.

    Matched MeSH terms: Intracranial Hypertension/etiology; Intracranial Hypertension/surgery*
  10. Suhaimi FW, Yusoff NH, Dewa A, Yusof AP
    Acta Neurol Belg, 2010 Mar;110(1):57-64.
    PMID: 20514927
    Obesity is intimately associated with hypertension; increases in blood pressure are closely related to the magnitude of weight gain. The present study aims to determine whether the excitatory amino acid input to rostral ventrolateral medulla (RVLM) contributes to elevated blood pressure in rats with diet-induced obesity. Male Sprague-Dawley rats weighing 280 to 300 grams were fed with a low-fat diet (10% kcal from fat) or moderately high-fat diet (32% kcal from fat) for 16 weeks. At week 16, rats on the moderate high-fat diet were segregated into obesity-prone and obesity-resistant rats based on body weight distribution. Baseline mean arterial pressure (MAP) was significantly higher in obesity-prone rats as compared to obesity-resistant and rats on a low-fat diet. Bilateral injection of kynurenic acid (KYN) (40 nM) into the RVLM of the obesity-prone rats reduced MAP to levels significantly different from those observed in rats on a low-fat diet and obesity-resistant rats (no change in MAP). At a lower concentration (4 nM), KYN injection did not produce any change in MAP in any group. The results obtained suggest that excitatory amino acid input to the RVLM does contribute to the development of hypertension in rats with diet-induced obesity.
    Matched MeSH terms: Hypertension/etiology*; Hypertension/pathology*
  11. Ashworth J, Flaherty M, Pitz S, Ramlee A
    Acta Ophthalmol, 2015 Mar;93(2):e111-7.
    PMID: 25688487 DOI: 10.1111/aos.12607
    Purpose: The mucopolysaccharidoses (MPS) are a group of rare lysosomal storage disorders, characterized by the accumulation of glycosaminoglycans within multiple organ systems including the eye. This study aimed to determine the prevalence of glaucoma in patients with MPS, as well as the characteristics, diagnosis and management of patients with MPS and glaucoma.
    Methods: A multicentre retrospective case-note review was carried out by ophthalmologists from four tertiary referral centres to identify patients with MPS who had been treated for glaucoma. Clinical ophthalmological data were collected using standardized data collection forms.
    Results: Fourteen patients were identified (27 eyes) of 294 patients with MPS. The prevalence of glaucoma ranged from 2.1% to 12.5%. The median age at diagnosis of glaucoma was 8 years. Diagnostic evaluation of glaucoma was incomplete in many patients: intraocular pressure was documented in all eyes, but optic disc appearance was only assessed in 67%, central corneal thickness in 26%, visual fields in 19% and iridocorneal angle in 15%.
    Conclusions: Patients with MPS need regular assessment for possible glaucoma including during childhood. Multiple factors contribute to the challenges of assessment, diagnosis and monitoring of glaucoma in these patients.
    Keywords: Hunter; Hurler; Hurler-Scheie; Maroteaux-Lamy; Morquio; Scheie; glaucoma; mucopolysaccharidosis; prevalence.
    Matched MeSH terms: Ocular Hypertension/diagnosis*; Ocular Hypertension/epidemiology; Ocular Hypertension/therapy
  12. Kanaheswari Y, Hamzaini AH, Wong SW, Zulfiqar A
    Acta Paediatr, 2008 Nov;97(11):1589-91.
    PMID: 18671691 DOI: 10.1111/j.1651-2227.2008.00971.x
    Phakomatosis pigmentovascularis (PPV) is a rare congenital syndrome characterized predominantly by cutaneous vascular malformations and pigmentary naevi. The most frequently reported form, Type II b, is associated with systemic involvement. Sturge-Weber Syndrome (SWS) with concomitant glaucoma, Klippel-Trenaunay Syndrome (KTS) and naevus of Ota have been frequently described, but there have only been two case reports with asymptomatic renal anomalies.
    Matched MeSH terms: Hypertension, Malignant/etiology*
  13. Armenia A, Sattar MA, Abdullah NA, Khan MA, Johns EJ
    Acta Pharmacol Sin, 2008 May;29(5):564-72.
    PMID: 18430364 DOI: 10.1111/j.1745-7254.2008.00788.x
    This study investigates the subtypes of the alpha1-adrenoceptor mediating the adrenergically-induced renal vasoconstrictor responses in streptozotocin-induced diabetic and non-diabetic 2-kidney one clip (2K1C) Goldblatt hypertensive rats.
    Matched MeSH terms: Hypertension, Renovascular/physiopathology*
  14. Abdulla MH, Sattar MA, Khan MA, Abdullah NA, Johns EJ
    Acta Physiol (Oxf), 2009 Mar;195(3):397-404.
    PMID: 19183357 DOI: 10.1111/j.1748-1716.2008.01895.x
    This study investigated the influence of angiotensin II (Ang II) receptor and adrenergic blockade on the renal vasoconstrictions caused by Ang II and adrenergic agonists in spontaneously hypertensive rats (SHR).
    Matched MeSH terms: Hypertension/physiopathology*
  15. Au A, Cheng KK, Wei LK
    Adv Exp Med Biol, 2017;956:599-613.
    PMID: 27722964 DOI: 10.1007/5584_2016_79
    Hypertension is a common but complex human disease, which can lead to a heart attack, stroke, kidney disease or other complications. Since the pathogenesis of hypertension is heterogeneous and multifactorial, it is crucial to establish a comprehensive metabolomic approach to elucidate the molecular mechanism of hypertension. Although there have been limited metabolomic, lipidomic and pharmacometabolomic studies investigating this disease to date, metabolomic studies on hypertension have provided greater insights into the identification of disease-specific biomarkers, predicting treatment outcome and monitor drug safety and efficacy. Therefore, we discuss recent updates on the applications of metabolomics technology in human hypertension with a focus on metabolic biomarker discovery.
    Matched MeSH terms: Hypertension/blood*; Hypertension/diagnosis; Hypertension/drug therapy*; Hypertension/physiopathology
  16. Wei LK, Au A, Teh LK, Lye HS
    Adv Exp Med Biol, 2017;956:561-581.
    PMID: 27957710 DOI: 10.1007/5584_2016_75
    Hypertension is a silent killer worldwide, caused by both genetic and environmental factors. Until now, genetic and genomic association studies of hypertension are reporting different degree of association on hypertension. Hence, it is essential to gather all the available information on the reported genetic loci and to determine if any biomarker(s) is/are significantly associated with hypertension. Current review concluded the potential biomarkers for hypertension, with regards to electrolyte and fluid transports, as well as sodium/potassium ions homeostasis, which are supported by the results of case-controls and meta-analyses.
    Matched MeSH terms: Hypertension/genetics*; Hypertension/physiopathology
  17. Chazova IE, Dongre N, Vigdorchik AV
    Adv Ther, 2011 Feb;28(2):134-49.
    PMID: 21240661 DOI: 10.1007/s12325-010-0099-1
    The aim of our study was to evaluate the safety and effectiveness of the free combination of amlodipine/valsartan in patients with arterial hypertension in a real-life setting.
    Matched MeSH terms: Hypertension/drug therapy*; Hypertension/physiopathology
  18. Manoharan S, Shuib AS, Abdullah N
    PMID: 28573254 DOI: 10.21010/ajtcam.v14i2.39
    BACKGROUND: The commercially available synthetic angiotensin-I-converting enzyme (ACE) inhibitors are known to exert negative side effects which have driven many research groups globally to discover the novel ACE inhibitors.

