151
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Du XP, Zheng ML, Yang XC, Zheng ML. High blood pressure is associated with increased risk of future fracture, but not vice versa. Sci Rep 2024; 14:8005. [PMID: 38580695 PMCID: PMC10997641 DOI: 10.1038/s41598-024-58691-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 04/02/2024] [Indexed: 04/07/2024] Open
Abstract
The association between high blood pressure and fracture showed obvious discrepancies and were mostly between hypertension with future fracture, but rarely between fracture and incident hypertension. The present study aims to investigate the associations of hypertension with future fracture, and fracture with incident hypertension. We included adult participants from the China Health and Nutrition Survey (CHNS) prospective cohort in 1997-2015 (N = 10,227), 2000-2015 (N = 10,547), 2004-2015 (N = 10,909), and 2006-2015 (N = 11,121) (baseline in 1997, 2000, 2004, 2006 respectively and outcome in 2015). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. In the analysis of the association between hypertension and future fracture, the adjusted HRs (95% CIs) were 1.34 (0.95-1.90) in 1997-2015, 1.40 (1.04-1.88) in 2000-2015, 1.32 (0.98-1.78) in 2004-2015, and 1.38 (1.01-1.88) in 2006-2015. In the analysis of the association between fracture and incident hypertension, the adjusted HRs (95% CIs) were 1.28 (0.96-1.72) in 1997-2015, 1.18 (0.94-1.49) in 2000-2015, 1.12 (0.89-1.40) in 2004-2015, and 1.09 (0.85-1.38) in 2006-2015. The present study showed that hypertension history was associated with increased risk of future fracture, but not vice versa.
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Affiliation(s)
- Xiang-Peng Du
- Department of Cardiology, Weihaiwei People's Hospital, Weihai, Shandong, China
| | - Mei-Liang Zheng
- Department of Orthopedics, The Second Central Hospital of Baoding, Zhuozhou, Hebei, China
| | - Xin-Chun Yang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chao-Yang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, China
| | - Mei-Li Zheng
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chao-Yang Hospital, Capital Medical University, 8# Gong-Ti South Road, Beijing, China.
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152
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Bu Y, Liu Y, Zhou M, Yin P, Liu K, Bai Y, Lu X. The Burden of Hypertension-Related Chronic Kidney Disease - China, 2010-2019. China CDC Wkly 2024; 6:282-288. [PMID: 38634099 PMCID: PMC11018709 DOI: 10.46234/ccdcw2024.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/22/2024] [Indexed: 04/19/2024] Open
Abstract
What is already known about this topic? The global burden of chronic kidney disease (CKD) is on the rise. What is added by this report? In 2019, 5.58 million individuals in China were affected by CKD related to hypertension, leading to 70,260 fatalities and 1.69 million disability-adjusted life years (DALYs). The most affected groups were men, older individuals, and residents of western China. Over the period from 2010-2019, the age-standardized prevalence rate (ASPR) remained constant, and the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) showed a decreasing trend. However, there was an increase in the number of cases, deaths, and DALYs associated with this condition. What are the implications for public health practice? Hypertension significantly contributes to the burden of CKD; therefore, raising awareness and implementing early screening measures are essential.
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Affiliation(s)
- Youyuan Bu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yueru Liu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center For Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center For Disease Control and Prevention, Beijing, China
| | - Peng Yin
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center For Disease Control and Prevention, Beijing, China
| | - Kejun Liu
- China National Health Development Research Center, Beijing, China
| | - Yamin Bai
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center For Disease Control and Prevention, Beijing, China
| | - Xuancheng Lu
- Chinese Center for Disease Control and Prevention, Beijing, China
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153
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Monower MM, Abid SUA, Abrar AK, Choudhury SR. Salt intake across the hypertension care cascade in the Bangladeshi adult population: a nationally representative cross-sectional study. BMJ Open 2024; 14:e081913. [PMID: 38580369 PMCID: PMC11002389 DOI: 10.1136/bmjopen-2023-081913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 03/27/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVES This study aimed to examine the distribution of daily salt intake across the hypertension care cascade and assess the proportional distribution of these care cascade categories across various salt consumption level. DESIGN A population-based national cross-sectional study. SETTINGS Data from the Bangladesh STEPS 2018 survey were used, encompassing both urban and rural strata within all eight divisions. National estimates were generated from weighted data. PARTICIPANTS A diverse population of 6754 men and women aged 18-69 years was included in the study. OUTCOME MEASURES Daily salt consumption was estimated using the spot urine sodium concentration following Tanaka equation. Distribution of salt intake among different categories of hypertension care cascade, including hypertensives, aware of hypertension status, on treatment and under control, was assessed. RESULTS Individuals with hypertension consume more salt on average (9.18 g/day, 95% CI 9.02 to 9.33) than those without hypertension (8.95 g/day, 95% CI 8.84 to 9.05) (p<0.02). No significant differences were found in salt intake when comparing aware versus unaware, treated versus untreated and controlled versus uncontrolled hypertension. In the overall population, 2.7% (95% CI 2.1% to 3.6%) of individuals without hypertension adhered to the recommended salt intake (<5 g/day) while 1.6% (95% CI 1.0% to 2.4%) with hypertension did so (p<0.03). Among individuals with hypertension, 2.4% (95% CI 1.4% to 4.0%) of those aware followed the guideline while only 0.8% (95% CI 0.4% to 1.9%) of those unaware adhered (p<0.03). Additionally, no significant differences were observed in adherence between the treated versus untreated and controlled versus uncontrolled hypertension. CONCLUSIONS Individuals with hypertension consume significantly more salt than those without, with no significant variations in salt intake based on aware, treated and controlled hypertension. Adhering to WHO salt intake guidelines aids better blood pressure management. By addressing salt consumption across hypertension care cascade, substantial progress can be made in better blood pressure control.
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Affiliation(s)
- Md Mostafa Monower
- Deaprtment of Epidemiology & Research, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - Shehab Uddin Al Abid
- Deaprtment of Epidemiology & Research, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - Ahmad Khairul Abrar
- Deaprtment of Epidemiology & Research, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
| | - Sohel Reza Choudhury
- Deaprtment of Epidemiology & Research, National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh
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154
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Suzuki Y, Kaneko H, Okada A, Komuro J, Mizuno A, Fujiu K, Jo T, Takeda N, Morita H, Nishiyama A, Yano Y, Node K, Yasunaga H, Komuro I. Awareness of Being Prescribed Antihypertensive Medications and Cardiovascular Outcomes. Circ J 2024:CJ-24-0039. [PMID: 38569871 DOI: 10.1253/circj.cj-24-0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
BACKGROUND Hypertension is a major cause of cardiovascular disease (CVD). In patients with hypertension, unawareness of the disease often results in poor blood pressure control and increases the risk of CVD. However, data in nationwide surveys regarding the proportion of unaware individuals and the implications of such on their clinical outcomes are lacking. We aimed to clarify the association between unawareness of being prescribed antihypertensive medications among individuals taking antihypertensive medications and the subsequent risk of developing CVD.Methods and Results: This retrospective cohort study analyzed data from the JMDC Claims Database, including 313,715 individuals with hypertension treated with antihypertensive medications (median age 56 years). The primary endpoint was a composite of myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation. Overall, 19,607 (6.2%) individuals were unaware of being prescribed antihypertensive medications. During the follow-up period, 33,976 composite CVD endpoints were documented. Despite their youth, minimal comorbidities, and the achievement of better BP control with a reduced number of antihypertensive prescriptions, unawareness of being prescribed antihypertensive medications was associated with a greater risk of developing composite CVD. Hazard ratios of unawareness of being prescribed antihypertensive medications were 1.16 for myocardial infarction, 1.25 for angina pectoris, 1.15 for stroke, 1.36 for heart failure, and 1.28 for atrial fibrillation. The results were similar in several sensitivity analyses, including the analysis after excluding individuals with dementia. CONCLUSIONS Among individuals taking antihypertensive medications, assessing the awareness of being prescribed antihypertensive medications may help identify those at high risk for CVD-related events.
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Affiliation(s)
- Yuta Suzuki
- Department of Cardiovascular Medicine, The University of Tokyo
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Advanced Cardiology, The University of Tokyo
| | - Akira Okada
- Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo
| | - Jin Komuro
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Cardiology, Keio University School of Medicine
| | - Atsushi Mizuno
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Cardiovascular Medicine, St. Luke's International Hospital
- Leonard Davis Institute for Health Economics, University of Pennsylvania
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Advanced Cardiology, The University of Tokyo
| | - Taisuke Jo
- Department of Health Services Research, The University of Tokyo
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, The University of Tokyo
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo
| | - Akira Nishiyama
- Department of Pharmacology, Faculty of Medicine, Kagawa University
| | - Yuichiro Yano
- Department of General Medicine, Juntendo University Faculty of Medicine
- Department of Family Medicine and Community Health, Duke University
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo
- Department of Frontier Cardiovascular Science, Graduate School of Medicine, The University of Tokyo
- International University of Health and Welfare
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155
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Alam MZ, Sheoti IH. The burden of diabetes and hypertension on healthy life expectancy in Bangladesh. Sci Rep 2024; 14:7936. [PMID: 38575655 PMCID: PMC10995204 DOI: 10.1038/s41598-024-58554-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 04/01/2024] [Indexed: 04/06/2024] Open
Abstract
Diabetes and hypertension are among the leading causes of death in Bangladesh. This study examined hypertension, diabetes, and either or both, free life expectancy, to measure the effect of the diseases on the overall health of individuals in Bangladesh with regional variations. We utilized data from Bangladesh Sample Vital Statistics 2018 for mortality and Bangladesh Demographic and Health Survey 2017-2018 for diabetes and hypertension. The Sullivan method was employed to estimate age-specific hypertension and diabetes-free life expectancy. Altogether, 10.3% of the people aged 18-19 years lived with either diabetes or hypertension. The hypertension-free life expectancy was 40.4 years, and the diabetes-free life expectancy was 53.2 years for those aged 15-19. Overall, individuals would expect to spend 38.7% of their lives with either of the diseases. Females suffered more from hypertension and males from diabetes. Still, females suffered more from the aggregate of both. Rural people had more diabetes and hypertension-free life expectancy than those of urban. Individuals of Mymensingh had the highest life expectancy free of both diseases compared to other divisions of Bangladesh. Diabetes and hypertension affect a considerable proportion of the life of the population in Bangladesh. Policy actions are needed to guide the prevention, diagnosis, and treatment of both diseases, specifically focusing on women and urban populations. Widespread health-enhancing actions need to be taken to diminish the effect of these two diseases in Bangladesh.
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Affiliation(s)
- Md Zakiul Alam
- Department of Population Sciences, University of Dhaka, Dhaka, 1000, Bangladesh.
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Maryland, 21205, USA.
| | - Isna Haque Sheoti
- Department of Population Sciences, University of Dhaka, Dhaka, 1000, Bangladesh
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156
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Wang R, Liu Y, Zhang Q, Zhang J, Peng H, Shi M, Peng Y, Xu T, Wang A, Xu T, Chen J, Zhang Y, He J. Twenty-four-hour blood pressure trajectories and clinical outcomes in patients who had an acute ischaemic stroke. Heart 2024:heartjnl-2023-323821. [PMID: 38569853 DOI: 10.1136/heartjnl-2023-323821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/19/2024] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE The management of blood pressure (BP) in acute ischaemic stroke remains a subject of controversy. This investigation aimed to explore the relationship between 24-hour BP patterns following ischaemic stroke and clinical outcomes. METHODS A cohort of 4069 patients who had an acute ischaemic stroke from 26 hospitals was examined. Five systolic BP trajectories were identified by using latent mixture modelling: trajectory category 5 (190-170 mm Hg), trajectory category 4 (180-140 mm Hg), trajectory category 3 (170-160 mm Hg), trajectory category 2 (155-145 mm Hg) and trajectory category 1 (150-130 mm Hg). The primary outcome was a composite outcome of death and major disability at 3 months poststroke. RESULTS Patients with trajectory category 5 exhibited the highest risk, while those with trajectory category 1 had the lowest risk of adverse outcomes at 3-month follow-up. Compared with the patients in the trajectory category 5, adjusted ORs (95% CIs) for the primary outcome were 0.79 (0.58 to 1.10), 0.70 (0.53 to 0.93), 0.64 (0.47 to 0.86) and 0.47 (0.33 to 0.66) among patients in trajectory category 4, trajectory category 3, trajectory category 2 and trajectory category 1, respectively. Similar trends were observed for death, vascular events and the composite outcome of death and vascular events. CONCLUSION Patients with persistently high BP at 180 mm Hg within 24 hours of ischaemic stroke onset had the highest risk, while those maintaining stable BP at a moderate-low level (150 mm Hg) or even a low level (137 mm Hg) had more favourable outcomes.
