Prognostic significance of the timing in the cardiac cycle of the first (TP1) and second (TP2) systolic peak of the central aortic pulse wave is ill-defined. Incidence rates and standardized multivariable-adjusted hazard ratios (HRs) of adverse health outcomes associated with TP1 and TP2, estimated by the SphygmoCor software, were assessed in the International Database of Central Arterial Properties for Risk Stratification (IDCARS) (n = 5529). Model refinement was assessed by the integrated discrimination (ID) and net reclassification (NR) improvement. Over 4.1 years (median), 201 participants died and 248 and 159 patients experienced cardiovascular or cardiac endpoints. Mean TP1 and TP2, standardized for cohort, sex, age, and heart rate, were 103 and 228 ms. Shorter TP1 and TP2 were associated with higher mortality and shorter TP1 with a higher risk of cardiovascular and cardiac endpoints (trend p ≤ 0.004). The HRs relating total mortality and cardiovascular endpoints to TP2 were 0.82 (95% confidence interval [CI]: 0.72-0.94) and 0.87 (0.77-0.98), respectively. The HR relating cardiac endpoints to TP1 was 0.81 (0.68-0.97). For total mortality and cardiovascular endpoints in relation to TP2, NRI was significant (p ≤ 0.010), but not for cardiac endpoints in relation to TP1. Integrated discrimination improvement (IDI) was not significant for any endpoint. The HRs relating total mortality to TP2 were smaller (p ≤ 0.026) in women than men (0.67 vs. 0.95) and in older (≥ 60 years) versus younger (< 60 years) participants (0.80 vs. 0.88). Our study adds to the evidence supporting risk stratification based on aortic pulse analysis by showing that TP2 and TP1 carry prognostic information.

• Klíčová slova
• cardiovascular risk, mortality, population science, pulse wave transit time, waveform analysis,
• MeSH
• analýza pulzové vlny * metody   MeSH
• aorta patofyziologie   MeSH
• hodnocení rizik metody   statistika a číselné údaje   MeSH
• hypertenze epidemiologie   mortalita   patofyziologie   MeSH
• kardiovaskulární nemoci * mortalita   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• prognóza MeSH
• rizikové faktory MeSH
• senioři MeSH
• srdeční frekvence fyziologie   MeSH
• systola fyziologie   MeSH
• tuhost cévní stěny fyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: The COVID-19 pandemic had a major impact on medical care. This study evaluated the influence of the pandemic on blood pressure (BP) control and hypertension phenotypes as assessed by office and 24-hour ambulatory BP monitoring (ABPM). DESIGN AND METHODS: Data were collected from 33 centers including Excellence Centers of the European Society of Hypertension. Two groups of patients with treated hypertension were compared. Pandemic group: including participants who had ABPM twice - at visit 2 during the COVID-19 pandemic and visit 1 performed 9-15 months prior to visit 2. Pre-pandemic group: had ABPM at two visits, performed before the pandemic within 9-15 months interval. We determined the following hypertension phenotypes: masked hypertension, white coat hypertension, sustained controlled hypertension (SCH) and sustained uncontrolled hypertension (SUCH). We analyzed the prevalence of phenotypes and their changes between visits. RESULTS: Data of 1419 patients, 616 (43 %) in the pandemic group and 803 (57 %) in the pre-pandemic group, were analyzed. At baseline (visit 1), the prevalence of hypertension phenotypes did not differ between groups. In the pandemic group, the change in hypertension phenotypes between two visits was not significant (p = 0.08). In contrast, in the pre-pandemic group, the prevalence of SCH increased during follow-up (28.8 % vs 38.4 %, p < 0.01) while the prevalence of SUCH decreased (34.2 % vs 27.8 %, p < 0.01). In multivariable adjusted analysis, the only factor influencing negative changes of hypertension phenotypes was the COVID-19 pandemic period. CONCLUSION: These results indicate a negative impact of the COVID-19 pandemic on BP control assessed by hypertension phenotypes.

