A SciTechnol Journal Research Article
Sukkarieh et al., Int J Cardiovasc Res 2018, 7:3
DOI: 10.4172/2324-8602.1000349
International Journal of
Cardiovascular Research
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*Corresponding author: Hatouf H Sukkarieh, College of Medicine, Female
Branch, King Saud Bin Abdul-Aziz University for Health Sciences (KSAU-HS),
Mail code 3155, Riyadh, PO BOX 11481, Saudi Arabia, Tel: +966 11-42-99772;
Email: sukkariehh@ksau-hs.edu.sa
Received: March 23, 2018 Accepted: May 10, 2018 Published: May 16, 2018
The Impact of Height on
Clinical Management of
Hypertension in Primary Care
Hatouf H Sukkarieh
1
*, Rami T Bustami
2
, Nadia El Amin
1
and
Hadeel Al-khaneen
1
Abstract
Study demonstrated that hypertension was signifcantly more
controlled with increased height. Also, beta-blockers appeared to
be effective for controlling BP in hypertensive patients. High blood
pressure is one of the major well-being issues in most developed
and developing countries. It is considered a major risk factor for
cardiovascular and kidney diseases globally. Worldwide, about one
billion individuals were found to have high blood pressure and 13%
of all fatalities were carefully related to hypertension.
Keywords
Hypertension; Clinical management; Primary care; Elevated blood
pressure
that stature was related to a reduced occurrence of hypertension in the
elderly, independent of antihypertensive medicines. Also, gender had
a contributing efect; a study from Brazil reported that hypertension
was signifcantly more prevalent of hypertension afer adjustment for
age, pay, smoking, sodium and alcohol intake and race. Systolic blood
pressure showed a U-shaped association with stature, mainly among
women [2,4-7].
Te mechanism underlying the association between height and
hypertension is unclear. A connection to the dynamic properties of
the arterial tree has been reported. Tat is, individuals of short stature
may have shorter arterial tree, which will likely make the refected
waves arrive earlier in the central aorta and augment central pressure
and pulse pressure in late systole. Shorter stature in the elderly, low
BMD and fractures are associated with increased arterial stifness and
hypertension [2,5,6]. Another possible explanation could be nutrition
in childhood, where evidence across studies indicates that short adult
height in low and middle-income countries is driven by environmental
conditions, particularly net nutrition during early years. Height is not
only an important marker of malnutrition in childhood, but also a
marker of mother’s nutrition during pregnancy [2,5-7].
Most of the above listed studies were conducted in western
countries, and were based on exploring the association between height
and hypertension. However, evidence on the relatioship hypertension
and height in adult patients is lacking. Te aim of this study was to
explore the association between height and control of blood pressure
in middle-aged and elderly hypertensive adult patients.
Data and Methods
Tis retrospective study was conducted for a random sample
of patients in the outpatient primary care clinic in King Abdulaziz
Medical City (KAMC) in Riyadh during 2016-2017. Patients were
included if they had records of 3 consecutive blood pressure (BP)
readings at least 1 month apart. In addition to BP, data on several
patient demographic and medication-related data were also collected
including age, gender, weight, height, body mass index (BMI), co-
morbidities and antihypertensive medications including thiazide-type
diuretics, calcium channel blocker (CCB), angiotensin-converting
enzyme inhibitors (ACEI), or angiotensin receptor blocker (ARB).
Lack of BP control was defned as having a BP measure of ≥ 140/90 on
at least two consecutive readings (Figure 1).
Statistical analysis
Descriptive statistical analyses were performed for the study
sample. Continuous variables were summarized using mean (SD),
median and interquartile range (IQR). Proportions were used for
categorical variables. Management of hypertension (hypertension
control status) was assessed and compared by demographic and
clinical factors. Categorical data were analyzed using the chi-square
test. Te distribution of all continuous data will be examined. For
continuous variables with normal distribution, a t-test was used
for comparisons. If there was evidence against normality, the non-
parametric Mann-Whitney U test is utilized. A logistic regression
analysis was used to determine the efect of height on BP control.
Adjustments were made for several demographic and clinical factors
Introduction
Having high blood pressure is one of the major well-being
issues in most developed and developing countries. It is considered
a major risk factor for cardiovascular and kidney diseases globally.
Worldwide, about one billion individuals were found to have high
blood pressure and 13% of all fatalities were carefully related to
hypertension. Epidemiological studies have established risk factors
for hypertension, including obesity, high salt intake; alcohol drinking,
cigarette smoking, and sedentary lifestyles, but other factors remain
unexplored [1]. It has been found that hypertension is carefully
associated with body weight and size in US children. Tere is a high
chance that having hypertension at an early age can develop into
hypertension in adulthood [2].
Some evidence reveals an inverse relationship between height and
risk of diabetes, cardiac arrest, and death rate [3]. Despite having a
large number of publications regarding adult height, there seems to
be little integration of the epidemiological and the population health
perspectives on modern adult height. Te Epidemiological research
revealed that height was inversely associated with heart diseases.
Contradictory results were reported in regards to an association
between height and having high blood pressure. while other studies
reported a signifcant positive relationship between height and elevated
BP levels [4]. Tese studies demonstrated that stature was associated
with lower systolic blood pressure (SBP) and pulse pressure (PP) but not
with diastolic blood pressure (DBP). It has been additionally observed