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Affiliation(s)
- Ruirui Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yang Liu
- Department of Cardiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Qilu Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Jing Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Hao Peng
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Mengyao Shi
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yanbo Peng
- Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan, Hebei, China
| | - Tian Xu
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA
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157
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Li Z, Guo JP, Huang L. Perimenopausal syndrome and hypertension during perimenopause in South China: prevalence, relationships and risk factors. BMC Womens Health 2024; 24:215. [PMID: 38570811 PMCID: PMC10988979 DOI: 10.1186/s12905-024-03056-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 03/27/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND More than 2 billion women are experiencing the menopausal transition in China, and some of these women have hypertension. Limited studies has focused on perimenopausal syndrome and hypertension in a specific population, so we aimed to investigate the prevalence of perimenopausal syndrome and hypertension and to analyse their relationships and risk factors in perimenopausal women in South China. METHODS This cross-sectional study included 3553 women aged 40 to 60 years from South China. We collected medical report, lifestyle, blood sample, general condition questionnaire, and modified Kupperman index (mKMI) data. Multivariate logistic regression analysis was performed to identify risk factors for perimenopausal syndrome and hypertension during perimenopause. RESULTS The prevalence of hypertension in perimenopause patients was 16.58%, and the prevalence of perimenopausal syndrome was 9.9%. Compared with women without hypertension during perimenopause, women with HTN during perimenopause had an increased risk of perimenopausal syndrome (26.4% vs. 8.7%, P < 0.001). Lipid levels and urinary tract infections were risk factors for hypertension and perimenopausal syndrome, in addition to the presence of breast nodules, the intake of snacks at night, high-salt diets, red meat and sugar-sweetened beverages, and a history of smoking and drinking for perimenopausal syndrome and the presence of gestational hypertension and diabetes for hypertension. CONCLUSION We concluded that perimenopausal syndrome and HTN are common in perimenopausal women in South China, and the associations between them are strong and positive. Perimenopausal syndrome shares some common risk factors with HTN during perimenopause, such as BMI and dyslipidaemia. Therefore, gynaecological endocrinologists in China should consider screening for perimenopausal syndrome in hypertensive perimenopausal women, and appropriate management of perimenopause is needed to alleviate these conditions.
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Affiliation(s)
- Zheng Li
- Obstetrics and Gynecology, Wuyunshan Hospital of Hangzhou, Hangzhou, 310000, China
| | - Jun-Ping Guo
- Obstetrics and Gynecology, Wuyunshan Hospital of Hangzhou, Hangzhou, 310000, China.
| | - Liu Huang
- Medical School, Hangzhou Normal University, Hangzhou, 310000, China
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158
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Mohseni P, Khalili D, Djalalinia S, Mohseni H, Farzadfar F, Shafiee A, Izadi N. The synergistic effect of obesity and dyslipidemia on hypertension: results from the STEPS survey. Diabetol Metab Syndr 2024; 16:81. [PMID: 38566160 PMCID: PMC10988884 DOI: 10.1186/s13098-024-01315-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Obesity and dyslipidemia are important risk factors for hypertension (HTN). When these two conditions coexist, they may interact in a synergistic manner and increase the risk of developing HTN and its associated complications. The aim of this study was to investigate the synergistic effect of general and central obesity with dyslipidemia on the risk of HTN. METHOD Data from 40,387 individuals aged 25 to 64 years were obtained from a repeated cross-sectional study examining risk factors for non-communicable diseases (STEPS) in 2007, 2011 and 2016. Body mass index (BMI) was calculated as a measure of general obesity and waist circumference (WC) as a measure of central obesity. Dyslipidemia was defined as the presence of at least one of the lipid abnormalities. Hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or current use of antihypertensive medication. To analyze the synergistic effect between obesity and dyslipidemia and HTN, the relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI) were calculated. A weighted logistic regression model was performed to estimate the odds ratios (ORs) for the risk of HTN. RESULTS The results showed an association between obesity, dyslipidemia and hypertension. The interaction between obesity and dyslipidemia significantly influences the risk of hypertension. In hypertensive patients, the presence of general obesity increased from 14.55% without dyslipidemia to 64.36% with dyslipidemia, while central obesity increased from 13.27 to 58.88%. This interaction is quantified by RERI and AP values of 0.15 and 0.06 for general obesity and 0.24 and 0.09 for central obesity, respectively. The corresponding SI of 1.11 and 1.16 indicate a synergistic effect. The OR also show that the risk of hypertension is increased in the presence of obesity and dyslipidemia. CONCLUSION Obesity and dyslipidemia are risk factors for HTN. In addition, dyslipidemia with central obesity increases the risk of HTN and has a synergistic interaction effect on HTN. Therefore, the coexistence of obesity and lipid abnormalities has many clinical implications and should be appropriately monitored and evaluated in the management of HTN.
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Affiliation(s)
- Parisa Mohseni
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Hamideh Mohseni
- Islamic Azad University of Larestan, Lar, Islamic Republic of Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Arman Shafiee
- School of Medicine, Alborz University of Medical Sciences, Alborz, Islamic Republic of Iran
| | - Neda Izadi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
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159
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Chandrasekharam VVS, Babu R, Shah M. How effective is nephrectomy in curing hypertension in children with unilateral poorly functioning kidney? A systematic review. Pediatr Surg Int 2024; 40:96. [PMID: 38568219 DOI: 10.1007/s00383-024-05676-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE Some children with hypertension (HTN) have unilateral poorly functional kidney (PFK). This provides an opportunity for the clinician to cure the HTN by removal of the PFK, thereby avoiding the problems of long-term medication. However, there is sparse data in children regarding the effect of PFK nephrectomy on curing HTN. In this review, we analysed the etiology of PFK causing HTN and the effectiveness of nephrectomy in curing HTN in children. METHODS We searched the databases to identify papers between January 2000 to December 2020 pertaining to children with PFK and HTN who underwent nephrectomy. Outcome analyzed was the resolution of HTN following nephrectomy. Duplicate publications, review articles and incomplete articles were excluded. Meta-analysis of heterogeneity was reported with I2statistics. Forest plot was constructed to compare the pooled prevalence of HTN resolution. RESULTS Five articles with 88 patients were included. Majority (43%) of PFK were due to the unilateral atrophic kidney with or without vesicoureteral reflux (VUR); ureteropelvic junction obstruction and multicystic dysplastic kidney together accounted for 35% of cases and renovascular pathology for 22% of cases. With a follow-up of 1.5 to 3.3 years, nephrectomy was effective to cure HTN in 65.9% (95% CI 55-75%) children. CONCLUSIONS In children with HTN and a unilateral PFK, nephrectomy cured the HTN in two-thirds of children. Unilateral atrophic kidney due to VUR was the most common cause of PFK. An increase in the utilisation of laparoscopy was observed in recent publications, hence laparoscopic nephrectomy may be considered a first choice of treatment in these children.
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Affiliation(s)
- V V S Chandrasekharam
- Pediatric Urology, Pediatric Surgery & MIS, Ankura Hospitals for Women and Children, Hyderabad, India.
| | | | - Mehul Shah
- Pediatric Nephrology, Apollo Hospitals, Hyderabad, India
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160
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Huang WC, Tsai KZ, Yang KT, Chen HH, Kwon Y, Lin GM. A comparison of various insulin resistance indices and the possibility of hypertension in military adults: CHIEF study. Diabetol Metab Syndr 2024; 16:78. [PMID: 38566188 PMCID: PMC10986110 DOI: 10.1186/s13098-024-01323-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/28/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Insulin resistance is associated with the development of hypertension, whereas there were rare studies comparing various non-insulin based insulin resistance (NI-IR) indices for the possibility of hypertension among young and middle-aged adults. METHODS This cross-sectional study included a total of 4,080 military personnel, aged 18-50 years, without antihypertensive medications therapy in 2014. All subjects received annual health examinations for blood pressure (BP) measurements. Stage I isolated diastolic hypertension (IDH) and isolated systolic hypertension (ISH) and combined hypertension were respectively defined as systolic BP (SBP) < 130 mmHg/diastolic BP (DBP) 80-89 mmHg, SBP 130-139 mmHg/DBP < 80 mmHg, and SBP 130-139 mmHg/DBP 80-89 mmHg. The cut-off values of stage II hypertension for SBP and DBP were 140-159 mmHg and 90-99 mmHg, respectively. Four NI-IR indices included the serum triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio, TyG index, Metabolic Score for IR (METS-IR) and ZJU index which were defined according to their specific formula. Multiple logistic regression analysis with adjustments for age, sex, anthropometrics, substance use, kidney function, serum uric acid, atherogenic cholesterols and physical activity was performed to determine the associations. RESULTS There were 1,024 subjects with hypertension (25.1%) in which 739 were stage I hypertension, and 285 were stage II hypertension. For total hypertension, there were an association with TyG and METS-IR indices [odds ratios (ORs) and 95% confidence intervals: 1.432 (1.215-1.688) and 1.553 (1.040-2.321), respectively]. For hypertension subtypes, TyG index was positively associated with overall, stage I, and stage II ISH [ORs: 1.447 (1.149-1.823), 1.317 (1.029-1.687), and 2.011 (1.351-2.994), respectively], while TG/HDL-C, METS-IR and ZJU indices were merely associated with stage II ISH [ORs: 1.053 (1.006-1.103), 3.001 (1.171-7.696) and 1.009 (1.000-1.017), respectively]. In addition, TyG and METS-IR indices were positively associated with stage II IDH [ORs: 1.813 (1.207-2.721) and 2.85 (1.080-7.520), respectively], and TyG index was also associated with combined hypertension [OR: 1.425 (1.007-1.833)]. CONCLUSION Among young and middle-aged adults, insulin resistance assessed by the four NI-IR indices was positively associated with stage II ISH, while only TyG index had a significant association for both stage II IDH and combined hypertension.
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Affiliation(s)
- Wei-Che Huang
- Department of Internal Medicine, Hualien-Armed Forces General Hospital, No. 100, Jinfeng St., 970, Hualien City, Taiwan
- Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kun-Zhe Tsai
- Department of Internal Medicine, Hualien-Armed Forces General Hospital, No. 100, Jinfeng St., 970, Hualien City, Taiwan
- Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Periodontology, School of Dentistry, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Kai-Ti Yang
- Department of Surgery, Mennonite Christian Hospital, Hualien, Taiwan
| | - Han-Hsing Chen
- Department of Internal Medicine, Mennonite Christian Hospital, Hualien, Taiwan
| | - Younghoon Kwon
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Gen-Min Lin
- Department of Internal Medicine, Hualien-Armed Forces General Hospital, No. 100, Jinfeng St., 970, Hualien City, Taiwan.
- Departments of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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161
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Gebre M, Alemayehu Beyene G, Muktar E, Zewdie A, Asfaw A, Wasie Kasahun A, Kemal A, Oumer A. Dietary determinants of overnutrition among hypertensive patients in southwest Ethiopia: an ordinal regression model. Sci Rep 2024; 14:7781. [PMID: 38565589 PMCID: PMC10987611 DOI: 10.1038/s41598-024-57496-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
Overnutrition is a recognized risk factor for hypertension, but evidence is lacking among hypertensive patients for tailored dietary interventions. This study assessed dietary factors in 331 hypertensive patients in southwest Ethiopia. The data was collected through a questionnaire and analyzed using factor analysis. Body mass index (BMI) was calculated, and a BMI above 25 kg m-2 was considered overnutrition. An ordinal logistic regression model was used to model the data and control confounders. Adjusted odds ratio and p-values were reported. Among the 331 respondents, consumption of cereals and grains (57.0%); roots and tubers (58.5); and legumes (50.0%), while 28.6% drink alcohol, was common. About 29.0% (24.1-34.2) had overnutrition (22%, 17.6-26.6%, overweight and 7.0%, 4.5-10.3%, obesity). While the predicted odds of overnutrition were higher among males (AOR = 2.85; 1.35-6.02), married (AOR = 1.47; 0.69-3.12), illiterates (AOR = 2.09; 1.18-3.72), advanced age (AOR = 1.65; 0.61-4.61), government employees (AOR = 6.83; 1.19-39.2), and urban dwellers (AOR = 4.06; 1.76-9.36), infrequent vegetable consumption (AOR = 1.47; 0.72-2.96) and lower and higher terciles of cereals and animal-source food consumption (AOR = 1.56; 0.72-3.34). Overnutrition among hypertensive patients was significantly high and associated with unhealthy dietary consumption, educational status, residence, and occupation, emphasizing the need for targeted dietary counseling.
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Affiliation(s)
- Melaku Gebre
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Gubre, Ethiopia
| | - Girma Alemayehu Beyene
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Gubre, Ethiopia
| | - Ebrahim Muktar
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Gubre, Ethiopia
| | - Amare Zewdie
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Gubre, Ethiopia
| | - Agize Asfaw
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Gubre, Ethiopia
| | - Abebaw Wasie Kasahun
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Gubre, Ethiopia
| | - Abdurezak Kemal
- Department of Health, Behavior and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abdu Oumer
- School of Public Health, College of Medicine and Health Sciences, Haramaya University, Harar, Ethiopia.
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162
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Cerezo GH, Fernández RA, Enders JE, Vicario A. Predicting cognitive function and dementia risk in patients with hypertension. Hypertens Res 2024:10.1038/s41440-024-01650-6. [PMID: 38565698 DOI: 10.1038/s41440-024-01650-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/30/2024] [Accepted: 03/01/2024] [Indexed: 04/04/2024]
Abstract
In spite of the fact that hypertension stand out as the main vascular risk factor for developing dementia, it is essential to acknowledge the presence of other risk factors, both vascular and non-vascular that contribute to increase this risk. This study stratified the dementia risk using CAIDE (Cardiovascular Risk Factors, Aging, and Incidence of Dementia) dementia risk score in a sample of 1279 hypertensive patients from the Heart-Brain Study in Argentina and to observed the association between the risk factors include in the CAIDE score and the current cognitive status. The average age of the sample was 60.2 ± 13.5 years (71% female) and the average years of education was 9.9 ± 5.1 years. To assess the current cognitive status, we used the Mini-mental test (MMSE), the clock drawing test (CDT) and Mini-Boston test. According to CAIDE score ( ≥9 points) the risk of dementia was 40.4% in the total sample and 28.1% in the middle-life hypertensive patients (between 47 to 53 years). An inverse association was observed between CAIDE score and the results of current cognitive tests (MMSE = R2 0.9128, p < 0.0001; CDT = R2 0.9215, p < 0.0001 y Mini-Boston= R2 0.829, p < 0.0001). The CAIDE score can predict the risk of dementia in hypertensive patients and its result was associated with the current cognitive status (result of cognitive tests).
