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He L, Yan Y, Wang Y, Sun Y, La Y, Liu J, Cai Y, Cao X, Feng Q. Identifying Excessive Intake of Oil and Salt to Prevent and Control Hypertension: A Latent Class Analysis. Front Cardiovasc Med 2022; 9:782639. [PMID: 35463793 PMCID: PMC9019702 DOI: 10.3389/fcvm.2022.782639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction To identify health hazard behaviors and provide a basis for targeted management and intervention for patients with hypertension, we classified their health-related behaviors. Methods A multi-stage random sampling method was used to conduct an on-site questionnaire survey among residents aged ≥15 years in a certain urban area of Taiyuan City, Shanxi Province, China. A latent class analysis was used to classify the lifestyle behaviors of patients with hypertension. The lifestyle behavior characteristics of different types of patients with hypertension and their awareness of hypertension were assessed. Results The prevalence of hypertension in Taiyuan City was 19.5%. Patients with hypertension were classified into three clusters according to their lifestyle patterns: smoking and drinking (13.35%), excessive edible oil and salt intake (68.27%), and healthy behavior (18.38%). Comparing the three latent classes of lifestyle, the distribution of age, sex, marital status, and education level was different (P < 0.05). The awareness of hypertension and the rate of control among the three classes were also different (P < 0.05). Conclusion The lifestyle behaviors of patients with hypertension have evident classification characteristics. Approximately two-thirds of the patients with hypertension have an excessive intake of oil and salt. Therefore, targeted and precise intervention measures should be taken to control the intake of oil and salt in this cohort.
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Affiliation(s)
- Lu He
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
- *Correspondence: Lu He
| | - Yan Yan
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yuxiao Wang
- Department of Health Economics, School of Management, Shanxi Medical University, Taiyuan, China
| | - Yudan Sun
- First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yuanyuan La
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jie Liu
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yutong Cai
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Xi Cao
- Department of Social Medicine, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Qilong Feng
- Department of Physiology, Key Laboratory of Cellular Physiology, Ministry of Education, Shanxi Medical University, Taiyuan, China
- Qilong Feng
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Buie JNJ, Stanley A, Nietert PJ, Logan A, Adams RJ, Magwood GS. Racial Disparities in Arterial Stiffness Between Healthy Whites and African Americans in the United States: A Meta-analysis. J Natl Med Assoc 2018; 111:7-17. [PMID: 30129482 DOI: 10.1016/j.jnma.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 06/01/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND African Americans (AAs) present with cardiovascular disease (CVD) risk factors at younger ages than whites. Consequently, CVD and stroke occur at a higher incidence and at earlier decades in life in AA populations. Arterial stiffness is a predictor of CVD outcomes and partially explains the CVD risk experienced by racial minorities. We evaluated the differences in arterial stiffness observed in AAs and whites through a systematic review and meta-analysis. METHODS We searched PubMed and SCOPUS for comparative studies published March 1995 to November 29, 2017 comparing arterial stiffness assessments (pulse wave velocity, augmentation index, and central blood pressure) between AAs and whites. Two independent reviewers examined 195 titles/abstracts, 85 full text articles and 11 articles were included in the meta-analysis using random effects modeling approaches. MAIN RESULTS A total of 5060 white and 3225 AAs were included across 11 relevant studies. Carotid-femoral pulse wave velocity (cfPWV) measures were statistically different between AAs and whites (mean difference = -0.44, 95% confidence interval [CI]: -[-0.67, -0.21], p = 0.0002). Aortic femoral pulse wave velocity was significantly different between AAs and whites (mean difference = -0.21, [95% CI] -0.35, -0.07, p = 0.003) regardless of sex. Augmentation index (AIx) and Augmentation index at a 75 beats per minutes heart rate (AIx @75) was also significantly different between AA and whites (mean difference = -4.36 [95% CI] = -6.59, -2,12, p = 0.0001 and -6.26, [95% CI] = -9.19, -3.33, p < 0.0001, respectively). CONCLUSIONS Racial disparities in arterial stiffness persist among African American racial groups in the United States. The lack of homogeneity in studies capturing racial disparities in cfPWV suggest that additional studies are needed to understand the magnitude of racial differences in African Americans and whites that might be clinically relevant.
