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Alparslan C, Malyszko J, Caskey FJ, Aleckovic-Halilovic M, Hrušková Z, Arruebo S, Bello AK, Damster S, Donner JA, Jha V, Johnson DW, Levin A, Malik C, Nangaku M, Okpechi IG, Tonelli M, Ye F, Tesar V, Racki S. Capacity for the management of kidney failure in the International Society of Nephrology Eastern and Central Europe region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA). Kidney Int Suppl (2011) 2024; 13:29-42. [PMID: 38618499 PMCID: PMC11010604 DOI: 10.1016/j.kisu.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 04/16/2024] Open
Abstract
Delivery of care for kidney failure (KF) globally has a significant disparity; even in some countries, it means end of life for the person. The International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) tries to address gaps in KF care and standardize global nephrology care. From the third iteration of the ISN-GKHA, we present data for countries in the ISN Eastern and Central Europe region. The median prevalences of chronic kidney disease (12.8%) and treated KF (873.5 pmp) were higher than the global rates, respectively. Hemodialysis was the most preferred modality for KF in adults, whereas kidney replacement therapy was more balanced in children. Although most of the countries in the region had lower-middle-income and upper-middle-income levels, health expenditures for kidney health care were almost generally covered publicly. Nephrologists were responsible for the medical kidney care of people with KF in all countries. There was adequate infrastructure to provide all kinds of treatment for kidney care in the region. Regional characteristics such as high levels of obesity, smoking, and Balkan nephropathy as an endemic disease coupled with a shortage of workforce and finance continued to affect kidney care in the region negatively. By making organizational and legislative arrangements, partnerships with national authorities and societies may accelerate the improvement of kidney health care in the region.
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Affiliation(s)
- Caner Alparslan
- Department of Pediatric Nephrology, İzmir Democracy University School of Medicine, İzmir, Turkey
| | - Jolanta Malyszko
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Fergus J. Caskey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mirna Aleckovic-Halilovic
- Clinic for Internal Diseases, Department of Nephrology, Dialysis and Transplantation, University Hospital Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Zdenka Hrušková
- Department of Nephrology, First Faculty of Medicine, Charles University and General Hospital in Prague, Prague, Czech Republic
| | - Silvia Arruebo
- The International Society of Nephrology, Brussels, Belgium
| | - Aminu K. Bello
- Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Jo-Ann Donner
- The International Society of Nephrology, Brussels, Belgium
| | - Vivekanand Jha
- George Institute for Global Health, University of New South Wales, New Delhi, India
- School of Public Health, Imperial College, London, UK
- Manipal Academy of Higher Education, Manipal, India
| | - David W. Johnson
- Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Translational Research Institute, Brisbane, Queensland, Australia
- Australasian Kidney Trials Network at the University of Queensland, Brisbane, Queensland, Australia
| | - Adeera Levin
- Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charu Malik
- The International Society of Nephrology, Brussels, Belgium
| | - Masaomi Nangaku
- Division of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Ikechi G. Okpechi
- Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa
- Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Canada and Pan-American Health Organization/World Health Organization’s Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, Alberta, Canada
| | - Feng Ye
- Division of Nephrology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Vladimir Tesar
- Department of Nephrology, First Faculty of Medicine, Charles University and General Hospital in Prague, Prague, Czech Republic
| | - Sanjin Racki
- Department of Nephrology, Dialysis and Transplantation, University Hospital Center Rijeka, Rijeka, Croatia
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152
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Drakos A, McCready T, Lopez-Jaramillo P, Islam S, McKee M, Yusuf S, Schwalm JD. Relationship Between Social Support and Clinical Outcomes: An Evaluation of Participant-Nominated Treatment Supporters in the HOPE 4 Intervention. Circ Cardiovasc Qual Outcomes 2024; 17:e009342. [PMID: 38440889 DOI: 10.1161/circoutcomes.122.009342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/04/2023] [Indexed: 03/06/2024]
Abstract
BACKGROUND The HOPE 4 trial (Heart Outcomes Prevention and Evaluation 4) investigated the effectiveness of a comprehensive, collaborative model of care, implemented in Colombia and Malaysia, which aimed to reduce cardiovascular disease risk in individuals with hypertension. One component of this intervention was the nomination of a treatment supporter, where participants could select a family member or friend to assist them with their care. The purpose of this study was to investigate the impact of these individuals on participant outcomes, as well as the relationship dynamics between participants and their treatment supporter. METHODS Participants in the HOPE 4 intervention group with baseline and 12 months of follow-up were included for analysis. They were divided into Every Visit (n=339) and RESULTS Groups were majority female (53% versus 62%) with a mean age of 63 and 66 years. Country of origin differed between groups (22% versus 86%; Colombia). A 15.5% ([95% CI, 6.2%-24.8%] P=0.004) greater increase in statin medication use was reported in the Every Visit group at 12 months compared with the CONCLUSIONS Long-term support from a nominated treatment supporter was associated with improved adherence, risk factor management, and medication use among individuals with hypertension. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT01826019.
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Affiliation(s)
- Anastasia Drakos
- Faculty of Medicine, University of Ottawa, ON, Canada (A.D.)
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (A.D., T.M., S.I., S.Y., J.D.S.)
| | - Tara McCready
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (A.D., T.M., S.I., S.Y., J.D.S.)
| | - Patricio Lopez-Jaramillo
- Research Institute, Fundación Oftalmológica de Santander, Floridablanca, Colombia (P.L.-J.)
- Masira Institute, Medical School, Universidad de Santander, Bucaramanga, Colombia (P.L.-J.)
| | - Shofiqul Islam
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (A.D., T.M., S.I., S.Y., J.D.S.)
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom (M.M.)
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (A.D., T.M., S.I., S.Y., J.D.S.)
- Department of Health Research Methods, Evidence and Impact, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada (S.Y.)
| | - J D Schwalm
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (A.D., T.M., S.I., S.Y., J.D.S.)
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153
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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] [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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154
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Dean YE, Motawea KR, Shebl MA, Elawady SS, Nuhu K, Abuzuaiter B, Awayda K, Fouad AM, Tanas Y, Batista R, Elsayed A, Hassan NAIF, El‐Sakka AA, Hasan W, Husain R, Lois A, Arora A, Arora A, Ayad E, Elbahaie MA, Shah J, Shady A, Chaudhuri D, Aiash H. Adherence to antihypertensives in the United States: A comparative meta-analysis of 23 million patients. J Clin Hypertens (Greenwich) 2024; 26:303-313. [PMID: 38488773 PMCID: PMC11007819 DOI: 10.1111/jch.14788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 04/12/2024]
Abstract
Adherence to antihypertensives is crucial for control of blood pressure. This study analyzed factors and interventions that could affect adherence to antihypertensives in the US. PubMed, Scopus, Web of Science, and Embase were searched on January 21, 2022 and December 25, 2023 for studies on the adherence to antihypertensives in the US. Nineteen studies and 23 545 747 patients were included in the analysis, which showed that adherence to antihypertensives was the highest among Whites (OR: 1.47, 95% CI 1.34-1.61 compared to African Americans). Employment status and sex were associated with insignificant differences in adherence rates. In contrast, marital status yielded a significant difference where unmarried patients demonstrated low adherence rates compared to married ones (OR: 0.8, 95% CI 0.67-0.95). On analysis of comorbidities, diabetic patients reported lower adherence to antihypertensives (OR: 0.95, 95% CI 0.92-0.97); furthermore, patients who did not have Alzheimer showed higher adherence rates. Different BMIs did not significantly affect the adherence rates. Patients without insurance reported significantly lower adherence rates than insured patients (OR: 3.93, 95% CI 3.43-4.51). Polypill users had higher adherence rates compared with the free-dose combination (OR: 1.21, 95% CI 1.2-1.21), while telepharmacy did not prove to be as effective. Lower adherence rates were seen among African Americans, uninsured, or younger patients. Accordingly, interventions such as fixed-dose combinations should be targeted at susceptible groups. Obesity and overweight did not affect the adherence to antihypertensives.
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Affiliation(s)
- Yomna E. Dean
- Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | | | | | | | | | | | | | | | - Yousef Tanas
- Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | | | - Ahmed Elsayed
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | | | | | - Walaa Hasan
- Faculty of MedicineSuez Canal UniversityIsmailiaEgypt
| | | | - Amanda Lois
- Medical University of South CarolinaCharlestonUSA
| | | | | | | | | | | | - Amr Shady
- SUNY Upstate Medical UniversitySyracuseUSA
| | | | - Hani Aiash
- SUNY Upstate Medical UniversitySyracuseUSA
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155
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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] [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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156
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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] [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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157
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Son JJ, Arif Y, Oludipe D, Weyrich L, Killanin AD, Wiesman AI, Okelberry HJ, Willett MP, Johnson HJ, Wilson TW. Multispectral brain connectivity during visual attention distinguishes controlled from uncontrolled hypertension. J Physiol 2024; 602:1775-1790. [PMID: 38516712 PMCID: PMC11150863 DOI: 10.1113/jp285568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/01/2024] [Indexed: 03/23/2024] Open
Abstract
Hypertension-related changes in brain function place individuals at higher risk for cognitive impairment and Alzheimer's disease. The existing functional neuroimaging literature has identified important neural and behavioural differences between normotensive and hypertensive individuals. However, previously-used methods (i.e. magnetic resonance imaging, functional near-infrared spectroscopy) rely on neurovascular coupling, which is a useful but indirect measure of neuronal activity. Furthermore, most studies fail to distinguish between controlled and uncontrolled hypertensive individuals, who exhibit significant behavioural and clinical differences. To partially remedy this gap in the literature, we used magnetoencephalography (MEG) to directly examine neuronal activity that is invariant to neurovascular coupling changes induced by hypertension. Our study included 52 participants (19 healthy controls, 15 controlled hypertensives, 18 uncontrolled hypertensives) who completed a modified flanker attention task during MEG. We identified significant oscillatory neural responses in two frequencies (alpha: 8-14 Hz, gamma: 48-60 Hz) for imaging and used grand-averaged images to determine seeds for whole-brain connectivity analysis. We then conducted Fisher-z tests for each pair of groups, using the relationship between the neural connectivity and behavioural attention effects. This highlighted a distributed network of regions associated with cognitive control and selective attention, including frontal-occipital and interhemispheric occipital connections. Importantly, the inferior frontal cortex exhibited a unique neurobehavioural relationship that distinguished the uncontrolled hypertensive group from the controlled hypertensive and normotensive groups. This is the first investigation of hypertension using MEG and identifies critical whole-brain connectivity differences based on hypertension profiles. KEY POINTS: Structural and functional changes in brain circuitry scale with hypertension severity and increase the risk of cognitive impairment and Alzheimer's disease. We harness the excellent spatiotemporal precision of magnetoencephalography (MEG) to directly quantify dynamic functional connectivity in healthy control, controlled hypertensive and uncontrolled hypertensive groups during a flanker task. In the first MEG study of hypertension, we show that there are neurobehavioural relationships that distinguish the uncontrolled hypertensive group from healthy and controlled hypertensive group in the prefrontal cortex. These results provide novel insights into the differential impact of hypertension on brain dynamics underlying selective attention.
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Affiliation(s)
- Jake J Son
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yasra Arif
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Davina Oludipe
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Lucas Weyrich
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
| | - Abraham D Killanin
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Alex I Wiesman
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Hannah J Okelberry
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Madelyn P Willett
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Hallie J Johnson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
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158
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Amri M, Tamir EM, Drighil A, Habbal R. Cafe-au-lait spots with resistant hypertension are an indicator of pheochromocytoma: a rare case report. ARCHIVOS PERUANOS DE CARDIOLOGIA Y CIRUGIA CARDIOVASCULAR 2024; 5:e351. [PMID: 39015197 PMCID: PMC11247971 DOI: 10.47487/apcyccv.v5i2.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/25/2024] [Indexed: 07/18/2024]
Abstract
This case report is one of the rare cases of bilateral pheochromocytoma associated with neurofibromatosis type 1. The interest lies in the clinical form in which the diagnosis was revealed. We report the case of a 38-year-old woman admitted for severe hypertension resistant to triple therapy. Clinical examination revealed Cafe-au-lait spots, which are pigmented birthmarks that appear as patches on the skin with a light to dark brown colour. More than six spots are present in an estimated 95% of people diagnosed with neurofibromatosis type 1 (NF1). Abdominal computed tomography (CT) showed bilateral adrenal tumor involvement. The diagnosis of pheochromocytoma was made by measuring urinary Vanillylmandelic acid (VMA). The evolution was favorable after the excision of the tumor, with normalization of blood pressure. In conclusion: resistant hypertension with café au lait spots may indicate pheochromocytoma, especially bilateral, suggesting an underlying genetic condition like NF1, warranting systematic screening.
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Affiliation(s)
- Meriam Amri
- Cardiology Department, Centre Hospitalo-Universitaire Ibn Rochd of Casablanca, Morocco.Cardiology DepartmentCentre Hospitalo-Universitaire Ibn Rochd of CasablancaMorocco
| | - El Mehdi Tamir
- Cardiology Department, Centre Hospitalo-Universitaire Ibn Rochd of Casablanca, Morocco.Cardiology DepartmentCentre Hospitalo-Universitaire Ibn Rochd of CasablancaMorocco
| | - Abdenasser Drighil
- Cardiology Department, Centre Hospitalo-Universitaire Ibn Rochd of Casablanca, Morocco.Cardiology DepartmentCentre Hospitalo-Universitaire Ibn Rochd of CasablancaMorocco
| | - Rachida Habbal
- Cardiology Department, Centre Hospitalo-Universitaire Ibn Rochd of Casablanca, Morocco.Cardiology DepartmentCentre Hospitalo-Universitaire Ibn Rochd of CasablancaMorocco
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159
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Han X, Yang X, Fang S, Chen Y, Chen Q, Li L, Song R. Preserving shape details of pulse signals for video-based blood pressure estimation. BIOMEDICAL OPTICS EXPRESS 2024; 15:2433-2450. [PMID: 38633075 PMCID: PMC11019694 DOI: 10.1364/boe.516388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/02/2024] [Accepted: 02/14/2024] [Indexed: 04/19/2024]
Abstract
In recent years, imaging photoplethysmograph (iPPG) pulse signals have been widely used in the research of non-contact blood pressure (BP) estimation, in which BP estimation based on pulse features is the main research direction. Pulse features are directly related to the shape of pulse signals while iPPG pulse signals are easily disturbed during the extraction process. To mitigate the impact of pulse feature distortion on BP estimation, it is necessary to eliminate interference while retaining valuable shape details in the iPPG pulse signal. Contact photoplethysmograph (cPPG) pulse signals measured at rest can be considered as the undisturbed reference signal. Transforming the iPPG pulse signal to the corresponding cPPG pulse signal is a method to ensure the effectiveness of shape details. However, achieving the required shape accuracy through direct transformation from iPPG to the corresponding cPPG pulse signals is challenging. We propose a method to mitigate this challenge by replacing the reference signal with an average cardiac cycle (ACC) signal, which can approximately represent the shape information of all cardiac cycles in a short time. A neural network using multi-scale convolution and self-attention mechanisms is developed for this transformation. Our method demonstrates a significant improvement in the maximal information coefficient (MIC) between pulse features and BP values, indicating a stronger correlation. Moreover, pulse signals transformed by our method exhibit enhanced performance in BP estimation using different model types. Experiments are conducted on a real-world database with 491 subjects in the hospital, averaging 60 years of age.
