Displaying publications 21 - 40 of 58 in total

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  1. Retinal vascular fractal and blood pressure in a multiethnic population
    Sng CC, Wong WL, Cheung CY, Lee J, Tai ES, Wong TY
    J Hypertens, 2013 Oct;31(10):2036-42.
    PMID: 23787404 DOI: 10.1097/HJH.0b013e328362c201
    OBJECTIVE(S): To examine the effect of blood pressure (BP) on retinal vascular fractal dimension (Df), a measure of microvascular network complexity and density in a multiethnic cohort.
    METHODS: A population-based study of 3876 Chinese, Malay and Indian participants in Singapore. Retinal Df was measured using a computer-based program from digital retinal photographs. Associations between retinal Df and mean arterial BP (MABP) in the whole cohort and in each racial group were analysed using linear regression analysis. Logistic regression was used to examine the association between retinal Df and hypertension status.
    RESULTS: The mean retinal Df of the study population was 1.45 (standard deviation 0.03). After adjustment for age, sex, race, diabetes, BMI, cholesterol and creatinine levels, persons with smaller Df had higher MABP (mean difference MABP was 6.18 mmHg comparing lowest to highest Df quartiles, P<0.001). This was similar in Chinese, Malay and Indian persons [mean difference 6.40 (P<0.001), 4.72 (P=0.011) and 6.62 (P<0.001)mmHg, respectively]. Persons with smaller retinal Df were more likely to have uncontrolled treated or untreated hypertension [odds ratio 1.79 (P=0.003) and 2.60 (P=0.003), respectively, comparing lowest to highest Df quartiles] than those with no hypertension; this relationship was not seen comparing persons with controlled treated hypertension with no hypertension (odds ratio 1.01, P=0.972).
    CONCLUSION: Hypertension was associated with a sparser retinal vascular network, which was similar across different racial/ethnic groups and most apparent in those with uncontrolled or untreated hypertension. These data suggest that microvascular remodelling can be quantified by measuring retinal vasculature.
    Matched MeSH terms: Hypertension/diagnosis
  2. Expert panel consensus recommendations for home blood pressure monitoring in Asia: the Hope Asia Network
    Park S, Buranakitjaroen P, Chen CH, Chia YC, Divinagracia R, Hoshide S, et al.
    J Hum Hypertens, 2018 Apr;32(4):249-258.
    PMID: 29386668 DOI: 10.1038/s41371-017-0025-y
    Hypertension is the leading cause of mortality throughout Asia. Home blood pressure monitoring has the potential to improve hypertension control and is a useful adjunct to conventional office blood pressure measurements due to its diagnostic accuracy and prognostic value in predicting cardiovascular outcomes. At present, there are no region-specific guidelines addressing the use of home blood pressure monitoring in Asia. Therefore, an expert panel was convened to address the use of home blood pressure monitoring and develop key recommendations to help guide clinical practice throughout the Asia region. The resulting recommendations support the use of home blood pressure monitoring with a validated device as an accurate adjunct for diagnosing hypertension and predicting cardiovascular outcome. Diagnosis and treatment of hypertension should still be guided by conventional office/clinic blood pressure measurements. The expert panel encourages the incorporation of home blood pressure monitoring into local clinical guidelines and offers practical recommendations to ensure continuity of care where a validated home blood pressure device is not available.
    Matched MeSH terms: Hypertension/diagnosis
  3. Fulltext Obesity indices predict hypertension among indigenous adults in Krau Wildlife Reserve, Peninsular Malaysia
    Chua EY, Zalilah MS, Haemamalar K, Norhasmah S, Geeta A
    J Health Popul Nutr, 2017 05 25;36(1):24.
    PMID: 28545536 DOI: 10.1186/s41043-017-0102-4
    BACKGROUND: The disease burden of indigenous peoples has been augmented by the rising prevalence of obesity and hypertension in this population. This study assessed the ability of obesity indices to predict hypertension among indigenous adults of Peninsular Malaysia.

    METHODS: In this cross-sectional study, 482 adults (223 men, 259 women) aged ≥18 years old were measured for body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and blood pressure. Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of obesity indices for hypertension in men and women. Gender-specific logistic regression analyses were done to examine the association between obesity, defined by BMI, WC, WHtR and WHR, and hypertension.