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Affiliation(s)
- Joy N J Buie
- Medical University of South Carolina WISSDOM Center, 96 Jonathan Lucas St., CSB 301, MSC 606, Charleston, SC 29425, USA
| | - Angela Stanley
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street, MSC 160, Charleston, SC 29425, USA
| | - Paul J Nietert
- Medical University of South Carolina, Department Public Health Sciences, 135 Cannon Street Suite 303, MSC 835, Charleston, SC 29425, USA
| | - Ayaba Logan
- Medical University of South Carolina, Department of Library Science and Informatics, 171 Ashley Avenue Suite 300, MSC 403, Charleston, SC 29425, USA
| | - Robert J Adams
- Medical University of South Carolina WISSDOM Center, 96 Jonathan Lucas St., CSB 301, MSC 606, Charleston, SC 29425, USA; Medical University of South Carolina, Department of Neurology, College of Medicine, 96 Jonathan Lucas St. CSB 301, MSC 606 Charleston, SC 29425, USA
| | - Gayenell S Magwood
- Medical University of South Carolina WISSDOM Center, 96 Jonathan Lucas St., CSB 301, MSC 606, Charleston, SC 29425, USA; Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas Street, MSC 160, Charleston, SC 29425, USA.
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Cheng YQ, Tan BY, Yu XH, Dong WZ, Su DF, Zhu DQ, Liu AJ. Synergism of amlodipine and candesartan on blood pressure reduction and organ protection in hypertensive rats. Clin Exp Pharmacol Physiol 2018; 45:514-524. [PMID: 29193272 DOI: 10.1111/1440-1681.12901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 11/02/2017] [Accepted: 11/07/2017] [Indexed: 01/18/2023]
Abstract
This study was designed to investigate the possible synergism of amlodipine and candesartan on the reduction of blood pressure (BP) in hypertensive rats. The end organ protection was also observed. In acute experiment, spontaneously hypertensive rats (SHRs) were treated with intragastric administration of amlodipine (0.5, 1, 2, 3 mg/kg), candesartan (1, 2, 3, 4, 6, 8 mg/kg), and 14 different combinations to find the possible ratio of synergistic interaction. In two kidneys, one clip (2K1C) rats, the effects of amlodipine (1 mg/kg), canderastan (2 mg/kg) and their combination on BP reduction were also observed. In chronic study, SHRs were treated with amlodipine (1 mg/kg), candesartan (2 mg/kg), and their combination for 5 months. Organ damage evaluation was performed after BP recording. The probability sum test (q test) was used to evaluate the synergistic action. There is a synergistic interaction between amlodipine and candesartan on BP reduction. The optimal dose ratio is 1:2. The synergistic effect was also confirmed by 2K1C hypertensive rats. In chronic study, this combination (1:2) possessed an obvious synergism on the reduction of BP and BP variability (BPV) and protection on end organs. Multiple regression analysis showed that heart and aortic hypertrophy indexes and glomerular damage parameters were positively related to BP and BPV. In conclusion, combination of amlodipine and candesartan exhibited a potent antihypertensive effect and possessed an obvious synergism on BP reduction and organ protection in hypertension. The optimal proportion was 1:2. BP and BPV reduction may both importantly contribute to end organ protection.
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Affiliation(s)
- Yan-Qiong Cheng
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China.,Department of Urinary Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Bing-Yi Tan
- Department of Spinal Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Xu-Hong Yu
- Department of Pharmacy, People Liberation Army 305 Hospital, Beijing, China
| | - Wen-Zhe Dong
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China.,Department of Pharmacology, Shanghai Institute of Health Sciences, Shanghai, China
| | - Ding-Feng Su
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - De-Qiu Zhu
- Division of Pharmacy, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ai-Jun Liu
- Department of Pharmacology, School of Pharmacy, Second Military Medical University, Shanghai, China
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Javorka M, Krohova J, Czippelova B, Turianikova Z, Lazarova Z, Javorka K, Faes L. Basic cardiovascular variability signals: mutual directed interactions explored in the information domain. Physiol Meas 2017; 38:877-894. [PMID: 28140353 DOI: 10.1088/1361-6579/aa5b77] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The study of short-term cardiovascular interactions is classically performed through the bivariate analysis of the interactions between the beat-to-beat variability of heart period (RR interval from the ECG) and systolic blood pressure (SBP). Recent progress in the development of multivariate time series analysis methods is making it possible to explore how directed interactions between two signals change in the context of networks including other coupled signals. Exploiting these advances, the present study aims at assessing directional cardiovascular interactions among the basic variability signals of RR, SBP and diastolic blood pressure (DBP), using an approach which allows direct comparison between bivariate and multivariate coupling measures. To this end, we compute information-theoretic measures of the strength and delay of causal interactions between RR, SBP and DBP using both bivariate and trivariate (conditioned) formulations in a group of healthy subjects in a resting state and during stress conditions induced by head-up tilt (HUT) and mental arithmetics (MA). We find that bivariate measures better quantify the overall (direct + indirect) information transferred between variables, while trivariate measures better reflect the existence and delay of directed interactions. The main physiological results are: (i) the detection during supine rest of strong interactions along the pathway RR → DBP → SBP, reflecting marked Windkessel and/or Frank-Starling effects; (ii) the finding of relatively weak baroreflex effects SBP → RR at rest; (iii) the invariance of cardiovascular interactions during MA, and the emergence of stronger and faster SBP → RR interactions, as well as of weaker RR → DBP interactions, during HUT. These findings support the importance of investigating cardiovascular interactions from a network perspective, and suggest the usefulness of directed information measures to assess physiological mechanisms and track their changes across different physiological states.