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Affiliation(s)
- Xuesong Han
- School of Computer and Information, Hefei University of Technology, Hefei, 230009, China
- Anhui Key Laboratory of Industry Safety and Emergency Technology, Hefei, 230009, China
| | - Xuezhi Yang
- School of Computer and Information, Hefei University of Technology, Hefei, 230009, China
- Anhui Key Laboratory of Industry Safety and Emergency Technology, Hefei, 230009, China
| | - Shuai Fang
- School of Computer and Information, Hefei University of Technology, Hefei, 230009, China
- Anhui Key Laboratory of Industry Safety and Emergency Technology, Hefei, 230009, China
| | - Yawei Chen
- School of Computer and Information, Hefei University of Technology, Hefei, 230009, China
- Anhui Key Laboratory of Industry Safety and Emergency Technology, Hefei, 230009, China
| | - Qin Chen
- School of Computer and Information, Hefei University of Technology, Hefei, 230009, China
- Anhui Key Laboratory of Industry Safety and Emergency Technology, Hefei, 230009, China
| | - Longwei Li
- The First Affiliated Hospital of the University of Science and Technology of China, Hefei, 230036, China
| | - RenCheng Song
- School of Instrument Science and Opto-electronics Engineering, Hefei University of Technology, Hefei, 230009, China
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Sun JY, Su Z, Yang J, Sun W, Kong X. The potential mechanisms underlying the modulating effect of perirenal adipose tissue on hypertension: Physical compression, paracrine, and neurogenic regulation. Life Sci 2024; 342:122511. [PMID: 38387699 DOI: 10.1016/j.lfs.2024.122511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/24/2024]
Abstract
Hypertension, a prevalent global cardiovascular disease, affects approximately 45.4 % of adults worldwide. Despite advances in therapy, hypertension continues to pose a significant health risk due to inadequate management. It has been established that excessive adiposity contributes majorly to hypertension, accounting for 65 to 75 % of primary cases. Fat depots can be categorised into subcutaneous and visceral adipose tissue based on anatomical and physiological characteristics. The metabolic impact and the risk of hypertension are determined more significantly by visceral fat. Perirenal adipose tissue (PRAT), a viscera enveloping the kidney, is known for its superior vascularisation and abundant innervation. Although traditionally deemed as a mechanical support tissue, recent studies have indicated its contributing potential to hypertension. Hypertensive patients tend to have increased PRAT thickness compared to those without, and there is a positive correlation between PRAT thickness and elevated systolic blood pressure. This review encapsulates the anatomical characteristics and biogenesis of PRAT. We provide an overview of the potential mechanisms where PRAT may modulate blood pressure, including physical compression, paracrine effects, and neurogenic regulation. PRAT has become a promising target for hypertension management, and continuous effort is required to further explore the underlying mechanisms.
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Affiliation(s)
- Jin-Yu Sun
- Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China; Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Zhenyang Su
- Medical School of Southeast University, Nanjing 21000, China
| | - Jiaming Yang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China
| | - Wei Sun
- Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China; Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China.
| | - Xiangqing Kong
- Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China; Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, China.
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Park CH, Kim HW, Joo YS, Park JT, Chang TI, Yoo TH, Park SK, Kim YH, Sung S, Hyun YY, Oh KH, Kang SW, Han SH. Findings from the KNOW-CKD Study indicate that higher systolic blood pressure time in target range is associated with a lower risk of chronic kidney disease progression. Kidney Int 2024; 105:835-843. [PMID: 38159679 DOI: 10.1016/j.kint.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
Time-in-target range (TTR) of systolic blood pressure (SBP) is determined by the proportion of time during which SBP remains within a defined optimal range. TTR has emerged as a useful metric for assessing SBP control over time. However, it is uncertain if SBP-TTR can predict the progression of chronic kidney disease (CKD). Here, we investigated the association between SBP-TTR during the first year of enrollment and CKD progression among 1758 participants from the KNOW-CKD (KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease). Baseline median estimated glomerular filtration rate (eGFR) was 51.7 ml/min per 1.73 m2. Participants were categorized into four SBP-TTR groups (0%, 1-50%, 51-99%, and 100%). The primary outcome was CKD progression defined as 50% or more decline in eGFR from baseline measurement or the initiation of kidney replacement therapy. During the follow-up period (9212 person-years over a median 5.4 years), the composite outcome occurred in 710 participants. In the multivariate cause-specific hazard model, a one-standard deviation increase in SBP-TTR was associated with an 11% lower risk of the composite outcome with hazard ratio, 0.89 (95% confidence interval, 0.82-0.97). Additionally, compared to patients with SBP-TTR 0%, the respective hazard ratios for those with SBP-TTR 1-50%, 51-99%, and 100% were 0.85 (0.68-1.07), 0.76 (0.60-0.96), and 0.72 (0.55-0.94), and the respective corresponding slopes of eGFR decline were -3.17 (-3.66 to -2.69), -3.02 (-3.35 to -2.68), -2.62 (-2.89 to - 2.36), and -2.33 (-2.62 to -2.04) ml/min/1.73 m2. Thus, higher SBP-TTR was associated with a decreased risk of CKD progression in patients with CKD.
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Affiliation(s)
- Cheol Ho Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Hyung Woo Kim
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Young Su Joo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea; Division of Nephrology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Tae Ik Chang
- Department of Internal Medicine, National Health Insurance Service Medical Center, Ilsan Hospital, Goyang, Republic of Korea
| | - Tae-Hyun Yoo
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Sue Kyung Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yeong Hoon Kim
- Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Suah Sung
- Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Young Youl Hyun
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Republic of Korea
| | - Kook-Hwan Oh
- Department of Internal Medicine, Seoul National University Hospital, Kidney Research Institute, Seoul, Republic of Korea
| | - Shin-Wook Kang
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea
| | - Seung Hyeok Han
- Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea.
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Okekunle AP, Asowata OJ, Akpa OM, Fakunle AG, Bodunde I, Komolafe M, Arulogun O, Sarfo FS, Obiako R, Osaigbovo G, Ogbole G, Bello A, Adeniyi S, Calys-Tagoe B, Appiah L, Jenkins C, Oyinloye O, Dambatta H, Balogun O, Singh A, Olalere A, Mensah Y, Ogah OS, Ibinaiye P, Adebayo O, Adebajo O, Adebayo P, Chukwuonye I, Akinyemi R, Ovbiagele B, Owolabi M. Dietary patterns associated with hypertension among stroke-free indigenous Africans: insights from the Stroke Investigative Research and Educational Network study. J Hypertens 2024; 42:620-628. [PMID: 38230616 PMCID: PMC11126300 DOI: 10.1097/hjh.0000000000003662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND The dietary factors associated with the high burden of hypertension among indigenous Africans remain poorly understood. We assessed the relationship between dietary patterns and hypertension among indigenous Africans. METHOD In this study, 1550 participants with hypertension matched (for age: ± 5 years, sex and ethnicity) with 1550 participants without hypertension were identified from the stroke-free population in the Stroke Investigative Research and Educational Network study in Ghana and Nigeria. Food consumption was assessed using a food frequency questionnaire, and dietary information was summarized using principal component analysis to identify seven dietary patterns. Conditional logistic regression was applied to compute the odds ratio (OR) and 95% confidence interval (CI) for the risk of hypertension by tertiles of dietary patterns adjusting for age, education, income, smoking, alcohol use, physical inactivity, family history of cardiovascular diseases, obesity and salt intake at a two-sided P less than 0.05. RESULTS Multivariable-adjusted OR [95% confidence interval (CI)] for risk of hypertension by second and third tertiles [using the lowest (first) tertile as reference] of dietary patterns were 0.62 (0.48-0.80), 0.70 (0.54-0.90) for whole grains and fruit drinks; 0.87 (0.68-1.12), 0.83 (0.64-1.08) for fruits; 0.85 (0.65-1.10), 0.97 (0.75-1.26) for vegetables, legumes and potatoes; 0.78 (0.60-1.00), 0.84 (0.65-1.08) for fried foods and sweetened drinks; 1.13 (0.88-1.45), 0.80 (0.62-1.03) for poultry product and organ meat; 1.11 (0.86-1.43), 0.88 (0.68-1.14) for red meat; and 1.14 (0.88-1.48), 1.09 (0.84-1.43) for processed foods ( P < 0.05). CONCLUSION A higher adherence to dietary consumption of whole grains and fruits was inversely associated with low odds of hypertension in this population.
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Affiliation(s)
- Akinkunmi Paul Okekunle
- Department of Medicine, University of Ibadan, Nigeria
- Department of Food and Nutrition, Seoul National University, Koreay
| | | | - Onoja Matthew Akpa
- Department of Epidemiology and Medical Statistics
- Institute of Cardiovascular Diseases, University of Ibadan
| | - Adekunle Gregory Fakunle
- Department of Medicine, University of Ibadan, Nigeria
- Department of Public Health, Osun State University, Osogbo, Osun State
| | | | - Morenikeji Komolafe
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife
| | - Oyedunni Arulogun
- Department of Health Promotion and Education, University of Ibadan, Nigeria
| | - Fred Stephen Sarfo
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Ghana
| | | | | | - Godwin Ogbole
- Department of Radiology, College of Medicine, University of Ibadan
| | - Abiodun Bello
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Sunday Adeniyi
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Benedict Calys-Tagoe
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Ghana
| | - Lambert Appiah
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Ghana
| | | | - Olalekan Oyinloye
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife
| | | | | | - Arti Singh
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | | | - Yaw Mensah
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Ghana
| | | | | | | | | | | | | | - Rufus Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training College of Medicine
- Center for Genomic and Precision Medicine, University of Ibadan, Nigeria
| | - Bruce Ovbiagele
- Weill Institute for Neurosciences, University of California San Francisco, USA
| | - Mayowa Owolabi
- Department of Medicine, University of Ibadan, Nigeria
- Center for Genomic and Precision Medicine, University of Ibadan, Nigeria
- Lebanese American University of Beirut, Lebanon
- Blossom Specialist Medican Centre, Ibadan, Nigeria
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163
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Reynolds AZ, Niedbalski SD. Sex-biased gene regulation varies across human populations as a result of adaptive evolution. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 183:e24888. [PMID: 38100225 DOI: 10.1002/ajpa.24888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 03/03/2024]
Abstract
OBJECTIVES Studies of human sexual dimorphism and gender disparities in health focus on ostensibly universal molecular sex differences, such as sex chromosomes and circulating hormone levels, while ignoring the extraordinary diversity in biology, behavior, and culture acquired by different human populations over their unique evolutionary histories. MATERIALS AND METHODS Using RNA-Seq data and whole genome sequences from 1000G and HGDP, we investigate variation in sex-biased gene expression across 11 human populations and test whether population-level variation in sex-biased expression may have resulted from adaptive evolution in regions containing sex-specific regulatory variants. RESULTS We find that sex-biased gene expression in humans is highly variable, mostly population-specific, and demonstrates between population reversals. Expression quantitative trait locus mapping reveals sex-specific regulatory regions with evidence of recent positive natural selection, suggesting that variation in sex-biased expression may have evolved as an adaptive response to ancestral environments experienced by human populations. DISCUSSION These results indicate that sex-biased gene expression is more flexible than previously thought and is not generally shared among human populations. Instead, molecular phenotypes associated with sex depend on complex interactions between population-specific molecular evolution and physiological responses to contemporary socioecologies.
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Affiliation(s)
- Adam Z Reynolds
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Sara D Niedbalski
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico, USA
- Human Evolutionary Genetics Unit, Institut Pasteur, Université Paris Cité, CNRS, Paris, France
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164
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Assiri AM, Al-Khaldi YM, Kaabi AA, Alshehri IA, Al-Shahrani MA, Almalki AA. Hypertension clinical pathway: Experience of Aseer region, Saudi Arabia. J Family Community Med 2024; 31:116-123. [PMID: 38800786 PMCID: PMC11114869 DOI: 10.4103/jfcm.jfcm_283_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/30/2024] [Accepted: 03/01/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Hypertension (HTN) is a common chronic health problem with many complications and high morbidity rates. This study aimed to describe the HTN pathway, to assess the performance of screening and registration programs, to explore the challenges and suggest solutions for those challenges. MATERIALS AND METHODS This study was conducted in primary care centers in the Aseer region, Saudi Arabia, at the end of 2022. The study consisted of three parts namely: Screening for HTN, registration of known hypertensive patients and opinions of representatives of Primary Healthcare Centers (PHCs) on challenges to the implementation of HTN pathway and suggestions for overcoming these challenges. Three Google forms were developed by the investigators to achieve the objectives of this study. The first two forms were completed by doctors and nurses at each PHC and reviewed by the leader of HTN pathway, and the third form completed by a representative of each PHC. SPSS version 26 was used for data management and analysis. Chi-square test was used to determine association between categorical variables; binary logistic regression analysis was performed to determine the correlates of being hypertensive and having good control of HTN. RESULTS A total of 159,243 individuals were screened for HTN, 55% of whom were females and 94% were Saudis. The prevalence of HTN was 13%; 70% were overweight or obese and 14% had diabetes. The total registered number of patients was 55,628; 50% had good HTN control. Major challenges were inadequate health coaches, care coordinators, laboratory and radiology facilities, lack of coordination with hospitals, and ineffective appointment system. CONCLUSION This study revealed that the current HTN pathway was successful with regard to screening and registration of patients with HTN. Many challenges need an executive plan with SMART objectives to optimize the care for HTN patients in the region.