    RESULTS: Prevalence of hypertension was 25.5%. Overall, WHtR was the best predictor of the presence of hypertension, in both men and women. The optimal WHtR cut-off values for hypertension were 0.45 and 0.52 in men and women, respectively. Obese adults with WHtR ≥0.5 had about two times increased odds of having hypertension compared to non-obese adults.

    CONCLUSIONS: WHtR may serve as a simple and inexpensive screening tool to identify individuals with hypertension in this relatively difficult to reach population.

    Matched MeSH terms: Hypertension/diagnosis*
  4. Fulltext Expert panel consensus recommendations for ambulatory blood pressure monitoring in Asia: The HOPE Asia Network
    Kario K, Shin J, Chen CH, Buranakitjaroen P, Chia YC, Divinagracia R, et al.
    J Clin Hypertens (Greenwich), 2019 Sep;21(9):1250-1283.
    PMID: 31532913 DOI: 10.1111/jch.13652
    Hypertension is an important public health issue because of its association with a number of significant diseases and adverse outcomes. However, there are important ethnic differences in the pathogenesis and cardio-/cerebrovascular consequences of hypertension. Given the large populations and rapidly aging demographic in Asian regions, optimal strategies to diagnose and manage hypertension are of high importance. Ambulatory blood pressure monitoring (ABPM) is an important out-of-office blood pressure (BP) measurement tool that should play a central role in hypertension detection and management. The use of ABPM is particularly important in Asia due to the specific features of hypertension in Asian patients, including a high prevalence of masked hypertension, disrupted BP variability with marked morning BP surge, and nocturnal hypertension. This HOPE Asia Network document summarizes region-specific literature on the relationship between ABPM parameters and cardiovascular risk and target organ damage, providing a rationale for consensus-based recommendations on the use of ABPM in Asia. The aim of these recommendations is to guide and improve clinical practice to facilitate optimal BP monitoring with the goal of optimizing patient management and expediting the efficient allocation of treatment and health care resources. This should contribute to the HOPE Asia Network mission of improving the management of hypertension and organ protection toward achieving "zero" cardiovascular events in Asia.
    Matched MeSH terms: Hypertension/diagnosis*; White Coat Hypertension/diagnosis; Masked Hypertension/diagnosis
  5. Fulltext Guidance on home blood pressure monitoring: A statement of the HOPE Asia Network
    Kario K, Park S, Buranakitjaroen P, Chia YC, Chen CH, Divinagracia R, et al.
    J Clin Hypertens (Greenwich), 2018 03;20(3):456-461.
    PMID: 29450979 DOI: 10.1111/jch.13216
    Hypertension is an important modifiable cardiovascular risk factor and a leading cause of death throughout Asia. Effective prevention and control of hypertension in the region remain a significant challenge despite the availability of several regional and international guidelines. Out-of-office measurement of blood pressure (BP), including home BP monitoring (HBPM), is an important hypertension management tool. Home BP is better than office BP for predicting cardiovascular risk and HBPM should be considered for all patients with office BP ≥ 130/85 mm Hg. It is important that HBPM is undertaken using a validated device and patients are educated about how to perform HBPM correctly. During antihypertensive therapy, monitoring of home BP control and variability is essential, especially in the morning. This is because HBPM can facilitate the choice of individualized optimal therapy. The evidence and practice points in this document are based on the Hypertension Cardiovascular Outcome Prevention and Evidence (HOPE) Asia Network expert panel consensus recommendations for HBPM in Asia.
    Matched MeSH terms: Hypertension/diagnosis
  6. Fulltext Home blood pressure control status in 2017-2018 for hypertension specialist centers in Asia: Results of the Asia BP@Home study
    Kario K, Tomitani N, Buranakitjaroen P, Chia YC, Park S, Chen CH, et al.
    J Clin Hypertens (Greenwich), 2018 12;20(12):1686-1695.
    PMID: 30444315 DOI: 10.1111/jch.13415