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Affiliation(s)
- Michal Javorka
- Department of Physiology, Comenius University in Bratislava, Jessenius Faculty of Medicine, Mala Hora 4C, 03601 Martin, Slovakia. Biomedical Center Martin, Comenius University in Bratislava, Jessenius Faculty of Medicine, Mala Hora 4C, 03601 Martin, Slovakia
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Interactions between CYP11B2 Promoter Methylation and Smoking Increase Risk of Essential Hypertension. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1454186. [PMID: 28078278 PMCID: PMC5204072 DOI: 10.1155/2016/1454186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 09/17/2016] [Accepted: 10/09/2016] [Indexed: 11/17/2022]
Abstract
Aldosterone synthase (CYP11B2) is closely linked to essential hypertension (EH). However, it remains unclear whether the methylation of the CYP11B2 promoter is involved in the development of EH in humans. Our study is aimed at evaluating the contribution of CYP11B2 promoter methylation to the risk of EH. Methylation levels were measured using pyrosequencing technology in 192 participants in a hospital-based case-control study. Logistic regression and multiple linear regression analyses were utilized to adjust for confounding factors and the GMDR method was applied to investigate high-order gene-environment interactions. Although no significant result was observed linking the four analyzed CpG sites to EH, GMDR detected significant interactions among CpG1, CpG3, CpG4, and smoking correlated with an increased risk of EH (OR = 4.62, adjusted P = 0.011). In addition, CpG2 (adjusted P = 0.013) and CpG3 (adjusted P = 0.039) methylation was significantly lower in healthy males than in healthy females. Likewise, after adjusting for confounding factors, CpG2 methylation (adjusted P = 0.007) still showed significant gender-specific differences among the participants of the study. CpG1 (P = 0.009) site was significantly positively correlated with age, and CpG3 (P = 0.007) and CpG4 (P = 0.006) were both inversely linked to smoking. Our findings suggest that gene-environment interactions are associated with the pathogenesis and progression of EH.
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Evaluation of the neutrophil–lymphocyte ratio in newly diagnosed nondiabetic hypertensive patients with ascending aortic dilatation. Blood Press Monit 2016; 21:238-43. [DOI: 10.1097/mbp.0000000000000187] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kindman LA, Turner JR, Lee J. Blood Pressure Measurement Modalities: A Primer for Busy Practitioners. J Clin Hypertens (Greenwich) 2016; 18:262-6. [PMID: 26558475 PMCID: PMC8032056 DOI: 10.1111/jch.12709] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | | | - John Lee
- Cardiovascular Center of ExcellenceQuintilesDurhamNC
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Borghi C, Urso R, Cicero AFG. The cost-effectiveness of irbesartan for hypertension. Expert Rev Pharmacoecon Outcomes Res 2015; 15:199-207. [PMID: 25703678 DOI: 10.1586/14737167.2015.1018894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
High blood pressure is a very common problem in the adult and elderly population, both in developed and developing countries. A relatively large number of drug classes are available to treat this condition and prevent its complications, which are not only more frequent in the aforementioned patients but also those affected by metabolic syndrome and/or Type 2 diabetes. Irbesartan is an angiotensin-receptor blocker class drug with good antihypertensive efficacy and specific pharmacological characteristics, whose efficacy has been more deeply evaluated in metabolically complex hypertensive patients. In this review, the authors will analyze its effectiveness in preventing or delaying organ damage in hypertensive patients, with a closer look at the economic implications of treating hypertension with irbesartan in the context of available antihypertensive drugs.