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Affiliation(s)
- Ali M.M. Assiri
- Department of Public Health, General Directorate of Health Affairs, Aseer Region, Abha, Saudi Arabia
| | - Yahia M. Al-Khaldi
- Department of Public Health, General Directorate of Health Affairs, Aseer Region, Abha, Saudi Arabia
| | - Abdu A.A. Kaabi
- Department of Public Health, General Directorate of Health Affairs, Aseer Region, Abha, Saudi Arabia
| | - Ibrahim A.M. Alshehri
- Department of Public Health, General Directorate of Health Affairs, Aseer Region, Abha, Saudi Arabia
| | - Mohammad A.S. Al-Shahrani
- Department of Public Health, General Directorate of Health Affairs, Aseer Region, Abha, Saudi Arabia
| | - Abdullah A. Almalki
- Department of Public Health, General Directorate of Health Affairs, Aseer Region, Abha, Saudi Arabia
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165
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Satapathy P, Khatib MN, Gaidhane S, Zahiruddin QS, Gaidhane AM, Rustagi S, Serhan HA, Padhi BK. Association of neighborhood deprivation and hypertension: A systematic review and meta-analysis. Curr Probl Cardiol 2024; 49:102438. [PMID: 38301916 DOI: 10.1016/j.cpcardiol.2024.102438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Hypertension impacts nearly one billion individuals and is a primary health challenge. While traditional perspectives have focused on individual behavior and genetics as principal risk factors, recent research underscores the profound influence of socioeconomic factors within neighborhoods on the risk of hypertension. This systematic review and meta-analysis is aimed to elucidate the association between neighborhood deprivation and the risk of hypertension. METHODS A comprehensive literature search was conducted across PubMed, Embase, and Web of Science from inception until December 25, 2023. Observational studies defining neighborhood deprivation and reporting hypertension incidence were included. Nested Knowledge software was used for screening and data extraction, with study quality assessed using the Newcastle-Ottawa Scale. Statistical analysis was performed with R software (V 4.3), using a random-effects model to calculate the pooled relative risk (RR). RESULTS Twenty-six studies were included in the qualitative analysis and 22 in the meta-analysis, covering over 62 million participants. The pooled RR was 1.139 (95% CI: 1.006 - 1.290), p=0.04, indicating a higher hypertension risk in deprived neighborhoods. Subgroup analyses showed variability by country and deprivation assessment methods. RR varied from 1.00 in Japan (95% CI: 0.93-1.08) to 1.60 (95% CI: 1.07-2.39) in France and 1.57 (95% CI: 0.67-3.70) in Germany, with significant heterogeneity observed in measures of neighborhood deprivation. CONCLUSION Our analysis confirms a significant association between neighborhood deprivation and hypertension, underscoring the importance of socioeconomic factors in public health. It highlights the need for targeted local assessments and interventions. Future research should explore the causal mechanisms and effectiveness of interventions addressing neighborhood deprivation.
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Affiliation(s)
- Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India; School of Pharmacy, Graphic Era Hill University, Dehradun, India; Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil 51001, Iraq
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- South Asia Infant Feeding Research Network (SAIFRN), Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Abhay M Gaidhane
- Jawaharlal Nehru Medical College, and Global Health Academy, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education, Wardha, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar.
| | - Bijaya K Padhi
- Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Hirani MM, Gandhi R, Thakkar DG, Kateshiya N, Murugan Y. Investigating the Prevalence and Predictors of Uncontrolled Hypertension: A Cross-Sectional Study in Gujarat, India. Cureus 2024; 16:e59036. [PMID: 38800155 PMCID: PMC11128033 DOI: 10.7759/cureus.59036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Uncontrolled hypertension is a major public health concern that contributes significantly to cardiovascular morbidity and mortality. Treatment of hypertension prevents and reduces cardiovascular morbidity, notably a 40% reduction in risk of stroke and a 15% reduction in risk of myocardial infarction. Understanding the prevalence and predictors of uncontrolled hypertension is crucial for developing targeted interventions. OBJECTIVE This study aimed to determine the prevalence of uncontrolled hypertension and identify potential predictors among patients attending the Non-Communicable Disease (NCD) clinic of a tertiary care center in Gujarat, India. METHODS A cross-sectional study involving 732 adult patients with hypertension was conducted. Sociodemographic data, lifestyle factors, anthropometric measurements, and comorbidities were assessed. Blood pressure was measured using standardized protocols, and uncontrolled hypertension was defined as a systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg. Univariate and multivariate logistic regression analyses were performed to identify predictors of uncontrolled hypertension. RESULTS The prevalence of uncontrolled hypertension was 60.2% (95% CI: 56.7%-63.7%). In the multivariate analysis, increasing age (adjusted OR: 1.21, 95% CI: 1.05-1.39), increased body mass index (adjusted OR: 1.49, 95% CI: 1.27-1.75), diabetes (adjusted OR: 1.68, 95% CI: 1.20-2.35), chronic kidney disease (adjusted OR: 2.11, 95% CI: 1.22-3.65), and current smoking status (adjusted OR: 1.83, 95% CI: 1.14-2.93) were identified as independent predictors of uncontrolled hypertension. CONCLUSION This study revealed a high prevalence of uncontrolled hypertension in this tertiary care setting. Age, obesity, diabetes, chronic kidney disease, and smoking were identified as significant predictors. Targeted interventions addressing these modifiable risk factors and comorbidities are crucial for improving blood pressure control and reducing the burden of hypertension-related complications.
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Affiliation(s)
- Mehjabin M Hirani
- General Medicine, Shri M P Shah Government Medical College, Jamnagar, IND
| | - Rohankumar Gandhi
- Community and Family Medicine, Shri M P Shah Government Medical College, Jamnagar, IND
| | - Dipenkumar G Thakkar
- Preventive and Social Medicine, Shri M P Shah Government Medical College, Jamnagar, IND
| | - Nilesh Kateshiya
- Internal Medicine, Guru Gobind Government Hospital, Jamnagar, IND
| | - Yogesh Murugan
- Family Medicine, Guru Gobind Government Hospital, Jamnagar, IND
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167
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Lee HJ, Choi JW. Association between waist circumference change after smoking cessation and incidence of hypertension in Korean adults. Public Health 2024; 229:73-79. [PMID: 38402666 DOI: 10.1016/j.puhe.2024.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/14/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study investigates the association between smoking cessation and hypertension incidence, as well as the association between waist circumference change after smoking cessation and hypertension incidence. STUDY DESIGN This was a nationwide population-based cohort study. METHODS We used the Korean Health Screening Cohort data and included 158,505 participants who had undergone two or more health examinations between 2008 and 2011, with follow-ups throughout 2019. Smoking cessation and waist changes were captured based on difference between first and follow-up screening dates. Hazard ratio (HR) and 95% confidence interval (CI) for hypertension risk were estimated using multivariable Cox proportional hazard regression models. RESULTS There were 31,270 cases of hypertension during a median follow-up of 8.50 years. After adjusting for potential confounding factors, HR for hypertension were 1.01 (95% CI: 0.97-1.05), 0.91 (95% CI: 0.87-0.95), and 0.88 (95% CI: 0.85-0.91) for recent quitters, long-term quitters, and non-smokers, respectively, compared with current smokers. HR for hypertension, compared with current smokers, were 0.89 (95% CI: 0.84-0.94), 0.91 (95% CI: 0.85-0.97), and 0.99 (95% CI: 0.91-1.08) for long-term quitters with no waist gain, long-term quitters with waist gain of 0.1-5.0 cm, and long-term quitters with waist gain of ≥5.0 cm, respectively. CONCLUSIONS Long-term smoking cessation was significantly associated with decreased risk of hypertension, and long-term smoking cessation with no waist gain or less than 5.0 cm of waist gain was significantly associated with decreased risk of hypertension. However, more than 5.0 cm of waist gain can attenuate the effect of long-term smoking cessation on lowering the risk of hypertension.
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Affiliation(s)
- H J Lee
- Department of Statistics and Data Science, Yonsei University, Seoul, Republic of Korea
| | - J W Choi
- Health Insurance Research Institute, National Health Insurance Service, Wonju, Republic of Korea.
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168
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Shi Z, D Langleben D, Rott D, Albanese M, Elman I. Blood pressure response to extended-release naltrexone in heroin and prescription opioid users and its implications for cardiovascular morbidity. J Addict Dis 2024:1-11. [PMID: 38555861 DOI: 10.1080/10550887.2024.2327739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
BACKGROUND Consuming opioid agonists is a risk factor for cardiovascular disease particularly in intravenous heroin users. The monthly injectable extended-release opioid antagonist, naltrexone (XR-NTX) is an effective treatment for opioid use disorder. The impact of opioid receptor blockade through XR-NTX on blood pressure, a critical risk factor for cardiovascular morbidity, has not yet been characterized. METHODS The study evaluated the change in blood pressure during XR-NTX treatment among 14 patients who predominately used intravenous heroin and 24 patients who used prescription oral opioids, all with opioid use disorder. Blood pressure was measured in each patient immediately before the first XR-NTX injection and ∼two weeks after the first injection. The change in diastolic and systolic pressure was compared between the heroin users and the prescription opioids users using analysis of variance. RESULTS XR-NTX treatment was associated with significant decreases in diastolic blood pressure in the heroin group, but not in the prescription opioids group. Systolic blood pressure values in the heroin users showed a decline at trend level only. CONCLUSIONS Further research is warranted to replicate our findings and to determine whether XR-NTX effect is relatively specific to blood pressure or generalizes to other components of metabolic syndrome. Distinguishing between heroin and prescription opioid users could shed light on the unique clinical and pharmacological profiles of opioid drugs, particularly regarding their cardiovascular safety. This information can be useful in developing personalized therapeutic strategies based on the route of opioid administration.
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Affiliation(s)
- Zhenhao Shi
- Department of Psychiatry, Center for Studies of Addiction, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Daniel D Langleben
- Department of Psychiatry, Center for Studies of Addiction, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - David Rott
- Department of Cardiology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv, Israel
| | - Mark Albanese
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Boston, MA, USA
- Physician Health Services, Massachusetts Medical Society, Waltham, MA, USA
| | - Igor Elman
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Boston, MA, USA
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169
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Hong S, He H, Fang P, Liu S, Chen C. Association of neutrophil-to-lymphocyte ratio and risk of cardiovascular and all-cause mortality in hypertension patients. Heliyon 2024; 10:e27517. [PMID: 38496832 PMCID: PMC10944217 DOI: 10.1016/j.heliyon.2024.e27517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/19/2024] Open
Abstract
Background and objective Hypertension affects over a billion people worldwide and is often associated with poor prognoses. The neutrophil-to-lymphocyte ratio (NLR) has become a significant marker, showing a connection to adverse outcomes in cardiovascular diseases (CVDs). The objective of this study is to examine the relationship between the NLR and outcomes in patients with hypertension. Methods The study included hypertensive individuals who were surveyed in the National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018. Mortality status was determined using the data from National Death Index (NDI). To investigate the dose-response relationship, restricted cubic spline (RCS) models were used. This study employed adjusted cox proportional hazards regression models to compute hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) for all-cause and cardiovascular mortality. The predictive accuracy of the NLR for survival outcomes was assessed utilizing time-dependent receiver operating characteristic (ROC) curve analysis. Results A total of 13,724 participants were included in the final analysis, including 7073 males and 6651 females. The cohort was stratified into higher (>2.0) and lower (≤2.0) NLR groups according to the median value. Over a median follow-up of 64 months, there were 1619 all-cause deaths and 522 cardiovascular deaths among participants. The RCS analysis indicated a non-linear relationship between NLR and the risk of mortality. The adjusted model showed that the group with a higher NLR had a significantly higher risk of all-cause (HR 1.47, 95% CI 1.22-1.77) and cardiovascular mortality (HR 2.08, 95% CI 1.52-2.86). ROC analysis showed that the area under the curves (AUCs) of 0.692, 0.662, 0.644, and 0.625 for predicting all-cause mortality, and 0.712, 0.692, 0.687, and 0.660 for cardiovascular mortality at 1, 3, 5, and 10 years. Conclusion Elevated NLR is associated with increased risk of cardiovascular and all-cause mortality, and NLR may independently predict outcomes in individuals with hypertension.
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Affiliation(s)
- Shaoqing Hong
- Corresponding author. Department of Cardiovascular Medicine, Huangshi Fifth Hospital, No.98 XiaLu Dadao, Xialu District, Huangshi, Hubei, 435005, China.
| | | | - Peng Fang
- Department of Cardiovascular Medicine, Huangshi Fifth Hospital, No.33 XiaLu Dadao, Xialu District, Huangshi, Hubei, 435005, China
| | - Shuai Liu
- Department of Cardiovascular Medicine, Huangshi Fifth Hospital, No.33 XiaLu Dadao, Xialu District, Huangshi, Hubei, 435005, China
| | - Changyi Chen
- Department of Cardiovascular Medicine, Huangshi Fifth Hospital, No.33 XiaLu Dadao, Xialu District, Huangshi, Hubei, 435005, China
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170
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Shin S, Park J, Choi HY, Bu Y, Lee K. Blood-Pressure-Lowering and Endothelium-Dependent Vasorelaxant Effects of Nutgall Tree in Rats. Foods 2024; 13:1041. [PMID: 38611347 PMCID: PMC11011363 DOI: 10.3390/foods13071041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
Hypertension is the crucial modifiable risk factor for cardiovascular diseases, and efforts to identify functional foods that are effective for hypertension control are increasing. The nutgall tree (NT, Rhus chinensis Mill.) is used in traditional medicine and food because of its medicinal value. However, the role of NT in hypertension has not been investigated. Therefore, the hypotensive effect of NT leaf ethanol extract (NTE) was investigated in spontaneously hypertensive rats (SHRs). SHRs were allocated to three groups (control, 300, or 1000 mg/kg NTE), and blood pressure was measured before and after oral administration. Systolic and diastolic blood pressure significantly decreased in the NTE 1000 mg/kg group and was the lowest at 2 h after administration (-26.4 ± 10.3, -33.5 ± 9.8%, respectively). Daily NTE administration for five days also resulted in a similar effect. Further, the vasorelaxant effects and related mechanisms were investigated in the aortas of Sprague Dawley rats. NTE showed the dose-dependent blood-vessel-relaxing effect, and its mechanism involves the NO-sGC-cGMP pathway, activation of K+ channels, and reduction in the vasoconstrictive action of angiotensin II. Therefore, our study provides basic data indicating the potential use of NTE as a functional food for high blood pressure.
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Affiliation(s)
- Sujin Shin
- Department of Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Junkyu Park
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Ho-Young Choi
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.-Y.C.); (Y.B.)
| | - Youngmin Bu
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.-Y.C.); (Y.B.)
| | - Kyungjin Lee
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (H.-Y.C.); (Y.B.)