    A self-measured home blood pressure (BP)-guided strategy is an effective practical approach to hypertension management. The Asia BP@Home study is the first designed to investigate current home BP control status in different Asian countries/regions using standardized home BP measurements taken with the same validated home BP monitoring device with data memory. We enrolled 1443 medicated hypertensive patients from 15 Asian specialist centers in 11 countries/regions between April 2017 and March 2018. BP was relatively well controlled in 68.2% of patients using a morning home systolic BP (SBP) cutoff of <135 mm Hg, and in 55.1% of patients using a clinic SBP cutoff of <140 mm Hg. When cutoff values were changed to the 2017 AHA/ACC threshold (SBP <130 mm Hg), 53.6% of patients were well controlled for morning home SBP. Using clinic 140 mm Hg and morning home 135 mm Hg SBP thresholds, the proportion of patients with well-controlled hypertension (46%) was higher than for uncontrolled sustained (22%), white-coat (23%), and masked uncontrolled (9%) hypertension, with significant country/regional differences. Home BP variability in Asian countries was high, and varied by country/region. In conclusion, the Asia BP@Home study demonstrated that home BP is relatively well controlled at hypertension specialist centers in Asia. However, almost half of patients remain uncontrolled for morning BP according to new guidelines, with significant country/regional differences. Strict home BP control should be beneficial in Asian populations. The findings of this study are important to facilitate development of health policies focused on reducing cardiovascular complications in Asia.
    Matched MeSH terms: Hypertension/diagnosis*; White Coat Hypertension/diagnosis; Masked Hypertension/diagnosis
  7. Therapeutic Implications of Nitrite in Hypertension
    Ling WC, Mustafa MR, Murugan DD
    J Cardiovasc Pharmacol, 2020 02;75(2):123-134.
    PMID: 31651673 DOI: 10.1097/FJC.0000000000000771
    Nitrite, an anion produced from the oxidative breakdown of nitric oxide (NO), has traditionally been viewed as an inert molecule. However, this dogma has been challenged with the findings that nitrite can be readily reduced to NO under pathological conditions, hence representing a physiologically relevant storage reservoir of NO either in the blood or tissues. Nitrite administration has been demonstrated to improve myocardial function in subjects with heart failure and to lower the blood pressure in hypertensive subjects. Thus, extensive amount of work has since been carried out to investigate the therapeutic potential of nitrite in treating cardiovascular diseases, especially hypertension. Studies done on several animal models of hypertension have demonstrated the efficacy of nitrite in preventing and ameliorating the pathological changes associated with the disease. This brief review of the current findings aims to re-evaluate the use of nitrite for the treatment of hypertension and in particular to highlight its role in improving endothelial function.
    Matched MeSH terms: Hypertension/diagnosis
  8. Endogenous Cushing syndrome from an ectopic adrenocorticotropic hormone production as a rare cause of ocular hypertension
    Khaw KW, Jalaludin MY, Suhaimi H, Harun F, Subrayan V
    J AAPOS, 2010 Aug;14(4):356-7.
    PMID: 20637667 DOI: 10.1016/j.jaapos.2010.04.009
    Ocular hypertension caused by endogenous Cushing syndrome from an ectopic adrenocorticotropic hormone-producing tumor is rare. We report an 11-year-old boy who presented with intraocular pressures (IOPs) of 50 mm Hg in both eyes. Surgical resection of the tumor was performed with subsequent normalization of serum cortisol and IOP levels.
    Matched MeSH terms: Ocular Hypertension/diagnosis
  9. Acute Ischemic Stroke and Acute on Chronic Kidney Disease
    Aftab RA, Khan AH, AbdulRazzaq HA, Adnan AS
    JNMA J Nepal Med Assoc, 2016 12 10;54(202):85-87.
    PMID: 27935930
    Ischemic stroke is due to either local thrombus formation or emboli that occlude a cerebral artery, together with chronic kidney disease represent major mortality and morbidity.Here we present a case of 53 years old Malay man, admitted to a hospital in Malaysia complaining of sudden on set of weakness on right sided upper and lower limb associated with slurred speech. Patient was also suffering from uncontrolled hypertension, hyperlipidemia, chronic kidney disease stage 4, and diabetes mellitus (uncontrolled). He was diagnosed with acute ischemic stroke with cranial nerve 7 palsy (with right hemiparesis), acute on chronic kidney disease precipitated by dehydration and ACE inhibitor, and hyperkalemia. Patients with ischemic disease and chronic kidney disaese require constant monitering and careful selected pharmacotherapy. Patient was placed under observation and was prescribed multiple pharamacotherpay to stabalise detoriating condition.
    Matched MeSH terms: Hypertension/diagnosis
  10. Evaluation of retinal nerve fiber layer thickness in eyes with hypertensive uveitis
    Din NM, Taylor SR, Isa H, Tomkins-Netzer O, Bar A, Talat L, et al.
    JAMA Ophthalmol, 2014 Jul;132(7):859-65.
    PMID: 24789528 DOI: 10.1001/jamaophthalmol.2014.404
    IMPORTANCE: Uveitic glaucoma is among the most common causes of irreversible visual loss in uveitis. However, glaucoma detection can be obscured by inflammatory changes.