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Affiliation(s)
- Gustavo H Cerezo
- Heart and Brain Unit. ICBA-Cardiovascular Institute, Buenos Aires, Argentina
| | - Ruth A Fernández
- Health Public School. Córdoba National University, Córdoba, Argentina
| | - Julio E Enders
- Health Public School. Córdoba National University, Córdoba, Argentina
| | - Augusto Vicario
- Heart and Brain Unit. ICBA-Cardiovascular Institute, Buenos Aires, Argentina.
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163
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Pokeerbux MR, Mavingui P, Gérardin P, Agrinier N, Gokalsing E, Meilhac O, Cournot M. A Holistic Approach to Cardiometabolic and Infectious Health in the General Population of Reunion Island: The REUNION Study. J Epidemiol Glob Health 2024:10.1007/s44197-024-00221-9. [PMID: 38564109 DOI: 10.1007/s44197-024-00221-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Reunion Island is a French overseas department in the South West Indian Ocean with a unique multi-ethnic population. Cardiovascular diseases are the most common chronic conditions with higher prevalences of hypertension and diabetes compared to mainland France. Moreover, Reunion Island is particularly exposed to vector-borne diseases such as chikungunya and dengue. Our objective is to describe the prevalence of cardiometabolic and infectious diseases in Reunion Island and explore causal mechanisms linking these diseases. METHODS The REUNION study is an ongoing French prospective study. From January 2022, 2,000 consenting participants (18-68 years old) are being recruited from the general population according to polling lists and random generation of cellphone number. Baseline examination consists of (i) general health examination, assessment of cardiovascular risk factors, markers of subclinical atherosclerosis, bronchial obstruction, neuropathic and autonomic dysfunction, (ii) questionnaires to determine sociodemographic characteristics, diet, exposure to vector-borne diseases, mental health and cognitive functions, social inequalities in health and ethnic origins, (iii) biological sampling for determination of cardiovascular risk factors, seroprevalence of infectious diseases, innovative lipid biomarkers, advanced omics, composition of intestinal, periodontal and skin microbiota, and biobanking. CONCLUSIONS The REUNION study should provide new insights into the prevalence of cardiometabolic and infectious diseases, as well as their potential associations through the examination of various environmental pathways and a wide range of health aspects.
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Affiliation(s)
- Mohammad Ryadh Pokeerbux
- Université de La Réunion, UMR Diabète Athérothrombose Réunion Océan Indien (DéTROI), INSERM U1188, Saint-Pierre, La Réunion, 97410, France.
| | - Patrick Mavingui
- Université de La Réunion, UMR Processus Infectieux en Milieu Insulaire et Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Sainte-Clotilde, La Réunion, 97490, France
| | - Patrick Gérardin
- Plateforme de Recherche Clinique et Translationnelle, INSERM CIC1410, CHU de La Réunion, Saint-Pierre, La Réunion, 97400, France
| | - Nelly Agrinier
- CHRU-Nancy, Université de Lorraine, CIC, Epidémiologie clinique, Inserm, Nancy, F-54000, France
- Université de Lorraine, Inserm, INSPIIRE, Nancy, F-54000, France
| | - Erick Gokalsing
- Etablissement Public de Santé Mentale de La Réunion, 42 chemin du Grand Pourpier, 97866, Saint-Paul Cedex, France
- Laboratoire IRISSE (IngéniéRIe de la Santé, du Sport et de l'Environnement), Université de La Réunion, UFR SHE, Saint Pierre, EA, 4075, France
| | - Olivier Meilhac
- Université de La Réunion, UMR Diabète Athérothrombose Réunion Océan Indien (DéTROI), INSERM U1188, Saint-Pierre, La Réunion, 97410, France
- Plateforme de Recherche Clinique et Translationnelle, INSERM CIC1410, CHU de La Réunion, Saint-Pierre, La Réunion, 97400, France
| | - Maxime Cournot
- Université de La Réunion, UMR Diabète Athérothrombose Réunion Océan Indien (DéTROI), INSERM U1188, Saint-Pierre, La Réunion, 97410, France
- Groupe de santé Clinifutur, Clinique Les Orchidées, Le Port, La Réunion, 97420, France
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164
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Ishii T, Tamura K. Blood pressure in the longevous population with different status of hypertension and frailty. Hypertens Res 2024:10.1038/s41440-024-01618-6. [PMID: 38565700 DOI: 10.1038/s41440-024-01618-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/20/2024] [Accepted: 01/27/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Takeo Ishii
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Yokohama, Japan.
- Yokohama Daiichi Hospital Zenjinkai, Yokohama, Japan.
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Yokohama, Japan
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165
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Zhang X, Wei R, Wang X, Zhang W, Li M, Ni T, Weng W, Li Q. The neutrophil-to-lymphocyte ratio is associated with all-cause and cardiovascular mortality among individuals with hypertension. Cardiovasc Diabetol 2024; 23:117. [PMID: 38566082 PMCID: PMC10985955 DOI: 10.1186/s12933-024-02191-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Identifying reliable prognostic markers is crucial for the effective management of hypertension. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a potential inflammatory marker linked to cardiovascular outcomes. This study aims to investigate the association of NLR with all-cause and cardiovascular mortality among patients with hypertension. METHODS This study analyzed data from 3067 hypertensive adults in the National Health and Nutritional Examination Surveys (NHANES) from 2009 to 2014. Mortality details were obtained from the National Death Index (NDI). Restricted cubic spline (RCS) was deployed to visualize the association of the NLR with mortality risk. Weighted Cox proportional hazards models were employed to assess the independent association of NLR with mortality risk. Time-dependent receiver operating characteristic curve (ROC) analysis was conducted to access the predictive ability of NLR for survival. Mediation analysis was used to explore the indirect impact of NLR on mortality mediated through eGFR. RESULTS Over a median 92.0-months follow-up, 538 deaths occurred, including 114 cardiovascular deaths. RCS analysis revealed a positive association between NLR and both all-cause and cardiovascular mortality. Participants were stratified into higher (> 3.5) and lower (≤ 3.5) NLR groups. Weighted Cox proportional hazards models demonstrated that individuals with higher NLR had a significantly increased risk of all-cause (HR 1.96, 95% confidence interval (CI) 1.52-2.52, p < 0.0001) and cardiovascular mortality (HR 2.33, 95% CI 1.54-3.51, p < 0.0001). Stratified and interaction analysis confirmed the stability of the core results. Notably, eGFR partially mediated the association between NLR and both all-cause and cardiovascular mortality by a 5.4% and 4.7% proportion, respectively. Additionally, the areas under the curve (AUC) of the 3-, 5- and 10- year survival was 0.68, 0.65 and 0.64 for all-cause mortality and 0.68, 0.70 and 0.69 for cardiovascular mortality, respectively. CONCLUSION Elevated NLR independently confers an increased risk for both all-cause and cardiovascular mortality in individuals with hypertension.
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Affiliation(s)
- Xuexue Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Rui Wei
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xujie Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Wantong Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Mengxuan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- China Academy of Chinese Medical Sciences, Beijing, China
| | - Tian Ni
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weiliang Weng
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, No. 1, Xiyuan Playground, Zhong Zhi Road, Hai Dian District, Beijing, 100091, China.
| | - Qiuyan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
- Department of General Medicine, Xiyuan Hospital, China Academy of Chinese Medical Sciences, No. 1, Xiyuan Playground, Zhong Zhi Road, Hai Dian District, Beijing, 100091, China.
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166
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Lemp JM, Pengpid S, Buntup D, Sornpaisarn B, Peltzer K, Geldsetzer P, Probst C. Stakeholder-Informed Solutions To Address Barriers for Alcohol Screening and Brief Intervention in Thai Hypertension Care. J Prev (2022) 2024; 45:227-236. [PMID: 38148463 DOI: 10.1007/s10935-023-00763-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 12/28/2023]
Abstract
Premature deaths from NCDs disproportionately affect people in low- and middle-income countries. Since alcohol use is one of the most common causes of reversible hypertension, interventions targeting alcohol use may be a feasible and effective low-cost approach to synergistically reduce the prevalence of harmful drinking and high blood pressure. This study sought to identify key factors in successfully implementing alcohol use screening and brief intervention in hypertension care in Thailand. For this purpose, we surveyed participants (NRound 1 = 91, NRound 2 = 27) from three different groups of Thai stakeholders (policy- and decisionmakers, primary healthcare practitioners, and patients diagnosed with hypertension) in a two-round stakeholder elicitation. In round 1, we identified limited resources, lack of clear guidelines for lifestyle intervention, stigmatization, and inconsistent monitoring of patients' alcohol use as important barriers. In round 2, we sought to elicit solutions for the barriers identified in round 1. While stakeholders emphasized the need for adaptability to existing realities in Thai primary healthcare such as a high workload and limited digitization, they favorably evaluated a digital alcohol assessment tool with integrated, tailored advice for brief intervention as a potential scalable solution. Findings suggest that as one possible route to reduce the NCD burden caused by hypertension in Thailand, primary healthcare services may be enhanced by digital tools that support resource-effective, intuitive, and seamless delivery of alcohol screening and brief intervention.
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Affiliation(s)
- Julia M Lemp
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Doungjai Buntup
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand
| | - Bundit Sornpaisarn
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Faculty of Public Health, Mahidol University, Ratchathewi, Bangkok, Thailand
| | - Karl Peltzer
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Chan Zuckerberg Biohub - San Francisco, San Francisco, CA, USA
| | - Charlotte Probst
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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167
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Banimostafavi ES, Taheri A, Malakian A, Zakariaei Z. Massive intracerebral hemorrhage following methamphetamine poisoning in a man: A case report. Int J Surg Case Rep 2024; 117:109489. [PMID: 38520890 PMCID: PMC10973807 DOI: 10.1016/j.ijscr.2024.109489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 03/25/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Methamphetamine (MAP) is a highly addictive stimulant known to have detrimental effects on the brain and various physiological systems, including an elevation in heart rate and blood pressure. Additionally, MAP use has been linked to the development of intracerebral hemorrhage (ICH), a serious and potentially fatal condition that is notably prevalent among young individuals. CASE PRESENTATION We present the case of a 42-year-old man who suffered a massive ICH due to hypertension resulting from MAP poisoning. The patient presented with symptoms of nausea, vomiting, and blurred vision for around two hours following the accidental inhalation of MAP. However, his condition was significantly improved through the implementation of neurosurgical intervention. CLINICAL DISCUSSION In recent years, the misuse of MAP among young adults has raised concerns about its association with ICH. ICH is a type of stroke where a blood vessel in the brain ruptures due to high blood pressure, causing bleeding. This medical emergency can lead to various symptoms, such as severe headaches, loss of consciousness, and paralysis. ICH is indeed a serious and life-threatening condition that necessitates prompt medical attention. It can also lead to long-term adverse effects for the individual affected. CONCLUSIONS The association with ICH and MAP abuse among young adults is a substantial public health issue. To gain a comprehensive understanding of the mechanisms underlying MAP abuse-induced elevation of ICH risk, further exploration is necessary.
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Affiliation(s)
- Elham Sadat Banimostafavi
- Department of Radiology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Amirmasoud Taheri
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdollah Malakian
- Department of Emergency Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zakaria Zakariaei
- Toxicology and Forensic Medicine Division, Mazandaran Registry Center for Opioids Poisoning, Orthopedic Research Center, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
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168
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Fujiwara T, Tucker KL, McManus RJ. Future of hypertension management through mobile applications. Hypertens Res 2024; 47:1087-1089. [PMID: 38242947 DOI: 10.1038/s41440-023-01568-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/05/2023] [Indexed: 01/21/2024]
Affiliation(s)
- Takeshi Fujiwara
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan.
| | - Katherine L Tucker
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Richard J McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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169
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Theodorakopoulou M, Georgiou A, Iatridi F, Karkamani E, Stamatiou A, Devrikis N, Karagiannidis A, Baroutidou A, Sarafidis P. Accuracy of 24 h ambulatory blood pressure recordings for diagnosing high 44 h blood pressure in hemodialysis: a diagnostic test study. Hypertens Res 2024; 47:1042-1050. [PMID: 38291259 DOI: 10.1038/s41440-024-01584-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 12/04/2023] [Accepted: 12/20/2023] [Indexed: 02/01/2024]
Abstract
Hypertension is highly prevalent in hemodialysis patients. Ambulatory-BP-monitoring(ABPM) during the 44 h interdialytic interval is recommended for hypertension diagnosis and management in these subjects. This study assessed the diagnostic accuracy of fixed 24 h ABPM recordings with 44 h BP in hemodialysis patients. 242 Greek hemodialysis patients that underwent valid 48 h ABPM(Mobil-O-Graph NG device) were included in the analysis. We used 44 h BP as reference method and tested the accuracy of the following BP metrics: 1st 24 h without HD period (20 h-1st), 1st 24 h including HD period (24 h-1st) and 2nd 24 h(24 h-2nd). All studied metrics showed strong correlations with 44 h SBP/DBP (20 h-1st: r = 0.973/0.978, 24 h-1st: r = 0.964/0.972 and 24 h-2nd: r = 0.978/0.977, respectively). In Bland-Altman analysis, small between-method differences (-1.70, -1.19 and +1.45 mmHg) with good 95% limits-of agreement([-10.83 to 7.43], [-11.12 to 8.74] and [-6.33 to 9.23] mmHg, respectively) for 20 h-1st, 24 h-1st and 24 h-2nd SBP were observed. The sensitivity/specificity and κ-statistic for diagnosing 44 h SBP ≥ 130 mmHg were high for 20 h-1st SBP(87.2%/96.0%, κ-statistic = 0.817), 24 h-1st SBP(88.7%/96.0%, κ-statistic = 0.833) and 24 h-2nd SBP (95.0%/88.1%, κ-statistic = 0.837). Similar observations were made for DBP. In ROC-analyses, all studied BP metrics showed excellent performance with high Area-Under-the- Curve values (20 h-1st: 0.983/0.992; 24 h-1st: 0.984/0.987 and 24 h-2nd: 0.982/0.989 for SBP/DBP respectively). Fixed 24 h ABPM recordings during either the first or the second day of interdialytic interval have high accuracy and strong agreement with 44 h BP in hemodialysis patients. Thus, ABPM recordings of either the first or the second interdialytic day could be used for hypertension diagnosis and management in these subjects.