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171
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Park JH, Kim K, Medina M, Ng BP, Smith ML, Edafetanure-Ibeh OM, Chang J. Hypertension Medication and Medicare Beneficiaries: Prescription Drug Coverage Satisfaction and Medication Non-Adherence among Older Adults. Healthcare (Basel) 2024; 12:722. [PMID: 38610145 PMCID: PMC11011680 DOI: 10.3390/healthcare12070722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Hypertension is so prevalent and requires strict adherence to medications to prevent further disease or death, but there is no study examining factors related to prescription drug non-adherence among 65 years old and older. This study aims to assess the likelihood of medication nonadherence among patients based on factors such as age, race, and socioeconomic status, with the goal of identifying strategies to enhance medication adherence and mitigate associated health risks. Using the 2020 Medicare Current Beneficiary Survey Public Use File to represent nationwide Medicare beneficiaries (unweighted n = 3917, weighted n = 27,134,782), medication non-adherence was related to multiple independent variables (i.e., age, sex, race/ethnicity, socioeconomic status, comorbidities, insurance coverage, and satisfaction with insurance). Cross-tabulations and Wald chi-square tests were used to determine how much each variable was related to non-adherence. Multivariate logistic regression was used to examine the association between medication non-adherence and factors such as prescription drug coverage satisfaction and cost-reducing behavior. Specific trends in medication non-adherence emerged among beneficiaries. Non-adherence was higher in older adults aged 65- to 74-year-olds and those with more chronic conditions (OR = 2.24; 95% CI = 1.74-2.89). If patients were dissatisfied with the medications on the insurance formulary or struggled to find a pharmacy that accepted their medication coverage, they had worse adherence (OR = 2.63; 95% CI = 1.80-3.84). Formulary and coverage must be expanded to improve adherence to antihypertensive medications in Medicare beneficiaries. Older adults aged 65 to 74 years may be less adherent to their medications because they do not see the seriousness of the disease and could benefit from further counseling. Patients with limited activities of daily living and more comorbidities may struggle with complex treatment regimens and should use adherence assistance tools.
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Affiliation(s)
- Jeong-Hui Park
- School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (J.-H.P.); (K.K.); (M.L.S.); (O.M.E.-I.)
| | - Kiyoung Kim
- School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (J.-H.P.); (K.K.); (M.L.S.); (O.M.E.-I.)
| | - Mar Medina
- School of Pharmacy, University of Texas at El Paso, 1101 N campbell St., El Paso, TX 79902, USA;
| | - Boon Peng Ng
- College of Nursing, University of Central Florida, 12201 Research Parkway, Orlando, FL 32826, USA;
| | - Matthew Lee Smith
- School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (J.-H.P.); (K.K.); (M.L.S.); (O.M.E.-I.)
- Center for Health Equity and Evaluation Research, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA
- Center for Community Health and Aging, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA
| | - Okeoghene Marcel Edafetanure-Ibeh
- School of Public Health, Texas A&M Health Science Center, 212 Adriance Lab Rd., College Station, TX 77843, USA; (J.-H.P.); (K.K.); (M.L.S.); (O.M.E.-I.)
| | - Jongwha Chang
- Irma Lerma Rangel School of Pharmacy, Texas A&M Health Science Center, 159 Reynolds Medical, College Station, TX 77843, USA
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172
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Sosa F, Shaban M, Lopez J, Duarte GJ, Jain S, Khizar A, Vittorio T, Mishra R, Rodriguez Guerra M. Impact of Hyperuricemia and Urate-Lowering Agents on Cardiovascular Diseases. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2024; 18:11795468241239542. [PMID: 38529322 PMCID: PMC10962038 DOI: 10.1177/11795468241239542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 02/29/2024] [Indexed: 03/27/2024]
Abstract
The association between hyperuricemia and cardiovascular diseases has been studied for many years. Research has shown a link between high uric acid levels and increased risk of including coronary artery disease hypertension and other cardiovascular conditions. Urate-lowering therapy, particularly with xanthine oxidase inhibitors like allopurinol, has shown promising results in reducing blood pressure in individuals with hyperuricemia and hypertension. Clinical trials and studies have demonstrated significant reductions in both systolic and diastolic blood pressure with urate-lowering treatment. Urate-lowering treatment has shown a favorable effect on reducing systolic blood pressure and major adverse cardiovascular events in patients with previous cardiovascular disease. In terms of cardiovascular safety, clinical trials have indicated that xanthine oxidase inhibitors such as febuxostat are non-inferior to allopurinol and do not increase the risk of death or serious adverse events. Overall, these findings highlight the importance of managing hyperuricemia and utilizing urate-lowering therapy to mitigate the adverse cardiovascular effects associated with elevated uric acid levels.
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Affiliation(s)
- Franklin Sosa
- BronxCare Health System, Icahn School of Medicine, Bronx, NY, USA
| | - Mohammed Shaban
- BronxCare Health System, Icahn School of Medicine, Bronx, NY, USA
| | - Jose Lopez
- Division of Cardiovascular Disease, University of Miami Miller School of Medicine/JFK Hospital, Atlantis, FL, USA
| | - Gustavo J. Duarte
- Division of Cardiology, Cleveland Clinic Florida, Fort Lauderdale, FL, USA
| | - Swati Jain
- Montefiore Medical Center, Einstein College of Medicine, Bronx, NY, USA
| | - Asma Khizar
- Montefiore Medical Center, Einstein College of Medicine, Bronx, NY, USA
| | - Timothy Vittorio
- BronxCare Health System, Icahn School of Medicine, Bronx, NY, USA
| | - Rishabh Mishra
- Montefiore Medical Center, Einstein College of Medicine, Bronx, NY, USA
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173
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Yang J, Yu J, Wang Y, Liao M, Ji Y, Li X, Wang X, Chen J, Qi B, Yang F. Development of hypertension models for lung cancer screening cohorts using clinical and thoracic aorta imaging factors. Sci Rep 2024; 14:6862. [PMID: 38514739 PMCID: PMC10957886 DOI: 10.1038/s41598-024-57396-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
This study aims to develop and validate nomogram models utilizing clinical and thoracic aorta imaging factors to assess the risk of hypertension for lung cancer screening cohorts. We included 804 patients and collected baseline clinical data, biochemical indicators, coexisting conditions, and thoracic aorta factors. Patients were randomly divided into a training set (70%) and a validation set (30%). In the training set, variance, t-test/Mann-Whitney U-test and standard least absolute shrinkage and selection operator were used to select thoracic aorta imaging features for constructing the AIScore. Multivariate logistic backward stepwise regression was utilized to analyze the influencing factors of hypertension. Five prediction models (named AIMeasure model, BasicClinical model, TotalClinical model, AIBasicClinical model, AITotalClinical model) were constructed for practical clinical use, tailored to different data scenarios. Additionally, the performance of the models was evaluated using receiver operating characteristic (ROC) curves, calibration curves and decision curve analyses (DCA). The areas under the ROC curve for the five models were 0.73, 0.77, 0.83, 0.78, 0.84 in the training set, and 0.77, 0.78, 0.81, 0.78, 0.82 in the validation set, respectively. Furthermore, the calibration curves and DCAs of both sets performed well on accuracy and clinical practicality. The nomogram models for hypertension risk prediction demonstrate good predictive capability and clinical utility. These models can serve as effective tools for assessing hypertension risk, enabling timely non-pharmacological interventions to preempt or delay the future onset of hypertension.
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Affiliation(s)
- Jinrong Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Yu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yaoling Wang
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Man Liao
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingying Ji
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Li
- Shanghai United Imaging Intelligence Inc., Shanghai, China
| | - Xuechun Wang
- Shanghai United Imaging Intelligence Inc., Shanghai, China
| | - Jun Chen
- Precision Healthcare Institute, GE Healthcare, Shanghai, China
| | - Benling Qi
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Fan Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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174
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Walquist MJ, Eilertsen KE, Elvevoll EO, Jensen IJ. Marine-Derived Peptides with Anti-Hypertensive Properties: Prospects for Pharmaceuticals, Supplements, and Functional Food. Mar Drugs 2024; 22:140. [PMID: 38667757 PMCID: PMC11051484 DOI: 10.3390/md22040140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 04/28/2024] Open
Abstract
Hypertension, a major health concern linked to heart disease and premature mortality, has prompted a search for alternative treatments due to side effects of existing medications. Sustainable harvesting of low-trophic marine organisms not only enhances food security but also provides a variety of bioactive molecules, including peptides. Despite comprising only a fraction of active natural compounds, peptides are ideal for drug development due to their size, stability, and resistance to degradation. Our review evaluates the anti-hypertensive properties of peptides and proteins derived from selected marine invertebrate phyla, examining the various methodologies used and their application in pharmaceuticals, supplements, and functional food. A considerable body of research exists on the anti-hypertensive effects of certain marine invertebrates, yet many species remain unexamined. The array of assessments methods, particularly for ACE inhibition, complicates the comparison of results. The dominance of in vitro and animal in vivo studies indicates a need for more clinical research in order to transition peptides into pharmaceuticals. Our findings lay the groundwork for further exploration of these promising marine invertebrates, emphasizing the need to balance scientific discovery and marine conservation for sustainable resource use.
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Affiliation(s)
- Mari Johannessen Walquist
- Faculty of Biosciences, Fisheries and Economics, The Norwegian College of Fishery Science, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (K.-E.E.); (E.O.E.)
| | - Karl-Erik Eilertsen
- Faculty of Biosciences, Fisheries and Economics, The Norwegian College of Fishery Science, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (K.-E.E.); (E.O.E.)
| | - Edel Oddny Elvevoll
- Faculty of Biosciences, Fisheries and Economics, The Norwegian College of Fishery Science, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (K.-E.E.); (E.O.E.)
| | - Ida-Johanne Jensen
- Faculty of Biosciences, Fisheries and Economics, The Norwegian College of Fishery Science, UiT The Arctic University of Norway, N-9037 Tromsø, Norway; (K.-E.E.); (E.O.E.)
- Department of Biotechnology and Food Science, Norwegian University of Science and Technology (NTNU), N-7491 Trondheim, Norway
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175
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Tseng PY, Sung FC, Muo CH, Lan YC, Hser YI, Chien SHL, Wang JY. Risk of diabetes and hypertension in a population with alcohol use disorders. BMC Public Health 2024; 24:868. [PMID: 38515085 PMCID: PMC10956217 DOI: 10.1186/s12889-024-18318-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND A population-based follow-up study assessing the risk of developing hypertension and diabetes associated with alcohol use disorder (AUD) is crucial. We investigated this relationship by using insurance claims data from Taiwan. METHODS From the claims data, an AUD cohort (N = 60,590) diagnosed between 2000 and 2006 and a non-AUD comparison cohort (N = 60,590) without the diagnosis of hypertension or diabetes at baseline were established and matched by propensity scores estimated by baseline demographic status and the Charlson comorbidity index (CCI). We assessed the incidence rates of hypertension and/or diabetes at the end of 2016 and used Cox's method to estimate the related hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS Relative to the comparison cohort, the AUD cohort had an approximately 1.70-fold higher incidence of hypertension (35.1 vs. 20.7 per 1,000 person-years), with an adjusted HR (aHR) of 1.72 (95% CI: 1.68-1.76), 2.16-fold higher incidence of diabetes (20.2 vs. 9.36 per 1,000 person-years), with an aHR of 2.18 (95% CI: 2.11-2.24), and 1.91-fold higher incidence of both diabetes and hypertension (10.3 vs. 5.38 per 1,000 person-years) with an aHR of 2.02 (95% CI: 1.94-2.10). The incidence rates of all outcomes were greater in men than in women, whereas the HRs were greater for AUD in women than for AUD in men relative to the respective comparison patients. The risk increased further for subjects with CCI ≥ 1, which was higher in the AUD cohort. CONCLUSIONS The increased risk of developing diabetes and hypertension in patients with AUD, especially the differences noted according to gender, indicates that clinicians should address potential comorbidities in these patients.
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Affiliation(s)
- Pei-Ying Tseng
- Department of Public Health, China Medical University, 406, Taichung, Taiwan
- Department of Medicine, Lee's General Hospital, 358, Yuanli, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, 404, Taichung, Taiwan
- Department of Health Services Administration, China Medical University College of Public Health, 406, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, 413, Taichung, Taiwan
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, 404, Taichung, Taiwan
| | - Yu-Ching Lan
- Expert Labs, IBM Taiwan Corporation, 110, Taipei, Taiwan
| | - Yih-Ing Hser
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, 90095, Los Angeles, CA, USA
| | - Sarina Hui-Lin Chien
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Jong-Yi Wang
- Department of Health Services Administration, China Medical University, 100 Jingmao Rd. Sec. 1, Beitun Dist, 406, Taichung, Taiwan.
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176
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Joshi AM, Raveendran AV, Arumugam M. Therapeutic role of yoga in hypertension. World J Methodol 2024; 14:90127. [PMID: 38577206 PMCID: PMC10989416 DOI: 10.5662/wjm.v14.i1.90127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 03/07/2024] Open
Abstract
Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event. Both non-pharmacological and pharmacological treatment options are available to treat hypertension. Yoga, recently received more attention as a treatment modality for various lifestyle disorders, even though practiced in India since ancient times. In this review, we are analyzing the role of yoga in the treatment of systemic hypertension.
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Affiliation(s)
- Anjali Mangesh Joshi
- Department of Psycho-Oncology, HCG NCHRI Cancer Center, Nagpur 440026, Maharashtra, India
| | - Arkiath Veettil Raveendran
- Department of Internal Medicine, Former Assistant Professor of Medicine, Govt. Medical College, Kozhikode 673010, Kerala, India
| | - Muruganathan Arumugam
- Department of Internal Medicine, Past president API Past Governor American College of Physicians Past President Hypertension Society of India Past Dean Indian College of Physicians, Tirupur 641602, Tamilnadu, India
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177
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Li Y, Yu B, Yin L, Li X, Nima Q. Long-term exposure to particulate matter is associated with elevated blood pressure: Evidence from the Chinese plateau area. J Glob Health 2024; 14:04039. [PMID: 38483442 PMCID: PMC10939114 DOI: 10.7189/jogh.14.04039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Background Ambient air pollution could increase the risk of hypertension; however, evidence regarding the relationship between long-term exposure to particulate matter and elevated blood pressure in plateau areas with lower pollution levels is limited. Methods We assessed the associations of long-term exposure to particulate matter (PM, PM1, PM2.5, and PM10) with hypertension, diastolic blood pressure (DBP), systolic blood pressure (SBP) and pulse pressure (PP) in 4.235 Tibet adults, based on the baseline of the China multi-ethnic cohort study (CMEC) in Lhasa city, Tibet from 2018-19. We used logistic regression and linear regression models to evaluate the associations of ambient PM with hypertension and blood pressure, respectively. Results Long-term exposure to PM1, PM2.5, and PM10 is positively associated with hypertension, DBP, and SBP, while negatively associated with PP. Among these air pollutants, PM10 had the strongest effect on hypertension, DBP, and SBP, while PM2.5 had the strongest effect on PP. The results showed for hypertension odds ratio (OR) = 1.99; 95% confidence interval (CI) = 1.58, 2.51 per interquartile range (IQR) μg/m3 increase in PM1, OR = 1.93; 95% CI = 1.55, 2.40 per IQR μg/m3 increase in PM2.5, and OR = 2.12; 95% CI = 1.67, 2.68 per IQR μg/m3 increase in PM10. Conclusions Long-term exposure to ambient air pollution was associated with an increased risk of hypertension, elevated SBP and DBP levels, and decreased PP levels. To reduce the risk of hypertension and PP reduction, attention should be paid to air quality interventions in plateau areas with low pollution levels.