    OBJECTIVE: To determine whether retinal nerve fiber layer (RNFL) measurement can be used to detect glaucoma in uveitic eyes with elevated intraocular pressure (IOP).

    DESIGN, SETTING, AND PARTICIPANTS: Comparative case series of RNFL measurement using optical coherence tomography performed from May 1, 2010, through October 31, 2012, at a tertiary referral center. We assigned 536 eyes with uveitis (309 patients) in the following groups: normal contralateral eyes with unilateral uveitis (n = 72), normotensive uveitis (Uv-N) (n = 143), raised IOP and normal optic disc and/or visual field (Uv-H) (n = 233), and raised IOP and glaucomatous disc and/or visual field (Uv-G) (n = 88).

    EXPOSURES: Eyes with uveitis and elevated IOP (>21 mm Hg) on at least 2 occasions.

    MAIN OUTCOMES AND MEASURES: Comparison of RNFL values between groups of eyes and correlation with clinical data; risk factors for raised IOP, glaucoma, and RNFL thinning.

    RESULTS: Mean (SD) global RNFL was thicker in Uv-N (106.4 [21.4] µm) compared with control (96.0 [9.0] µm; P 

    Matched MeSH terms: Ocular Hypertension/diagnosis*
  11. A longitudinal study of age-related changes in intraocular pressure: the Kangbuk Samsung Health Study
    Zhao D, Kim MH, Pastor-Barriuso R, Chang Y, Ryu S, Zhang Y, et al.
    Invest Ophthalmol Vis Sci, 2014 Oct;55(10):6244-50.
    PMID: 25183763 DOI: 10.1167/iovs.14-14151
    To examine the longitudinal association between age and intraocular pressure (IOP) in a large sample of Korean men and women.
    Matched MeSH terms: Ocular Hypertension/diagnosis
  12. Fulltext Comparison of the Framingham Risk Score, SCORE and WHO/ISH cardiovascular risk prediction models in an Asian population
    Selvarajah S, Kaur G, Haniff J, Cheong KC, Hiong TG, van der Graaf Y, et al.
    Int J Cardiol, 2014 Sep;176(1):211-8.
    PMID: 25070380 DOI: 10.1016/j.ijcard.2014.07.066
    BACKGROUND:Cardiovascular risk-prediction models are used in clinical practice to identify and treat high-risk populations, and to communicate risk effectively. We assessed the validity and utility of four cardiovascular risk-prediction models in an Asian population of a middle-income country.
    METHODS:Data from a national population-based survey of 14,863 participants aged 40 to 65 years, with a follow-up duration of 73,277 person-years was used. The Framingham Risk Score (FRS), SCORE (Systematic COronary Risk Evaluation)-high and -low cardiovascular-risk regions and the World Health Organization/International Society of Hypertension (WHO/ISH) models were assessed. The outcome of interest was 5-year cardiovascular mortality. Discrimination was assessed for all models and calibration for the SCORE models.
    RESULTS:Cardiovascular risk factors were highly prevalent; smoking 20%, obesity 32%, hypertension 55%, diabetes mellitus 18% and hypercholesterolemia 34%. The FRS and SCORE models showed good agreement in risk stratification. The FRS, SCORE-high and -low models showed good discrimination for cardiovascular mortality, areas under the ROC curve (AUC) were 0.768, 0.774 and 0.775 respectively. The WHO/ISH model showed poor discrimination, AUC=0.613. Calibration of the SCORE-high model was graphically and statistically acceptable for men (χ(2) goodness-of-fit, p=0.097). The SCORE-low model was statistically acceptable for men (χ(2) goodness-of-fit, p=0.067). Both SCORE-models underestimated risk in women (p<0.001).
    CONCLUSIONS:The FRS and SCORE-high models, but not the WHO/ISH model can be used to identify high cardiovascular risk in the Malaysian population. The SCORE-high model predicts risk accurately in men but underestimated it in women.
    KEYWORDS:Cardiovascular disease prevention; Mortality; Risk prediction; Risk score; Validation
    Matched MeSH terms: Hypertension/diagnosis
  13. Admissions with atrial fibrillation in a multiracial population in Kuala Lumpur, Malaysia
    Freestone B, Rajaratnam R, Hussain N, Lip GY
    Int J Cardiol, 2003 Oct;91(2-3):233-8.
    PMID: 14559136
    BACKGROUND: There are established differences in cardiovascular disease in different racial groups. Worldwide, the literature regarding the clinical epidemiology of atrial fibrillation in non-white populations is scarce.