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Affiliation(s)
- Marieta Theodorakopoulou
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Areti Georgiou
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fotini Iatridi
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Karkamani
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anastasia Stamatiou
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Devrikis
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Artemios Karagiannidis
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Amalia Baroutidou
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Pantelis Sarafidis
- First Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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170
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Kario K, Hoshide S, Mogi M. Salt and seasonal variation research in Asia. Hypertens Res 2024; 47:833-834. [PMID: 38575712 DOI: 10.1038/s41440-024-01625-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 04/06/2024]
Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Masaki Mogi
- Department of Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan
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171
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Rubio González E, de Valdenebro Recio M, Galán Fernández MI. [Hypertensive Emergency as the Debut of Paraneoplastic Cushing Syndrome]. Hipertens Riesgo Vasc 2024; 41:135-138. [PMID: 38508875 DOI: 10.1016/j.hipert.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 03/22/2024]
Abstract
We present the case of a patient with a history of renal-vascular hypertension treated with stent one year previously, who attended the emergency room due to hypertensive emergency and dyspnea. Once the first suspicion of renal artery restenosis was ruled out with CT angiography, the study was completed, confirming the diagnosis of lung cancer through imaging and pathological anatomy. In the hormonal study, elevation of ACTH, hypercortisolism and analytical data of hyperaldosteronism were detected. With the final diagnosis of Cushing's syndrome secondary to ectopic production of ACTH, medical treatment was started, without being able to receive anything else due to the death of the patient after a few days.
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Affiliation(s)
- E Rubio González
- Universidad de Puerta de Hierro, Hospital de Majadahonda, Madrid, España.
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172
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Matsuda H, Kuragaichi T, Sato Y. Investigating the seasonal variation of heart failure hospitalizations and in-hospital mortality risks in Japan using a nationwide database. J Cardiol 2024; 83:236-242. [PMID: 37666321 DOI: 10.1016/j.jjcc.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Studies have reported seasonal variations in heart failure (HF) hospitalizations and mortality that are observed to peak in the winter, although many of these studies are from Europe or the USA. However, some studies on non-US patients have reported contrasting results. We aimed to determine whether seasonal variation exists in hospitalizations due to HF, investigate the risk of death during hospitalization, and examine possible contributors to such variability in Japan. METHODS This study was an exploratory analysis of our previous report, which included 269,636 hospitalizations due to HF between 2008 and 2018. The monthly hospitalization rate for HF was evaluated using a linear regression model with April as the reference month. The risk factors for in-hospital and monthly mortality were evaluated using the Cox proportional hazards model. RESULTS The hospitalizations due to HF were significantly higher in the winter than in the summer. The peak admission rate occurred in January, and the lowest rate occurred in July. Based on April, changes in the number of hospitalizations per month were estimated using linear multiple regression analysis (adjusted R2 = 0.911). The risk of death during hospitalization was lowest in April and gradually increased from August to October (hazard ratio, 1.18-1.21). CONCLUSIONS There was a significant seasonal variation in HF hospitalizations in Japan. Peak admission rates occurred in January. However, the risk of death during hospitalization was higher in August, September, and October than that in January.
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Affiliation(s)
- Hideyuki Matsuda
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan.
| | - Takashi Kuragaichi
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | - Yukihito Sato
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
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173
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Uchikawa H, Uekawa K, Hasegawa Y. Perivascular macrophages in cerebrovascular diseases. Exp Neurol 2024; 374:114680. [PMID: 38185314 DOI: 10.1016/j.expneurol.2024.114680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/10/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
Cerebrovascular diseases are a major cause of stroke and dementia, both requiring long-term care. These diseases involve multiple pathophysiologies, with mitochondrial dysfunction being a crucial contributor to the initiation of inflammation, apoptosis, and oxidative stress, resulting in injuries to neurovascular units that include neuronal cell death, endothelial cell death, glial activation, and blood-brain barrier disruption. To maintain brain homeostasis against these pathogenic conditions, brain immune cells, including border-associated macrophages and microglia, play significant roles as brain innate immunity cells in the pathophysiology of cerebrovascular injury. Although microglia have long been recognized as significant contributors to neuroinflammation, attention has recently shifted to border-associated macrophages, such as perivascular macrophages (PVMs), which have been studied based on their crucial roles in the brain. These cells are strategically positioned around the walls of brain vessels, where they mainly perform critical functions, such as perivascular drainage, cerebrovascular flexibility, phagocytic activity, antigen presentation, activation of inflammatory responses, and preservation of blood-brain barrier integrity. Although PVMs act as scavenger and surveillant cells under normal conditions, these cells exert harmful effects under pathological conditions. PVMs detect mitochondrial dysfunction in injured cells and implement pathological changes to regulate brain homeostasis. Therefore, PVMs are promising as they play a significant role in mitochondrial dysfunction and, in turn, disrupt the homeostatic condition. Herein, we summarize the significant roles of PVMs in cerebrovascular diseases, especially ischemic and hemorrhagic stroke and dementia, mainly in correlation with inflammation. A better understanding of the biology and pathobiology of PVMs may lead to new insights on and therapeutic strategies for cerebrovascular diseases.
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Affiliation(s)
- Hiroki Uchikawa
- Department of Translational Neuroscience, Barrow Aneurysm and AVM Research Center, Barrow Neurological Institute, Phoenix, AZ, USA; Department of Neurosurgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Kumamoto, Japan
| | - Ken Uekawa
- Department of Neurosurgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Kumamoto, Japan
| | - Yu Hasegawa
- Department of Pharmaceutical Science, School of Pharmacy at Fukuoka, International University of Health and Welfare, Okawa, Fukuoka, Japan.
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174
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Taha K, Catapang M, Becknell B, Matsell DG. Hypertension in children with congenital anomalies of the kidney and urinary tract. Pediatr Nephrol 2024; 39:1185-1192. [PMID: 37910243 PMCID: PMC10922869 DOI: 10.1007/s00467-023-06207-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/01/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of childhood chronic kidney disease (CKD). We hypothesized that hypertension varies across CAKUT categories and increases the risk of CKD. METHODS This was a retrospective cohort study and included cases with a multicystic dysplastic kidney (MCDK, n = 81), unilateral kidney agenesis (UKA, n = 47), kidney hypoplasia (KH, n = 130), and posterior urethral valves (PUV, n = 75). Hypertension was defined as systolic or diastolic blood pressure ≥ 95th percentile for age, sex and height, and CKD as an estimated glomerular filtration rate < 60 ml/min/1.73 m2, both at 2 consecutive clinic visits at least 3 months apart. RESULTS Sixty-two (19%) out of 333 cases developed hypertension, with significant difference according to CAKUT type. Patients with smaller kidney size (7.7 vs. 8.3, p = 0.045), kidney anomalies in addition to the primary diagnosis (aCAKUT) (53 vs. 38%, p = 0.03), proteinuria (46 vs. 12%, p < 0.001), and CKD (51 vs. 23%, p < 0.001) were more likely to develop hypertension. When adjusted for kidney size, the diagnoses of PUV (OR 10.9, 95%CI 3.0, 40.5), UKA (OR 6.4, 95%CI 1.6, 24.9) and KH (OR 4.2, 95%CI 1.1, 16.1), and aCAKUT (OR 2.1, 95%CI 1.2, 3.9) were independent risk factors for hypertension. Hypertension increased the risk of developing CKD by twofold (HR 1.9, 95%CI 1.19, 2.94). CONCLUSION Hypertension is common in children with CAKUT and increases the risk of CKD. These findings will aid in the development of a standardized clinical pathway for the care of hypertensive children with CAKUT.
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Affiliation(s)
- Khalid Taha
- Division of Nephrology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Marisa Catapang
- Division of Nephrology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Brian Becknell
- Kidney and Urinary Tract Center, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Douglas G Matsell
- Division of Nephrology, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
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175
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Li S, Hou L, Zhu S, Sun W, Cao J, Yi Q, Zhao D, Song P. Associations of serum uric acid with hypertension status, stages, phenotypes and progressions among Chinese middle-aged and elderly. Nutr Metab Cardiovasc Dis 2024; 34:988-997. [PMID: 38176957 DOI: 10.1016/j.numecd.2023.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 09/15/2023] [Accepted: 10/21/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND AND AIMS No consensus has been reached on the association between serum uric acid (SUA) and hypertension. This study aimed to investigate the associations between SUA and hypertension, including its status, stages, phenotypes and progressions, among middle-aged and older Chinese. METHODS AND RESULTS Data were obtained from the China Health and Retirement Longitudinal Study 2011-2015. Binary logistic regression was used to evaluate the association between SUA and hypertension status. Multinomial logistic regression was used to explore the associations of SUA with hypertension stages, phenotypes and hypertension status progressions. Models were adjusted for potential confounders and stratified by sex. A total of 7931 individuals aged ≥45 years were included, with 39.16 % of hypertension. Significant associations were found of SUA with stage2 and above hypertension (quartile 4 [Q4] vs quartile 1 [Q1]: odds ratio 1.78, 95 % confidence interval 1.31-2.42, P < 0.001), and systolic diastolic hypertension (SDH) (Q4 vs Q1: 1.53, 1.14-2.06, P = 0.005). In sex stratification, significant associations were found between SUA and stage2 and above hypertension and SDH only for men. Moreover, higher quartiles of baseline SUA showed increased risks of maintained hypertension from 2011 to 2015 (Q3 vs Q1: 1.23, 1.03-1.48, P = 0.024; Q4 vs Q1: 1.73, 1.43-2.10, P < 0.001). CONCLUSION Higher SUA was associated with hypertension and maintained hypertension among Chinese middle-aged and elderly. Sex-specific associations of SUA with hypertension stages and phenotypes were observed. Regular measurement of SUA in clinical practice may indicate hypertension and its progression, particularly among men.
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Affiliation(s)
- Shuting Li
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Leying Hou
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Siyu Zhu
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Weidi Sun
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jin Cao
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qian Yi
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Dong Zhao
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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176
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Amini MR, Askarpour M, Ghalandari H, Gholizadeh M, Pouraram H. Effect of ketogenic diet on blood pressure: A GRADE-Assessed systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2024; 34:823-837. [PMID: 38310076 DOI: 10.1016/j.numecd.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 02/05/2024]
Abstract
AIMS Cardiovascular diseases (CVDs) are major causes of mortality around the world. High blood pressure (BP) or hypertension is one of the most significant predisposing factors to CVDs. Ketogenic diets (KDs) have been the center of attention for their possible health benefits. The aim of this analysis is to study the impact of KDs on BP through the existing literature. DATA SYNTHESIS We investigated the impact of KDs on systolic and diastolic blood pressures (SBP and DBP) conducted in the format of randomized controlled trials (RCTs). Four online databases (PubMed/Medline, SCOPUS, Cochrane Library, and Google Scholar) were searched from inception up to November 2022. Subgroup analyses were carried out to find the sources of heterogeneities. Twenty-three RCTs with 1664 participants were identified. KDs did not exert any significant impacts on SBP (WMD: -0.87 mmHg, 95% CI: -2.05, 0.31) nor DBP (WMD: -0.11 mmHg, 95% CI -1.14, 0.93). Subgroup analyses did not reveal any further information. Also, non-linear dose-response analysis could not detect any associations between the percentage of calorie intake from fat in the KD format and BP levels. CONCLUSION KDs do not seem to be effective in improving BP. Nonetheless, further investigations are recommended to examine the proportion of fat intake needed to induce favorable clinical impacts.