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Affiliation(s)
- Yajie Li
- Tibet Centre for Disease Control and Prevention, Lhasa, Tibet Autonomous Region, China
| | - Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University – Hong Kong Polytechnic University, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Li Yin
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
- Clinical Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
- Dali University, Dali, China
| | - Xianzhi Li
- Meteorological Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
- Clinical Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
- Dali University, Dali, China
| | - Qucuo Nima
- Tibet Centre for Disease Control and Prevention, Lhasa, Tibet Autonomous Region, China
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178
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Garg K, Staunton MK, Peixoto AJ, Wilson FP, Ghazi L. Correlates of Spontaneous Blood Pressure Reduction Following Severe Inpatient Hypertension Development. Am J Hypertens 2024; 37:273-279. [PMID: 37988620 DOI: 10.1093/ajh/hpad112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/29/2023] [Accepted: 11/18/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Severe hypertension (sHTN) is prevalent in 10% of hospitalized patients and treatment guidelines are lacking. As such, patients who develop sHTN might unnecessarily receive antihypertensive medications which could lead to worse outcomes. Our goal was to investigate correlates of spontaneous blood pressure (BP) reduction to help guide future treatment decisions and avoid harm associated with aggressive BP treatment. METHODS This is a retrospective cohort study of hospitalized adults between 2016 and 2020 who developed sHTN, SBP >180 or DBP >110 mm Hg, after admission. Spontaneous BP reduction was defined as a SBP <160 and a DBP <100 mm Hg achieved within 3 h of sHTN in the absence of antihypertensive therapy. Multivariable logistic regression was used to identify correlates of spontaneous BP reduction. RESULTS Of the 12,825 patients who developed sHTN, 44.2% had spontaneous BP reduction. After adjustment, we found that patients most likely to experience a BP drop received steroids before onset of sHTN (Odds ratio [OR]: 1.3 [1.09, 1.56]), had higher potassium levels on admission (OR: 1.2 [1.09, 1.24]) and were more likely to have a history of chronic pulmonary disease (OR: 1.1 [1.01, 1.18]) or cardiac arrythmia (OR: 1.1 [1.01, 1.18]). While numerically different, these differences were not clinically relevant. CONCLUSIONS Our findings indicate that almost half the patients who develop sHTN have spontaneous BP reduction. Conventional clinical and demographic characteristics were not strong predictors of spontaneous BP reduction following sHTN development. More research is needed to confirm our findings and help guide treatment of sHTN.
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Affiliation(s)
- Kanika Garg
- Department of Internal Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut, USA
| | - Mary Kate Staunton
- Department of Internal Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut, USA
| | - Aldo J Peixoto
- Section of Nephrology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Francis Perry Wilson
- Department of Internal Medicine, Clinical and Translational Research Accelerator, Yale University, New Haven, Connecticut, USA
- Section of Nephrology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Lama Ghazi
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Olatoye FJ, Akindele A, Awodele O. The role of Kolaviron, a bioflavonoid from Garcinia kola, in the management of cardiovascular diseases: A systematic review. Heliyon 2024; 10:e27333. [PMID: 38449600 PMCID: PMC10915569 DOI: 10.1016/j.heliyon.2024.e27333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 02/17/2024] [Accepted: 02/28/2024] [Indexed: 03/08/2024] Open
Abstract
While the cardiovascular effects of Kolaviron (KV) and Garcinia kola (GK) are documented in the literature, a thorough search through literature revealed a fragmentation of information on the effect of KV and GK on cardiovascular diseases (CVDs). This systematic review aims to evaluate and summarize preclinical or clinical evidence on the effect of KV and GK on CVDs. Using the PRISMA guidelines, a systematic literature search was conducted in five medical databases (PubMed, Cochrane, EMBASE, CINAHL, and Web of Science). Inclusion criteria included both in vivo and in vitro studies related to CVDs. Eligible studies included those in which specific clinical parameters, CVD biomarkers, or voltage-gated channel effects were reported. The quality of the included studies was assessed using a modified Collaborative Approach to Meta-Analysis and Review of Animal Data from the Experimental Studies (CAMARADE) checklist. A total of 22 studies were included in this systematic review. The median and mean values of the included studies' quality scores were 6 and 5.864 ± 0.296, respectively. The results from the quality assessment of included studies validate their suitability, usefulness, and fit. Based on this systematic review, the effect of KV and GK on CVDs can be divided into eight emerging trends: (1) Anti-hypertensive/Blood pressure lowering effect; (2) Lipid profile improvement effect (3) Anti-atherosclerotic effect; (4) Anti-thrombotic effect; (5) Cardioprotection; (6) Vasodilatory effect; (7) Antioxidant effects; and (8) Genetic expression and therapeutic target for cardiovascular dysfunction. From this systematic review, it can be concluded that KV is helpful in managing CVD risk factors such as hypertension and high lipids/cholesterol. Several included studies in this review demonstrated the antihypertensive, lipid improvement, antioxidant, and signaling pathway modulation effects of KV. This potentially makes KV a good therapeutic target for the management of CVDs.
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Affiliation(s)
- Francis J. Olatoye
- Department of Pharmacology, Therapeutics and Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, P.M.B. 12003, Lagos, Nigeria
| | - Abidemi.J. Akindele
- Department of Pharmacology, Therapeutics and Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, P.M.B. 12003, Lagos, Nigeria
| | - Olufunsho Awodele
- Department of Pharmacology, Therapeutics and Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Idi-Araba, P.M.B. 12003, Lagos, Nigeria
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180
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Faraci FM, Scheer FA. Hypertension: Causes and Consequences of Circadian Rhythms in Blood Pressure. Circ Res 2024; 134:810-832. [PMID: 38484034 PMCID: PMC10947115 DOI: 10.1161/circresaha.124.323515] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/16/2024] [Indexed: 03/19/2024]
Abstract
Hypertension is extremely common, affecting approximately 1 in every 2 adults globally. Chronic hypertension is the leading modifiable risk factor for cardiovascular disease and premature mortality worldwide. Despite considerable efforts to define mechanisms that underlie hypertension, a potentially major component of the disease, the role of circadian biology has been relatively overlooked in both preclinical models and humans. Although the presence of daily and circadian patterns has been observed from the level of the genome to the whole organism, the functional and structural impact of biological rhythms, including mechanisms such as circadian misalignment, remains relatively poorly defined. Here, we review the impact of daily rhythms and circadian systems in regulating blood pressure and the onset, progression, and consequences of hypertension. There is an emphasis on the impact of circadian biology in relation to vascular disease and end-organ effects that, individually or in combination, contribute to complex phenotypes such as cognitive decline and the loss of cardiac and brain health. Despite effective treatment options for some individuals, control of blood pressure remains inadequate in a substantial portion of the hypertensive population. Greater insight into circadian biology may form a foundation for novel and more widely effective molecular therapies or interventions to help in the prevention, treatment, and management of hypertension and its related pathophysiology.
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Affiliation(s)
- Frank M. Faraci
- Department of Internal Medicine, Francois M. Abboud Cardiovascular Center, Carver College of Medicine, University of Iowa, Iowa City, IA 52242-1081
- Department of Neuroscience and Pharmacology, Francois M. Abboud Cardiovascular Center, Carver College of Medicine, University of Iowa, Iowa City, IA 52242-1081
| | - Frank A.J.L. Scheer
- Division of Sleep Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, 02115
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, 02115
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181
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Andishgar A, Bazmi S, Tabrizi R, Rismani M, Keshavarzian O, Pezeshki B, Ahmadizar F. Machine learning-based models to predict the conversion of normal blood pressure to hypertension within 5-year follow-up. PLoS One 2024; 19:e0300201. [PMID: 38483860 PMCID: PMC10939282 DOI: 10.1371/journal.pone.0300201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Factors contributing to the development of hypertension exhibit significant variations across countries and regions. Our objective was to predict individuals at risk of developing hypertension within a 5-year period in a rural Middle Eastern area. METHODS This longitudinal study utilized data from the Fasa Adults Cohort Study (FACS). The study initially included 10,118 participants aged 35-70 years in rural districts of Fasa, Iran, with a follow-up of 3,000 participants after 5 years using random sampling. A total of 160 variables were included in the machine learning (ML) models, and feature scaling and one-hot encoding were employed for data processing. Ten supervised ML algorithms were utilized, namely logistic regression (LR), support vector machine (SVM), random forest (RF), Gaussian naive Bayes (GNB), linear discriminant analysis (LDA), k-nearest neighbors (KNN), gradient boosting machine (GBM), extreme gradient boosting (XGB), cat boost (CAT), and light gradient boosting machine (LGBM). Hyperparameter tuning was performed using various combinations of hyperparameters to identify the optimal model. Synthetic Minority Over-sampling Technology (SMOTE) was used to balance the training data, and feature selection was conducted using SHapley Additive exPlanations (SHAP). RESULTS Out of 2,288 participants who met the criteria, 251 individuals (10.9%) were diagnosed with new hypertension. The LGBM model (determined to be the optimal model) with the top 30 features achieved an AUC of 0.67, an f1-score of 0.23, and an AUC-PR of 0.26. The top three predictors of hypertension were baseline systolic blood pressure (SBP), gender, and waist-to-hip ratio (WHR), with AUCs of 0.66, 0.58, and 0.63, respectively. Hematuria in urine tests and family history of hypertension ranked fourth and fifth. CONCLUSION ML models have the potential to be valuable decision-making tools in evaluating the need for early lifestyle modification or medical intervention in individuals at risk of developing hypertension.
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Affiliation(s)
- Aref Andishgar
- USERN Office, Fasa University of Medical Sciences, Fasa, Iran
| | - Sina Bazmi
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Reza Tabrizi
- Noncommunicable Diseases Research Center, Fasa University of Medical Science, Fasa, Iran
| | - Maziyar Rismani
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Omid Keshavarzian
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Babak Pezeshki
- Clinical Research Development Unit, Valiasr Hospital, Fasa University of Medical Sciences, Fasa, Iran
| | - Fariba Ahmadizar
- Department of Data Science and Biostatistics, Julius Global Health, University Medical Center Utrecht, Utrecht, The Netherlands
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182
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Gumilang RA, Fan YC, Wu SH, Bai CH. Adiposity indices and their higher predictive value for new-onset hypertension in metabolically healthy young women: findings from a population-based prospective cohort study. BMC Cardiovasc Disord 2024; 24:150. [PMID: 38475731 DOI: 10.1186/s12872-024-03817-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/26/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND AND AIMS The present study aimed to investigate the predictive ability of selected adiposity indices, such as body mass index (BMI), waist-to-hip ratio (WHR), waist circumference (WC), and waist-to-height ratio (WHtR), for new-onset hypertension in metabolically healthy Taiwanese adults. The study also sought to establish sex-specific cutoff points for these indices and to analyze the risk of new-onset hypertension, taking into account sex and age. METHODS This prospective cohort study utilized the Taiwan Biobank database to examine metabolically healthy participants aged between 20 and 65 at baseline. Four adiposity indices, namely BMI, WHR, WC, and WHtR, were calculated and used to predict new-onset hypertension over 4 years. Receiver operating characteristics (ROCs) and areas under the curve (AUCs) were used to evaluate the effectiveness of the parameters in predicting new-onset hypertension over 4 years. Sex-specific cutoff points were identified and used to assess the risk of new-onset hypertension. RESULTS This study analyzed 13,375 participants over 4.28 years. The incidence of new-onset hypertension was 17.65%. The new-onset rate of hypertension was 34.39% in men and 65.61% in women. Adiposity indices effectively predict new-onset hypertension, with WHtR having the highest predictive value (i.e., AUC) for both sexes. The classification of participants into low and high categories for each adiposity index was based on sex-specific cutoff points, and the risk of new-onset hypertension was assessed according to sex and age. This study found that high adiposity indices predicted a significantly higher risk of new-onset hypertension in metabolically healthy adults. The risk was equal for both sexes. Young women had a higher risk of new-onset hypertension than middle-aged women when they were further categorized. All risk ratios of the indices in young women were over two-fold and significant. CONCLUSION According to the sex-specific cutoff point, high adiposity indices had a higher predictive value for new-onset hypertension in metabolically healthy Taiwanese young women.
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Affiliation(s)
- Rizki Amalia Gumilang
- International Master/Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Faculty of Medicine, Public Health, and Nursing/Academic Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yen-Chun Fan
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Department of Allied Health Education and Digital Learning, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shang-Hao Wu
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chyi-Huey Bai
- Department of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
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183
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Pasdar Y, Rezaeian S, Mohammadi E, Khosravi Shadmani F, Shahnazi N, Najafi F, Nazar MM, Darbandi M. The interaction between general or abdominal obesity and hypertension on the risk of type 2 diabetes mellitus: a cross-sectional analysis in Iranian adults from the RaNCD cohort study. BMC Public Health 2024; 24:752. [PMID: 38462604 PMCID: PMC10926646 DOI: 10.1186/s12889-024-18290-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/05/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Interactions between risk factors may influence disease severity. Knowing this relationship is important for preventive interventions and disease control. The purpose of this study was to determine the interactions effects of obesity and hypertension on the risk of type 2 diabetes mellitus (T2DM). METHODS The data of 9,283 adults 35 to 65 years were examined from the cohort study of Ravansar Non-Communicable Disease (RaNCD). Waist circumference (WC) was used to identify both general and abdominal obesity based on body mass index (BMI). To assess the interaction between hypertension and obesity (general/abdominal) and the risk of T2DM, the additive interaction was calculated. RESULTS The adjusted odds ratios for T2DM were 2.38 (1.67, 3.41) in men and 4.02 (2.47, 6.47) in women for the combinations of hypertension and abdominal obesity. The adjusted odds ratios for T2DM were 2.53 (1.63, 3.82) in men and 2.66 (1.92, 3.70) in women for the combinations of hypertension and general obesity. The results of the additive interaction indicators were inconsistent with gender. The relative excess risk due to interaction (interaction between hypertension and central obesity) (RERI), attributable proportion due to interaction (AP) and synergy index (SI) were0.27 (-1.01, 1.54), 0.11 (-0.41, 0.63) and 1.23 (0.41, 3.68) in male and were 0.61 (-1.12, 2.33), 0.23 (0.08, 0.37) and 1.26 (0.60, 2.61) in female, respectively. CONCLUSION General/abdominal obesity and hypertension have a synergistic effect on the risk of T2DM. The recommendation for preventing T2DM is lifestyle modification. Large longitudinal studies are necessary to investigate causal relationships.
