Effect of hypertension duration on relationship between blood pressure and signs and symptoms in hypertensive patients:a cross sectional survey

Authors

  • Syeda Nosheen Zehra Department of Medicine, Liaqat National Hospital and Medical College, Karachi, Sindh, Pakistan
  • Adnan Anwar 2Department of Physiology, Altibri Medical College, Karachi, Sindh, Pakistan
  • Shahid Kamran Department of Forensic Medicine, Altibri Medical College, Karachi, Sindh, Pakistan
  • Hafsa Jawaid Medical Student, Dow University of Health Sciences, Karachi, Sindh, Pakistan
  • Syeda Maheen Department of Medicine, JPMC, Karachi, Sindh, Pakistan
  • Madiha Ariff Medical Officer, DUHS, Karachi, Sindh, Pakistan

DOI:

https://doi.org/10.18203/2320-6012.ijrms20192883

Keywords:

Blood pressure, Cross-sectional survey, Hypertension duration, Hypertensive patients, Signs and symptoms

Abstract

Background: Hypertension is defined as a systolic blood pressure of 140 mmHg or more, or a diastolic blood pressure of 90 mmHg or more or taking anti-hypertensive medication. The clinical presentation of high blood pressure may depend upon several factors such as age, gender, severity and duration of hypertension. There is a paucity of data exploring the role hypertension duration may play in shaping the relationship between blood pressure and signs and symptoms of hypertension. To evaluate the effect of hypertension duration on relationship between blood pressure and signs and symptoms in hypertensive patients.

Methods: A cross-sectional study was carried out among 250 patients, aged 18 or above, with self-reported history of hypertension and on anti-hypertensive medication. Data were collected by means of a structured questionnaire whereas the blood pressure level was measured with the help of sphygmomanometer using stethoscope. Inferential analysis was performed by applying chi-square test whereas the significance level was set at 0.05.

Results: The study results revealed that among patients with ≥5 years duration of hypertension headache history (P=0.021), edema (P=0.034), increased urinary frequency (P=0.031), sleep apnoea (P=0.016), palpitation (P=0.005) and confusion (p=0.021) were significantly associated with systolic whereas only increased urinary frequency (P=0.009) was significantly associated with diastolic blood pressure. Moreover, among patients with <5 years duration of hypertension vision problems (P=0.03), sleep apnoea (P=0.015) and palpitation (P=0.035) were significantly associated with systolic whereas sleep apnoea (P=0.048) and palpitation (P=0.028) were significantly associated with diastolic blood pressure.

Conclusions: The study results showed that patients with higher blood pressure were more likely to have the signs and symptoms of hypertension. Also, patients with longer duration of hypertension had greater number of signs and symptoms associated with systolic hypertension.

References

Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circul. 2012;125(22):e1002.

Kearney MP, Whelton M, Reynolds K, Muntner P, Whelton KP, Heet J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455): 217-23.

Noncommunicable Diseases Country Profile 2014. World Health Organization, 2014. Available at: http://www.who.int/nmh/publications/ncd-profiles-2014/en/. Accessed November 2018.

Pereira M, Lunet N, Azevedo A, Barros H. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens. 2009;27(5):963-75.

World Health Day. WHO, 2013. Available at: http://www.emro.who.int/world-health days/2013/overview.html. Accessed 5 January 2018.

Ibrahim MM, Damasceno A. Hypertension in developing countries. Lancet. 2012;380(9841):611-9.

Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903-13.

Messerli FH, Williams B, Ritz E. Essential hypertension. Lancet. 2007;370(9587):591-603.

Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159-219.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hyperten. 2003;42(6):1206-52.

Wei TM, Wang I. Anxiety symptoms in patients with hypertension: a community-based study. Int J Psychiatry Med. 2006;36(3):315-22.

D'Alonzo GE, Barst RJ, Ayres SM, Bergofsky EH, Brundage BH, Detre KM, et al. Survival in patients with primary pulmonary hypertension. Results from a national prospective registry. Ann Internal Med. 1991;115(5):343-9.

Hughes JS, Dove HG, Gifford Jr RW, Feinstein AR. Duration of blood pressure elevation in accurately predicting surgical cure of renovascular hypertension. Am Heart J. 1981;101(4):408-13.

Su TC, Lee YT, Chou S, Hwang WT, Chen CF, Wang JD. Twenty-four-hour ambulatory blood pressure and duration of hypertension as major determinants for intima-media thickness and atherosclerosis of carotid arteries. Atheroscl. 2006;184(1):151-6.

Alhadad A, Mattiasson I, Ivancev K, Gottsäter A, Lindblad B. Revascularisation of renal artery stenosis caused by fibromuscular dysplasia: effects on blood pressure during 7-year follow-up are influenced by duration of hypertension and branch artery stenosis. J Human Hypertens. 2005;19(10):761-7.

Kearney PM, Whelton M, Reynolds K, Whelton PK, He J. Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004;22(1):11-9.

Mazzucchi A, Mutti A, Poletti A, Ravanetti C, Novarini A, Parma M. Neuropsychological deficits in arterial hypertension. Acta Neurol Scand. 1986;73(6):619-27.

Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. JAMA. 2000;283(14):1829-36.

Carlson JT, Hedner JA, Ejnell H, Peterson LE. High prevalence of hypertension in sleep apnea patients independent of obesity. Am J Resp Critical Care Med. 1994;150(1):72-7.

Hla KM, Young TB, Bidwell T, Palta M, Skatrud JB, Dempsey J. Sleep apnea and hypertension: a population-based study. Ann Int Med. 1994;120(5):382-8.

Shepard JJ. Hypertension, cardiac arrhythmias, myocardial infarction, and stroke in relation to obstructive sleep apnea. Clin Chest Med. 1992;13(3):437-58.

Marin JM, Agusti A, Villar I, Forner M, Nieto D, Carrizo SJ, Jelic S, et al. Association between treated and untreated obstructive sleep apnea and risk of hypertension. JAMA. 2012;307(20):2169-76.

Wolk R, Shamsuzzaman AS, Somers VK. Obesity, sleep apnea, and hypertension. Hypertens. 2003;42(6):1067-74.

Williams AJ, Houston D, Finberg S, Lam CH, Kinney JL, Santiago S. Sleep apnea syndrome and essential hypertension. Am J Cardiol. 1985;55(8):1019-22.

Downloads

Published

2019-06-28

How to Cite

Zehra, S. N., Anwar, A., Kamran, S., Jawaid, H., Maheen, S., & Ariff, M. (2019). Effect of hypertension duration on relationship between blood pressure and signs and symptoms in hypertensive patients:a cross sectional survey. International Journal of Research in Medical Sciences, 7(7), 2588–2594. https://doi.org/10.18203/2320-6012.ijrms20192883

Issue

Section

Original Research Articles