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Affiliation(s)
- Mohammad Reza Amini
- Student Research Committee, Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition & Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Moein Askarpour
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Ghalandari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Gholizadeh
- Department of Clinical Nutrition, Faculty of Nutrition Sciences and Food Industries, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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177
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Lee EM. When and how to use ambulatory blood pressure monitoring and home blood pressure monitoring for managing hypertension. Clin Hypertens 2024; 30:10. [PMID: 38556887 PMCID: PMC10983625 DOI: 10.1186/s40885-024-00265-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/10/2024] [Indexed: 04/02/2024] Open
Abstract
Many individuals have different blood pressure (BP) values in the office setting compared to that outside the office setting. Therefore, confirming hypertension based on office BP (OBP) measurement alone can lead to misdiagnosis and mistreatment. The limitations of OBP measurement have led to the complementary use of out-of-office BP measurements, including 24-hour ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM). This review aims to describe when and how ABPM or HBPM can be used to accurately diagnose and treat hypertension. Both methods should be performed using validated automated oscillometric devices. To minimize user errors, ABPM should be performed using standard techniques, whereas HBPM requires patient education regarding proper BP measurements. ABPM provides short-term comprehensive information on BP, including daytime, nighttime, morning, and 24-h BP. Therefore, ABPM is recommended for the initial diagnosis of hypertension, assessment of BP phenotypes and circadian patterns, and detection of nocturnal hypertension, Furthermore, ABPM plays a critical role in confirming true resistant hypertension thereby excluding pseudo-resistant hypertension. However, it is not suitable for long-term follow-up of patients with hypertension. In contrast, HBPM involves multiple BP readings taken at specific times during the day and evening over a long period. Therefore, HBPM is recommended for diagnosing hypertension and assessing BP phenotypes. However, this method has limitations in measuring nocturnal BP and circadian BP patterns. HBPM is preferred over ABPM for the long-term follow-up of patients with hypertension. This approach improves patient adherence to treatment and ultimately enhances the rate of control of hypertension. Additionally, both methods play an important role in diagnosing and treating white coat hypertension during pregnancy. Consequently, out-of-office BP measurement is essential to prevent the misdiagnosis and mistreatment of hypertension. However, these two methods offer different information regarding the BP status of an individual, and they indeed show discrepancies in the diagnosis of hypertensive phenotypes. Therefore, it is crucial to understand the advantages and limitations of both ABPM and HBPM to ensure their appropriate use in clinical practice.
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Affiliation(s)
- Eun Mi Lee
- Division of Cardiology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Gyeonggi-do, 15865, Republic of Korea.
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178
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Morey BN, Shi Y, Ryu S, Redline S, Kawachi I, Park HW, Lee S. Risk of sleep apnea associated with higher blood pressure among Chinese and Korean Americans. Ethn Health 2024; 29:295-308. [PMID: 38303653 PMCID: PMC10987275 DOI: 10.1080/13557858.2024.2311417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE This study examines associations between sleep apnea risk and hypertension in a sample of immigrant Chinese and Korean Americans. DESIGN The dataset included Chinese and Korean patients ages 50-75 recruited from primary care physicians' offices from April 2018 to June 2020 in the Baltimore-Washington DC Metropolitan Area (n = 394). Hypertension risk was determined using a combination of blood pressure measurements, self-reported diagnosis of hypertension by a medical professional, and/or self-reported use of antihypertensive medications. Linear regression models examined the associations between sleep apnea risk and blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP]). Poisson regression models examined associations sleep apnea risk and hypertension. Models controlled for body mass index (BMI), demographic, and socioeconomic risk factors. We further examined models for potential effect modification by age, gender, Asian subgroup, and obesity, as well as effect modification of daytime sleepiness on the association between snoring and hypertension risk. RESULTS High risk of sleep apnea appeared to be associated positively with SBP (β = 6.77, 95% CI: 0.00-13.53), but not with DBP. The association was positive for hypertension, but it was not statistically significant (PR = 1.11, 95% CI: 0.87-1.41). We did not find effect modification of the associations between sleep apnea and hypertension risk, but we did find that daytime sleepiness moderated the effect of snoring on SBP. Snoring was associated with higher SBP, primarily in the presence of daytime sleepiness, such that predicted SBP was 133.27 mmHg (95% CI: 126.52, 140.02) for someone with both snoring and daytime sleepiness, compared to 123.37 mmHg (95% CI: 120.40, 126.34) for someone neither snoring nor daytime sleepiness. CONCLUSION Chinese and Korean immigrants living in the U.S. who are at high risk of sleep apnea have higher SBP on average, even after accounting for sociodemographic characteristics and BMI. CLINICAL TRAIL REGISTRATION : NCT03481296, date of registration: 3/29/2018.
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Affiliation(s)
- Brittany N. Morey
- University of California, Irvine, Program in Public Health, Department of Health, Society, & Behavior, Irvine, CA, U.S.A
| | - Yuxi Shi
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, U.S.A
| | - Soomin Ryu
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI, U.S.A
| | - Susan Redline
- Harvard Medical School, Brigham and Women’s Hospital, Department of Medicine, and Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, U.S.A
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, MA, U.S.A
| | - Hye Won Park
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, U.S.A
| | - Sunmin Lee
- University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, U.S.A
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179
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Pellegrino A, Calabrese M, Boddi M, Vacirca I, Baccari C, Bonvicini L, Venturelli F, Petrelli A, Di Napoli A, Perticone M, Rossi PG, Modesti PA. Cardiovascular risk and access to primary care: Comparisons among Chinese documented and undocumented immigrants. Diabetes Res Clin Pract 2024; 210:111645. [PMID: 38554810 DOI: 10.1016/j.diabres.2024.111645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/02/2024]
Abstract
AIMS The aim of this study was to examine main risk factors of undocumented Chinese migrants living in Italy when compared with Chinese migrants registered with National Health Service (NHS). METHODS A cohort of 3435 Chinese first-generation immigrants living in Prato underwent blood pressure (BP) measurement and blood tests. Hypertension was diagnosed for BP ≥ 140/90 mmHg at 2 visits, and/or antihypertensive drug use; type 2 diabetes (T2DM) for fasting glucose ≥ 126 mg/dL at 2 visits, and/or use of hypoglycemic drugs; hypercholesterolemia (HC) for cholesterol ≥ 240 mg/dL and/or statins use. Subjects diagnosed with hypertension, T2DM, or HC unaware of their condition were considered newly diagnosed. Comparisons were performed using multivariable adjusted logistic regression analysis. RESULTS A large proportion of Chinese migrants were undocumented (1766, 51 %); newly diagnoses of risk factors were performed especially among undocumented migrants; registration with NHS was associated with higher level of awareness for hypertension and T2DM and with 6 times higher rate of treatment for T2DM. Only a small minority of subjects with high cholesterol were treated with statins. CONCLUSIONS Undocumented immigrants had high prevalence of risk factors with lower levels of awareness than migrants registered with the NHS. Health policies targeting this hard-to-reach population needs to be improved.
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Affiliation(s)
- Alessio Pellegrino
- Medicina dello Sport e dell'Esercizio Fisico, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; Department of Medicina Sperimentale e Clinica, University of Florence, Florence, Italy
| | - Maria Calabrese
- Diabetology Unit, Ospedale Misericordia e Dolce, Prato, Italy
| | - Maria Boddi
- Medicina dello Sport e dell'Esercizio Fisico, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; Department of Medicina Sperimentale e Clinica, University of Florence, Florence, Italy
| | - Irene Vacirca
- Medicina dello Sport e dell'Esercizio Fisico, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Cecilia Baccari
- Medicina dello Sport e dell'Esercizio Fisico, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Laura Bonvicini
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Alessio Petrelli
- Epidemiology Unit, National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Anteo Di Napoli
- Epidemiology Unit, National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Maria Perticone
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pietro Amedeo Modesti
- Medicina dello Sport e dell'Esercizio Fisico, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy; Department of Medicina Sperimentale e Clinica, University of Florence, Florence, Italy.
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180
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Samaddar D, Sinha S, Shekhar R, Singh SK, Gupta A, Singh TB. Assessing the Brainstem Auditory Evoked Potentials in Subjects with Family History of Hypertension. Ann Neurosci 2024; 31:115-120. [PMID: 38694718 PMCID: PMC11060133 DOI: 10.1177/09727531231184680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/03/2022] [Indexed: 05/04/2024] Open
Abstract
Background Hypertension (HTN) has a genetic predisposition and it also impairs microcirculation, thereby, affecting the well vascularized structures like the brainstem and causing changes in Brainstem Auditory Evoked Potentials (BAEPs). Purpose To find out the usefulness of BAEPs as a screening tool in apparently healthy individuals with a family history of HTN. Methods One hundred and ten volunteers, aged 17 to 23 years, were enrolled in the study as participants with proper consent. After excluding the subjects with existing diseases or co-morbidities (e.g. diabetes, HTN, schizophrenia, neuropathy, etc.), those on ototoxic or neurotoxic drugs, a preliminary physical examination was performed, following which BAEPs were recorded with a proper device. Statistical analysis is done with SPSS 2016 software using the chi-square test. Results A consistent distortion in the inter-peak latency of III-V waves is noted when a family history of HTN is present in either parent or maternal grandparents. Other statistically significant findings are present in V/I% (HTN in mother), wave I (HTN in paternal grandfather), wave III (HTN in maternal grandfather), and inter-peak latency I-V (HTN in maternal grandmother). Conclusion BAEP may be used as a screening tool in individuals with a family history of HTN with supportive evidence from further studies in the near future.
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Affiliation(s)
| | - Shivangi Sinha
- Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India
| | - Raj Shekhar
- Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India
| | - Samir Kumar Singh
- Department of Physiology, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India
| | - Anita Gupta
- Department of Physiology, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India
| | - Tej Bali Singh
- Division of Biostatistics, Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Joshi A, Kaur S, Taneja SK, Mandal R. Review Article on Molecular Mechanism of Regulation of Hypertension by Macro-elements (Na, K, Ca and Mg), Micro-elements/Trace Metals (Zn and Cu) and Toxic Elements (Pb and As). Biol Trace Elem Res 2024; 202:1477-1502. [PMID: 37523058 DOI: 10.1007/s12011-023-03784-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023]
Abstract
Hypertension (HT) is a medical condition arising due to increase in blood pressure (BP) prevalent worldwide. The balanced dietary intakes of macro-elements and micro-elements including Na, K, Ca, Mg, Zn, and Cu have been described to maintain BP in humans by regulating the osmolarity of blood, cells/tissues, prevention of generation of oxidative and nitrosative stress (OANS), and endothelial damage through their functioning as important components of renin-angiotensin-aldosterone system (RAAS), antioxidant enzyme defense system, and maintenance of blood vascular-endothelial and vascular smooth muscle cell (VSMC) functions. However, inadequate/excess dietary intakes of Na/K, Ca/Mg, and Zn/Cu along with higher Pb and As exposures recognized to induce HT through common mechanisms including the followings: endothelial dysfunctions due to impairment of vasodilatation, increased vasoconstriction and arterial stiffness, blood clotting, inflammation, modification of sympathetic activity and higher catecholamine release, increased peripheral vascular resistance, and cardiac output; increased OANS due to reduced and elevated activities of extracellular superoxide dismutase and NAD(P)H oxidase, less nitric oxide bioavailability, decrease in cGMP and guanylate cyclase activity, increase in intracellular Ca2+ ions in VSMCs, and higher pro-inflammatory cytokines; higher parathyroid and calcitriol hormones; activation/suppression of RAAS resulting imbalance in blood Na+, K+, and water regulated by renin, angiotensin II, and aldosterone through affecting natriuresis/kaliuresis/diuresis; elevation in serum cholesterol and LDL cholesterol, decrease in HDL cholesterol due to defect in lipoprotein metabolism. The present study recommends the need to review simple dietary mineral intervention studies/supplementation trials before keeping their individual dietary excess intakes/exposures in consideration because their interactions lead to elevation and fall of their concentrations in body affecting onset of HT.
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Affiliation(s)
- Amit Joshi
- PG Department of Biotechnology and Microbial Biotechnology, Sri Guru Gobind Singh College, Sector-26, Chandigarh, UT, India
| | - Sukhbir Kaur
- Department of Zoology, Panjab University, Sector-14, Chandigarh, UT, India
| | | | - Reshu Mandal
- PG Department of Zoology, Sri Guru Gobind Singh College, Sector-26, Chandigarh, UT, India.
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182
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Egan BM, Mattix-Kramer HJ, Basile JN, Sutherland SE. Managing Hypertension in Older Adults. Curr Hypertens Rep 2024; 26:157-167. [PMID: 38150080 PMCID: PMC10904451 DOI: 10.1007/s11906-023-01289-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE OF REVIEW The population of older adults 60-79 years globally is projected to double from 800 million to 1.6 billion between 2015 and 2050, while adults ≥ 80 years were forecast to more than triple from 125 to 430 million. The risk for cardiovascular events doubles with each decade of aging and each 20 mmHg increase of systolic blood pressure. Thus, successful management of hypertension in older adults is critical in mitigating the projected global health and economic burden of cardiovascular disease. RECENT FINDINGS Women live longer than men, yet with aging systolic blood pressure and prevalent hypertension increase more, and hypertension control decreases more than in men, i.e., hypertension in older adults is disproportionately a women's health issue. Among older adults who are healthy to mildly frail, the absolute benefit of hypertension control, including more intensive control, on cardiovascular events is greater in adults ≥ 80 than 60-79 years old. The absolute rate of serious adverse events during antihypertensive therapy is greater in adults ≥ 80 years older than 60-79 years, yet the excess adverse event rate with intensive versus standard care is only moderately increased. Among adults ≥ 80 years, benefits of more intensive therapy appear non-existent to reversed with moderate to marked frailty and when cognitive function is less than roughly the twenty-fifth percentile. Accordingly, assessment of functional and cognitive status is important in setting blood pressure targets in older adults. Given substantial absolute cardiovascular benefits of more intensive antihypertensive therapy in independent-living older adults, this group merits shared-decision making for hypertension targets.