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Affiliation(s)
- Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahab Rezaeian
- Infectious Disease Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Mohammadi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Khosravi Shadmani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Cardiovascular Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradi Nazar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Haider SA, Wagener M, Iqbal T, Shahzad S, Del Sole PA, Leahy N, Murphy D, Sharif R, Ullah I, Sharif F. Does renal denervation require cardiovascular outcome-driven data? Hypertens Res 2024:10.1038/s41440-024-01598-7. [PMID: 38462663 DOI: 10.1038/s41440-024-01598-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/01/2024] [Accepted: 01/13/2024] [Indexed: 03/12/2024]
Abstract
Hypertension is a major driver of cardiovascular disease with a prevalence of 32-34% in adults worldwide. This poses a formidable unmet challenge for healthcare systems, highlighting the need for enhanced treatment strategies. Since 2017, eight major sham-controlled randomised controlled trials have examined the effectiveness and safety of renal denervation (RDN) as therapy for BP control. Although most trials demonstrated a reduction in systolic 24-hour/daytime ambulatory BP compared to control groups, open to discussion is whether major adverse cardiovascular events (MACE)-driven RDN trials are necessary or whether the proof of BP reduction as a surrogate for better cardiovascular outcomes is sufficient. We conducted an analysis of the statistical methods used in various trials to assess endpoint definitions and determine the necessity for MACE-driven outcome data. Such comprehensive analysis provides further evidence to confidently conclude that RDN significantly reduces blood pressure compared to sham controls. Importantly, this enables the interpolation of RDN trial endpoints with other studies that report on outcome data, such as pharmacological trials which demonstrate a significant reduction in MACE risk with a decrease in BP. Moreover, limitations associated with directly evaluating outcome data further support the use of BP as a surrogate endpoint. For example, conducting lengthier trials with larger numbers of participants to ensure robust statistical power presents a substantial challenge to evaluating outcome data. Thus, in light of the crucial need to tackle hypertension, there are notable advantages of considering BP as a surrogate for outcome data.
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Affiliation(s)
- Syedah Aleena Haider
- Department of Cardiology, University Hospital Galway, Galway, Ireland.
- Department of Medicine, University of Galway, Galway, Ireland.
| | - Max Wagener
- Department of Cardiology, University Hospital Galway, Galway, Ireland
| | - Talha Iqbal
- Department of Mathematics, University of Galway, Galway, Ireland
| | - Shirjeel Shahzad
- Department of Cardiology, University Hospital Galway, Galway, Ireland
| | | | - Niall Leahy
- Department of Cardiology, University Hospital Galway, Galway, Ireland
| | - Darragh Murphy
- Department of Cardiology, University Hospital Galway, Galway, Ireland
- Department of Medicine, University of Galway, Galway, Ireland
| | - Ruth Sharif
- Department of Cardiology, University Hospital Galway, Galway, Ireland
| | - Ihsan Ullah
- Department of Mathematics, University of Galway, Galway, Ireland
| | - Faisal Sharif
- Department of Cardiology, University Hospital Galway, Galway, Ireland.
- Department of Medicine, University of Galway, Galway, Ireland.
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185
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Ye H, Li Y, Liu S, Zhang X, Liang H, Wang Y, Wang R, Liu H, Wen Y, Jing C, Wang L. Association between serum 25-hydroxyvitamin D and vitamin D dietary supplementation and risk of all-cause and cardiovascular mortality among adults with hypertension. Nutr J 2024; 23:33. [PMID: 38459491 PMCID: PMC10924411 DOI: 10.1186/s12937-024-00914-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/09/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND The relationship between vitamin D status and mortality among adults with hypertension remains unclear. METHODS This prospective cohort study involved a sample of 19,500 adults with hypertension who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018. We utilized a weighted COX proportional hazard model to assess the association between vitamin D status and mortality. This statistical model calculates hazard ratios (HR) and their corresponding 95% confidence intervals (95% CI). RESULTS The study indicated that lower serum 25(OH)D concentration was associated with an increased risk of all-cause mortality among individuals with hypertension. Specially. Those with concentrations between 25.0 and 49.9 nmol/L (HR = 1.71, 95%CI = 1.22-2.40) and less than 25.0 nmol/L (HR = 1.97, 95%CI = 1.15-3.39) had higher hazard ratios for all-cause mortality. Individuals with hypertension who took vitamin D supplements had a lower risk of all-cause mortality, but not the risk of CVD mortality (HR 0.75, 95%CI 0.54-1.03), compared to those who did not supplement (HR = 0.76, 95%CI = 0.61-0.94). Subgroup analysis further revealed that vitamin D supplementation was associated with a reduced risk of all-cause mortality among individuals without diabetes (HR = 0.65, 95%CI = 0.52-0.81) and individuals without CVD (HR = 0.75, 95%CI = 0.58-0.97), and a decreased risk of CVD mortality among individuals without diabetes (HR = 0.63, 95%CI = 0.45-0.88) and without CVD (HR = 0.61, 95%CI = 0.40-0.92). Furthermore, higher-dose vitamin D supplementation was also associated with a greater reduction in all-cause mortality among hypertensive individuals, and there was the potential synergistic effect of combining normal-dose calcium and vitamin D supplementation, showing a superior effect on mortality compared to low-dose supplementation in adults with hypertension. CONCLUSIONS This prospective cohort study demonstrated a significant association between lower serum 25 (OH)D concentration and increased all-cause mortality among adults with hypertension. Furthermore, the study found that vitamin D supplementation had a strong and significantly positive correlation with reduced all-cause and CVD mortality among hypertensive individuals without diabetes or CVD. This positive correlation suggests that vitamin D supplementation could potentially be an effective strategy to reduce the risk of mortality in this specific group of people.
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Affiliation(s)
- Haowen Ye
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yexin Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, Guangdong, 510632, China
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Shaomin Liu
- Department of Oncology Medilcal Center, The First People's Hospital of Zhaoqing, Zhaoqing, China
| | - Xiaofang Zhang
- Department Clinical Experimental Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Huanzhu Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, Guangdong, 510632, China
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Ying Wang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ruxin Wang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Han Liu
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yun Wen
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Chunxia Jing
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, Guangdong, 510632, China.
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, Guangdong, 510632, China.
| | - Lihong Wang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China.
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186
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Adorni R, Zanatta F, Cappelletti ER, Greco A, Steca P, D'Addario M. Effectiveness of a tailored communication intervention to improve physical activity in hypertensive patients: a twelve-month randomized controlled trial. BMC Cardiovasc Disord 2024; 24:143. [PMID: 38443805 PMCID: PMC10913652 DOI: 10.1186/s12872-024-03786-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality globally. Arterial hypertension is one of the main cardiovascular risk factors. Despite this, individuals with hypertension often fail to follow medical advice to counteract cardiovascular risks. A physically active lifestyle is one of the most challenging behaviors to adopt. This study aimed to preliminarily investigate the effectiveness of a tailored print message intervention to increase physical activity in patients with arterial hypertension. METHODS A sample of 188 patients with hypertension (mean age = 63 years; SD = 10.9; 50% men) participated in a theory-based tailored health communication intervention. Participants were randomly assigned to three parallel groups: (1) the tailored group, which received tailored health brochures; (2) the non-tailored group, which received non-tailored health brochures; or (3) the usual care group, which received no informative print materials. The longitudinal physical activity trajectories (baseline, 6- and 12-month follow-ups) were examined using repeated measures ANOVA and growth curve models. RESULTS At the baseline, 38.8% of patients achieved the target physical activity. This percentage rose to 43.0% at 6-month follow-up and 46.0% at 12-month follow-up. The descriptive statistics divided in function of the experimental group suggested differences in the longitudinal trend of the mean physical activity depending on the experimental group. However, statistical significance using repeated measures ANOVA did not support this observation. The analysis of the growth curves suggested that the tailored group showed a progressive increase in physical activity over twelve months (the model that best described the longitudinal trajectory was a linear growth model). The non-tailored group showed an increase in physical activity six months after the beginning of the intervention, followed by a decrease (free time score model). The usual care group did not change over time (no-growth model). CONCLUSIONS Findings suggest the effectiveness of the tailored intervention proposed. However, further investigations and empirical confirmations are required. TRIAL REGISTRATION ISRCTN13415993 ( https://doi.org/10.1186/ISRCTN13415993 ). Registration date: 08/04/2019.
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Affiliation(s)
- Roberta Adorni
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.
| | | | - Andrea Greco
- Department of Human and Social Sciences, University of Bergamo, Bergamo, 24129, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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187
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Lee FK, Chan NJY, Krishnan P, Datu Abdul Salam DS, Chee XW, Muhamad A, Low YY, Ting KN, Lim KH. Preparation and Preliminary Structure-Activity Relationship Studies of Schwarzinicine A Analogs as Vasorelaxant Agents. JOURNAL OF NATURAL PRODUCTS 2024. [PMID: 38442031 DOI: 10.1021/acs.jnatprod.3c00707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Schwarzinicines A-D, a series of alkaloids recently discovered from Ficus schwarzii, exhibit pronounced vasorelaxant activity in rat isolated aorta. Building on this finding, a concise synthesis of schwarzinicines A and B has been reported, allowing further investigations into their biological properties. Herein, a preliminary exploration of the chemical space surrounding the structure of schwarzinicine A (1) was carried out aiming to identify structural features that are essential for vasorelaxant activity. A total of 57 analogs were synthesized and tested for vasorelaxant activity in rat isolated aorta. Both efficacy (Emax) and potency (EC50) of these analogs were compared. In addition to identifying structural features that are required for activity or associated with potency enhancement effect, four analogs showed significant potency improvements of up to 40.2-fold when compared to 1. Molecular dynamics simulation of a tetrameric 44-bound transient receptor potential canonical-6 (TRPC6) protein indicated that 44 could potentially form important interactions with the residues Glu509, Asp530, Lys748, Arg758, and Tyr521. These results may serve as a foundation for guiding further structural optimization of the schwarzinicine A scaffold, aiming to discover even more potent analogs.
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Affiliation(s)
- Fong-Kai Lee
- Faculty of Pharmacy and Biomedical Sciences, MAHSA University, 42610 Jenjarom, Selangor, Malaysia
| | | | - Premanand Krishnan
- Foundation in Science, University of Nottingham Malaysia, 43500 Semenyih, Selangor, Malaysia
| | | | - Xavier Wezen Chee
- School of Engineering and Science, Swinburne University of Technology Sarawak, 93350 Kuching, Sarawak, Malaysia
| | - Azira Muhamad
- Malaysia Genome Institute, Jalan Bangi, 43000 Kajang, Selangor, Malaysia
| | - Yun-Yee Low
- Department of Chemistry, Faculty of Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Kang-Nee Ting
- School of Pharmacy, University of Nottingham Malaysia, 43500 Semenyih, Selangor, Malaysia
| | - Kuan-Hon Lim
- School of Pharmacy, University of Nottingham Malaysia, 43500 Semenyih, Selangor, Malaysia
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188
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Li Y, Jiang M, Ren X, Han L, Zheng X, Wu W. Hypertension combined with limitations in activities of daily living and the risk for cardiovascular disease. BMC Geriatr 2024; 24:225. [PMID: 38439007 PMCID: PMC10913420 DOI: 10.1186/s12877-024-04832-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVE The aim of present study was to evaluate the combined effect of hypertension and activities of daily living (ADL)/instrumental activities of daily living (IADL) with the risk of CVD, stroke and cardiac events. METHODS A total of 14,083 participants aged 45 years or older from the China Health and Retirement longitudinal study were included in current study. Participants were divided into 4 groups according to hypertension and ADL/IADL status. Cox proportional hazards regression model was used to explore the associations between hypertension, ADL/IADL and new-onset CVD, stroke and cardiac events. RESULTS During the 7-year follow-up, a total of 2,324 respondents experienced CVD (including 783 stroke and 1,740 cardiac events). Individuals with limitations in ADL alone, or with hypertension alone, or with both limitations in ADL and hypertension were associated with increased risk of CVD, with the adjusted hazard ratios (95% confidence intervals) were 1.17(1.00-1.35), 1.36(1.24-1.49) and 1.44(1.23-1.68), respectively. Those with limitations in ADL and hypertension also had higher risk of stroke (hazard ratios = 1.64; 1.26-2.14) and cardiac events (hazard ratios = 1.37; 1.14-1.64). Similarly, individuals with both limitations in IADL and hypertension were associated with increased risk of CVD (hazard ratios = 1.34; 1.15-1.57), stroke (hazard ratios = 1.50; 1.17-1.95) and cardiac events (hazard ratios = 1.27; 1.06-1.53). CONCLUSION Hypertension and limitations in ADL/IADL jointly increased the risk of CVD, stroke and cardiac events.
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Affiliation(s)
- Yiqun Li
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Minglan Jiang
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Xiao Ren
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Longyang Han
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China
| | - Xiaowei Zheng
- Public Health Research Center, Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, 1800 Lihu Road, Binhu District, 214122, Wuxi, Jiangsu Province, China.
| | - Wenyan Wu
- Center of Clinical Laboratory, The Fifth People's Hospital of Wuxi, Affiliated Hospital of Jiangnan University, Jiangnan University , 214011, Wuxi, Jiangsu, China.