• Klíčová slova
• Ambulatory blood pressure monitoring, Antihypertensive treatment, Covid-19 pandemic, Hypertension, Hypertension phenotypes,
• MeSH
• ambulantní monitorování krevního tlaku * MeSH
• antihypertenziva terapeutické užití   MeSH
• COVID-19 * epidemiologie   MeSH
• fenotyp * MeSH
• hypertenze * epidemiologie   MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• maskovaná hypertenze epidemiologie   diagnóza   MeSH
• prevalence MeSH
• SARS-CoV-2 MeSH
• senioři MeSH
• syndrom bílého pláště epidemiologie   diagnóza   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Názvy látek
• antihypertenziva MeSH

BACKGROUND: Pediatric blood pressure (BP) assessment and management is increasingly important. Uncontrolled systolic and combined hypertension leads to hypertension-mediated organ damage. The impact of isolated diastolic hypertension is less clearly understood. METHODS: We analyzed the prevalence of ambulatory isolated diastolic hypertension (IDH) in primary (PH) and secondary (SH) hypertension, and associations with BMI Z-score (BMIz) and left ventricular mass index adjusted to the 95th percentile (aLVMI) in a large, multicenter cohort of hypertensive children. Hypertensive children were divided and analyzed in three ambulatory hypertension subgroups: 24-h, daytime, and nighttime. Specifically, we sought to determine the prevalence of ambulatory 24-h, daytime, or nighttime IDH. RESULTS: Prevalence of IDH varied based on ambulatory phenotypes, ranging from 6 to 12%, and was highest in children with SH. Children with IDH tended to be more likely female and, in some cases, were leaner than those with isolated systolic hypertension (ISH). Despite previous pediatric studies suggesting no strong association between diastolic blood pressure and left ventricular hypertrophy (LVH), we observed that children with IDH were equally likely to have LVH and had comparable aLVMI to those with ISH and combined systolic-diastolic hypertension. CONCLUSIONS: In summary, ambulatory IDH appears to be a unique phenotype with a female sex, and younger age predilection, but equal risk for LVH in children with either PH or SH.

• Klíčová slova
• Ambulatory blood pressure monitoring, Children, Diastolic blood pressure, Hypertension,
• MeSH
• ambulantní monitorování krevního tlaku * MeSH
• diastola MeSH
• dítě MeSH
• hypertenze * epidemiologie   diagnóza   etiologie   MeSH
• hypertrofie levé komory srdeční * epidemiologie   etiologie   diagnóza   MeSH
• krevní tlak * MeSH
• lidé MeSH
• mladiství MeSH
• předškolní dítě MeSH
• prevalence MeSH
• rizikové faktory MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

BACKGROUND: Individuals with congenital solitary functioning kidney (SFK) are at an increased risk of kidney damage. According to some studies, the risk is higher in unilateral kidney agenesis (UKA) than in unilateral multicystic dysplastic kidney (UMCDK). We hypothesized that with early detection of children with UKA and UMCDK, there would be no difference in the presence of hypertension, proteinuria, and reduced glomerular filtration rate (GFR) between UKA and UMCDK. METHODS: Based on a long-term follow-up protocol, we evaluated a cohort of 160 children followed from birth for SFK (84 with UKA and 76 with UMCDK) detected by prenatal or routine neonatal ultrasound screening. Hypertension, proteinuria, and reduced GFR were monitored as markers of kidney damage. We compared the characteristics and outcomes of the subgroups of children with UKA and UMCDK. RESULTS: GFR was reduced in 42 (26.2%) children, of whom 41 showed only mild reduction. Hypertension and proteinuria were found in 22 (13.8%) and 14 (8.8%) children, respectively. Combined kidney damage was present in 57 (35.6%) children. The UMCDK and UKA subgroups differed in GFR at final examination, with UMCDK patients being significantly more likely to have normal GFR compared to UKA patients (82% vs. 67%; p = 0.039). CONCLUSIONS: One third of the children showed signs of SFK damage, albeit mild. Patients with UKA had reduced GFR significantly more often than those with UMCDK, but did not differ in the rates of hyperfiltration injury or congenital anomalies of the kidneys and urinary tract (CAKUT) in SFK.