    OBJECTIVES: To document the prevalence of atrial fibrillation (AF) in the multiracial population of Malaysia, and to describe the clinical features and management of these patients.

    SETTING: Busy city centre general hospital in Kuala Lumpur, Malaysia, over a 1-month period.

    SUBJECTS: One-thousand four hundred and thirty-five acute medical admissions, of whom 40 patients (2.8%) had AF.

    RESULTS: Of 1435 acute medical admissions to Kuala Lumpur General Hospital over the 4-week study period, 40 had AF (21 male, 19 female; mean age 65 years). Of these, 18 were Malay, 16 Chinese and six Indian. Nineteen patients had previously known AF (seven with paroxysmal AF) and 21 were newly diagnosed cases. The principal associated medical conditions were ischaemic heart disease (42.5%), hypertension (40%) and heart failure (40%). Dyspnoea was the commonest presentation, whilst stroke was the cause of presentation in only two patients. Investigations were under-utilised, with chest X-ray and echocardiography in only 62.5% of patients and thyroid function checked in 15%. Only 16% of those with previously diagnosed AF were on warfarin, with a further three on aspirin. Anticoagulant therapy was started in 13.5% of patients previously not on warfarin, and aspirin in 8%. Records of contraindications to warfarin were unreliable, being identified in only 25%. For those with known AF, 58% were on digoxin. For new onset AF, digoxin was again the most common rate-limiting treatment, initiated in 38%, whilst five patients with new onset AF were commenced on amiodarone. DC cardioversion was not used in any of the patients with new onset AF.

    CONCLUSION: Amongst acute medical admissions to a single centre in Malaysia the prevalence of AF was 2.8%. Consistent with previous similar surveys in mainly western (caucasian) populations, standard investigations in this Malaysian cohort were also inadequate and there was underuse of anticoagulation, medication for ventricular rate control and cardioversion to sinus rhythm.

