Projection of new thresholds for hypertension to outpatient clinic patients and impact of risk factors: a cross-sectional study

ABSTRACT BACKGROUND: The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines on hypertension management recommend new stage 1 hypertension thresholds (130-139/80-89 mmHg) for starting antihypertensive treatment. OBJECTIVE: To analyze the impact of the 2017 ACC/AHA guidelines on patients' diagnoses within daily practice, in comparison with management using the 2018 European hypertension guidelines, regarding the new thresholds. DESIGN AND SETTING: Cross-sectional study conducted in a hypertension outpatient clinic at a tertiary-level public hospital. METHODS: The diagnosis of hypertension was defined separately using each guideline. The participants were patients who were attending the hypertension clinic, who were evaluated using the thresholds of two guidelines, based on cardiovascular risk factors, including age, gender, smoking status, diabetes mellitus, dyslipidemia, obesity, osteoporosis, chronic renal failure and family history of hypertension. RESULTS: After adapting the guidelines to the blood pressure values of our sample, 74.5% (n = 277) of the patients were diagnosed as hypertensive according to the blood pressure classification of the European Society of Cardiology (ESC) guidelines published in 2018, while 91.1% (n = 339) of the patients were hypertensive according to the new 2017 ACC/AHA guidelines. Multivariate regression analysis revealed that the significant demographic and cardiovascular risk factors associated with hypertension, based on the 2018 European Society of Hypertension (ESH)/ESC guidelines, were age (odds ratio, OR: 1.027; 95% confidence interval, CI: 1.001-1.054; P = 0.042), obesity (OR: 4.534; 95% CI: 1.830-11.237; P = 0.001) and family history of hypertension (OR: 2.199; 95% CI: 1.252-3.862; P = 0.006). CONCLUSIONS: The factors associated with the definition of hypertension may vary through changing the threshold values.

A Case Of Retroperitoneal Fibrosis As A Confusing Reason Of Positive FDG/PET.

Retroperitoneal fibrosis is a rare disease and characterized by the presence of fibrous and inflammatory retroperitoneal tissue. Fluorine-18-fluorodeoxyglucose positron emission tomography (FDG/PET)is a beneficial methods for inflammatory dieseases. We presented here a case of 40 year old woman with idiopathic retroperitoenal fibrosis which detected high SUVmax level (21.4) on FDG/PET and had high erythrocyte sedimentatiton rate (140mm/h). If high SUVmax is detected, histologic confirmation is necessary to exclude malignancies.

Eosinophilic Fasciitis And Associated Late Emerging Hodgkin Lymphoma.

Abstracts: Eosinophilic fasciitis is often seen between the ages of 40-50, and is characterized with skin thickening, and etiopathogenesis is still unclear. Patients diagnosed as eosinophilic fasciitis have accompanying hematologic diseases in less than 10 %. In cases reported previously in the literature with a diagnosis of eosinophilic fascitis, accompanying hematological malignancies and solid organ malignancies were within the first 5 years after diagnosis. We here present, in this case 58 years old male who diagnosed hodgkin lymphoma after 21 years of eosinophilic fasciitis.