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Affiliation(s)
- Claudio Borghi
- Department of Medical and Surgical Sciences, U.O di Medicina Interna, Ospedale Policlinico S.Orsola-Malpighi, University of Bologna, Via Albertoni, 15, 40138 Bologna, Italy
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Bramlage P, Fronk EM, Wolf WP, Smolnik R, Sutton G, Schmieder RE. Safety and effectiveness of a fixed-dose combination of olmesartan, amlodipine, and hydrochlorothiazide in clinical practice. Vasc Health Risk Manag 2015; 11:1-8. [PMID: 25565857 PMCID: PMC4275113 DOI: 10.2147/vhrm.s75380] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background Clinical trials indicate that the use of fixed-dose combinations (FDCs) is associated with a higher level of treatment adherence and prolonged blood pressure (BP) control. The aim of this study was to document the safety and effectiveness of the FDC olmesartan/amlodipine/hydrochlorothiazide in patients with essential hypertension in clinical practice. Methods This multicenter, prospective, 24-week, noninterventional study enrolled 5,831 patients from primary care offices in Germany and Austria. Inclusion criteria were a diagnosis of essential hypertension and newly initiated treatment with the FDC. Results The mean age of patients was 63.5 years, almost 50% of patients had a time since diagnosis of essential hypertension of over 5 years, and approximately 70% of patients had at least one cardiovascular risk factor, including 29.4% of patients with diabetes mellitus. Following approximately 24 weeks of treatment, the mean reduction in systolic/diastolic BP was 29.0/14.0 mmHg, a BP response was observed by 94.2% of patients, and a target BP of <140/90 mmHg was attained in 67.5% of patients. At least one adverse drug reaction (ADR) was experienced by 1.2% of patients, with the most common being peripheral edema. Subanalyses demonstrated that the following factors did not have a significant influence on the ADR rate: age (<65 years versus ≥65 years), diabetes mellitus (no/yes), cardiovascular risk (low/high), and concomitant medication (no/yes). Conclusion This study demonstrates that in clinical practice, treatment with the three-drug combination as an FDC tablet resulted in a very high proportion of patients with a BP response and control, accompanied by a very low rate of ADRs.
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Affiliation(s)
- Peter Bramlage
- Institut für Pharmakologie und präventive Medizin, Mahlow, Germany
| | | | | | | | - Gemma Sutton
- Institut für Pharmakologie und präventive Medizin, Mahlow, Germany
| | - Roland E Schmieder
- Abteilung für Nephrologie und Hypertensiologie, Universitätsklinikum Erlangen, Erlangen, Germany
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Ramia E, Zeenny R. Completion of therapeutic and safety monitoring tests in Lebanese outpatients on chronic medications: a cross-sectional study. Patient Prefer Adherence 2014; 8:1195-204. [PMID: 25228798 PMCID: PMC4162632 DOI: 10.2147/ppa.s69250] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate the appropriateness of laboratory-test monitoring recommended for patients on chronic medication therapies in the Lebanese community setting. PATIENTS AND METHODS In October 2011, all outpatients visiting selected community pharmacies in Lebanon were screened by pharmacists to evaluate their use of one or more chronic medications requiring safety and/or therapeutic laboratory tests. The list of medications was elaborated after an extensive review of laboratory-test monitoring recommendations from pertinent up-to-date clinical guidelines, medications that have been issued black box warnings for monitoring, and the most current information from the US Food and Drug Administration website. Patients receiving these medications were subjected to a questionnaire assessing the appropriateness of their laboratory-test monitoring. The study was approved by the Lebanese American University's Institutional Review Board. RESULTS A total of 284 outpatients, with almost equal distribution by sex, were identified during the aforementioned period to be on one or more of the specified medications. The majority of the sample (68%) was younger than 65 years of age. Overall, most of the study group (65%) were found to be partially monitored with laboratory tests, while only 27% were fully monitored and 8% were not monitored at all. The study group reported clinic-visit intervals as follows: more than a year (35%), on yearly basis (18%), every 6 months (25%), every 3 months (16%), less than 3 months (6%). CONCLUSION Seventy-three percent (73%) of the study group were receiving incomplete therapeutic/safety laboratory-test monitoring recommended for patients on chronic medication in the Lebanese community. It is concluded from the results that patients need to better understand the importance of recommended test monitoring for the safe and effective use of their medications. Education by physicians may be required to achieve better understanding.
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Affiliation(s)
- Elsy Ramia
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon
- Correspondence: Elsy Ramia, Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, PO Box 36, Byblos, Lebanon, Tel +961 9 547 254, Fax +961 9 547 256, Email
| | - Rony Zeenny
- Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, Byblos, Lebanon
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