    Matched MeSH terms: Hypertension/diagnosis
  14. Effect of blood pressure on the retinal vasculature in a multi-ethnic Asian population
    Jeganathan VS, Sabanayagam C, Tai ES, Lee J, Sun C, Kawasaki R, et al.
    Hypertens Res, 2009 Nov;32(11):975-82.
    PMID: 19713968 DOI: 10.1038/hr.2009.130
    Blood pressure has a significant effect on retinal arterioles. There are few data on whether this effect varies by race/ethnicity. We examined the relationship of blood pressure and retinal vascular caliber in a multi-ethnic Asian population. The study is population-based and cross sectional in design. A total of 3749 Chinese, Malay and Indian participants aged > or =24 years residing in Singapore were included in the study. Retinal vascular caliber was measured using a computer program from digital retinal photographs. The associations of retinal vascular caliber with blood pressure and hypertension in each racial/ethnic group were analyzed. The main outcome measures are retinal arteriolar caliber and venular caliber. The results show that retinal arterioles were narrower in persons with uncontrolled/untreated hypertension (140.0 microm) as compared with persons with controlled hypertension (142.1 microm, P=0.0001) and those with no hypertension (146.0 microm, P<0.0001). On controlling for age, gender, body mass index, lipids and smoking, each 10 mm Hg increase in mean arterial blood pressure was associated with a 3.1 microm decrease in arteriolar caliber (P<0.0001), with a similar magnitude seen in all three racial/ethnic groups: 3.1 microm in Chinese, 2.8 microm in Malays and 3.2 microm in Indians (P<0.0001 for all). Each 10 mm Hg increase in mean arterial blood pressure was associated with a 1.8 microm increase in venular caliber (P<0.0001); furthermore, the magnitude of this effect was similar across the three racial/ethnic groups. The effect of blood pressure on the retinal vasculature was similar across three major racial/ethnic groups in Asia.
    Matched MeSH terms: Hypertension/diagnosis
  15. Paroxysmal Hypertension Associated With Urination
    Lou Y, Fan L, Hou X, Dominiczak AF, Wang JG, Staessen JA, et al.
    Hypertension, 2019 11;74(5):1068-1074.
    PMID: 31564165 DOI: 10.1161/HYPERTENSIONAHA.119.13140
    Matched MeSH terms: Hypertension/diagnosis*
  16. Diagnosis and Management of Resistant Hypertension: A Case Report
    Zhang ZY, Yang WY, Dominiczak AF, Wang JG, Wu Y, Almustafa B, et al.
    Hypertension, 2019 11;74(5):1064-1067.
    PMID: 31422692 DOI: 10.1161/HYPERTENSIONAHA.119.13206
    Matched MeSH terms: Hypertension/diagnosis*
  17. Prevalence and Risk Factors of Hypertension in the Vietnamese Elderly
    Bui Van N, Vo Hoang L, Bui Van T, Anh HNS, Minh HT, Do Nam K, et al.
    High Blood Press Cardiovasc Prev, 2019 Jun;26(3):239-246.
    PMID: 31020550 DOI: 10.1007/s40292-019-00314-8
    INTRODUCTION: Hypertension (HT) is considered as a major determinant of cardiovascular complications. However, few studies have addressed HT prevalence among adults aged 60 years and older in the northern mountainous region of Vietnam.

    AIM: To determine the prevalence of HT and its risk factors in the elderly in that area.

    METHODS: A cross-sectional study was conducted in a study area in the northern of Vietnam. We interviewed 354 adults aged 60 years or over who were randomly selected, and then measured their blood pressure.

    RESULTS: The overall HT prevalence was 62.15%. The isolated systolic hypertension (ISH) prevalence was 22.88%. There was a slight decrease in the proportion of HT by stage 1, stage 2 and stage 3 respectively. The univariate and multivariate logistic regression analysis indicated some risk factors for HT including age groups, body mass index (BMI) and waist-hip ratio (WHR) (p 

    Matched MeSH terms: Hypertension/diagnosis
  18. Diurnal variation of intraocular pressure in suspected glaucoma patients and their outcome
    Tajunisah I, Reddy SC, Fathilah J
    Graefes Arch Clin Exp Ophthalmol, 2007 Dec;245(12):1851-7.
    PMID: 17901971
    BACKGROUND: A case-controlled prospective study was conducted to evaluate the diurnal variation of intraocular pressure (IOP); the mean, the amplitude of variation and the peak and trough times of pressure readings in the suspected open-angle glaucoma patients as compared with a control group. We also looked at the outcome of these suspects after diurnal variation of IOP measurements.

    METHODS: Diurnal variation of intraocular pressure was measured in 202 eyes of suspected open-angle glaucoma patients and 100 control eyes, at 4-hourly intervals for 24 hours (phasing). Based on the phasing results, optic disc changes and visual field defects, the patients were diagnosed as primary open angle glaucoma (POAG), normal tension glaucoma (NTG), ocular hypertension (OHT), or physiologic cup (PC), or still remained as glaucoma suspects due to inconclusive diagnosis. The last group (glaucoma suspects) was then followed up 6-monthly for their eventual outcome.

    RESULTS: The highest percentage of suspected glaucoma patients had peak (maximum) readings in the mid-morning (10-11 A.M.) and trough (minimum) readings after midnight (2-3 A.M.); the highest percentage of control group had peak readings in the late evening (6-7 P.M.) and trough readings after midnight (2-3 A.M.). The mean amplitude of variance was 6 mm Hg in suspected glaucoma group and 4 mm Hg in the control group. After 'phasing', 18.8% of the suspected glaucoma patients were diagnosed as POAG, 16.8% as NTG, 5% as OHT, and 28.7% as physiologic cup; 30.9% remained as glaucoma suspects. After 4 years follow-up, 70% of the glaucoma suspects still remained as glaucoma suspects, 6.7% developed NTG and another 6.7% POAG; 16.6% were normal.