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Affiliation(s)
- Brent M Egan
- American Medical Association, Improving Health Outcomes, 2 West Washington Street, Suite 601, Greenville, SC, 29601, USA.
| | - Holly J Mattix-Kramer
- Department of Public Health Sciences and Medicine, Loyola University Chicago Loyola University Medical Center, Maywood, IL, USA
| | - Jan N Basile
- Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC, USA
| | - Susan E Sutherland
- American Medical Association, Improving Health Outcomes, 2 West Washington Street, Suite 601, Greenville, SC, 29601, USA
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Heitaku S, Sasase T, Sotani T, Maki M, Kawai T, Morinaga H, Nishiu J. JTT-654, an 11-beta hydroxysteroid dehydrogenase type 1 inhibitor, improves hypertension and diabetic kidney injury by suppressing angiotensinogen production. J Pharmacol Sci 2024; 154:246-255. [PMID: 38485342 DOI: 10.1016/j.jphs.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/09/2024] [Accepted: 02/02/2024] [Indexed: 03/19/2024] Open
Abstract
11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) plays an important role in regulating the expression of glucocorticoid actions in target tissues. Overexpression of 11β-HSD1 in mouse adipose tissue causes a metabolic syndrome-like phenotype, leading to hypertension. Although, many 11β-HSD1 inhibitors have been studied, few have shown a clear ameliorative effect against hypertension. We investigated whether JTT-654, a novel 11β-HSD1 inhibitor, ameliorated hypertension and elucidated the underlying mechanisms. JTT-654 showed inhibitory effects on angiotensinogen production in cortisone-treated 3T3-L1 adipocytes and in a rat model. JTT-654 improved hypertension not only in cortisone-treated rats and spontaneously hypertensive rats (SHR), but also in SHR/NDmcr-cp rats. In the SHR study, JTT-654 and losartan showed the same degree of antihypertensive efficacy. In addition, JTT-654 ameliorated diabetic nephropathy by suppressing renal angiotensinogen production in SHR/NDmcr-cp rats. These effects of JTT-654 were independent of its insulin-sensitizing effects, and similar effects were not observed for pioglitazone, an insulin sensitizer. Moreover, JTT-654 did not affect normotension or hypothalamus-pituitary-adrenal (HPA) axis function in normal Sprague-Dawley rats. Our results indicate that JTT-654 ameliorates hypertension and diabetic nephropathy by inhibiting 11β-HSD1 in the adipose tissue, liver, and kidney.
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Affiliation(s)
- Shiro Heitaku
- Biological/Pharmacological Research Laboratories, Takatsuki Research Center, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Tomohiko Sasase
- Biological/Pharmacological Research Laboratories, Takatsuki Research Center, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan.
| | - Tomohiro Sotani
- Biological/Pharmacological Research Laboratories, Takatsuki Research Center, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Mimi Maki
- Biological/Pharmacological Research Laboratories, Takatsuki Research Center, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Takashi Kawai
- Biological/Pharmacological Research Laboratories, Takatsuki Research Center, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Hisayo Morinaga
- Biological/Pharmacological Research Laboratories, Takatsuki Research Center, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
| | - Jun Nishiu
- Biological/Pharmacological Research Laboratories, Takatsuki Research Center, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan
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184
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Zhang X, Zhang T, Chen X, Ni J, Xu S, Peng Y, Wang G, Sun W, Liu X, Pan F. The impact of short-term exposure to meteorological factors on the risk of death from hypertension and its major complications: a time series analysis based on Hefei, China. Int Arch Occup Environ Health 2024; 97:313-329. [PMID: 38403848 DOI: 10.1007/s00420-024-02046-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/16/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study aimed to reveal the short-term impact of meteorological factors on the mortality risk in hypertensive patients, providing a scientific foundation for formulating pertinent prevention and control policies. METHODS In this research, meteorological factor data and daily death data of hypertensive patients in Hefei City from 2015 to 2018 were integrated. Time series analysis was performed using distributed lag nonlinear model (DLNM) and generalized additive model (GAM). Furthermore, we conducted stratified analysis based on gender and age. Relative risk (RR) combined with 95% confidence interval (95% CI) was used to represent the mortality risk of single day and cumulative day in hypertensive patients. RESULTS Single-day lag results indicated that high daily mean temperature (T mean) (75th percentile, 24.9 °C) and low diurnal temperature range (DTR) (25th percentile, 4.20 °C) levels were identified as risk factors for death in hypertensive patients (maximum effective RR values were 1.144 and 1.122, respectively). Extremely high levels of relative humidity (RH) (95th percentile, 94.29%) reduced the risk of death (RR value was 0.893). The stratified results showed that the elderly and female populations are more susceptible to low DTR levels, whereas extremely high levels of RH have a more significant protective effect on both populations. CONCLUSION Overall, we found that exposure to low DTR and high T mean environments increases the risk of death for hypertensive patients, while exposure to extremely high RH environments significantly reduces the risk of death for hypertensive patients. These findings contribute valuable insights for shaping targeted prevention and control strategies.
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Affiliation(s)
- Xu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tao Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xuyang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Jianping Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Siwen Xu
- School of Medicine, Tongji University, 500 Zhennan Road, Shanghai, 200333, China
| | - Yongzhen Peng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Guosheng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Wanqi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Hospital Management Research, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Xuxiang Liu
- Hefei Center for Disease Control and Prevention, 86 Luan Road, Hefei, 230032, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- The Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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185
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Shimizu S. Insights into the associative role of hypertension and angiotensin II receptor in lower urinary tract dysfunction. Hypertens Res 2024; 47:987-997. [PMID: 38351189 DOI: 10.1038/s41440-024-01597-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/05/2024] [Accepted: 01/13/2024] [Indexed: 02/16/2024]
Abstract
In men, the lower urinary tract comprises the urinary bladder, urethra, and prostate, and its primary functions include urine storage and voiding. Hypertension is a condition that causes multi-organ damage and an age-dependent condition. Hypertension and the renin-angiotensin system activation are associated with the development of lower urinary tract dysfunction. Hypertensive animal models show bladder dysfunction, urethral dysfunction, and prostatic hyperplasia. In the renin-angiotensin system, angiotensin II and the angiotensin II type 1 receptor, which are expressed in the lower urinary tract, have been implicated in the pathogenesis of lower urinary tract dysfunction. Moreover, among the several antihypertensives, renin-angiotensin system inhibitors have proven effective in human and animal models of lower urinary tract dysfunction. This review aimed to elucidate the hitherto known mechanisms underlying the development of lower urinary tract dysfunction in relation to hypertension and the angiotensin II/angiotensin II type 1 receptor axis and the effect of renin-angiotensin system inhibitors on lower urinary tract dysfunction. Possible mechanisms through which hypertension or activation of Ang II/AT1 receptor axis causes LUTD such as bladder dysfunction, urethral dysfunction, and prostatic hyperplasia. LUT: lower urinary tract, LUTD: lower urinary tract dysfunction, AT1: angiotensin II type 1, ACE: angiotensin-converting enzyme.
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Affiliation(s)
- Shogo Shimizu
- Department of Pharmacology, Kochi Medical School, Kochi University, Kohasu, Okocho, Nankoku, 783-8505, Japan.
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186
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Morimoto S, Ichihara A. Effects of esaxerenone, a nonsteroidal mineralocorticoid receptor blocker, independent of urinary sodium/potassium ratio and salt intake. Hypertens Res 2024; 47:970-971. [PMID: 38273001 DOI: 10.1038/s41440-024-01579-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024]
Affiliation(s)
- Satoshi Morimoto
- Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan.
| | - Atsuhiro Ichihara
- Department of Internal Medicine, Tokyo Women's Medical University, Tokyo, Japan
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187
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Dar JA, Jacob JR. Beta Blockers in Contemporary Cardiology: Is It Better to Cast Them Out? Korean Circ J 2024; 54:165-171. [PMID: 38654562 PMCID: PMC11040266 DOI: 10.4070/kcj.2023.0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/25/2024] [Accepted: 02/13/2024] [Indexed: 04/26/2024] Open
Abstract
Beta blockers are one of the commonest prescription drugs in medicine and they have been thought to revolutionize the treatment of heart failure (HF) with reduced ejection fraction (HFrEF) in the last century. In addition to HFrEF, they are prescribed for a variety of diseases in cardiology from hypertension to HF, angina, and stable coronary artery disease (CAD). The increased prescription of beta blockers in conditions like HF with preserved ejection fraction (HFpEF), and stable CAD may be doing more harm than good as per the data we have so far. The available data shows that beta blockers are associated with increased stroke risk and atrial fibrillation (AF) in hypertension and in patients with HFpEF, they have been associated with decreased exercise capacity. In patients with stable CAD and patients with myocardial infarction with normal systolic functions, beta blockers don't offer any mortality benefit. In this article, we critically review the common indications and the uses of beta blockers in patients with HFpEF, CAD, hypertension and AF and we propose that beta blockers are over-prescribed under the shadow of their beneficial effects in patients with HFrEF.
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Affiliation(s)
- Javaid Ahmad Dar
- Department of Cardiology, Christian Medical College, Vellore, India.
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188
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Xiong S, Jiang W, Wang Y, Hu C, Yang J, Bao M, Hou H, Li F, Liu T, Zhang X, Ma Y, Ye P, Wang Q, Chen Z, Mao L, Peiris D, Tian M. Using routinely collected data to determine care cascades of hypertension and type-2 diabetes management in China: a cross-sectional study. Lancet Reg Health West Pac 2024; 45:101019. [PMID: 38371948 PMCID: PMC10869296 DOI: 10.1016/j.lanwpc.2024.101019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/27/2023] [Accepted: 01/15/2024] [Indexed: 02/20/2024]
Abstract
Background China's National Essential Public Health Service Package (NEPHSP) aims to promote health for all at the primary health care level and includes a focus on hypertension and type-2 diabetes mellitus (T2DM). However, there are limited contemporary data to quantify the care cascades of hypertension and T2DM in primary health care. Methods This cross-sectional study involved individual level linkage of routinely collected data from the NEPHSP, health insurance claims and hospital electronic health records, from four diverse regions in China, including Xiling District (central China), Wenchuan County (western), Acheng District and Jiao District (northern). We first compared numbers of people aged ≥35 with a recorded diagnosis of hypertension and T2DM against expected numbers derived from epidemiological data. We then constructed care cascades to assess the percentages (1) enrolled in the NEPHSP, (2) adherent to the follow-up care of NEPHSP, (3) receiving medication treatment, and (4) having hypertension and/or T2DM controlled. Findings In the four regions, the total numbers of people aged ≥35 diagnosed of hypertension and T2DM from any data source were 149,176 and 50,828, respectively. This was estimated to be 46.0% (95% confidence interval [CI]: 45.8%-46.2%) and 45.6% (95% CI: 45.3%-45.9%) of the expected totals for hypertension and T2DM, respectively. Among those diagnosed, 65.4% (95% CI: 65.1%-65.6%) with hypertension and 66.1% (95% CI: 65.7%-66.5%) with T2DM were enrolled in the NEPHSP, respectively, in which 54.8% (95% CI: 54.5%-55.2%) with hypertension and 64.7% (95% CI: 64.1%-65.2%) with T2DM were adherent to the required services. Among those enrolled, the overall treatment rates were 70.8% (95% CI: 70.6%-71.1%) for hypertension and 82.2% (95% CI: 81.8%-82.6%) for T2DM. Among those treated, a further 80.9% (95% CI: 80.6%-81.2%) with hypertension and 73.9% (95% CI: 73.3%-74.4%) with T2DM achieved control. These results varied considerably across regions, with the northern sites showing relatively higher enrolment rates while the central site had higher control rates. Interpretation Detection and control rates for hypertension and T2DM are suboptimal in these four regions of China. Further strategies are needed to improve people's enrolment in and adherence to the NEPHSP and strengthen care delivery processes. Of note, our estimations of the diagnosis rates for each region are based on national level large epidemiological data. The interpretation of these data needs caution due to potential bias caused by regional variations. Funding This study is funded by National Health and Medical Research Council (NHMRC) Global Alliance for Chronic Diseases funding (APP1169757), and National Natural Science Foundation of China (72074065).