    METHOD: Literature search was performed within the PubMed, ScienceDirect.com and Google Scholar.

    RESULTS: The presence of proline at the C-terminal tripeptide of ACE inhibitor can competitively inhibit the ACE activity. The effects of other amino acids are less studied leading to difficulties in predicting potent peptide sequences. The broad specificity of the enzyme may be due to the dual active sites observed on the somatic ACE. The inhibitors may not necessarily competitively inhibit the enzyme which explains why some reported inhibitors do not have the common ACE inhibitor characteristics. Finally, the in vivo assay has to be carried out before the peptides as the antihypertensive agents can be claimed. The peptides must be absorbed into circulation without being degraded, which will affect their bioavailability and potency. Thus, peptides with strong in vitro IC50 values do not necessarily have the same effect in vivo and vice versa.

    CONCLUSION: The relationship between peptide amino acid sequence and inhibitory activity, in vivo studies of the active peptides and bioavailability must be studied before the peptides as antihypertensive agents can be claimed.

    Matched MeSH terms: Hypertension/drug therapy; Hypertension/metabolism
  19. Schwalm JR, McCready T, Lamelas P, Musa H, Lopez-Jaramillo P, Yusoff K, et al.
    Am Heart J, 2018 09;203:57-66.
    PMID: 30015069 DOI: 10.1016/j.ahj.2018.06.004
    BACKGROUND: Cardiovascular disease is the leading cause of death throughout the world, with the majority of deaths occurring in low- and middle-income countries. Despite clear evidence for the benefits of blood pressure reduction and availability of safe and low-cost medications, most individuals are either unaware of their condition or not adequately treated.

    OBJECTIVE: The primary objective of this study is to evaluate whether a community-based, multifaceted intervention package primarily provided by nonphysician health workers can improve long-term cardiovascular risk in people with hypertension by addressing identified barriers at the patient, health care provider, and health system levels.

    METHODS/DESIGN: HOPE-4 is a community-based, parallel-group, cluster randomized controlled trial involving 30 communities (1,376 participants) in Colombia and Malaysia. Participants ≥50 years old and with newly diagnosed or poorly controlled hypertension were included. Communities were randomized to usual care or to a multifaceted intervention package that entails (1) detection, treatment, and control of cardiovascular risk factors by nonphysician health workers in the community, who use tablet-based simplified management algorithms, decision support, and counseling programs; (2) free dispensation of combination antihypertensive and cholesterol-lowering medications, supervised by local physicians; and (3) support from a participant-nominated treatment supporter (either a friend or family member). The primary outcome is the change in Framingham Risk Score after 12 months between the intervention and control communities. Secondary outcomes including change in blood pressure, lipid levels, and Interheart Risk Score will be evaluated.

    SIGNIFICANCE: If successful, the study could serve as a model to develop low-cost, effective, and scalable strategies to reduce cardiovascular risk in people with hypertension.

    Matched MeSH terms: Hypertension/mortality; Hypertension/physiopathology; Hypertension/therapy*
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