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189
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Kim HL, Park SJ, Bae YJ, Ihm SH, Shin J, Kim KI. The role of ambulatory blood pressure monitoring in enhancing medication adherence among patients with newly diagnosed hypertension: an analysis of the National Health Insurance cohort database. Clin Hypertens 2024; 30:6. [PMID: 38424656 PMCID: PMC10905829 DOI: 10.1186/s40885-024-00264-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 01/20/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Improving adherence to antihypertensive medication (AHM) is a key challenge in hypertension management. This study aimed to assess the impact of ambulatory blood pressure monitoring (ABPM) on AHM adherence. METHODS We utilized the Korean National Health Insurance Service database. Among patients newly diagnosed with hypertension who started AHM between July 2010 and December 2013, we compared clinical characteristics and adherence between 28,116 patients who underwent ABPM prior to starting AHM and 118,594 patients who did not undergo ABPM. Good adherence was defined as a proportion of days covered (PDC) of 0.8 or higher. RESULTS The total study population was 146,710, with a mean age of 50.5 ± 6.4 years; 44.3% were female. Co-morbidities were noted in 4.2%. About a third of patients (33.1%) showed good adherence. The ABPM group had a notably higher PDC (total PDC: 0.64 ± 0.35 vs. 0.45 ± 0.39; P < 0.001), irrespective of the number of medications, dosing frequency, or prescription duration. After adjusting for significant clinical variables, ABPM was still closely linked with good adherence (odds ratio, 2.35; 95% confidence interval, 2.28-2.41; P < 0.001). CONCLUSIONS In newly diagnosed hypertension, undergoing ABPM prior to AHM prescription appears to enhance adherence to AHM. The exact mechanisms driving this association warrant further exploration.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - So-Jeong Park
- Department of Data Science, Hanmi Pharm. Co., Ltd., Seoul, Republic of Korea
| | - Yoon-Jong Bae
- Department of Data Science, Hanmi Pharm. Co., Ltd., Seoul, Republic of Korea
| | - Sang Hyum Ihm
- Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital & Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Kwang-Il Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea.
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190
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Bao WW, Jiang N, Zhao Y, Yang B, Chen G, Pu Y, Ma H, Liang J, Xiao X, Guo Y, Dong G, Chen Y. Urban greenspaces and child blood pressure in China: Evidence from a large population-based cohort study. ENVIRONMENTAL RESEARCH 2024; 244:117943. [PMID: 38104917 DOI: 10.1016/j.envres.2023.117943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/22/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND With the world's population steadily shifting toward urban living, children's engagement with the natural environment seems to be diminishing. This raises significant concerns about the influence of urban greenspaces on the cardiovascular health of children. OBJECTIVE To assess the association between urban greenspaces exposure and blood pressure (BP) in Chinese primary schoolchildren. METHODS This prospective cohort study used data from the Children's growth environment, lifestyle, physical, and mental health development (COHERENCE) project in Guangzhou, China. Participants included 164,853 primary schoolchildren starting from 2016/17 to 2019/20 academic year. We assessed the surrounding greenspaces at home and school by using Sentinel-2 satellite data on the normalized difference vegetation index. Prehypertension and hypertension status were defined with BP above 90th to less than the 95th percentile, at or above the 95th percentile, respectively. The association of surrounding greenness with children's BP levels and risk of prehypertension/hypertension were examined using linear mixed-effects models and Cox proportional hazards model. RESULTS Among 164,853 eligible children aged 7.21 (0.74) years, 89,190 (54.1%) were boys. Our results showed that average systolic and diastolic BP increased by 0.48 and 0.42 standard deviations, respectively, over the 3-year follow-up. We identified 23,225 new cases of prehypertension and 35,067 of hypertension status. An interquartile range increase both in home-, school- and home-school NDVI100m was significantly associated with a reduction of 0.018-0.037 in BP z-scores and a 2.7%-7.6% lower risk of hypertension. Additionally, family socioeconomic status modified the impact of home-school greenness on BP levels. Air pollution exhibited mediating effects solely in school-greenness-BP associations, while physical activity and children's BMI mainly mediated the relationships between home-greenness and BP. CONCLUSION The findings of this large cohort study suggest that surrounding greenspaces are associated with lower BP levels and a decreased risk of prehypertension and hypertension in Chinese schoolchildren.
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Affiliation(s)
- Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yu Zhao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Boyi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yinqi Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Hanping Ma
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinghong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiang Xiao
- Department of Geography, Hong Kong Baptist University, Hong Kong Special Administrative Region, China; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Mansoori A, Seifi N, Vahabzadeh R, Hajiabadi F, Mood MH, Harimi M, Poudineh M, Ferns G, Esmaily H, Ghayour-Mobarhan M. The relationship between anthropometric indices and the presence of hypertension in an Iranian population sample using data mining algorithms. J Hum Hypertens 2024; 38:277-285. [PMID: 38040904 DOI: 10.1038/s41371-023-00877-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/10/2023] [Accepted: 11/01/2023] [Indexed: 12/03/2023]
Abstract
Hypertension (HTN) is a common chronic condition associated with increased morbidity and mortality. Anthropometric indices of adiposity are known to be associated with a risk of HTN. The aim of this study was to identify the anthropometric indices that best associate with HTN in an Iranian population. 9704 individuals aged 35-65 years were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study. Demographic and anthropometric data of all participants were recorded. HTN was defined as a systolic blood pressure (SBP) ≥ 140 mmHg, and/ or a diastolic blood pressure (DBP) ≥ 90 mmHg on two subsequent measurements, or being treated with oral drug therapy for BP. Data mining methods including Logistic Regression (LR), Decision Tree (DT), and Bootstrap Forest (BF) were applied. Of 9704 participants, 3070 had HTN, and 6634 were normotensive. LR showed that body roundness index (BRI), body mass index (BMI) and visceral adiposity index (VAI) were significantly associated with HTN in both genders (P < 0.0001). BRI showed the greatest association with HTN (OR = 1.276, 95%CI = (1.224, 1.330)). For BMI we had OR = 1.063, 95%CI = (1.047, 1.080), for VAI we had OR = 1.029, 95%CI = (1.020, 1.038). An age < 47 years and BRI < 4.04 was associated with a 90% probability of being normotensive. The BF indicated that age, sex and BRI had the most important role in HTN. In summary, among anthropometric indices the most powerful indicator for discriminating hypertensive from normotensive patients was BRI.
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Affiliation(s)
- Amin Mansoori
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran, Mashhad, Iran
| | - Najmeh Seifi
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reihaneh Vahabzadeh
- Student Research Committee, Paramedicine Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Hajiabadi
- Student Research Committee, Paramedicine Faculty, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Melika Hakimi Mood
- Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - Mahdiar Harimi
- Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - Mohadeseh Poudineh
- Faculty of Medicine, Islamic Azad University of Mashhad, Mashhad, Iran
- Student of Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran, Zanjan, Iran
| | - Gordon Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, UK
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ghayour-Mobarhan
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
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192
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Liu R, Cheng W. Association between HDL-C and intensive blood pressure control in patients with hypertension: A post-hoc analysis of SPRINT. J Clin Hypertens (Greenwich) 2024; 26:225-234. [PMID: 38318688 PMCID: PMC10918727 DOI: 10.1111/jch.14754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 02/07/2024]
Abstract
Previous studies in patients with hypertension have demonstrated that there is a U-shaped association between HDL-C (high-density lipoprotein cholesterol) and the risk of cardiovascular events in male patients with hypertension. However, to the best of our knowledge, the relationship between HDL-C and intensive blood pressure control in specific cardiovascular events has never been investigated. To fill this knowledge gap, the authors analyzed the relationship between HDL-C levels and cardiovascular events in hypertensive patients within the Systolic Blood Pressure Intervention Trial (SPRINT). The SPRINT evaluated the impact of intensive blood pressure control (systolic blood pressure < 120 mm Hg) versus standard blood pressure control (systolic blood pressure < 140 mm Hg). The Cox proportional risk regression was used to investigate the association between different HDL-C status and clinical outcomes. Additional stratified analyzes were performed to evaluate the robustness of sex difference. A total of 9323 participants (6016 [64.53%] males and 3307 [35.47%] females) with hypertension from the SPRINT research were included in the analysis. The median follow-up period was 3.26 years. Our population was divided into five groups based on the HDL-C plasma levels: HDL-C < 30 mg/dL, HDL-C between 30 and 40 mg/dL, HDL-C between 40 and 60 mg/dL, HDL-C between 60 and 80 mg/dL and HDL-C > 80 mg/dL. Sensitivity analyzes showed that in the SPRINT, women in the HDL-C high population had a higher risk of mortality from all causes than men. In this cohort study, results suggest that patients with HDL-C levels higher than 80 mg/dL had lower risk of SPRINT primary outcome, cardiovascular death, and stroke, but this study tested association, not causation. HDL-C levels were associated with composite cardiovascular outcomes in male but not female patients. Our results demonstrated that in patients with hypertension, the association between HDL-C and risk of cardiovascular events is L-shaped.
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Affiliation(s)
- Rufei Liu
- Hypertension CenterBeijing Anzhen HospitalCapital Medical UniversityBeijingChina
| | - Wenli Cheng
- Hypertension CenterBeijing Anzhen HospitalCapital Medical UniversityBeijingChina
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193
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Yang ML, Xu C, Gupte T, Hoffmann TJ, Iribarren C, Zhou X, Ganesh SK. Sex-specific genetic architecture of blood pressure. Nat Med 2024; 30:818-828. [PMID: 38459180 DOI: 10.1038/s41591-024-02858-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/05/2024] [Indexed: 03/10/2024]
Abstract
The genetic and genomic basis of sex differences in blood pressure (BP) traits remain unstudied at scale. Here, we conducted sex-stratified and combined-sex genome-wide association studies of BP traits using the UK Biobank resource, identifying 1,346 previously reported and 29 new BP trait-associated loci. Among associated loci, 412 were female-specific (Pfemale ≤ 5 × 10-8; Pmale > 5 × 10-8) and 142 were male-specific (Pmale ≤ 5 × 10-8; Pfemale > 5 × 10-8); these sex-specific loci were enriched for hormone-related transcription factors, in particular, estrogen receptor 1. Analyses of gene-by-sex interactions and sexually dimorphic effects identified four genomic regions, showing female-specific associations with diastolic BP or pulse pressure, including the chromosome 13q34-COL4A1/COL4A2 locus. Notably, female-specific pulse pressure-associated loci exhibited enriched acetylated histone H3 Lys27 modifications in arterial tissues and a female-specific association with fibromuscular dysplasia, a female-biased vascular disease; colocalization signals included Chr13q34: COL4A1/COL4A2, Chr9p21: CDKN2B-AS1 and Chr4q32.1: MAP9 regions. Sex-specific and sex-biased polygenic associations of BP traits were associated with multiple cardiovascular traits. These findings suggest potentially clinically significant and BP sex-specific pleiotropic effects on cardiovascular diseases.
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Affiliation(s)
- Min-Lee Yang
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Chang Xu
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Trisha Gupte
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Thomas J Hoffmann
- Department of Epidemiology & Biostatistics, and Institute for Human Genetics, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Xiang Zhou
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Santhi K Ganesh
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA.
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA.
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA.
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194
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Chen H, Su D, Guo Y, Chen C, Chen S, Zhang S, Ding Y, Li M, Tong G, Zeng G. Effects of the Chinese heart-healthy diet (Sichuan cuisine) on lowering blood pressure in adults with hypertension: a randomized controlled feeding trial. Asia Pac J Clin Nutr 2024; 33:11-22. [PMID: 38494683 PMCID: PMC11170007 DOI: 10.6133/apjcn.202403_33(1).0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/22/2023] [Accepted: 10/06/2023] [Indexed: 03/19/2024]
Abstract
BACKGROUND AND OBJECTIVES Sichuan cuisine is characterized by high salt and oil content. We aimed to evaluate the effects of the Sichuan cuisine version of Chinese heart-healthy diet (CHH diet-SC) on blood pressure reduction among hypertensive adults. METHODS AND STUDY DESIGN The Chinese heart-healthy diet (CHH) trial was a multicenter randomized controlled feeding trial among Chinese hypertensive people. We conducted a secondary analysis of the CHH trial using data from the Sichuan center in Southwest China. Fifty-three people aged 25 to 75 years with a mean systolic blood pressure (SBP) between 130 and 159 mmHg were enrolled. Eligible participants underwent a 1-week run-in period with the typical local diet and were randomized 1:1 to consume the CHH diet-SC (n=27) or typical local diet (n=26) for the next 4-week. The primary outcome was the net change in SBP, the secondary outcomes included diastolic blood pressure (DBP), mean arterial pressure (MAP), and the rate of BP control. RESULTS Compared with the control group, the CHH diet-SC decreased cooking salt, oil, and red meat content and increased inclusion of whole grains, fruits, seafood, low-fat dairy, soybean, and nuts; the SBP experienced reductions of 7.54, 8.60, 9.14, and 10.1 mmHg at the end of weeks 1 through 4; the DBP was reduced 4.01 mmHg at week 4; the MAP was significantly reduced 6.02 mmHg finally; and rate of BP control significantly increased (p<0.05). CONCLUSIONS Adoption of the CHH diet-SC for 4 weeks can significantly reduce BP and increase the rate of BP control in hypertensive adults.
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Affiliation(s)
- Hong Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Danping Su
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yishan Guo
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Cong Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Sijia Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shiyu Zhang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanxi Ding
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ming Li
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | | | - Guo Zeng
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
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195
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Sharma AK, Rastogi S, Ali F, Yadav AP, Goyal RK. A comprehensive quality control and cost comparison study of branded and generic angiotensin receptor blockers. Saudi Pharm J 2024; 32:101985. [PMID: 38380162 PMCID: PMC10877430 DOI: 10.1016/j.jsps.2024.101985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/04/2024] [Indexed: 02/22/2024] Open
Abstract
This study was designed to assess both the quality and cost aspects of various branded and generic formulations of angiotensin receptor blockers, specifically Irbesartan, Losartan Potassium, Olmesartan Medoxomil, Telmisartan, and Valsartan. The collected samples underwent distinct quality evaluations using the methods outlined in different global Pharmacopoeias (British Pharmacopoeia/European Pharmacopoeia, Indian Pharmacopoeia and United States Pharmacopoeia). These drugs were characterized using Fourier-Transform Infrared Spectroscopy and Nuclear Magnetic Resonance techniques, while their quality and concentration were analysed using High Performance Liquid Chromatography. The release profile of the drugs was examined through dissolution testing. Additionally, a cost comparison analysis was carried out by determining the prevailing market prices of the drugs. The evaluated branded and generic angiotensin receptor blockers were found to meet the established standards for impurities, active drug content, and dissolution as set by these Pharmacopoeias, indicating their optimal quality. Notably, the generic drugs exhibited significantly lower costs compared to their branded counterparts. This study confirms that the quality of generic angiotensin receptor blockers is equivalent to that of their branded counterparts. Consequently, these findings support the practicality of utilizing generic drugs as a more economically sustainable and cost-effective approach to managing diseases, especially those of chronic nature.