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Affiliation(s)
- Shangzhi Xiong
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Global Health Research Centre, Duke Kunshan University, Kunshan, China
| | - Wei Jiang
- National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Yongchen Wang
- Department of General Practice, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chi Hu
- Yichang City Centre for Disease Control and Prevention, Yichang, China
| | - Jiajuan Yang
- Yichang City Centre for Disease Control and Prevention, Yichang, China
| | - Mingjia Bao
- Jiamusi City Centre for Disease Control and Prevention, Jiamusi, China
| | - Huinan Hou
- Jiamusi City Centre for Disease Control and Prevention, Jiamusi, China
| | - Fan Li
- Health Bureau of Wenjiang District, Chengdu, China
| | - Tingzhuo Liu
- School of Public Health, Harbin Medical University, Harbin, China
| | - Xinyi Zhang
- School of Public Health, Harbin Medical University, Harbin, China
| | - Yanqiuzi Ma
- National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Pengpeng Ye
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- National Centre for Non-Communicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Qiujun Wang
- Department of General Practice, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zhengming Chen
- Nuffield Department of Population Health, Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), University of Oxford, Oxford, UK
| | - Limin Mao
- Centre for Social Research in Health, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, Australia
| | - David Peiris
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Maoyi Tian
- Department of General Practice, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- School of Public Health, Harbin Medical University, Harbin, China
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189
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Wu O, Wu Y, Zhang X, Liu W, Zhang H, Khederzadeh S, Lu X, Zhu XW. Causal effect of interleukin (IL)-6 on blood pressure and hypertension: A mendelian randomization study. Immunogenetics 2024; 76:123-135. [PMID: 38427105 DOI: 10.1007/s00251-024-01332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024]
Abstract
To examine whether circulating interleukin-6 (IL-6) levels (CirIL6) have a causal effect on blood pressure using Mendelian randomization (MR) methods. We used data from genome-wide association studies (GWAS) of European ancestry to obtain genetic instruments for circulating IL-6 levels and blood pressure measurements. We applied several robust MR methods to estimate the causal effects and to test for heterogeneity and pleiotropy. We found that circulating IL-6 had a significant positive causal effect on systolic blood pressure (SBP) and pulmonary arterial hypertension (PAH), but not on diastolic blood pressure (DBP) or hypertension. We found that as CirIL6 genetically increased, SBP increased using Inverse Variance Weighted (IVW) method (for ukb-b-20175, β = 0.082 with SE = 0.032, P = 0.011; for ukb-a-360, β = 0.075 with SE = 0.031, P = 0.014) and weighted median (WM) method (for ukb-b-20175, β = 0.061 with SE = 0.022, P = 0.006; for ukb-a-360, β = 0.065 with SE = 0.027, P = 0.014). Moreover, CirIL6 may be associated with an increased risk of PAH using WM method (odds ratio (OR) = 15.503, 95% CI, 1.025-234.525, P = 0.048), but not with IVW method. Our study provides novel evidence that circulating IL-6 has a causal role in the development of SBP and PAH, but not DBP or hypertension. These findings suggest that IL-6 may be a potential therapeutic target for preventing or treating cardiovascular diseases and metabolic disorders. However, more studies are needed to confirm the causal effects of IL-6 on blood pressure and to elucidate the underlying mechanisms and pathways.
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Affiliation(s)
- Ou Wu
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, People's Republic of China.
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
| | - Ya Wu
- Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Xingyu Zhang
- Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Wei Liu
- JFIntelligent Healthcare Technology Co., Ltd Building No.5-7, No.699 Tianxiang Avenue, Hi-Tech Zone, Nanchang, Jiangxi Province, People's Republic of China
| | - Hu Zhang
- Department of Thoracic Surgery, Sir Run Run Shaw Hospital Affiliated with Medical College of Zhejiang University, Hangzhou, Zhejiang, People's Republic of China
| | - Saber Khederzadeh
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, Zhejiang, People's Republic of China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, People's Republic of China
| | - Xi Lu
- Hangzhou Vocational and Technical College, Hangzhou, Zhejiang, People's Republic of China.
| | - Xiao-Wei Zhu
- School of Medicine, Shaoxing University, Shaoxing, Zhejiang, People's Republic of China.
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190
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Pant A, Gribbin S, Machado P, Hodge A, Wasfy JH, Moran L, Marschner S, Chow CK, Zaman S. Ultra-processed foods and incident cardiovascular disease and hypertension in middle-aged women. Eur J Nutr 2024; 63:713-725. [PMID: 38147150 PMCID: PMC10948520 DOI: 10.1007/s00394-023-03297-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/28/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE Ultra-processed food (UPF) intake has increased in recent decades, yet limited knowledge of long-term effects on cardiovascular health persists and sex-specific data is scant. We determined the association of UPF intake with incident cardiovascular disease (CVD) and/or hypertension in a population-based cohort of women. METHODS In the Australian Longitudinal Study on Women's Health, women aged 50-55 years were prospectively followed (2001-2016). UPFs were identified using NOVA classification and contribution of these foods to total dietary intake by weight was estimated. Primary endpoint was incident CVD (self-reported heart disease/stroke). Secondary endpoints were self-reported hypertension, all-cause mortality, type 2 diabetes mellitus, and/or obesity. Logistic regression models assessed associations between UPF intake and incident CVD, adjusting for socio-demographic, medical comorbidities, and dietary variables. RESULTS We included 10,006 women (mean age 52.5 ± 1.5; mean UPF intake 26.6 ± 10.2% of total dietary intake), with 1038 (10.8%) incident CVD, 471 (4.7%) deaths, and 4204 (43.8%) hypertension cases over 15 years of follow-up. In multivariable-adjusted models, the highest [mean 42.0% total dietary intake] versus the lowest [mean 14.2% total dietary intake] quintile of UPF intake was associated with higher incident hypertension [odds ratio (OR) 1.39, 95% confidence interval (CI) 1.10-1.74; p = 0.005] with a linear trend (ptrend = 0.02), but not incident CVD [OR 1.22, 95% CI 0.92-1.61; p = 0.16] or all-cause mortality (OR 0.80, 95% CI 0.54-1.20; p = 0.28). Similar results were found after multiple imputations for missing values. CONCLUSION In women, higher UPF intake was associated with increased hypertension, but not incident CVD. These findings may support minimising UPFs within a healthy diet for women.
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Affiliation(s)
- Anushriya Pant
- Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, 2145, Australia.
| | - Sarah Gribbin
- Department of General Medicine, The Alfred Hospital, Alfred Health, Melbourne, VIC, Australia
| | - Priscila Machado
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Allison Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Jason H Wasfy
- Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Lisa Moran
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC, Australia
| | - Simone Marschner
- Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, 2145, Australia
| | - Clara K Chow
- Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, 2145, Australia
| | - Sarah Zaman
- Westmead Applied Research Centre and Faculty of Medicine and Health, University of Sydney, Westmead, NSW, 2145, Australia
- Department of Cardiology, Westmead Hospital, Westmead, NSW, Australia
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191
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Vogl B, Sularz A, Lilly S, Thourani VH, Lindman BR, Alkhouli M, Hatoum H. Effect of Blood Pressure Levels on Sinus Hemodynamics in Relation to Calcification After Bioprosthetic Aortic Valve Replacement. Ann Biomed Eng 2024; 52:888-897. [PMID: 38157105 DOI: 10.1007/s10439-023-03426-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
Coexisting hypertension and aortic stenosis are common. Some studies showed that elevated blood pressures may be associated with progression of calcific aortic valve disease (CAVD) while others showed no correlation. Flow dynamics in the sinuses of Valsalva are considered key factors in the progression of CAVD. While the relationship between hemodynamics and CAVD is not yet fully understood, it has been demonstrated that they are tightly correlated. This study aims to investigate the effect of changing systolic and diastolic blood pressures (SBP and DBP, respectively) on sinus hemodynamics in relation to potential initiation or progression of CAVD after aortic valve replacement (AVR). Evolut R, SAPIEN 3 and Magna valves were deployed in an aortic root under pulsatile conditions. Using particle image velocimetry, the hemodynamics in the sinus were assessed. The velocity, vorticity, circulation ( Γ ) and shear stress were calculated. This study shows that under elevated SBP and DBP, velocity, vorticity, and shear stress nearby the leaflets increased. Additionally, larger fluctuations of Γ and area under the curve throughout the cardiac cycle were observed. Elevated blood pressures are associated with higher velocity, vorticity, and shear stress near the leaflets which may initiate or accelerate pro-calcific changes in the prosthetic leaflets leading to bioprosthetic valve degeneration.
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Affiliation(s)
- Brennan Vogl
- Biomedical Engineering Department, Michigan Technological University, 1400 Townsend Dr, Houghton, MI, 49931, USA
| | - Agata Sularz
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Scott Lilly
- Department of Cardiovascular Medicine, The Ohio State University, Columbus, OH, USA
| | - Vinod H Thourani
- Department of Cardiovascular Surgery, Marcus Valve Center, Piedmont Heart Institute, Atlanta, GA, USA
| | - Brian R Lindman
- Division of Cardiovascular Medicine, Structural Heart and Valve Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mohamad Alkhouli
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Hoda Hatoum
- Biomedical Engineering Department, Michigan Technological University, 1400 Townsend Dr, Houghton, MI, 49931, USA.
- Health Research Institute, Center of Biocomputing and Digital Health and Institute of Computing and Cybernetics, Michigan Technological University, Houghton, MI, USA.
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192
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Liu T, Wang W, Liu Z, Pei G, Wang C, Jiang Y, Pang C. A previously healthy 3-year-old female with hypertension, proteinuria, and hypercalciuria. Pediatr Nephrol 2024; 39:1301-1313. [PMID: 38165475 PMCID: PMC10899356 DOI: 10.1007/s00467-023-06230-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 01/03/2024]
Abstract
A 3-year-old female patient with no significant medical history presented to her pediatrician with foamy urine. Initial testing revealed moderate proteinuria on qualitative testing, although she was incidentally noted to have severe hypertension (240/200 mmHg). Physical examination of the carotid and femoral areas revealed significant systolic vascular murmurs. Labs showed elevated serum creatinine, hypokalemia, metabolic alkalosis, elevated renin and aldosterone and hypercalciuria. Echocardiography identified ventricular hypertrophy. Computed tomography (CT) of the abdomen and magnetic resonance angiography of the head showed multiple tortuous or interrupted arteries and multiple calcifications in the renal sinus area. B-mode ultrasonography suggested thickening of the carotid and femoral artery walls, with numerous spotted calcifications. Genetic testing revealed that ABCC6 had a complex heterozygous mutation (exon 24: c.3340C > T and intron 30: c.4404-1G > A). Our panel of experts reviewed the evaluation of this patient with hypertension, proteinuria, hypercalciuria, and vascular abnormalities as well as the diagnosis and appropriate management of a rare disease.
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Affiliation(s)
- Tao Liu
- Department of Nephrology, Tianjin Children's Hospital (Children's Hospital, Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, 238 Longyan Road, Beichen District, Tianjin, 300134, China
| | - Wenhong Wang
- Department of Nephrology, Tianjin Children's Hospital (Children's Hospital, Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, 238 Longyan Road, Beichen District, Tianjin, 300134, China.
| | - Zhufeng Liu
- Department of Nephrology, Tianjin Children's Hospital (Children's Hospital, Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, 238 Longyan Road, Beichen District, Tianjin, 300134, China
| | - Guanghua Pei
- Ultrasonography Lab, Tianjin Children's Hospital (Children's Hospital, Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, China
| | - Chunxiang Wang
- Department of Imaging, Tianjin Children's Hospital (Children's Hospital, Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, China
| | - Ying Jiang
- Department of Nephrology, Tianjin Children's Hospital (Children's Hospital, Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, 238 Longyan Road, Beichen District, Tianjin, 300134, China
| | - Chuyue Pang
- Department of Nephrology, Tianjin Children's Hospital (Children's Hospital, Tianjin University), Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, 238 Longyan Road, Beichen District, Tianjin, 300134, China
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193
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McCalla G, Brown PD, Nwokocha C. Cadmium induces microcytosis and anisocytosis without anaemia in hypertensive rats. Biometals 2024; 37:519-526. [PMID: 38184813 DOI: 10.1007/s10534-023-00567-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024]
Abstract
Dietary cadmium (Cd2+) intake is implicated in the pathogenesis of hypertension and anaemia, but there is a paucity of information on the haematological changes in hypertensive conditions. This study, therefore, aims to evaluate the effects of Cd2+ on blood pressure (BP) and haematological indices in the Sprague-Dawley rat model. Three cohorts (n = 10 each) of control and Cd2+-fed male Sprague-Dawley rats were selected. Cd2+-exposed rats received 2.5 or 5 mg/kg b.w. cadmium chloride via gavage thrice-weekly for eight weeks, while control animals received tap water. BP and flow were measured non-invasively from rat tails twice-weekly using a CODA machine, while weights were measured thrice-weekly. Haematological indices were assessed using the Cell-Dyn Emerald Haematology Analyzer. Data were reported as mean ± SEM, and statistically analyzed using One-Way Analysis of Variance. Bonferroni post hoc test was used for multiple comparisons. Cd2+-exposure induced hypertension by significantly (p < 0.05) elevating systolic, diastolic, and mean arterial BPs, pulse pressure, and heart rate (HR), and increased (p < 0.05) blood flow. Mean cell volume (MCV) and haemoglobin (MCH) were significantly (p < 0.05) reduced, and red cell distribution width (RDW) significantly (p < 0.01) increased by exposure to 5 mg/kg b.w. Cd2+. Haemoglobin concentration (MCHC), haematocrit, haemoglobin, red blood cell, platelet, mean platelet volume, and white blood cell counts were unaffected by Cd2+-exposure. Cd2+ induced hypertension, microcytosis, hypochromicity, and anisocytosis without anaemia, which may be precursor to microcytic anaemia and coronary artery disease. This study is important in Cd2+-exposed environments and warrants further investigations.
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Affiliation(s)
- Garsha McCalla
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica.
| | - Paul D Brown
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Chukwuemeka Nwokocha
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica
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194
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Chen TY, Kao CW, Cheng SM, Liu CY. Mediating Effect of Heart Rate Variability on the Relationship Between Anxiety Symptoms and Blood Pressure in Patients with Primary Hypertension. Appl Psychophysiol Biofeedback 2024:10.1007/s10484-024-09641-6. [PMID: 38557778 DOI: 10.1007/s10484-024-09641-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Patients with hypertension (HTN) are at increased risk of developing cardiovascular disease, which can be reduced with blood pressure (BP) control. Anxiety can contribute to high BP and low heart rate variability (HRV). Although relationships between social support, self-rated health-status (SRHS), anxiety and measures of HRV and BP have been suggested, they have not been clearly established. This cross-sectional correlational study aimed to 1) examine relationships between social support, SRHS, and anxiety; and 2) examine if HRV mediated relationships between anxiety symptoms and BP. Patients with primary HTN were recruited from a cardiovascular outpatient clinic using convenience sampling (N = 300). Data included scale scores for SRHS, social support, and anxiety (Hospital Anxiety and Depression Scale). A handheld limb-lead electrocardiogram monitor measured HRV, using the ratio of low-frequency bands to high-frequency bands; an automatic sphygmomanometer measured systolic and diastolic blood pressure (SBP and DBP, respectively). Path analysis of structural equation models examined relationships between variables; the bootstrap method examined the mediating effects of HRV. Analysis showed scores for SRHS and social support had a direct effect on anxiety scores. Scores for anxiety directly affected HRV and BP. HRV also had a direct effect on BP. Bootstrapping indicated HRV mediated the relationship between anxiety symptoms and BP. The final model indicated SRHS, social support, and anxiety symptoms together explained 80% of SBP and 33% of DBP. These findings suggest HRV could be used to measure the effectiveness of strategies aimed at reducing anxiety and improving control of BP.