• Klíčová slova
• CAKUT, Functional solitary kidney, Glomerular filtration rate, Unilateral kidney agenesis, Unilateral multicystic dysplastic kidney,
• MeSH
• časná diagnóza * MeSH
• dítě MeSH
• hodnoty glomerulární filtrace * MeSH
• hypertenze diagnóza   etiologie   epidemiologie   patofyziologie   MeSH
• kojenec MeSH
• ledviny * abnormality   patofyziologie   diagnostické zobrazování   MeSH
• lidé MeSH
• multicystické dysplastické ledviny * diagnóza   komplikace   patofyziologie   MeSH
• následné studie MeSH
• nemoci ledvin vrozené   MeSH
• novorozenec MeSH
• novorozenecký screening metody   MeSH
• předškolní dítě MeSH
• prognóza MeSH
• proteinurie * etiologie   diagnóza   MeSH
• solitární ledvina * komplikace   diagnóza   patofyziologie   MeSH
• vrozené vady diagnóza   diagnostické zobrazování   MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

In Uganda, hypertension is a rapidly increasing non-communicable disease with high morbidity and mortality, leading to complications such as renal failure, heart failure, stroke, and myocardial infarctions. This study aimed to determine the factors associated with left ventricular hypertrophy (LVH) among hypertensive patients at Jinja Regional Referral Hospital. A cross-sectional study was conducted among 323 participants using convenience sampling, the study utilized structured questionnaires and data was analyzed using STATA. Results indicated that factors independently associated with LVH included alcohol consumption (aOR 0.26, 95%CI 0.10-0.70, P=0.007), lack of physical exercise (aOR 0.47, 95%CI 0.23-0.94, P=0.033), Low medication adherence (aOR 0.31, 95%CI 0.13-0.71, P=0.006)., female participants who had waist-hip-ratio >0.80 (aOR 3.70, 95%CI 1.18-11.64, P=0.025), diastolic blood pressure of 100 - 109 mmHg (aOR 4.58, 95%CI 1.65-12.74, P=0.004) and diastolic blood pressure of ≤89 mmHg (aOR 3.03, 95%CI 1.03-8.89, P=0.044). The study highlights the need for better management of hypertension and lifestyle modifications to reduce LVH prevalence.

• Klíčová slova
• Hypertension factors, Hypertrophy, Left ventricular,
• MeSH
• dospělí MeSH
• hypertenze * epidemiologie   MeSH
• hypertrofie levé komory srdeční * epidemiologie   MeSH
• konziliární vyšetření a konzultace MeSH
• lidé středního věku MeSH
• lidé MeSH
• prevalence MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• srdeční arytmie * epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Uganda epidemiologie   MeSH

BACKGROUND: Systemic lupus erythematosus (SLE) is characterised by increased cardiovascular morbidity and mortality risk. We aimed to examine the prevalence of traditional cardiovascular risk factors and their control in an international survey of patients with systemic lupus erythematosus. METHODS: In this multicentre, cross-sectional study, cardiovascular risk factor data from medical files of adult patients (aged ≥18) with SLE followed between Jan 1, 2015, and Jan 1, 2020, were collected from 24 countries, across five continents. We assessed the prevalence and target attainment of cardiovascular risk factors and examined potential differences by country income level and antiphospholipid syndrome coexistence. We used the Systemic Coronary Risk Evaluation algorithm for cardiovascular risk estimation, and the European Society of Cardiology guidelines for assessing cardiovascular risk factor target attainment. People with lived experience were not involved in the research or writing process. FINDINGS: 3401 patients with SLE were included in the study. The median age was 43·0 years (IQR 33-54), 3047 (89·7%) of 3396 patients were women, 349 (10.3%) were men, and 1629 (48·1%) of 3390 were White. 556 (20·7%) of 2681 patients had concomitant antiphospholipid syndrome. We found a high cardiovascular risk factor prevalence (hypertension 1210 [35·6%] of 3398 patients, obesity 751 [23·7%] of 3169 patients, and hyperlipidaemia 650 [19·8%] of 3279 patients), and suboptimal control of modifiable cardiovascular risk factors (blood pressure [target of <130/80 mm Hg], BMI, and lipids) in the entire SLE group. Higher prevalence of cardiovascular risk factors but a better blood pressure (target of <130/80 mm Hg; 54·9% [1170 of 2132 patients] vs 46·8% [519 of 1109 patients]; p<0·0001), and lipid control (75·0% [895 of 1194 patients] vs 51·4% [386 of 751 patients], p<0·0001 for high-density lipoprotein [HDL]; 66·4% [769 of 1158 patients] vs 60·8% [453 of 745 patients], p=0·013 for non-HDL; 80·9% [1017 of 1257 patients] vs 61·4% [486 of 792 patients], p<0·0001 for triglycerides]) was observed in patients from high-income versus those from middle-income countries. Patients with SLE with antiphospholipid syndrome had a higher prevalence of modifiable cardiovascular risk factors, and significantly lower attainment of BMI and lipid targets (for low-density lipoprotein and non-HDL) than patients with SLE without antiphospholipid syndrome. INTERPRETATION: High prevalence and inadequate cardiovascular risk factor control were observed in a large multicentre and multiethnic SLE cohort, especially among patients from middle-income compared with high-income countries and among those with coexistent antiphospholipid syndrome. Increased awareness of cardiovascular disease risk in SLE, especially in the above subgroups, is urgently warranted. FUNDING: None.