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Affiliation(s)
- Arvind Kumar Sharma
- Delhi Pharmaceutical Science and Research University (DPSRU), Mehrauli-Badarpur Road, Sector-3, Pushp Vihar, New Delhi, 110017, India
- Indian Pharmacopoeia Commission, Ministry of Health and Family Welfare, Government of India, Sector-23 Raj Nagar, Ghaziabad, Uttar Pradesh, 201002, India
| | - Shruti Rastogi
- Indian Pharmacopoeia Commission, Ministry of Health and Family Welfare, Government of India, Sector-23 Raj Nagar, Ghaziabad, Uttar Pradesh, 201002, India
| | - Faraat Ali
- Department of Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Akademika Heyrovského 1203, Hradec Králové, 500 05, Czech Republic
| | - Anuj Prakash Yadav
- Indian Pharmacopoeia Commission, Ministry of Health and Family Welfare, Government of India, Sector-23 Raj Nagar, Ghaziabad, Uttar Pradesh, 201002, India
| | - Ramesh K. Goyal
- Delhi Pharmaceutical Science and Research University (DPSRU), Mehrauli-Badarpur Road, Sector-3, Pushp Vihar, New Delhi, 110017, India
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196
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Zhang Y, Liu M, Yang S, Zhang Y, Ye Z, Wu Q, Li R, Zhou C, He P, Liu C, Jiang J, Liang M, Wang G, Hou FF, Qin X. Positive association between dietary manganese intake and new-onset hypertension: A nationwide cohort study in China. Nutr Metab Cardiovasc Dis 2024; 34:699-705. [PMID: 38161121 DOI: 10.1016/j.numecd.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND AIM To date, few studies have investigated the association between dietary manganese intake and the risk of hypertension, so the prospective relationship of dietary manganese intake and new-onset hypertension remains uncertain. We aimed to investigate the association between dietary manganese intake and the risk of new-onset hypertension in the general Chinese population. METHODS AND RESULTS This prospective cohort study included 12,177 participants who were free of hypertension at baseline from China Health and Nutrition Survey (CHNS). Dietary intake was measured by 3 consecutive 24-h dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or diagnosed by a physician or under antihypertensive treatment during the follow-up. During a median follow-up duration of 6.1 years, 4269 (44.9 per 1000 person-years) participants developed new-onset hypertension. Overall, there was a positive association between dietary manganese intake and new-onset hypertension. The adjusted HRs (95%CIs) of new-onset hypertension were 1.00 (reference), 0.97 (0.87, 1.08), 1.24 (1.10, 1.39) and 1.75 (1.52, 2.01) across the quartiles of dietary manganese intake, respectively. Accordingly, a significantly higher risk of new-onset hypertension (HR, 1.38; 95%CI: 1.27, 1.50) was found in participants in quartiles 3-4 of dietary manganese intake (≥6.0 mg/day), compared with those in quartiles 1-2 (<6.0 mg/day). CONCLUSIONS In the general Chinese population, dietary manganese intake was positively associated with the risk of new hypertension, independent of sodium intake and other important covariates.
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Affiliation(s)
- Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Mengyi Liu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Sisi Yang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Yanjun Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Ziliang Ye
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Qimeng Wu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Rui Li
- Institute of Biomedicine, Anhui Medical University, Hefei 230032, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Panpan He
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Chengzhang Liu
- Institute of Biomedicine, Anhui Medical University, Hefei 230032, China
| | - Jianping Jiang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Min Liang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Guobao Wang
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China.
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197
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Charles JA, Habibullah NK, Bautista S, Davis B, Joshi S, Hull SC. Planting the Seed for Blood Pressure Control: The Role of Plant-Based Nutrition in the Management of Hypertension. Curr Cardiol Rep 2024; 26:121-134. [PMID: 38526748 PMCID: PMC10990999 DOI: 10.1007/s11886-023-02008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 03/27/2024]
Abstract
PURPOSE OF REVIEW Hypertension results in significant morbidity, mortality, and healthcare expenditures. Fortunately, it is largely preventable and treatable by implementing dietary interventions, though these remain underutilized. Here, we aim to explore the role of healthy dietary patterns in hypertension management and describe approaches for busy clinicians to address nutrition effectively and efficiently with patients. RECENT FINDINGS DASH, Mediterranean, vegetarian, and vegan diets that include minimally processed, plant-based foods as core elements have consistently shown positive effects on hypertension. Recommendations that distill the most healthful components of these diets can significantly impact patient outcomes. Clinicians can harness evidence-based dietary assessment and counseling tools to implement and support behavioral changes, even during brief office visits. Healthful plant-based dietary patterns can often effectively prevent and treat hypertension. Clinicians may help improve patient outcomes by discussing evidence-based nutrition with their patients. Future work to promote infrastructural change that supports incorporating evidence-based nutrition into medical education, clinical care, and society at large can support these efforts.
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Affiliation(s)
- Justin A Charles
- Department of Family Medicine and Public Health, UC San Diego Health, San Diego, CA, USA.
| | | | - Saul Bautista
- Ethos Farm to Health/Ethos Primary Care, Long Valley, NJ, USA
| | - Brenda Davis
- Brenda Davis, Nutrition Consultations, Calgary, AB, Canada
| | - Shivam Joshi
- Department of Veterans Affairs, Orlando, FL, USA
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Sarah C Hull
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
- Program for Biomedical Ethics, Yale School of Medicine, New Haven, CT, USA
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198
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Mansour N, Bruedgam D, Dischinger U, Kürzinger L, Adolf C, Walter R, Öcal O, Schmidt VF, Rudolph J, Ricke J, Reisch N, Reincke M, Wildgruber M, Heinrich D. Effect of mild cortisol cosecretion on body composition and metabolic parameters in patients with primary hyperaldosteronism. Clin Endocrinol (Oxf) 2024; 100:212-220. [PMID: 38164017 DOI: 10.1111/cen.15013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/08/2023] [Accepted: 12/15/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To investigate the effects of simultaneous cortisol cosecretion (CCS) on body composition in computed tomography (CT)-imaging and metabolic parameters in patients with primary aldosteronism (PA) with the objective of facilitating early detection. DESIGN Retrospective cohort study. PATIENTS Forty-seven patients with PA and CCS confirmed by 1-mg dexamethasone suppression test (DST) with a cutoff of ≥1.8 µg/dL were compared with PA patients with excluded CCS (non-CCS, n = 47) matched by age and sex. METHODS Segmentation of the fat compartments and muscle area at the third lumbar region was performed on non-contrast-enhanced CT images with dedicated segmentation software. Additionally, liver, spleen, pancreas and muscle attenuation were compared between the two groups. RESULTS Mean cortisol after DST was 1.2 µg/dL (33.1 nmol/L) in the non-CCS group and 3.2 µg/dL (88.3 nmol/L) in the CCS group with mild autonomous cortisol excess (MACE). No difference in total, visceral and subcutaneous fat volumes was observed between the CCS and non-CCS group (p = .7, .6 and .8, respectively). However, a multivariable regression analysis revealed a significant correlation between total serum cholesterol and results of serum cortisol after 1-mg DST (p = .026). Classification of the patients based on visible lesion on CT and PA-lateralization via adrenal venous sampling also did not show any significant differences in body composition. CONCLUSION MACE in PA patients does not translate into body composition changes on CT-imaging. Therefore, early detection of concurrent CCS in PA is currently only attainable through biochemical tests. Further investigation of the long-term clinical adverse effects of MACE in PA is necessary.
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Affiliation(s)
- Nabeel Mansour
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Denise Bruedgam
- Medizinische Klinik und Poliklinik IV, LMU Klinikum Innenstadt, Munich, Germany
| | - Ulrich Dischinger
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - Lydia Kürzinger
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - Christian Adolf
- Medizinische Klinik und Poliklinik IV, LMU Klinikum Innenstadt, Munich, Germany
| | - Roman Walter
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Osman Öcal
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Vanessa F Schmidt
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Jan Rudolph
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Jens Ricke
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Nicole Reisch
- Medizinische Klinik und Poliklinik IV, LMU Klinikum Innenstadt, Munich, Germany
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, LMU Klinikum Innenstadt, Munich, Germany
| | - Moritz Wildgruber
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Daniel Heinrich
- Medizinische Klinik und Poliklinik IV, LMU Klinikum Innenstadt, Munich, Germany
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199
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Talukder A, Sara SS, Khan ZI, Yadav UN, Mistry SK, Biswas T, Alam A, Ali MW, Jannat Z, Haseen F, Uddin MJ, Gray DJ, Ahmed T, Kelly M, Islam SMS, Sarma H. Prevalence and determinants of hypertension in South-Asian Urban Communities: findings from Demographic and Health Surveys (DHS) data of South Asian countries. J Hum Hypertens 2024; 38:257-266. [PMID: 38049636 DOI: 10.1038/s41371-023-00879-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/04/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023]
Abstract
Hypertension increases risk of stroke and other cardiovascular diseases, however, its prevalence and determinants in South Asian urban communities using country representative community-based datasets is lacking. This study evaluated prevalence of hypertension and it's determinants among urban residents of three South Asian countries. Urban population data from demographic and health surveys in Bangladesh, India, and Nepal were extracted. Hypertension prevalence was defined as systolic/diastolic blood pressure ≥ 140/ 90 mmHg. Age, education, wealth, physical activity, alcohol, BMI were considered as risk factors associated with the increased risk of hypertension. We performed binary logistic regression and calculated adjusted Odds Ratios (AOR) with 95% confidence interval (CI) to assess factors related to hypertension. Hypertension prevalence was 37.4% in India, 25.1% in Bangladesh and 18.4% in Nepal. Prevalence increased with age in all settings. Females had reduced odds of hypertension in Bangladesh (AOR 0.75; CI: 0.69, 0.81) and Nepal (AOR 0.62; CI: 0.54, 0.71), but higher risk in India (AOR 2.54; CI: 2.45, 2.63). Low education, caffeine consumption, obesity was associated with higher prevalence of hypertension in all three countries. Smokers had increased odds of hypertension in India (AOR 1.11; CI: 1.06, 1.15) and Nepal (AOR 1.23; 1.02, 1.47). Overall, hypertension prevalence is high in all three countries. Modifiable socioeconomic and lifestyle factors (education, wealth index, smoking status, caffeine consumption and BMI) associated with hypertension. Comprehensive hypertension pacific and sensitive interventions (including behavioral modification treatments and timely screening and access to health care) are urgently needed to prevent and control hypertension among urban populations in South Asia.
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Affiliation(s)
- Ashis Talukder
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, 2600, Australia.
- Statistics Discipline, Khulna University, Khulna, 9208, Bangladesh.
| | | | | | - Uday Narayan Yadav
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, ACT, 2600, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney NSW, Australia
| | - Sabuj Kanti Mistry
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
- Department of Public Health, Daffodil International University, Dhaka, 1207, Bangladesh
| | - Tuhin Biswas
- ARC Centre of Excellence for Children and Families Over the Life Course, The University of Queensland, Brisbane, QLD, Australia
| | - Ariful Alam
- Health Nutrition, Population and Nutrition Program, BRAC, Dhaka, 1212, Bangladesh
| | - Md Wazid Ali
- Health System and Population Studies Division, icddr,b (International Centre for Diarrhoeal Disease Research), Dhaka, 1212, Bangladesh
| | - Zerin Jannat
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68-Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Fariha Haseen
- Department of Public Health & Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1212, Bangladesh
| | - Md Jasim Uddin
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68-Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Darren J Gray
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, 2600, Australia
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, icddr,b, Dhaka, 1212, Bangladesh
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, 2600, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Melbourne Burwood Campus, Melbourne, VIC, Australia
| | - Haribondhu Sarma
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, 2600, Australia
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200
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Budzyń M, Gryszczyńska B, Begier-Krasińska B, Kaja E, Mikołajczak P, Kujawski R, Grupińska J, Iskra M, Tykarski A, Kaczmarek M. Decreased toll-like receptor 4 and CD11b/CD18 expression on peripheral monocytes of hypertensive patients correlates with a lesser extent of endothelial damage: a preliminary study. J Hypertens 2024; 42:471-483. [PMID: 37937521 DOI: 10.1097/hjh.0000000000003617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND Low-grade chronic inflammation is recognized to contribute to the physiopathology of arterial hypertension. Therefore, this study aimed to assess the pro-inflammatory phenotype of peripheral monocytes of hypertensive patients by analyzing Toll-like receptor 4 (TLR4) and CD11b/CD18 surface expression. In the second part, the influence of phenotypic alterations of monocytes on the endothelial status reflected by circulating endothelial cells (CECs) was evaluated. PATIENTS The study included 60 patients with arterial hypertension, who were divided into two subgroups based on the disease severity according to the applicable criteria. The mild hypertension and resistant hypertension groups included 30 patients each. The control group consisted of 33 normotensive volunteers matched for age and sex. RESULTS Both in the entire group of patients and individual subgroups, reduced surface expression of TLR4 and CD11b/CD18 was found compared to normotensive volunteers. A reduced percentage of monocytes with the CD14 + TLR4 + immunophenotype was correlated with a lower MFI level of CD18 and CD11b in the entire group of patients and after division only in the mild hypertension group. Reduced surface expression of TLR4 in hypertensive patients correlated with a lower number of CECs. This relationship was not observed in the resistant hypertension group; instead, an independent effect of reduced CD11b/CD18 expression on the reduction of CEC number was demonstrated. CONCLUSION Our preliminary study showed for the first time that hypertension of varying severity is accompanied by phenotypic changes in monocytes, manifested by reduced surface expression of both TLR4 and CD11b/CD18. These phenotypic changes were associated with a reduced degree of endothelial injury. Our study opens a new, unexplored area of research on the protective features of peripheral monocytes in hypertension.
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Affiliation(s)
- Magdalena Budzyń
- Chair and Department of Medical Chemistry and Laboratory Medicine
| | | | | | - Elżbieta Kaja
- Chair and Department of Medical Chemistry and Laboratory Medicine
| | | | | | - Joanna Grupińska
- Chair and Department of Medical Chemistry and Laboratory Medicine
| | - Maria Iskra
- Chair and Department of Medical Chemistry and Laboratory Medicine
| | | | - Mariusz Kaczmarek
- Department of Cancer Immunology, Poznan University of Medical Sciences
- Gene Therapy Unit, Department of Diagnostics and Cancer Immunology, Greater Poland Cancer Center, Poznan, Poland
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