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Affiliation(s)
- Ting-Yu Chen
- Department of Nursing, Chang Gung University of Science and Technology, Rm. A611, No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County, 613061, Taiwan.
| | - Chi-Wen Kao
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Shu-Meng Cheng
- Division of Cardiology, Department of Internal Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Chieh-Yu Liu
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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195
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De Ciuceis C, Rosei CA, Malerba P, Rossini C, Nardin M, Chiarini G, Famà F, Lemoli M, Baresi M, Petelca A, Bortoluzzi C, Porteri E, Salvetti M, Muiesan ML, Rosei EA, Rizzoni D. Prognostic significance of the wall to lumen ratio of retinal arterioles evaluated by adaptive optics. Eur J Intern Med 2024; 122:86-92. [PMID: 37914655 DOI: 10.1016/j.ejim.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/16/2023] [Accepted: 10/27/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Microvascular structural alterations may be considered an important form of hypertension-mediated organ damage. An increased media-to-lumen ratio of subcutaneous small arteries evaluated with locally invasive techniques (micromyography) predicts the development of cardiovascular (CV) events. However, it is not known whether retinal arteriole structural alterations evaluated with a noninvasive approach (Adaptive Optics) may have a prognostic significance. DESIGN AND METHODS Two-hundred and thirty-seven subjects (mean age 58.7 ± 16.1 years, age range 13-89 years; 116 males) were included in the study: 65 normotensive subjects (27.4 %) and 172 patients with essential hypertension or primary aldosteronism (72.6 %). All subjects underwent a non-invasive evaluation of retinal arteriolar wall-to-lumen ratio (WLR) by Adaptive Optics. Subjects were re-evaluated after an average follow-up time of 4.55 years in order to assess the occurrence of clinical events (non CV and/or CV death or events). RESULTS Fifty-four events occurred in the study population:26 were cardio-cerebrovascular events (ischemic or hemorragic stroke, atrial fibrillation, heart failure, coronary artery disease, peripheral artery disease, cardiac valvular disease) while the remaining were deaths for any cause, or neoplastic diseases. Subjects with events were older and had a WLR of retinal arterioles significantly greater than those without events. The event-free survival was significantly worse in those with a baseline WLR above the median value of the population (0.28) according to Kaplan-Mayer survival curves and multivariate analysis (Cox's proportional hazard model). The evidence was confirmed after restricting the analysis to CV events. CONCLUSIONS Structural alterations of retinal arterioles evaluated by Adaptive Optics may predict total and CV events.
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Affiliation(s)
- Carolina De Ciuceis
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy.
| | - Claudia Agabiti Rosei
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Paolo Malerba
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Claudia Rossini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Matteo Nardin
- Third Division of Medicine, ASST Spedali Civili di Brescia, Italy
| | - Giulia Chiarini
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Francesca Famà
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Matteo Lemoli
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Mattia Baresi
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Alina Petelca
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Chiara Bortoluzzi
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Enzo Porteri
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Massimo Salvetti
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Maria Lorenza Muiesan
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Enrico Agabiti Rosei
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy
| | - Damiano Rizzoni
- Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, Brescia 25123, Italy; Division of Medicine, ASST Spedali Civili di Brescia, Montichiari, Brescia, Italy
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196
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Miao H, Zhou Z, Yang S, Zhang Y. The association of triglyceride-glucose index and related parameters with hypertension and cardiovascular risk: a cross-sectional study. Hypertens Res 2024; 47:877-886. [PMID: 38012411 DOI: 10.1038/s41440-023-01502-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/13/2023] [Accepted: 10/20/2023] [Indexed: 11/29/2023]
Abstract
The objective of this study was to investigate the association between triglyceride-glucose index (TyG) and related parameters (TyG-BMI, TyG-WC, TyG-WHR, and TyG-WHtR) with hypertension and cardiovascular risk. Additionally, the study aimed to compare the performance of these parameters in identifying patients with hypertension and high cardiovascular risk and determine appropriate indicators for the prediction of cardiovascular risk. Residents from a community in Beijing, China, who underwent health examinations at a regional hospital between December 2011 and August 2012, were recruited. Logistic regression analysis was used to explore the association between each parameter with hypertension and cardiovascular disease (CVD). The receiver operating characteristic curve was used to compare the predictive ability of each parameter in identifying people with hypertension or high cardiovascular risk. A total of 16,834 participants were included. After adjusting for confounders, the highest quartile groups of TyG and related parameters showed a significantly increased risk of hypertension compared to the lowest quartile groups. Among the parameters, TyG-WC exhibited the highest diagnostic efficacy for hypertension [area under the curve (AUC): 0.665, 95% CI: 0.656-0.673] followed by TyG-WHtR, TyG-BMI, TyG-WHR, and TyG index. Similarly, the highest quartile groups of each parameter demonstrated significantly increased risks of high cardiovascular risk compared to the lowest quartile groups. TyG-WHR performed best in distinguishing participants with high cardiovascular risk (AUC: 0.718, 95% CI: 0.710-0.726) followed by TyG-WC, TyG-WHtR, TyG-BMI, and TyG index. In conclusion, TyG-related parameters had independent associations with hypertension and cardiovascular risk. TyG-WHR exhibited the highest efficacy in distinguishing participants with high cardiovascular risk, which might contribute to the primary prevention of CVD.
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Affiliation(s)
- Huanhuan Miao
- Department of Cardiology, Heart Failure Center, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhanyang Zhou
- Department of Cardiology, Heart Failure Center, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shijie Yang
- Department of Cardiology, Heart Failure Center, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuqing Zhang
- Department of Cardiology, Heart Failure Center, Fu Wai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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197
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Ozawa T, Kimura R, Terai H, Takemura R, Namkoong H, Kondo M, Fukuda K, Yagi K, Asakura T, Masaki K, Chubachi S, Miyata J, Ohgino K, Kawada I, Kagyo J, Odani T, Kuwahara N, Nakachi I, Ishii M, Sato Y, Fukunaga K. Calcium channel blockers may reduce the development of long COVID in females. Hypertens Res 2024; 47:934-943. [PMID: 37978232 DOI: 10.1038/s41440-023-01501-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 11/19/2023]
Abstract
With the rising numbers of patients infected with severe acute respiratory syndrome coronavirus 2, long coronavirus disease 2019 (COVID-19)-a sequelae of COVID-19-has become a major problem. Different sexes and age groups develop different long COVID symptoms, and the risk factors for long COVID remain unclear. Therefore, we performed subgroup analyses of patients with COVID-19, classifying them into different groups. In this multicenter cohort study, using an original questionnaire, we examined patients (≥18 years old) diagnosed with COVID-19 from November 2020 to March 2022 and hospitalized at participating medical facilities. In total, 1066 patients were registered (361 female, 620 male). Hypertension was the most common comorbidity (n = 344; 32.5%). Females with hypertension were significantly less likely to develop long COVID symptoms than those without hypertension (odds ratio [OR] 0.51, 95% confidence interval [CI] 0.27-0.98; p = 0.043). In females, Ca channel blocker administration, rather than having hypertension, was significantly associated with reductions in the frequency of alopecia (OR 0.14, 95% CI 0.03-0.67, p = 0.015), memory impairment (OR 0.14, 95% CI 0.02-0.82, p = 0.029), sleeping disorders (OR 0.17, 95% CI 0.04-0.67, p = 0.012), tinnitus (OR 0.23, 95% CI 0.05-0.98, p = 0.047), sputum (OR 0.31, 95% CI 0.10-0.92, p = 0.035), and fever (OR 0.33, 95% CI 0.12-0.93, p = 0.036). Several long COVID symptoms, including alopecia, were significantly negatively associated with Ca channel-blocker administration in female patients with long COVID. Calcium channel blockers may reduce the development of long COVID in females.
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Affiliation(s)
- Takuya Ozawa
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Ryusei Kimura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Hideki Terai
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
- Keio Cancer Center, Keio University School of Medicine, Tokyo, Japan.
| | - Ryo Takemura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan.
| | - Ho Namkoong
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan
| | - Masahiro Kondo
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Keitaro Fukuda
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuma Yagi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Internal Medicine, Keiyu Hospital, Yokohama, Kanagawa, Japan
| | - Takanori Asakura
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Respiratory Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jun Miyata
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Keiko Ohgino
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ichiro Kawada
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Research Centers and Institutes, Health Center, Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Junko Kagyo
- Department of Internal Medicine, Keiyu Hospital, Yokohama, Kanagawa, Japan
| | - Toshio Odani
- Department of Rheumatology, National Hospital Organization Hokkaido Medical Center, Hokkaido, Japan
| | - Naota Kuwahara
- Department of Medicine, Division of Allergology and Respiratory Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Ichiro Nakachi
- Pulmonary Division, Department Internal Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Makoto Ishii
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasunori Sato
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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198
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Ciardullo S, Cannistraci R, Muraca E, Zerbini F, Perseghin G. Liver fibrosis, NT-ProBNP and mortality in patients with MASLD: A population-based cohort study. Nutr Metab Cardiovasc Dis 2024; 34:963-971. [PMID: 38161125 DOI: 10.1016/j.numecd.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND & AIM Liver fibrosis is the strongest predictor of liver-related mortality in many chronic liver diseases. NT-ProBNP is independently associated with cardiovascular mortality in general population settings. Here, we evaluate the relative contribution of non-invasively identified liver fibrosis and NT-ProBNP on all-cause and cardiovascular mortality in patients with metabolic (dysfunction)-associated steatotic liver disease (MASLD). METHODS AND RESULTS Serum NT-ProBNP levels were measured in 4229 patients with MASLD from the general population without a known history of heart failure that participated in the 1999-2004 cycles of the National Health and Nutrition Examination Survey. Presence of liver fibrosis was estimated using the Fibrosis-4 index (FIB-4). We applied Cox proportional hazard models adjusted for cardiovascular risk factors to evaluate the association between NT-ProBNP and FIB-4 levels and all-cause and cardiovascular mortality through December 2019. Mortality was lower for participants with normal levels of both biomarkers, intermediate if a single biomarker was elevated and highest when both were above the chosen threshold. In the multivariable-adjusted models, both elevated FIB-4 (≥2.67) and elevated NT-ProBNP levels (≥125 pg/ml) were independently associated with higher risks of all-cause mortality (HR 2.2, 95 % CI 1.5-3.2 and HR 1.6, 95 % CI 1.4-2.0, respectively) and cardiovascular mortality (HR 2.1, 95 % CI 1.2-3.7 and HR 2.1, 95 % CI 1.5-2.9, respectively). The associations remained consistent in subgroup analyses based on sex, obesity and age. CONCLUSIONS Both FIB-4 and NT-ProBNP are independently associated with higher mortality in patients with MASLD. Their combined use might prove useful to risk-stratify patients in clinical practice.
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Affiliation(s)
- Stefano Ciardullo
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy; Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
| | - Rosa Cannistraci
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy.
| | - Emanuele Muraca
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy.
| | - Francesca Zerbini
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy.
| | - Gianluca Perseghin
- Department of Medicine and Rehabilitation, Policlinico di Monza, Monza, Italy; Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
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Codazzi V, Frontino G, Galimberti L, Giustina A, Petrelli A. Mechanisms and risk factors of metabolic syndrome in children and adolescents. Endocrine 2024; 84:16-28. [PMID: 38133765 PMCID: PMC10987369 DOI: 10.1007/s12020-023-03642-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
Metabolic syndrome (MetS) is a complex disorder characterized by abdominal obesity, elevated blood pressure, hyperlipidemia, and elevated fasting blood glucose levels. The diagnostic criteria for MetS in adults are well-established, but there is currently no consensus on the definition in children and adolescents. The etiology of MetS is believed to involve a complex interplay between genetic predisposition and environmental factors. While genetic predisposition explains only a small part of MetS pathogenesis, modifiable environmental risk factors play a significant role. Factors such as maternal weight during pregnancy, children's lifestyle, sedentariness, high-fat diet, fructose and branched-chain amino acid consumption, vitamin D deficiency, and sleep disturbances contribute to the development of MetS. Early identification and treatment of MetS in children and adolescents is crucial to prevent the development of chronic diseases later in life. In this review we discuss the latest research on factors contributing to the pathogenesis of MetS in children, focusing on non-modifiable and modifiable risk factors, including genetics, dysbiosis and chronic low-grade inflammation.
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200
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Yoshida Y, Shibata H. Relations between glomerular hyperfiltration and podocyte injury: potential role of Piezo1 in the Rac1-mineralocorticoid receptor activation pathway. Hypertens Res 2024; 47:1092-1094. [PMID: 38337007 DOI: 10.1038/s41440-024-01603-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/17/2024] [Indexed: 02/12/2024]
Affiliation(s)
- Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan.
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