Recent Advances in the Genetics of Hypertension

Comparison of blood pressure values and expression of genes associated with hypertension in children before and after hematopoietic cell transplantation

Hypertension is a well-known late effect of hematopoietic cell transplantation (HCT), but no markers predicting its development are known. Our aim was to assess short-term blood pressure (BP) values and expressions of hypertension-associated genes as possible markers of hypertension in children treated with HCT. We measured systolic blood pressure (SBP) and diastolic blood pressure (DBP), using both office procedure and ambulatory BP monitoring (ABPM) in children before HCT and after a median of 6 months after HCT. We compared the results with two control groups, one of healthy children and another of children with simple obesity. We also performed microarray analysis of hypertension-associated genes in patients treated with HCT and children with obesity. We found no significant differences in SBP and DBP in patients before and after HCT. We found significant differences in expressions of certain genes in patients treated with HCT compared with children with obesity. We concluded that BP values in short-term follow-up after HCT do not seem to be useful predictors of hypertension as a late effect of HCT. However, over expressions of certain hypertension-associated genes might be used as markers of hypertension as a late effect of HCT if this is confirmed in larger long-term studies.

Prevalence of Hypertension in Homeless Adults: An Interprofessional Education Community-Based Health Fairs Cross-Sectional Study in Urban Long Beach, California

INTRODUCTION

Hypertension (SBP/DBP > 130/80 mmHg) is a leading risk factor for cardiovascular disease worldwide.

AIM

To determine the prevalence of hypertension in a homeless community during an interprofessional education (IPE)-based health fair.

METHODS

Homeless participants were recruited between August 2019-September 2019. Faculty, nursing, and pharmacist students, educated 477 participants, aged 18-80 years, on the risk factors associated with untreated hypertension. Then, participants self-completed the consented demographic survey questionnaire. Finally, the sitting blood pressure (BP) was recorded three times based on a standardized procedure, using Omron BPN monitor with cuff.

RESULTS

Seven pharmacy students, nine nursing students, two registered nurses, five registered pharmacists, and two medical doctors collaboratively provided health education to the homeless community and screened their sitting BP. 390/477 (81.8%) of participants satisfied the inclusion criteria. Participants (54.7%) of the reported education level was at the high School level or less. More than the half of the participants (average age of 51 ± 13 years) had hypertension (median SBP/DBP ≥ 130/82.7 mmHg), respectively. The prevalence of hypertension for the overall cohort was 61.52% (95% CI, 56.59-66.35). Age (p value = 0.000) was significantly associated with hypertension based on the binary logistic analysis.

CONCLUSION

This study demonstrated a high prevalence of hypertension in the homeless community in Long Beach, California with high risk of cardio-vascular events or strokes. This works sheds new light on an issue of major public health significance and points to the need for fostering IPE community-based health fairs intervention program for the US homeless population.

The impact of sedentarism on heart rate variability (HRV) at rest and in response to mental stress in young women

Sedentarism is one of the main risk factors for the onset of cardiometabolic diseases. Some biomarkers, such as heart rate variability (HRV), have been largely studied and found to be involved in the genesis of the dysfunctions associated with sedentary behavior. However, comparatively few studies have focused on the female sex. The objective of this study was to analyze the hemodynamic, autonomic and quality of life parameters at rest and in response to mental stress of sedentary and physically active young women. A total of 96 women, 18-30 years of age, were divided into sedentary (SW = 48) and active (AW = 48) groups. Anthropometric, hemodynamic and quality of life parameters were evaluated and the R-R interval was recorded to quantify the cardiac autonomic modulation at rest and in response to the Stroop Color Test. The groups were similar in age, weight, height, body mass index, fat percentage, systolic and diastolic blood pressure values and glycemia. The physical health domain of quality of life was compromised in the SW group. The SW group presented higher heart rate, lower variance of RR interval and RMSSD and higher cardiac sympathovagal balance (LF/HF) both at rest and in response to the mental stress test. We concluded that sedentary lifestyle in women induces impairment in autonomic cardiac modulation at rest and in response to physiological stress, compromising the quality of life, even before altering any cardiovascular or metabolic clinical parameters, reinforcing the potential role of HRV as early marker of cardiovascular risk in this population.

Relevance of microRNA 21 in Different Types of Hypertension

Hypertension (HTN) is a chronic medical condition that commonly affects the aging population worldwide. The prevalence of HTN is increasing in developing countries and is one of the leading causes of death in older individuals. HTN results from a complex interplay of genetic and environmental factors. Besides, HTN can result in various other health complications such as stroke and chronic kidney diseases, if not treated. Although various studies have explained the underlying mechanisms in the pathogenesis of HTN, limited information is available on their biomarkers. MicroRNAs (miRNAs) are RNA molecules that have been recognized as key regulators for HTN. miR-21 is a common microRNA that is has been reported to be significantly upregulated in HTN individuals. Hence, miR-21 can be a potential therapeutic target for HTN. The number of studies related to miR-21 on hypertension is limited. Therefore, the main thrust of this paper is to provide an overview of the current clinical evidence and significance of miR-21 in HTN.