    CONCLUSIONS: Serial measurement of IOP ( phasing) in a 24-hour period is still needed, in order not to miss the peak and the trough IOP readings in suspected open-angle glaucoma patients, which helps in better management of glaucoma. Among 30.9% of patients who remained as glaucoma suspects after the initial phasing, 13.4% developed NTG/POAG over a period of 4 years.

    Matched MeSH terms: Ocular Hypertension/diagnosis
  19. [FEATURES MANIFESTATIONS COMORBID CURRENTS OF GASTROESOPHAGEAL REFLUX DISEASE AND ARTERIAL HYPERTENSION DEPENDING ON THE DEGREE OF ARTERIAL HYPERTENSION]
    Fadieienko G, Gridniev O
    Georgian Med News, 2015 Nov.
    PMID: 26656546
    The purpose of research - to study the features of circadian profile of blood pressure (BP), the data of echocardiography, pH-monitoring, lipid spectrum, level of apelin and the state of the system "lipid peroxidation-antioxidant protection" in patients with a combination of arterial hypertension (AH) and gastroesophageal reflux disease (GERD) depending on the level of AH. It was examined 126 patients with combination of AH II stage, 2-3 degrees, and GERD, 70 (55.56%) men and 56 (44.44%) women, mean age 56.84 ± 1.17. The anthropometric indicators, a condition of "lipid peroxidation- antioxidant protection", the level of apelin, ambulatory blood pressure monitoring (ABPM), echocardiography, esophageal pH-monitoring were evaluated. Analysis of the results was performed using a computer program IBM SPSS Statistics 21.0 for Windows XP. According to the daily averages ABPM systolic BP/diastolic BP in the I group were 141.2 ± 0.8/90.4 ± 0.4 mm Hg., in II group - 163.3 ± 0.9/101.0 ± 0.5 mm Hg., in III group - 185.6 ± 0.8/112.1 ± 0.5 mm Hg., p = 0.001. There are only 25.39% of patients had normal indicators of the variability of BP among individuals with comorbidity. Transformation from mild AH to moderate was accompanied by a significant increase in the severity of left ventricular remodeling by type of concentric hypertrophy. The data of esophageal pH-monitoring allow us to classify the disorders as severe gastroesophageal reflux in patients with a combination of AH and GERD (DeMeester, 1993). In the group with first degree of AH the average rate of circulating apelin was 930.58 ± 56.27 pg/mL, for the patients with 2nd degree of AH - 880.56 ± 17.97 pg/ml, p>0.05, in patients with third degree of AH - 650.91 ± 12.87 pg/ml (p = 0.001). Assessment of lipid profile has allowed to establish the worse dyslipidemia in patients with 3rd degree of AH combined with GERD (atherogenic ratio - 3.11 ± 0.09). The deterioration of degree of AH combined with GERD accompanied by an increase of oxidative stress with increase of nitrites plasma and malondialdehyde concentration, and decrease of glutathione peroxidase and of SH-groups concentration. Increased degree of AH in patients with severe GERD accompanied by worsening of left ventricular remodeling, reduction of apelin levels, progression of dyslipidemia, and imbalances in the system of "lipid peroxidation-antioxidant protection."
    Matched MeSH terms: Hypertension/diagnosis
  20. Spontaneous sublingual hematoma as a complication of severe hypertension: first report of a case
    Prepageran N, Raman R, Ismail SM, Rahman ZA
    Ear Nose Throat J, 2002 Aug;81(8):576-8.
    PMID: 12199178
    We describe what we believe is the first reported case of a sublingual hematoma secondary to severe hypertension. The patient, a 77-year-old woman, experienced a spontaneous hematoma of the floor of the mouth, tongue, and sublingual space that eventually caused an airway obstruction. We performed an emergency tracheostomy under local anesthesia and then evacuated the hematoma through an incision along the floor of the mouth. The patient recovered uneventfully.
    Matched MeSH terms: Hypertension/diagnosis
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