• MeSH
• antifosfolipidový syndrom * epidemiologie   komplikace   MeSH
• dospělí MeSH
• hypertenze epidemiologie   MeSH
• kardiovaskulární nemoci * epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• prevalence MeSH
• průřezové studie MeSH
• rizikové faktory kardiovaskulárních chorob * MeSH
• rizikové faktory MeSH
• systémový lupus erythematodes * epidemiologie   komplikace   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

In Uganda, hypertension is an escalating health issue, but there is limited specific data regarding the prevalence of left ventricular hypertrophy (LVH) among hypertensive patients in eastern Uganda. This study aimed to establish the prevalence of LVH among hypertensive patients at Jinja Regional Referral Hospital. A cross-sectional study conducted at the hospital enrolled 323 participants using convenience sampling. The results revealed a prevalence rate of 19.50 % for LVH, primarily observed in male participants and younger age groups (25-35 years). Furthermore, the study found a low incidence of associated cardiac arrhythmia, with only 1.59 % of participants having atrial fibrillation. These findings indicate a relatively low burden of LVH and arrhythmia in this population, emphasizing the importance of continued efforts in hypertension management and LVH prevention. Further research and interventions are necessary to mitigate the impact of hypertension-related complications in the eastern region of Uganda.

• Klíčová slova
• Burden, Cardiac arrhythmia, Hypertension, Left ventricular hypertrophy,
• MeSH
• dospělí MeSH
• hypertenze * epidemiologie   MeSH
• hypertrofie levé komory srdeční * epidemiologie   MeSH
• incidence MeSH
• konziliární vyšetření a konzultace statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• prevalence MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• srdeční arytmie * epidemiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Uganda epidemiologie   MeSH

International differences in the incidence of many cancer types indicate the existence of carcinogen exposures that have not yet been identified by conventional epidemiology make a substantial contribution to cancer burden1. In clear cell renal cell carcinoma, obesity, hypertension and tobacco smoking are risk factors, but they do not explain the geographical variation in its incidence2. Underlying causes can be inferred by sequencing the genomes of cancers from populations with different incidence rates and detecting differences in patterns of somatic mutations. Here we sequenced 962 clear cell renal cell carcinomas from 11 countries with varying incidence. The somatic mutation profiles differed between countries. In Romania, Serbia and Thailand, mutational signatures characteristic of aristolochic acid compounds were present in most cases, but these were rare elsewhere. In Japan, a mutational signature of unknown cause was found in more than 70% of cases but in less than 2% elsewhere. A further mutational signature of unknown cause was ubiquitous but exhibited higher mutation loads in countries with higher incidence rates of kidney cancer. Known signatures of tobacco smoking correlated with tobacco consumption, but no signature was associated with obesity or hypertension, suggesting that non-mutagenic mechanisms of action underlie these risk factors. The results of this study indicate the existence of multiple, geographically variable, mutagenic exposures that potentially affect tens of millions of people and illustrate the opportunities for new insights into cancer causation through large-scale global cancer genomics.

• MeSH
• genom lidský genetika   MeSH
• genomika MeSH
• hypertenze epidemiologie   MeSH
• incidence MeSH
• karcinom z renálních buněk * genetika   epidemiologie   chemicky indukované   MeSH
• kouření tabáku škodlivé účinky   genetika   MeSH
• kyseliny aristolochové škodlivé účinky   MeSH
• lidé MeSH
• mutace * MeSH
• mutageny * škodlivé účinky   MeSH
• nádory ledvin * genetika   epidemiologie   chemicky indukované   MeSH
• obezita epidemiologie   MeSH
• rizikové faktory MeSH
• vystavení vlivu životního prostředí * škodlivé účinky   analýza   MeSH
• zeměpis * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Japonsko epidemiologie   MeSH
• Rumunsko epidemiologie   MeSH
• Srbsko epidemiologie   MeSH
• Thajsko epidemiologie   MeSH
• Názvy látek
• kyseliny aristolochové MeSH
• mutageny * MeSH