The Epigenetic Machinery in Vascular Dysfunction and Hypertension

Hypertension (HT) is among the major components of the metabolic syndrome, i.e., obesity, dyslipidemia, and hyperglycemia/insulin resistance. It represents a significant health problem with foremost risks for chronic cardiovascular disease and a significant cause of morbidity and mortality worldwide. Therefore, it is not surprising that this disorder constitutes a serious public health concern. Although multiple studies have stressed the multifactorial nature of HT, the pathogenesis remains largely unknown. However, if we want to reduce the global prevalence of HT, restrain the number of deaths (currently 9.4 million/year in the world), and alleviate the socio-economic burden, a deeper insight into the mechanisms is urgently needed in order to define new meaningful therapeutic targets. Recently, the role of epigenetics in the development of various complex diseases has attracted much attention. In the present review, we provide a critical update on the available literature and ongoing research regarding the epigenetic modifications of genes involved in several pathways of elevated blood pressure, especially those linked to the vascular epithelium. This review also focuses on the role of microRNA (miRNA) in the regulation of gene expression associated with HT and of fetal programming mediating susceptibility to HT in adulthood.

The impact of APOA5, APOB, APOC3 and ABCA1 gene polymorphisms on ischemic stroke: Evidence from a meta-analysis

BACKGROUND AND AIMS

Genetic studies have been reported on the association between APOA5, APOB, APOC3 and ABCA1 gene polymorphisms and ischemic stroke, but results remain controversial. Hence, this meta-analysis aimed to infer the causal relationships of APOA5 (rs662799, rs3135506), APOB (rs693, rs1042031, rs1801701), APOC3 (rs4520, rs5128, rs2854116, rs2854117) and ABCA1 rs2230806 with ischemic stroke risk.

METHODS

A systematic review was performed for all the articles retrieved from multiple databases, up until March 2017. Data were extracted from all eligible studies, and meta-analysis was carried out using RevMan 5.3 and R package 3.2.1. The strength of association between each studied polymorphism and ischemic stroke risk was measured as odds ratios (ORs) and 95% confidence intervals (CIs), under fixed- and random-effect models.

RESULTS

A total of 79 studies reporting on the association between the studied polymorphisms and ischemic stroke risk were identified. The pooled data indicated that all genetic models of APOA5 rs662799 (ORs = 1.23-1.43), allelic and over-dominant models of APOA5 rs3135506 (ORs = 1.77-1.97), APOB rs1801701 (ORs = 1.72-2.13) and APOB rs1042031 (ORs = 1.66-1.88) as well as dominant model of ABCA1 rs2230806 (OR = 1.31) were significantly associated with higher risk of ischemic stroke. However, no significant associations were observed between ischemic stroke and the other five polymorphisms, namely ApoB (rs693) and APOC3 (rs4520, rs5128, rs2854116 and rs2854117), under any genetic model.

CONCLUSIONS

The present meta-analysis confirmed a significant association of APOA5 rs662799 CC, APOA5 rs3135506 CG, APOB rs1801701 GA, APOB rs1042031 GA and ABCA1 rs2230806 GG with increased risk of ischemic stroke.

Polymorphisms of MTHFR, eNOS, ACE, AGT, ApoE, PON1, PDE4D, and Ischemic Stroke: Meta-Analysis

INTRODUCTION

The association between ischemic stroke and genetic polymorphisms of methylenetetrahydrofolate reductase (MTHFR; 677C>T and 1298A>C), endothelial nitric oxide synthase (eNOS; -786T>C, +894G>T, and variable number tandem repeat [VNTR]), phosphodiesterase 4D (PDE4D; SNPs 83 and 87), angiotensin-converting enzyme (ACE) I/D, angiotensinogen (AGT) 235M>T, paraoxonase 1 (PON1) 192Q>R, and apolipoprotein E (ApoE) ε2ε3ε4 remains inconclusive. Therefore, this updated meta-analysis aimed to clarify the presumed influence of genetic polymorphisms on ischemic stroke by meta-analyzing the comprehensive coverage of all individual association studies.

METHODS

All case-control studies published in different languages such as English, Japanese, Korean, Spanish, Chinese, Hungarian, Ukrainian, or Russian were identified from databases. The pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated via fixed- and random-effect models. Sensitivity analysis, heterogeneity test, Hardy Weinberg Equilibrium, and Egger's regression analyses were performed in this study.

RESULTS

A total of 490 case-control studies with 138,592 cases and 159,314 controls were included in this meta-analysis. Pooled ORs from all the genetic models indicated that MTHFR 677TT and 1298CC, eNOS +894TT and VNTR, PDE4D SNP 83, ACE DD, AGT 235TT, PON1 192RR, and ApoE ε4 polymorphisms were increasing the risks of ischemic stroke. Nevertheless, PDE4D SNP 87 and eNOS -786T>C polymorphisms are not associated with ischemic stroke risks.

CONCLUSIONS

Hence, the evidence from this meta-analysis concluded that MTHFR (677C>T and 1298A>C), eNOS (+894G>T and VNTR), PDE4D SNP 83, ACE I/D, AGT 235M>T, PON1 192Q>R, and ApoE ε2ε3ε4 polymorphisms predispose individuals to ischemic stroke.