BACKGROUND: Despite accessible diagnostics and treatment of hypertension, a high proportion of patients worldwide remain unaware of their diagnosis, and even more remain untreated. Several studies suggest that absence of comorbidities is a predictive factor for unawareness and consequently non-treatment of hypertension. There are only a few studies that have assessed the hypertension prevalence and management among apparently healthy individuals. OBJECTIVE: The aim of the study was to assess and compare hypertension prevalence, awareness, treatment and control among apparently healthy individuals, patients with internal diseases, and patients with non-internal diseases. METHODS: Data from standardised blood pressure measurements conducted during the Czech European Health Examination Survey 2014 and information on health status and health care use collected during the Czech European Health Interview Survey 2014 were analyzed. We focused on participants aged 25-64. Data were weighted on sex and age to ensure an appropriate sex and age structure of the population. The χ2-test and binary logistic regression analyses were used to compare distribution of cascade of care for hypertension between the health-status groups of respondents. RESULTS: The final eligible sample consisted of 1121 participants. The prevalence of hypertension was 32.8% in the healthy group, 29.8% in the non-internal disease group and 52.4% in the internal disease group, (p < 0.001). Awareness was 54.1%, 59.1% and 85.2% respectively, (p < 0.001). Treatment was 44.2%, 52.6% and 86.4%, respectively, (p < 0.001). Among apparently healthy respondents 62.6% had their blood pressure measured by a medical professional in the last year, compared to 71.1% in the non-internal disease group and 91.7% in the internal disease group, (p < 0.001). Differences in hypertension control were not statistically significant. CONCLUSIONS: Generally, our data show a discordance in hypertension management within the Czech population. Apparently healthy individuals are the least aware of their diagnosis and the highest proportion of them remain untreated.

• MeSH
• dospělí MeSH
• hypertenze * epidemiologie   terapie   diagnóza   MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• prevalence MeSH
• zdraví - znalosti, postoje, praxe MeSH
• zdravotnické přehledy MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

BACKGROUND AND AIMS: Cardiovascular (CV) diseases are the most common risk factors (RFs) for retinal vein occlusion (RVO) development in general. The aim of this study was to identify the most frequent causes of RVO in patients under 50. METHODS: We retrospectively evaluated a group of patients with RVO under 50 years. The parameters of interest included age and sex, RVO type, presence of arterial hypertension (HT), hyperlipidaemia (HLD), diabetes mellitus (DM), congenital thrombophilic disorder (TD), obstructive sleep apnoea syndrome (OSAS), thyroid eye disease (TED), use of hormone contraception (HC) or hormone replacement therapy (HRT), glaucoma and other potential RFs. Patients with central RVO (CRVO), hemi-central RVO (HRVO), branch RVO (BRVO), impending CRVO and combined arterial-venous (AV) occlusion were included. RESULTS: The group consisted of 110 eyes of 103 patients. CV disease was the most common systemic abnormality. 55.3% patients had HT, 17.5% had HLD. TD was the third most frequent RF (12.6%). The cohort also included patients with DM (6.8%), glaucoma (6.8%) and women using HC/HRT (26.2% of female patients). There were isolated cases of RVO due to retinal vasculitis, intense exercise, antiphospholipid syndrome and COVID-19 pneumonia. None of the patients had OSAS, TED or a haemato-oncological disease. The etiology remained unexplained in 20.4% patients. No difference was observed in RF occurrence between patients with CRVO and HRVO and those with BRVO. CONCLUSION: The most common systemic abnormality in our cohort was CV disease, especially HT and HLD. The risk factors for central, hemi-central and branch RVOs were similar.

• Klíčová slova
• arterial hypertension, congenital thrombophilic disorder, hyperlipidaemia, retinal vein occlusion, risk factors, systemic comorbidities, younger patients,
• MeSH
• glaukom * MeSH
• hyperlipidemie * komplikace   epidemiologie   MeSH
• hypertenze * komplikace   epidemiologie   MeSH
• kardiovaskulární nemoci * MeSH
• lidé MeSH
• obstrukční spánková apnoe * MeSH
• okluze retinální žíly * epidemiologie   etiologie   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• trombofilie * komplikace   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH