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Wei L, Sun J, Xie H, Zhuang Q, Wei P, Zhao X, Chen Y, Dong J, Li M, Chen C, Yang S, Shen C. Interaction Analysis of Abnormal Lipid Indices and Hypertension for Ischemic Stroke: A 10-Year Prospective Cohort Study. Front Cardiovasc Med 2022; 9:819274. [PMID: 35360026 PMCID: PMC8962740 DOI: 10.3389/fcvm.2022.819274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/18/2022] [Indexed: 01/23/2023] Open
Abstract
BackgroundDyslipidemia and hypertension are two important independent risk factors for ischemic stroke (IS); however, their combined effect on IS remains uncertain.ObjectivesThis present study aimed to evaluate the interaction effect of hypertension and abnormal lipid indices on IS in a 10-year prospective cohort in Chinese adults.MethodsThe cohort study of 4,128 participants was conducted in May 2009 and was followed up to July 2020. All qualified participants received a questionnaire survey, physical examination, and blood sample detection. Cox regression was used to evaluate the association of dyslipidemia and hypertension with IS, and calculate the hazard ratio (HR) and 95% confidence interval (CI). The relative excess risk of interaction (RERI) and the HR (95%CI) of interaction terms were used to examine additive and multiplicative interactions.ResultsIn the hypertensive population, Non-HDL-C ≥190 mg/dl, LDL-C/HDL-C ≥2 and HDL-C ≥60 mg/dl were statistically associated with IS, and after adjusting for covariates, HRs (95%CIs) were 1.565 (1.007–2.429), 1.414 (1.034–1.933) and 0.665 (0.450–0.983), respectively. While in the non-hypertension population, no significant association of Non-HDL-C ≥190 mg/dl, LDL-C/HDL-C ≥2, and HDL-C ≥60 was detected with IS (P > 0.05). There was a significant association between TC/HDL-C ≥ 3.6 and the decreased risk of IS in the non-hypertension population, and the HR (95%CI) was 0.479 (0.307–0.750). Whereas, a similar association was not observed in the hypertensive population. HDL-C ≥ 60 mg/dl, Non-HDL-C ≥ 190 mg/dl, TC/HDL-C ≥ 3.6, and TG/HDL-C ≥ 1 have additive and multiplicative interactions with hypertension (P < 0.05). The RERIs (95% CIs) of the additive interaction are −0.93 (−1.882–0.044), 1.394 (0.38–2.407), 0.752 (0.354–1.151) and 0.575 (0.086–1.065), respectively. The HRs (95% CIs) of the multiplicative interaction terms were 0.498 (0.272–0.911), 4.218 (1.230–14.464), 2.423 (1.437–4.086) and 1.701 (1.016–2.848), respectively.ConclusionHigh concentration of HDL-C reduces the impact of hypertension on IS, while the high concentration of Non-HDL-C, TC/HDL-C, and TG/HDL-C positively interact with hypertension affecting the incidence of IS. This study provides useful evidence for the combined effects of dyslipidemia and hypertension in predicting IS.
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Affiliation(s)
- Lai Wei
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Junxiang Sun
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
| | - Hankun Xie
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qian Zhuang
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
| | - Pengfei Wei
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
| | - Xianghai Zhao
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
| | - Yanchun Chen
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
| | - Jiayi Dong
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Mengxia Li
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Changying Chen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Song Yang
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, China
- Song Yang
| | - Chong Shen
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
- *Correspondence: Chong Shen
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Semerdzhieva NE, Denchev S. Association of High Density Cholesterol With Hyperemic Epicardial Flow and Frame Count Reserve in Patients With Moderate Coronary Lesions and Slow Coronary Flow. Cureus 2021; 13:e13985. [PMID: 33758725 PMCID: PMC7978158 DOI: 10.7759/cureus.13985] [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] [Indexed: 11/09/2022] Open
Abstract
Background Patients with microvascular angina and non-obstructive coronary atherosclerotic disease have an elevated risk of adverse events and all-cause mortality compared with individuals without ischaemic heart disease. The diagnosis coronary microvascular dysfunction in this setting relies on the detection of impaired coronary flow at rest or on calculation of coronary flow reserve. Previous studies demonstrate that the coronary flow reserve assessed by the corrected thrombolysis in myocardial infarction method - the frame count reserve is an objective quantitative alternative to other widely used invasive methods for microvascular status evaluation. Purpose We assessed the significance of clinical, hemodynamic, angiographic variables and therapy with reference to FCR in a small group of patients with up to moderate atherosclerotic coronary lesions and slow coronary flow. Materials and methods: Frame count reserve was evaluated in 15 patients without flow-limiting (>50%) coronary stenoses admitted with unstable angina. Frame count reserve was calculated by dividing the baseline corrected thrombolysis in myocardial infarction frame count (cTFC) by the cTFC assessed after intracoronary infusion of 100 µg of the calcium channel blocker - verapamil. Results The values of frame count reserve correlate positively with the levels of high density cholesterol (r= 0.900, p=0.001), inversely coronary flow after the application of verapamil - cTFCv (r= - 0.534, p=0.049). cTFCv was positively related with the levels of high density lipoproteins (r = - 0.645; p= 0.044) and was negatively influenced by the presence of atherosclerotic lesions at quantitative angiography (42.8±19.1 (n=8) vs 23±5.4 (n=7), p=0.029).The therapy with β-blocker and long-acting nitrate was associated with insignificantly higher frame count reserves after intracoronary verapamil compared to the continuous intake only of β-blocker or β-blocker and verapamil (2.1±0.78 vs 1.34±0.14 vs 1.70±0.70, p=NS). Conclusions Higher high-density lipoproteins relate to higher frame count reserves evaluated using verapamil. The improved blood flow after this microvascular vasodilator is consistently positively related to high-density cholesterol and the lack of atherosclerosis at conventional coronary angiography. The combined intake of micro- and macrovascular vasodilator could be associated with higher frame count reserves compared to therapy with β-blocker and one vasodilating drug.
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Affiliation(s)
| | - Stefan Denchev
- Department of Cardiology, Medical Center 'Mediva', Sofia, BGR
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Abdullah S, Jarrar Y, Alhawari H, Abed E, Zihlif M. The Influence of Endothelial Nitric Oxide Synthase (eNOS) Genetic Polymorphisms on Cholesterol Blood Levels Among Type 2 Diabetic Patients on Atorvastatin Therapy. Endocr Metab Immune Disord Drug Targets 2021; 21:352-359. [DOI: 10.2174/1871530320666200621174858] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/30/2020] [Accepted: 05/08/2020] [Indexed: 11/22/2022]
Abstract
Background:
Endothelial nitric oxide synthase (eNOS) plays a major role in the response of
anti-hypercholesterol statin drugs. Genetic polymorphisms in the eNOS gene affect the activity of
eNOS thereby modulating the statin response.
Objectives:
This study investigated the influence of major functional eNOS gene polymorphisms
(rs2070744, rs1799983, and rs61722009) on the lipid profile of type 2 diabetes mellitus (T2DM) Jordanian
patients treated with atorvastatin.
Methods:
The sample comprised 103 T2DM patients who attended the diabetes clinic of Jordan University
Hospital. The T2DM patients had regularly been taking 20 mg atorvastatin. The atorvastatin
response was calculated by measuring the lipid profile before and after three months of atorvastatin
treatment. The eNOS genotypes of the subjects were analyzed using polymerase chain reaction (PCR)
followed by restriction fragment length polymorphism (RFLP) assay.
Results:
No significant association was found between eNOS genetic polymorphisms and the response
to atorvastatin (ANOVA, p > 0.05). In addition, no significant difference in the frequency of eNOS
genotypes was found between T2DM patients and healthy subjects. However, patients with eNOS
rs1799983, 4a/4a, and rs61722009 G/G genotypes showed significantly lower levels of baseline total
cholesterol (TC) and low density lipoprotein (LDL) than did patients carrying the rs1799983 4b/4b or
rs61722009 T/T genotype (p < 0.05). The eNOS rs1799983 and rs61722009 polymorphisms were in
complete linkage disequilibrium (D' = 1).
Conclusion:
Although no association was found between eNOS genetic polymorphisms and atorvastatin
response, there was a significant association between the rs1799983 and rs61722009 genotypes
and baselines levels of TC and LDL in Jordanian T2DM patients. These genetic variants affect cholesterol
levels and may play a role in the susceptibility to cardiovascular diseases in T2DM patients. Further
studies are needed to validate these findings.
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Affiliation(s)
- Sarah Abdullah
- Department of Pharmacology, Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Yazun Jarrar
- Department of Pharmaceutical Science, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Hussam Alhawari
- Department of Internal Medicine, Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Eyada Abed
- Department of Pharmacology, Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Malek Zihlif
- Department of Pharmacology, Faculty of Medicine, University of Jordan, Amman, Jordan
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Chen H, Chen Y, Wu W, Cai Z, Chen Z, Yan X, Wu S. Total cholesterol, arterial stiffness, and systolic blood pressure: a mediation analysis. Sci Rep 2021; 11:1330. [PMID: 33446746 PMCID: PMC7809132 DOI: 10.1038/s41598-020-79368-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 12/07/2020] [Indexed: 02/05/2023] Open
Abstract
On the basis of 45,092 participants (mean age of 54.04 ± 13.09 years) from the Kailuan study, this study was performed to explore the relationships among total cholesterol (TC), brachial-ankle pulse wave velocity (BaPWV), and systolic blood pressure (SBP) and quantify their separate effects. The correlations among TC, SBP, and BaPWV were analyzed using multivariate linear regression models. Mediation analysis was performed to determine whether the effect of TC on SBP can be explained by arterial stiffness. Multivariate linear regression analysis showed that for every one standard deviation increase in TC and BaPWV, SBP increased by 0.33 mmHg and 0.044 mmHg, respectively; for every one standard deviation increase in TC, BaPWV increased by 5.34 cm/s. Mediation analysis showed that the TC-induced SBP elevation was mediated by arterial stiffness in more than half of the whole cohort (indirect effect, 0.73; percent mediated, 54.5%). Furthermore, the TC-induced SBP elevation was mediated by arterial stiffness in less than half of the males (indirect effect, 0.70; percent mediated, 47.9%); however, the results were not statistically significant in females. In conclusion, TC and BaPWV are positively correlated with SBP, whereas TC is positively correlated with BaPWV. Almost half of the increase in SBP contributed to TC is mediated by arterial stiffness.
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Affiliation(s)
- Haojia Chen
- Shantou University Medical College, Shantou, 515041, Guangdong, China
- Department of Cardiology, First Hospital of Medical College of Shantou University, Shantou, 515041, Guangdong, China
| | - Youren Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China.
| | - Weiqiang Wu
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Zefeng Cai
- Shantou University Medical College, Shantou, 515041, Guangdong, China
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Zhichao Chen
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Xiuzhu Yan
- School of Foreign Language, Guangdong Polytechnic Normal University, Guangzhou, 510000, Guangdong, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, 063001, China.
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Mahadir Naidu B, Mohd Yusoff MF, Abdullah S, Musa KI, Yaacob NM, Mohamad MS, Sahril N, Aris T. Factors associated with the severity of hypertension among Malaysian adults. PLoS One 2019; 14:e0207472. [PMID: 30605462 PMCID: PMC6317782 DOI: 10.1371/journal.pone.0207472] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/30/2018] [Indexed: 02/05/2023] Open
Abstract
High blood pressure is a worldwide problem and major global health burden. Whether alone or combined with other metabolic diseases, high blood pressure increases the risk of cardiovascular disease. This study is a secondary data analysis from the National Health and Morbidity Survey 2015, a population-based study that was conducted nationwide in Malaysia using a multi-stage stratified cluster sampling design. A total of 15,738 adults ≥18-years-old were recruited into the study, which reports the prevalence of hypertension stages among adults in Malaysia using the JNC7 criteria and determinants of its severity. The overall prevalence of raised blood pressure was 66.8%, with 45.8% having prehypertension, 15.1% having Stage 1 hypertension, and 5.9% having Stage 2 hypertension. In the multivariate analysis, a higher likelihood of having prehypertension was observed among respondents with advancing age, males (OR = 2.74, 95% CI: 2.41-3.12), Malay ethnicity (OR = 1.21, 95% CI: 1.02-1.44), lower socioeconomic status, and excessive weight. The factors associated with clinical hypertension (Stages 1 and 2) were older age, rural residency (Stage 1 OR = 1.22, Stage 2 OR = 1.28), Malay ethnicity (Stage 2 OR = 1.64), diabetes (Stage 2 OR = 1.47), hypercholesterolemia (Stage 1 OR = 1.34, Stage 2 OR = 1.82), being overweight (Stage 1 OR = 2.86, Stage 2 OR = 3.44), obesity (Stage 1 OR = 9.01, Stage 2 OR = 13.72), and lower socioeconomic status. Almost 70% of Malaysian adults are at a risk of elevated blood pressure. The highest prevalence was in the prehypertension group, which clearly predicts a future incurable burden of the disease. Public health awareness, campaigns through mass and social media, and intervention in the work place should be a priority to control this epidemic.
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Affiliation(s)
- Balkish Mahadir Naidu
- School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
- Department of Statistics, Federal Government Administrative Centre, Putrajaya, Malaysia
| | | | - Sarimah Abdullah
- School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Kamarul Imran Musa
- School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Najib Majdi Yaacob
- School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Maria Safura Mohamad
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Norhafizah Sahril
- School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Tahir Aris
- Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Haplotype analysis of endothelial nitric oxide synthase (NOS3) genetic variants and metabolic syndrome in healthy subjects and schizophrenia patients. Int J Obes (Lond) 2018; 42:2036-2046. [PMID: 29907847 PMCID: PMC6291422 DOI: 10.1038/s41366-018-0124-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 04/11/2018] [Accepted: 04/22/2018] [Indexed: 11/18/2022]
Abstract
Background/objectives The frequency of metabolic syndrome (MetS) is significantly higher in schizophrenia (SCH) patients, when compared to the general populatiotin. The goal of this study was to evaluate whether genetic variants T-786C (rs2070744), G894T (rs1799983) and C774T (rs1549758) in the endothelial nitric oxide (NOS3) gene and/or their haplotypes could be associated with the risk of MetS in SCH patients or healthy subjects from Russian population. Subjects/methods We performed two case−control comparisons. NOS3 polymorphisms were genotyped in 70 SCH patients with MetS, 190 normal weight SCH patients, 155 MetS patients, and 100 healthy controls. MetS was defined as per the criteria proposed by the International Diabetes Federation (IDF). Anthropometric, clinical, biochemical parameters, and serum nitrite concentrations were measured in all samples. Haplotype frequency estimations and linkage disequilibrium measures were made using Haploview 4.2. Results The higher C allele (P = 0.009) and lower TT genotype (P = 0.008) frequencies of T-786C polymorphism were found in SCH patients with MetS compared to those in normal weight SCH patients. SCH patients with MetS who were carriers of the T-786C TT genotype had lower serum total cholesterol levels in comparison to the CC genotype (P = 0.016). Furthermore, the 774T/894T haplotype was more frequent in non-SCH individuals with MetS compared to healthy controls (P = 0.0004, odds ratio = 2.18, 95% confidence interval 1.4–3.37). Conversely, the most common haplotype 774C/894G was less frequent in MetS patients than in healthy controls (P = 0.013, odds ratio = 0.61, 95% confidence interval 0.41–0.9). Conclusions These results indicate that the NOS3 T-786C promoter polymorphism was closely associated with MetS risk in SCH patients. In addition, the haplotypes composed of G894T and C774T polymorphisms are associated with the MetS susceptibility in Russian population.
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Shahid SU, Rehman A. Association Patterns of Endothelial Nitric Oxide Synthase Gene (NOS3) Variant Glu298Asp with Blood Pressure and Serum Lipid Levels in Subjects with Coronary Artery Disease from Pakistan. Ann Hum Genet 2017. [DOI: 10.1111/ahg.12192] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Saleem Ullah Shahid
- Department of Microbiology and Molecular Genetics; University of the Punjab; Lahore Pakistan
| | - Abdul Rehman
- Department of Microbiology and Molecular Genetics; University of the Punjab; Lahore Pakistan
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Fu S, Chen W, Luo L, Ye P. Roles of fasting and postprandial blood glucose in the effect of type 2 diabetes on central arterial stiffness: a 5-year prospective community-based analysis. Diabetol Metab Syndr 2017; 9:33. [PMID: 28507608 PMCID: PMC5427581 DOI: 10.1186/s13098-017-0231-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 05/05/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Cardiovascular disease constitutes a major challenge for the health of community-dwelling population, it is essential to delay the development of atherosclerosis. However, long-term prospective studies analyzing the effect of type 2 diabetes (T2D) on central arterial stiffness are lacking, and roles of fasting and postprandial blood glucose (FBG and PBG) in this effect are controversial. Purpose of the current analysis was to investigate the effect of T2D on central arterial stiffness during the 5 years of follow-up, and explore whether both FBG and PBG were determinants of this effect in Chinese community-dwelling population. METHODS The current analysis involved 898 individuals with carotid-femoral pulse wave velocity (cfPWV) ≤12 m/s. Central arterial stiffness was assessed by standard cfPWV at baseline and follow-up. RESULTS Incidence of cfPWV >12 m/s was 21.3% (102 participants). Participants without T2D had an increase of cfPWV with a median of 0.6 m/s, whereas participants with T2D had an increase of cfPWV with a median of 1.2 m/s (p = 0.007). T2D had an independent effect on increased cfPWV in multivariate Logistic regression models (p < 0.05 for all). Elevated levels of both FBG and PBG determined the independent effect on increased cfPWV in multivariate linear regression models (p < 0.05 for all). CONCLUSIONS Type 2 diabetes had an independent effect on the development of central arterial stiffness in Chinese community-dwelling population. Both FBG and PBG should be responsible for the development of central arterial stiffness and treated as the targets of glycemic control.
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Affiliation(s)
- Shihui Fu
- Department of Geriatric Cardiology, Chinese People’s Liberation Army General Hospital, Beijing, 100853 China
- Department of Cardiology and Hainan Branch, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Wenji Chen
- Department of Rheumatology and Hainan Branch, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Leiming Luo
- Department of Geriatric Cardiology, Chinese People’s Liberation Army General Hospital, Beijing, 100853 China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese People’s Liberation Army General Hospital, Beijing, 100853 China
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de Oliveira Alvim R, Mourao CA, Magalhães GL, de Oliveira CM, Krieger JE, Mill JG, Pereira AC. Non-HDL cholesterol is a good predictor of the risk of increased arterial stiffness in postmenopausal women in an urban Brazilian population. Clinics (Sao Paulo) 2017; 72:106-110. [PMID: 28273234 PMCID: PMC5304361 DOI: 10.6061/clinics/2017(02)07] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 11/24/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES: Increased arterial stiffness is an important determinant of the risk of cardiovascular disease. Lipid profile impairment, especially hypercholesterolemia, is associated with stiffer blood vessels. Thus, the aim of this study was to determine which of the five circulating lipid components (high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL), total cholesterol (TC) and triglycerides) is the best predictor of increased arterial stiffness in an urban Brazilian population. METHODS: A random sample of 1,662 individuals from the general population of Vitoria, Brazil (25-64 years), was selected, and lipid components were measured using standard methods. Pulse wave velocity was measured using a non-invasive automatic device, and increased arterial stiffness was defined as a pulse wave velocity ≥10 m/s. RESULTS: In men, only total cholesterol (OR=1.59; CI=1.02 to 2.48, p=0.04) was associated with the risk of increased arterial stiffness. In women, HDL-C (OR=1.99; CI=1.18 to 3.35, p=0.01) and non-HDL-C (OR=1.61; CI=1.01 to 2.56, p=0.04) were good predictors of the risk of increased arterial stiffness. However, these associations were only found in postmenopausal women (OR=2.06; CI=1.00 to 4.26, p=0.05 for HDL-C and OR=1.83; CI=1.01 to 3.33, p=0.04 for non-HDL-C). CONCLUSION: Our findings indicate that both HDL-C and non-HDL-C are good predictors of the risk of increased arterial stiffness in postmenopausal women in an urban Brazilian population and may be useful tools for assessing the risk of arterial stiffness.
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Affiliation(s)
- Rafael de Oliveira Alvim
- Universidade Federal do Espírito Santo, Departamento de Saúde Pública, Vitória/ES, Brazil
- *Corresponding author. E-mail:
| | - Carlos Alberto Mourao
- Universidade Federal de Juiz de Fora, Departamento Fisiologia, Juiz de Fora/MG, Brazil
| | - Géssica Lopes Magalhães
- Faculdade de Medicina da Universidade de São Paulo, Instituto do Coração (INCOR), Laboratório de Genética e Cardiologia Molecular, São Paulo/SP, Brazil
| | - Camila Maciel de Oliveira
- Faculdade de Medicina da Universidade de São Paulo, Instituto do Coração (INCOR), Laboratório de Genética e Cardiologia Molecular, São Paulo/SP, Brazil
| | - José Eduardo Krieger
- Faculdade de Medicina da Universidade de São Paulo, Instituto do Coração (INCOR), Laboratório de Genética e Cardiologia Molecular, São Paulo/SP, Brazil
| | - José Geraldo Mill
- Universidade Federal do Espírito Santo, Departamento de Saúde Pública, Vitória/ES, Brazil
| | - Alexandre Costa Pereira
- Faculdade de Medicina da Universidade de São Paulo, Instituto do Coração (INCOR), Laboratório de Genética e Cardiologia Molecular, São Paulo/SP, Brazil
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ALrefai AA, Habib MSED, Yaseen RI, Gabr MK, Habeeb RM. Association of endothelial nitric oxide synthase (eNOS) gene G894T polymorphism with hypertension risk and complications. Mol Cell Biochem 2016; 421:103-10. [PMID: 27557897 DOI: 10.1007/s11010-016-2790-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/05/2016] [Indexed: 10/21/2022]
Abstract
This study evaluated the association of NOS3 polymorphisms with hypertension risk and complications. eNOS (G894T) SNP was performed by RT-PCR on 70 hypertensive patients (25 were hypertensive, 25 were hypertensive with CAD, and 20 were diabetic with hypertension) and 30 age- and gender-matched individuals. Lipid and glucose profile were assessed by standard colorimetric assay. Our results revealed that combination of (GT + TT) genotype and T allele significantly increases the risk of hypertension (OR = 3.86 and 4.33), respectively. Subgroup analysis showed significant association between CAD with eNOS (G894T) mutant genotype (P = 0.002) and allele frequency (P < 0.001). Moreover, the mutant homozygous and heterozygous eNOS genotype together were significantly associated with higher TC, LDLc, (P < 0.001), and TG (P = 0.001). Thus, hypercholesterolemia (P < 0.001 and OR = 12.48) increases the risk of hypertension among T carrier. These results indicated that the T carriers significantly increase hypertension risk and complication (CAD), mainly with hypercholesterolemia and in elderly.
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Affiliation(s)
- Abeer A ALrefai
- Department of Medical Biochemistry, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt.
| | - Mona Salah El-Din Habib
- Department of Medical Biochemistry, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
| | - Rehab I Yaseen
- Departments of Cardiology, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
| | - Mahmoud K Gabr
- Departments of Cardiology, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
| | - Rabab M Habeeb
- Departments of Anesthesia, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
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Eshkoor SA, Hamid TA, Shahar S, Ng CK, Mun CY. Factors Affecting Hypertension among the Malaysian Elderly. J Cardiovasc Dev Dis 2016; 3:E8. [PMID: 29367559 PMCID: PMC5715699 DOI: 10.3390/jcdd3010008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/24/2016] [Accepted: 02/26/2016] [Indexed: 02/07/2023] Open
Abstract
Hypertension is a common chronic disease in the elderly. This study aimed to determine the effects of age, ethnicity, gender, education, marital status, nutritional parameters, and blood elements on the risk of high blood pressure in the Malaysian elderly. This research was conducted on a group of 2322 non-institutionalized Malaysian elderly. The hierarchy binary logistic regression analysis was applied to estimate the risk of hypertension in respondents. Approximately, 45.61% of subjects had hypertension. The findings indicated that the female gender (Odds ratio (OR) = 1.54), an increase in body weight (OR = 1.61), and an increase in the blood levels of albumin (OR = 1.51), glucose (OR = 1.92), and triglycerides (OR = 1.27) significantly increased the risk of hypertension in subjects (p < 0.05). Conversely, an increase in both dietary carbohydrates (OR = 0.74), and blood cholesterol level (OR = 0.42) significantly reduced the risk of hypertension in samples (p < 0.05). Furthermore, the results showed that ethnicity was a non-relevant factor to increase the risk of hypertension in subjects. It was concluded that female gender, an increase in body weight, and an increase in the blood levels of glucose, triglycerides, and albumin enhanced the risk of high blood pressure in the Malaysian elderly. In addition, an increase in both dietary carbohydrates and blood cholesterol level decreased hypertension in subjects.
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Affiliation(s)
- Sima Ataollahi Eshkoor
- Malaysian Research on Aging (MyAging), University Putra Malaysia, Serdang 43400, Malaysia.
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713834, Iran.
| | - Tengku Aizan Hamid
- Malaysian Research on Aging (MyAging), University Putra Malaysia, Serdang 43400, Malaysia.
| | - Suzana Shahar
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.
| | - Chee Kyun Ng
- Malaysian Research on Aging (MyAging), University Putra Malaysia, Serdang 43400, Malaysia.
| | - Chan Yoke Mun
- Malaysian Research on Aging (MyAging), University Putra Malaysia, Serdang 43400, Malaysia.
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Magalhães P. Knowledge, attitude and behaviour regarding dietary salt intake among medical students in Angola. Cardiovasc J Afr 2015; 26:57-62. [PMID: 25940118 PMCID: PMC4473291 DOI: 10.5830/cvja-2015-018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 01/27/2015] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Levels of salt consumption and its awareness among medical students in Angola remain insufficiently studied. This study determined salt intake and assessed medical students' knowledge, attitude and behaviour regarding salt consumption. METHODS Were collected 24-hour urine samples from a random sample of 123 undergraduate medical students aged 17-43 years who were studying at the University of Agostinho Neto in Luanda. Their knowledge, attitude and behaviour regarding dietary salt were surveyed. Socio-demographic, clinical and anthropometric data were collected. RESULTS Average salt intake was 14.2 ± 5.1 g/day, without significant difference between genders (p = 0.221). In total, 96.7% consumed over 5 g/day, but only 6.5% of participants were aware of their excessive salt intake. The majority knew about salt-related health consequences and 45.5% reported they controlled their salt intake. CONCLUSIONS This study indicated a high salt intake and inadequate behaviour regarding dietary salt consumption among medical students studying at the University of Agostinho Neto. This highlights the need for nutritional education to improve their dietary habits and future role in counselling.
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Affiliation(s)
- Pedro Magalhães
- Department of Physiology, Faculty of Medicine, University Agostinho Neto, Luanda, Angola
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de Oliveira Alvim R, Mourao-Junior CA, de Oliveira CM, de Faria Lima R, Horimoto ARVR, Hong VAC, Bortolotto LA, Krieger JE, Pereira AC. Glycemic control and arterial stiffness in a Brazilian rural population: Baependi Heart Study. Diabetol Metab Syndr 2015; 7:86. [PMID: 26445602 PMCID: PMC4595065 DOI: 10.1186/s13098-015-0082-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 09/28/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Increased arterial stiffness predicts morbidity and mortality, independently of other cardiovascular risk factors, and glycemic control impairments are related to higher vascular stiffness. The aim of this study was to evaluate the association between HbA1c levels and increased arterial stiffness in a Brazilian rural population. METHODS For this study were selected 1675 individuals (both genders and aged over 18 years) resident in the municipality of Baependi, a city located in the Southeast of Brazil. HbA1c levels were determined by HPLC. Pulse wave velocity (PWV) was measured with a non-invasive automatic device (Complior). RESULTS HbA1c levels were associated with an increased PWV. This was more relevant for the third tertile of age. In addition, logistic regression multivariate model including age, blood pressure, gender, BMI and fasting glucose showed that the elevation of a single unit percentage of HbA1c represented an increase of 54 % in the odds of increased arterial stiffness [OR 1.54 (95 % CI 1.01-2.17)]. Both, HbA1c and fasting glucose showed higher discriminatory power in the risk assessment for increased arterial stiffness in the non-diabetic when compared to the diabetic group (AUC of HbA1c = 0.71 vs 0.57, p = 0.02; AUC of fasting glucose = 0.66 vs 0.45, p = 0.0007, respectively). CONCLUSION Our findings indicate that a increase in HbA1c levels is associated with increased arterial stiffness and that both, HbA1c and fasting glucose, presented higher discriminatory power in the risk assessment for increased arterial stiffness in the non-diabetic group as compared to diabetic individuals.
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Affiliation(s)
- Rafael de Oliveira Alvim
- />Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 Cerqueira César, São Paulo, SP CEP 05403-000 Brazil
| | - Carlos Alberto Mourao-Junior
- />Department of Physiology, Federal University of Juiz de Fora, Campus Universitário – Bairro Martelos, Juiz de Fora, Minas Gerais - MG CEP 36036-900 Brazil
| | - Camila Maciel de Oliveira
- />Department of Physiology, Federal University of Juiz de Fora, Campus Universitário – Bairro Martelos, Juiz de Fora, Minas Gerais - MG CEP 36036-900 Brazil
| | - Rerisson de Faria Lima
- />Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 Cerqueira César, São Paulo, SP CEP 05403-000 Brazil
| | - Andréa Roseli Vançan Russo Horimoto
- />Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 Cerqueira César, São Paulo, SP CEP 05403-000 Brazil
| | - Valéria Aparecida Costa Hong
- />Hypertension Unit, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44, Cerqueira César, Sãos Paulo, SP CEP 05403-000 Brazil
| | - Luiz Aparecido Bortolotto
- />Hypertension Unit, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44, Cerqueira César, Sãos Paulo, SP CEP 05403-000 Brazil
| | - José Eduardo Krieger
- />Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 Cerqueira César, São Paulo, SP CEP 05403-000 Brazil
| | - Alexandre Costa Pereira
- />Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 Cerqueira César, São Paulo, SP CEP 05403-000 Brazil
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Ramanathan G, Periyasamy S, Lakkakula BVKS. NOS3 tagSNPs does not modify the chronic kidney disease progression in autosomal dominant polycystic kidney disease. Nephrology (Carlton) 2014; 19:537-41. [DOI: 10.1111/nep.12278] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2014] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Bhaskar VKS Lakkakula
- Department of Biomedical Sciences; Sri Ramachandra University; Chennai India
- Sickle Cell Institute Chhattisgarh; Raipur India
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Alvim RDO, Mourao-Junior CA, de Oliveira CM, Krieger JE, Mill JG, Pereira AC. Body mass index, waist circumference, body adiposity index, and risk for type 2 diabetes in two populations in Brazil: general and Amerindian. PLoS One 2014; 9:e100223. [PMID: 24937307 PMCID: PMC4061074 DOI: 10.1371/journal.pone.0100223] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 05/25/2014] [Indexed: 11/30/2022] Open
Abstract
Objective The use of the anthropometric indices of adiposity, especially body mass index and waist circumference in the prediction of diabetes mellitus has been widely explored. Recently, a new body composition index, the body adiposity index was proposed. The aim of this study was to compare the effectiveness of body mass index, waist circumference, and body adiposity index in the risk assessment for type 2 diabetes mellitus. Design and methods A total of 1,572 individuals from the general population of Vitoria City, Brazil and 620 Amerindians from the Aracruz Indian Reserve, Brazil were randomly selected. BMI, waist circumference, and BAI were determined according to a standard protocol. Type 2 diabetes mellitus was diagnosed by the presence of fasting glucose ≥126 mg/dL or by the use of antidiabetic drugs. Results The area under the curve was similar for all anthropometric indices tested in the Amerindian population, but with very different sensitivities or specificities. In women from the general population, the area under the curve of waist circumference was significantly higher than that of the body adiposity index. Regarding risk assessment for type 2 diabetes mellitus, the body adiposity index was a better risk predictor than body mass index and waist circumference in the Amerindian population and was the index with highest odds ratio for type 2 diabetes mellitus in men from the general population, while in women from the general population waist circumference was the best risk predictor. Conclusion Body adiposity index was the best risk predictor for type 2 diabetes mellitus in the Amerindian population and men from the general population. Our data suggest that the body adiposity index is a useful tool for the risk assessment of type 2 diabetes mellitus in admixture populations.
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Affiliation(s)
- Rafael de Oliveira Alvim
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
| | | | | | - José E. Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - José G. Mill
- Department of Physiology, Federal University of Espírito Santo, Espírito Santo, Brazil
| | - Alexandre C. Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil
- * E-mail:
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Magalhães P. Prevalence of the metabolic syndrome and determination of optimal cut-off values of waist circumference in university employees from Angola. Cardiovasc J Afr 2014; 25:27-33. [PMID: 24626517 PMCID: PMC3959186 DOI: 10.5830/cvja-2013-086] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 12/09/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Estimates of the prevalence of the metabolic syndrome in Africans may be inconsistent due to lack of African-specific cut-off values of waist circumference (WC). This study determined the prevalence of the metabolic syndrome and defined optimal values of WC in Africans. METHODS This cross-sectional study collected demographic, anthropometric and clinical data of 615 Universitary employees, in Luanda, Angola. The metabolic syndrome was defined using the third report of the National Cholesterol Education Program Adult Treatment Panel (ATPIII) and the Joint Interim Statement (JIS) criteria. Receiver operating characteristics curves were constructed to assess cut-off values of WC. RESULTS The crude prevalence of the metabolic syndrome was higher with the JIS definition (27.8%, age-standardised 14.1%) than with the ATP III definition (17.6%, age-standardised 8.7%). Optimal cut-off values of WC were 87.5 and 80.5 cm in men and women, respectively. CONCLUSION There was a high prevalence of the metabolic syndrome among our African subjects. Our data suggest different WC cut-off values for Africans in relation to other populations.
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Affiliation(s)
- Pedro Magalhães
- Department of Physiology, Faculty of Medicine, University Agostinho Neto, Luanda, Angola
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Magalhães P, Capingana DP, Silva ABT, Ferreira AVL, de Sá Cunha R, Rodrigues SL, Mill JG. Age- and gender-specific reference values of pulse wave velocity for African adults: preliminary results. AGE (DORDRECHT, NETHERLANDS) 2013; 35:2345-2355. [PMID: 23319362 PMCID: PMC3824996 DOI: 10.1007/s11357-012-9504-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 12/27/2012] [Indexed: 06/01/2023]
Abstract
Pulse wave velocity (PWV) is an independent predictor of cardiovascular (CV) risk. Higher PWV values have been observed in Africans; however, there are no established age- and gender-adjusted reference values for this population. Therefore, PWV was measured using a validated device (Complior SP) in 544 subjects recruited from an occupational cohort of employees of a public university in Angola. Since high blood pressure (BP) is an important factor influencing PWV, a subsample of 301 normotensive subjects (aged 22-72 years) was selected for this study. A subset of 131 individuals without CV risk factors was considered the healthy group (HG), while the entire group (n = 301) comprised the less healthy group (LHG). Predictors of PWV were evaluated using multiple regression analyses and age- and gender-specific percentile tables and curves were constructed. Age and PWV means were 36 ± 9.7 years and 6.6 ± 1.0 m/s in the HG, respectively, and 39.9 ± 10.2 years and 7.3 ± 1.3 m/s in the LHG. Age and plasma uric acid (UA) were the only significant PWV predictors in the HG, while age, mean BP (MBP), and gender showed significant prediction of PWV in the multiple regression analysis in the LHG. Age- and gender-adjusted reference values of PWV were provided for healthy and less healthy normotensive Africans. Considering the small sample size of our cohort, these preliminary results should be used cautiously until data on robust sample of the general population can be obtained.
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de Oliveira Alvim R, Santos PCJL, Musso MM, de Sá Cunha R, Krieger JE, Mill JG, Pereira AC. Impact of diabetes mellitus on arterial stiffness in a representative sample of an urban Brazilian population. Diabetol Metab Syndr 2013; 5:45. [PMID: 23965633 PMCID: PMC3765236 DOI: 10.1186/1758-5996-5-45] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 08/19/2013] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Independent of other cardiovascular (CV) risk factors, increased arterial stiffness has been established as a predictor of morbidity and mortality. The main aim of this study was to investigate the impact of diabetes on arterial stiffness in a representative sample of an urban Brazilian population plus Amerindians. METHODS A total of 1,415 individuals from the general population were randomly selected plus 588 Amerindians from a native community in Brazil. In addition, a sub-sample of 380 individuals from the general population had 5-year follow-up data. Pulse wave velocity (PWV) was measured with a non-invasive automatic device (Complior, Colson; Garges les Gonesses, France) and increased arterial stiffness was defined as PWV ≥ 12 m/s. RESULTS In the overall group, diabetic individuals had higher frequencies of increased arterial stiffness and hypertension. They also had higher values of PWV, body mass index, total cholesterol, triglycerides, systolic and diastolic blood pressures compared to non-diabetic individuals (p < 0.01). In an analysis stratified by hypertension, PWV values and increased arterial stiffness frequency were higher in diabetic individuals in both groups (hypertensive and non-hypertensive) (p < 0.05). Furthermore, higher risk for increased arterial stiffness was observed in the diabetic individuals from the overall group (OR = 2.27; CI = 1.47-3.52, p < 0.001) and from the hypertensive group (OR = 2.70; CI = 1.58-4.75, p < 0.001), adjusted for covariates. Regarding the ethnic stratification, diabetic individuals from Amerindian, White, and Mulatto (mixed-race) groups had higher PWV values and a greater frequency of increased arterial stiffness compared to non-diabetic individuals. Both diabetic and non-diabetic individuals had higher PWV values after 5 years. There was no significant difference in the 5-year PWV progression in diabetic compared to non-diabetic individuals. CONCLUSIONS These results confirm, in a sample of Brazilian population, that the presence of diabetes is associated with increased arterial stiffness and it may contribute in part to increased cardiovascular risk in diabetic patients.
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Affiliation(s)
- Rafael de Oliveira Alvim
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 Cerqueira César, São Paulo, SP CEP 05403-000, Brazil
| | - Paulo Caleb Junior Lima Santos
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 Cerqueira César, São Paulo, SP CEP 05403-000, Brazil
| | - Mariane Manso Musso
- Department of Medicine, Juiz de Fora Federal University, Juiz de Fora, MG, Brazil
| | - Roberto de Sá Cunha
- Department of Physiology, Espirito Santo Federal University, Espirito Santo, ES, Brazil
| | - José Eduardo Krieger
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 Cerqueira César, São Paulo, SP CEP 05403-000, Brazil
| | - José Geraldo Mill
- Department of Physiology, Espirito Santo Federal University, Espirito Santo, ES, Brazil
| | - Alexandre Costa Pereira
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 Cerqueira César, São Paulo, SP CEP 05403-000, Brazil
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Exercise intensity modulates nitric oxide and blood pressure responses in hypertensive older women. Aging Clin Exp Res 2013; 25:43-8. [PMID: 23740632 DOI: 10.1007/s40520-013-0017-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 11/25/2011] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND AIMS Whether intensity or other characteristics of physical activity can better promote the release of nitric oxide (NO) and reduction of blood pressure in hypertensive older-adults is still unknown. In this study, the post-exercise blood pressure (BP) response and NO release after different intensities of aerobic exercise in elderly women were analyzed. METHODS Blood pressure response and NO were analyzed in 23 elderly mildly hypertensive women. Participants underwent (1) high-intensity incremental exercise (IT); (2) moderate-intensity 20 min exercise at 90% of the anaerobic threshold (AT), and (3) control (CONT) session. BP was measured before and after interventions; volunteers remained seated for 1 h. NO estimates were made through NO2- analyses. RESULTS After CONT session, both diastolic BP and mean arterial pressure (MAP) were significantly higher than during pre-exercise resting. Post-exercise hypotension (PEH) was observed after exercise at IT and 90% of AT. Although exercise in both sessions lowered SBP and MAP compared with CONT, exercise at the highest intensity (IT) was more effective on lowering systolic BP after exercise. In comparison with pre-exercise resting, NO2- increased significantly only after IT, but both exercise sessions caused NO2- to increase compared with CONT. CONCLUSION Exercise intensity and NO release may exert a role in eliciting PEH in mildly hypertensive elderly women.
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Endothelial NO synthase gene polymorphisms and risk of ischemic stroke in Asian population: a meta-analysis. PLoS One 2013; 8:e60472. [PMID: 23544143 PMCID: PMC3609746 DOI: 10.1371/journal.pone.0060472] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 02/26/2013] [Indexed: 01/06/2023] Open
Abstract
Background The association between polymorphism 4b/a, T-786C and G894T in endothelial NO synthase gene (eNOS) and ischemic stroke (IS) remains controversial in Asian. A meta-analysis was performed to better clarify the association between eNOS gene and IS risk. Methods Based on the search of PubMed, Web of Science (ISI), CNKI (National Knowledge Infrastructure), Wan Fang Med Online and CBM (Chinese Biology Medical Literature Database) databases, all eligible case-control or cohort studies were identified. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) from fixed and random effect models were calculated. Heterogeneity among studies was evaluated using the I2. Meta-regression was used to explore the potential sources of between-study heterogeneity. Begg's test was used to estimate publication bias. Results Our study included 27 articles, contained 28 independent case–control studies, involved a total of 3,742 cases and 3,691 controls about 4b/a, 1,800 cases and 1,751 controls about T-786C and 2,747 cases and 2,872 controls about G894T. A significant association of 4a allele with increased risk of IS was found in dominant (FEM: OR = 1.498, 95% CI = 1.329–1.689), recessive (FEM: OR = 2.132, 95% CI = 1.383–3.286) and codominant (REM: OR = 1.456, 95% CI = 1.235–1.716) models. For T-786C and G894T, there were significant associations with dominant and codominant genetic models, but not with recessive genetic model. Conclusions The meta-analysis indicated that eNOS gene 4b/a, T-786C, G894T polymorphism might be associated with IS.
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GSTT1 null genotype and risk of coronary heart disease. Mol Biol Rep 2013. [DOI: 10.1007/s11033-012-2260-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kayhan FE, Koldemir M, Cagatay P, Ciftci C, Susleyici-Duman B. Prevalence of endothelial nitric oxide synthase E298D polymorphism in Turkish patients with essential hypertension. Diabetes Metab Syndr 2013; 7:12-16. [PMID: 23517789 DOI: 10.1016/j.dsx.2013.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Our aim was to evaluate the effects of endothelial nitric oxide synthase (eNOS) E298D polymorphism in obesity variables and essential hypertension (eHT) development risk. The genotype frequencies of E298D polymorphism in eHT patients and non-hypertensive (non-HT) controls (proven to have normal coronaries angiographically) were analyzed for their association with demographic and obesity related data of the eHT patients and controls. MATERIALS AND METHODS eNOS gene E298D genotypes were determined with qPCR. RESULTS The eNOS E298D polymorphism frequencies for 298E/E, 298E/D and 298D/D genotypes were respectively as 41.1%, 44.6%, 14.3% in subjects eHT and 52.8%, 38.9%, 8.3% in the non-HT groups. The combined E298D homozygous polymorphic and heterozygous genotypes were found to have a decreasing effect on serum total-cholesterol levels in comparison to wild-type genotypes in eHT patients but not controls. CONCLUSIONS Our results support the idea that, the eNOS E298D polymorphism, which is not associated with hypertension, may increase the risk of hypertension when associated with high serum total-cholesterol levels.
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Gatti RR, Santos PS, Sena AAS, Marangoni K, Araújo MA, Goulart LR. The interaction of AGT and NOS3 gene polymorphisms with conventional risk factors increases predisposition to hypertension. J Renin Angiotensin Aldosterone Syst 2012; 14:360-8. [PMID: 22791701 DOI: 10.1177/1470320312452027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Renin-angiotensin and kallikrein-kinin systems are interconnected, regulating blood pressure homeostasis. We have demonstrated the interactions among polymorphisms of the angiotensinogen (AGT) and endothelial nitric oxide synthase (NOS3) genes and conventional risk factors affecting the hypertension occurrence. Individuals were recruited (n=192) and classified into hypertensive (HG; n=140) and normotensive (NG; n=52) groups. The genotypic distribution of the Met235Thr (AGT) and Glu298Asp (NOS3) polymorphisms demonstrated that both are independent risk factors of hypertension (p=0.02 and p=0.008, respectively). The concomitant presence of these polymorphisms in the HG group was significantly different (p=0.001) from the NG. Both gene polymorphisms presented an additive effect for the unfavourable alleles T and A, respectively, and 95% of the double mutant homozygotes were classified into the HG. Specific interactions among certain conventional factors and the presence of at least one unfavourable allele presented significant odds towards hypertension. Blood pressure homeostasis was affected by genetic polymorphisms conditioned by the T and A alleles of the AGT and NOS3 genes, respectively, which acted independently. However, their interaction with smoking, sedentariness, age and total cholesterol may have increased the predisposition to hypertension, which may explain most of the hypertension cases.
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Affiliation(s)
- Renata R Gatti
- 1Institute of Genetics and Biochemistry, Federal University of Uberlândia, Brazil
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George TW, Waroonphan S, Niwat C, Gordon MH, Lovegrove JA. The Glu298Asp single nucleotide polymorphism in the endothelial nitric oxide synthase gene differentially affects the vascular response to acute consumption of fruit and vegetable puree based drinks. Mol Nutr Food Res 2012; 56:1014-24. [PMID: 22689471 DOI: 10.1002/mnfr.201100689] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 04/05/2012] [Accepted: 04/06/2012] [Indexed: 11/08/2022]
Abstract
SCOPE Diets low in fruits and vegetables (FV) are responsible for 2.7 million deaths from cardiovascular diseases (CVD) and certain cancers annually. Many FV and their juices contain flavonoids, some of which increase endothelial nitric oxide synthase (eNOS) activity. A single nucleotide polymorphism in the eNOS gene, where thymine (T) replaces guanine (G) at position 894 predicting substitution of glutamate for aspartate at codon 298 (Glu298Asp), has been associated with increased CVD risk due to effects on nitric oxide synthesis and subsequently vascular reactivity. Individuals can be homozygous for guanine (GG), thymine (TT) or heterozygous (GT). METHODS AND RESULTS We investigated the effects of acute ingestion of a FV-puree-based-drink (FVPD) on vasodilation and antioxidant status in subjects retrospectively genotyped for this polymorphism. Healthy volunteers (n = 24; 11 GG, 11 GT, 2 TT) aged 30-70 were recruited to a randomized, controlled, crossover, acute study. We showed that acute consumption of 400 mL FVPD differentially affected individuals depending on their genotype. There was a significant genotype interaction for endothelium-dependent vasodilation measured by laser Doppler imaging with iontophoresis (P < 0.05) and ex vivo low-density lipoproteins (LDL) oxidation (P = 0.002). GG subjects had increased endothelium-dependent vasodilation 180 min (P = 0.028) and reduced ex vivo LDL oxidation (P = 0.013) after 60 min after FVPD compared with control, no differences were observed in GT subjects. CONCLUSION eNOS Glu298Asp genotype differentially affects vasodilation and ex vivo LDL oxidation after consumption of FV in the form of a puree-based drink.
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Affiliation(s)
- Trevor W George
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, The University of Reading, Whiteknights, Berkshire, UK
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de Oliveira Alvim R, Santos PCJL, Dias RG, Rodrigues MV, de Sa Cunha R, Mill JG, Junior WN, Krieger JE, Pereira AC. Association between the C242T polymorphism in the p22phox gene with arterial stiffness in the Brazilian population. Physiol Genomics 2012; 44:587-92. [PMID: 22496489 DOI: 10.1152/physiolgenomics.00122.2011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
NADPH oxidase p22phox subunit is responsible for the production of reactive oxygen species in the vascular tissue. The C242T polymorphism in the p22phox gene has been associated with diverse coronary artery disease phenotypes, but the findings about the protective or harmful effects of the T allele are still controversial. Our main aim was to assess the effect of p22phox C242T genotypes on arterial stiffness, a predictor of late morbidity and mortality, in individuals from the general population. We randomly selected 1,178 individuals from the general population of Vitoria City, Brazil. Genotypes for the C242T polymorphism were detected by PCR-RFLP, and pulse wave velocity (PWV) values were measured with a noninvasive automatic device Complior. p22phox and TNF-α gene expression were quantified by real-time PCR in human arterial mammary smooth muscle cells. In both the entire and nonhypertensive groups: individuals carrying the TT genotype had higher PWV values and higher risk for increased arterial stiffness [odds ratio (OR) 1.93, 95% confidence interval (CI) 1.27-2.92 and OR 1.78, 95% CI 1.07-2.95, respectively] compared with individuals carrying CC+CT genotypes, even after adjustment for covariates. No difference in the p22phox gene expression according C242T genotypes was observed. However, TNF-α gene expression was higher in cells from individual carrying the T allele, suggesting that this genetic marker is associated with functional phenotypes at the gene expression level. In conclusion, we suggest that p22phox C242T polymorphism is associated with arterial stiffness evaluated by PWV in the general population. This genetic association shed light on the understanding of the genetic modulation on vascular dysfunction mediated by NADPH oxidase.
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Affiliation(s)
- Rafael de Oliveira Alvim
- Laboratory of Genetics and Molecular Cardiology, Heart Institute-InCor, University of Sao Paulo Medical School, Sao Paulo, Brazil
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da Costa Escobar Piccoli J, Manfredini V, Hamester FI, Bandinelli JB, Turkienicz IM, Chies JAB, Peres A, Bodanese LC, Bogo MR. Interaction between endothelial nitric oxide synthase gene polymorphisms (-786T>C, 894G>T and intron 4 a/b) and cardiovascular risk factors in acute coronary syndromes. Arch Med Res 2012; 43:205-11. [PMID: 22475779 DOI: 10.1016/j.arcmed.2012.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 03/14/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Endothelial rupture of coronary plaque can represent the pathomorphological substratum of acute coronary syndrome (ACS). Polymorphisms in the NOS3 gene (eNOS) -786T>C, 894G>T and intron 4 a/b VNTR can be associated with a higher susceptibility for ACS. The present study is focused on the investigation of the interaction of these polymorphisms and cardiovascular risk factors in 135 patients with ACS and 115 control subjects. METHODS Case-control study where the allele and genotype frequencies of the polymorphisms -786T> C, 894G> T and intron 4 VNTR of the gene encoding eNOS were determined by PCR-RFLP associated with cardiovascular risk factors. RESULTS An association of the 894TT genotype and 894GT+GG (OR 1.4; 95% CI 1.0-1.8) in ACS has been observed. Subjects without dyslipidemia and intron 4 a/b genotype present a lower chance for ACS development, whereas subjects without diabetes and 894TT genotype show a higher risk for ACS (OR 1.7; 95% CI 1.2-2.3). In patients without dyslipidemia, the 894GG genotype presented a tendency to behave as a protector factor against ACS. Also, the 894GG genotype has been a protective factor for ACS in females (OR 0.5; CI 95% 0.2-0.9). CONCLUSIONS Our results suggest that eNOS polymorphisms may be an additional risk factor in development of ACS.
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Rahimi Z, Nourozi-Rad R. Association of Endothelial Nitric Oxide Synthase Gene Variant (G894T) With Coronary Artery Disease in Western Iran. Angiology 2012; 63:131-137. [DOI: 10.1177/0003319711409741] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
There are conflicting reports about the association of endothelial nitric oxide synthase (eNOS) gene polymorphism and the risk of coronary artery disease (CAD). To determine the frequency of eNOS G894T variant and to find the possible association between this polymorphism with CAD we studied 207 unrelated patients with total CAD (with and without diabetes) and 92 controls. The eNOS variants were detected by polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP). The presence of GT + TT genotype was associated with 2.1-fold ( P = .006), 2.29-fold ( P = .006), and 1.93-fold ( P = .032) increased risk of CAD in total CAD, CAD with diabetes, and in CAD without diabetes patients, respectively. The presence of T allele of eNOS increased the risk of CAD 2.15-fold ( P = .001). The levels of low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) tended to be higher in patients carrier for T allele compared to those with G allele. The results of present study revealed that eNOS G894T polymorphism is associated with increased risk of CAD in our population.
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Affiliation(s)
- Zohreh Rahimi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Biochemistry, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Nourozi-Rad
- Department of Biochemistry, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Biochemistry, Medical School, Ahvaz University of Medical Sciences, Ahvaz, Iran
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Yugar-Toledo JC, Martin JFV, Krieger JE, Pereira AC, Demacq C, Coelho OR, Pimenta E, Calhoun DA, Júnior HM. Gene variation in resistant hypertension: multilocus analysis of the angiotensin 1-converting enzyme, angiotensinogen, and endothelial nitric oxide synthase genes. DNA Cell Biol 2011; 30:555-64. [PMID: 21438754 DOI: 10.1089/dna.2010.1156] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Resistant hypertension, a complex multifactorial hypertensive disease, is triggered by genetic and environmental factors and involves multiple physiological pathways. Single genetic variants may not reveal significant associations with resistant hypertension because their effects may be dependent on gene-gene or gene-environment interactions. We examined the interaction of angiotensin I-converting enzyme (ACE), angiotensinogen (AGT), and endothelial nitric oxide synthase (NOS3) polymorphisms with environmental factors (gender, age, body mass index, glycemia, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, estimated glomerular filtration rate, and urinary sodium excretion) in 70 resistant, 80 well-controlled hypertensive patients, and 70 normotensive controls. All subjects were genotyped for ACE insertion/deletion (rs1799752); AGT M235T (rs699), and NOS3 Glu298Asp (rs 1799983). Multifactorial associations were tested using two statistical methods: the traditional parametric method (adjusted logistic regression analysis) and gene-gene and gene-environment interactions evaluated by multifactor dimensionality reduction analyses. While adjusted logistic regression found no significant association between the studied polymorphisms and controlled or resistant hypertension, the multifactor dimensionality reduction analyses showed that carriers of the AGT 235T allele were at increased risk for resistant hypertension, especially if they were older than 50 years. The AGT 235T allele constituted an independent risk factor for resistant hypertension.
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Affiliation(s)
- Juan Carlos Yugar-Toledo
- Laboratory of Cardiovascular Pharmacology, Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
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Interaction of eNOS polymorphism with MTHFR variants increase the risk of diabetic nephropathy and its progression in type 2 diabetes mellitus patients. Mol Cell Biochem 2011; 353:23-34. [PMID: 21380725 DOI: 10.1007/s11010-011-0770-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 02/24/2011] [Indexed: 10/18/2022]
Abstract
The present study has investigated the role of endothelial nitric oxide (eNOS) G894T polymorphism and its interaction with methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C variants on the predisposition to diabetic nephropathy and its progression. Using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method the eNOS G894T and MTHFR polymorphisms were detected in 72 microalbuminuric, 68 macroalbuminuric, and 72 normoalbuinuric type 2 diabetes mellitus (T2DM) patients from Western Iran. The presence of GT and GT + TT genotypes of eNOS were associated with insignificantly 1.86- and 1.68-fold increased risk of macroalbuminuria, respectively and 1.21- and 1.13-fold increased risk of microalbuminuria, respectively. However, the concomitant presence of eNOST and MTHFR 1298C alleles were significantly increased the risk of macroalbuminuria (6.6-fold, P < 0.001) and progression from micro- to macro-albuminuria (3.85 times, P = 0.011). Also, the presence of both alleles of eNOST and MTHFR 677T were significantly associated with increased risk of macroalbuminuria (4.8-fold, P = 0.005). The presence of GT + TT genotypes of eNOS was significantly associated with increased risk of coronary artery disease in micro- and macro-albuminuric patients compared to normoalbuminuric patients. The concomitant presence of three mutant alleles significantly increased the risk of macroalbuminuria and progression from micro- to macro-albuminuria 38.5- and 10.5-fold, respectively. Our study indicated that eNOS T allele interacts with MTHFR variants, especially MTHFR A1298C to increase the risk of macroalbuminuria and progression from micro-to macro-albuminuria. Also, Interaction between three alleles of eNOST, MTHFR 677T, and 1298C highly increased the risk of macroalbuminuria and progression of diabetic nephropathy in T2DM patients.
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Alvim RO, Freitas SRS, Ferreira NE, Santos PCJL, Cunha RS, Mill JG, Krieger JE, Pereira AC. APOE polymorphism is associated with lipid profile, but not with arterial stiffness in the general population. Lipids Health Dis 2010; 9:128. [PMID: 21059196 PMCID: PMC2992057 DOI: 10.1186/1476-511x-9-128] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 11/08/2010] [Indexed: 12/30/2022] Open
Abstract
Background Cardiovascular diseases (CVD) are the main cause of death and disability in developed countries. In most cases, the progress of CVD is influenced by environmental factors and multifactorial inheritance. The purpose of this study was to investigate the association between APOE genotypes, cardiovascular risk factors, and a non-invasive measure of arterial stiffness in the Brazilian population. Methods A total of 1493 urban Brazilian individuals were randomly selected from the general population of the Vitoria City Metropolitan area. Genetic analysis of the APOE polymorphism was conducted by PCR-RFLP and pulse wave velocity analyzed with a noninvasive automatic device. Results Age, gender, body mass index, triglycerides, creatinine, uric acid, blood glucose, blood pressure phenotypes were no different between ε2, ε3 and ε4 alleles. The ε4 allele was associated with higher total-cholesterol (p < 0.001), LDL-C (p < 0.001), total-cholesterol/HDL-C ratio (p < 0.001), LDL/HDL-C ratio (p < 0.001), lower HDL-C values (p < 0.001) and higher risk to obesity (OR = 1.358, 95% CI = 1.019-1.811) and hyperuricemia (OR = 1.748, 95% CI = 1.170-2.611). Nevertheless, pulse wave velocity (p = 0.66) measures were no different between genotypes. The significant association between APOE genotypes and lipid levels persisted after a 5-year follow-up interval, but no interaction between time and genotype was observed for lipids longitudinal behavior. Conclusion The ε4 allele of the APOE gene is associated with a worse lipid profile in the Brazilian urban population. In our relatively young sample, the observed effect of APOE genotype on lipid levels was not translated into significant effects in arterial wall stiffness.
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Affiliation(s)
- Rafael O Alvim
- Heart Institute (InCor), University of São Paulo Medical School, Brazil
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Dias RG, Gowdak MM, Pereira AC. Genetics and cardiovascular system: influence of human genetic variants on vascular function. GENES AND NUTRITION 2010; 6:55-62. [PMID: 21437030 DOI: 10.1007/s12263-010-0193-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 10/14/2010] [Indexed: 10/18/2022]
Abstract
Candidate gene association studies in cardiovascular diseases have provided evidence on the molecular basis of phenotypic differences between individuals. The comprehension of how inherited genetic variants are able to affect protein functions has increased the knowledge of how genes interact with environment in order to modulate a particular phenotype. Although it is known that the human genome contains more than 10 million SNPs, only a minor part of them are supposed to be functional. A causative SNP in a particular gene may confer a small to moderate effect in complex phenotypes, such as functions important to cardiovascular homeostasis. This paper is a selective review of the literature on the evidence for interactions between vascular function and naturally occurring genetic variants in endothelial nitric oxide synthase (eNOS) and beta-2 adrenergic receptor (ADRB2), two genes among those influencing vascular phenotype and examples for which there is a strong evidence base. eNOS and ADRB2 will be characterized, as well as the mechanisms by which the enzyme and the receptor work to control vascular responses will be described. Understanding the molecular mechanisms underlying gene-mediated vascular function and their modification by genetic variants is expected to result in a better comprehension about individual's phenotypic differences.
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Sposito AC, Santos RD, Abdalla DS, Moreira A, Lima JC, Pereira AC, Krieger JE, Martinez TR, Ramires JA, Pereira A. Plasma cholesterol is involved in the setting of resting blood pressure: A study in hypercholesterolemic young subjects and in monozygotic twins. Int J Cardiol 2010; 144:88-9. [DOI: 10.1016/j.ijcard.2008.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Accepted: 12/10/2008] [Indexed: 11/26/2022]
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Santos DGB, Resende MF, Mill JG, Mansur AJ, Krieger JE, Pereira AC. Nuclear Factor (NF) kappaB polymorphism is associated with heart function in patients with heart failure. BMC MEDICAL GENETICS 2010; 11:89. [PMID: 20534156 PMCID: PMC2897791 DOI: 10.1186/1471-2350-11-89] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 06/09/2010] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cardiac remodeling is generally an adverse sign and is associated with heart failure (HF) progression. NFkB, an important transcription factor involved in many cell survival pathways, has been implicated in the remodeling process, but its role in the heart is still controversial. Recently, a promoter polymorphism associated with a lesser activation of the NFKB1 gene was also associated with Dilated Cardiomyopathy. The purpose of this study was to evaluate the association of this polymorphism with clinical and functional characteristics of heart failure patients of different etiologies. METHODS A total of 493 patients with HF and 916 individuals from a cohort of individuals from the general population were investigated. The NFKB1 -94 insertion/deletion ATTG polymorphism was genotyped by High Resolution Melt discrimination. Allele and genotype frequencies were compared between groups. In addition, frequencies or mean values of different phenotypes associated with cardiovascular disease were compared between genotype groups. Finally, patients were prospectively followed-up for death incidence and genotypes for the polymorphism were compared regarding disease onset and mortality incidence in HF patients. RESULTS We did not find differences in genotype and allelic frequencies between cases and controls. Interestingly, we found an association between the ATTG1/ATTG1 genotype with right ventricle diameter (P = 0.001), left ventricle diastolic diameter (P = 0.04), and ejection fraction (EF) (P = 0.016), being the genotype ATTG1/ATTG1 more frequent in patients with EF lower than 50% (P = 0.01). Finally, we observed a significantly earlier disease onset in ATTG1/ATTG1 carriers. CONCLUSION There is no genotype or allelic association between the studied polymorphism and the occurrence of HF in the tested population. However, our data suggest that a diminished activation of NFKB1, previously associated with the ATTG1/ATTG1 genotype, may act modulating on the onset of disease and, once the individual has HF, the genotype may modulate disease severity by increasing cardiac remodeling and function deterioration.
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Affiliation(s)
- Diogo G B Santos
- Laboratory of Genetics and Molecular Cardiology, Heart Institute InCor, Sao Paulo University Medical School, Sao Paulo, Brazil
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Association of NOS3 Glu298Asp SNP with hypertension and possible effect modification of dietary fat intake in the ARIC study. Hypertens Res 2009; 33:165-9. [PMID: 19960019 DOI: 10.1038/hr.2009.198] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Endothelial nitric oxide synthase breaks down nitric oxide and has a key role in blood pressure regulation. Earlier studies have shown associations between single nucleotide polymorphisms (SNPs) in the NOS3 gene and hypertension. Studies also suggest that such associations may vary by dietary fat intake. We investigated associations between the NOS3 Glu298Asp SNP (rs1799983) and hypertension, as well as the interaction between NOS3 genotypes and dietary fat intake using data from baseline examination in white and African American participants in the Atherosclerosis Risk in Community (ARIC) study. Dietary fat intake was measured by a Food Frequency Questionnaire during the baseline examination in 15 792 individuals aged 45-64 years in ARIC study participants. Race-stratified unconditional logistic regression was performed to investigate the association between prevalent hypertension and NOS3 Glu298Asp genotypes. There was no significant interaction between dietary fat intake and NOS3 Glu298Asp genotype with regards to hypertension status in either African Americans or whites (P for interaction=0.3 and 0.4, respectively). We found a significant relationship between NOS3 Glu298Asp and triglycerides in African Americans. We did not find an association between the NOS3 Glu298Asp polymorphism and hypertension, and dietary fat intake did not interact with NOS3 genotypes to influence hypertension. We recommend further exploration of the relationship between NOS3 Glu298Asp and triglycerides in African Americans.
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Piccoli JCE, Gottlieb MGV, Castro L, Bodanese LC, Manenti ERF, Bogo MR, Peres A, Rocha MIUMD, Cruz IBMD. Association between 894G>T endothelial nitric oxide synthase gene polymorphisms and metabolic syndrome. ACTA ACUST UNITED AC 2009; 52:1367-73. [PMID: 19169496 DOI: 10.1590/s0004-27302008000800027] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2008] [Accepted: 10/16/2008] [Indexed: 01/05/2023]
Abstract
Metabolic syndrome (MS) is a cluster of cardiovascular risk factors such as hypertension, dyslipidemia, obesity and type II diabetes. Here, we performed a case-control study analyzing the association between 894G>T endothelial nitric oxide synthase gene polymorphism (NOS3) and MS in 616 subjects. Genotype frequencies were TT= 9.3%, GG= 37.2 and TG= 53.6% and the allelic frequencies were T=0.36 and G= 0.64. We observed a higher TT genotype frequency in the male MS group than control subjects (p=0.02), independent of other variables. We found an association between hypertension and TT genotype in females. Our data suggests that 894G>T plays a significant role in the mechanistic interaction between metabolic risk such as hypertension and MS, although sex-related differences may exist.
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Stepien M, Banach M, Mikhailidis DP, Gluba A, Kjeldsen SE, Rysz J. Role and significance of statins in the treatment of hypertensive patients. Curr Med Res Opin 2009; 25:1995-2005. [PMID: 19555312 DOI: 10.1185/03007990903098081] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Statins are the first-line drug therapy in the treatment of hypercholesterolemia. The beneficial clinical impact of statins on the cardiovascular system results not only from their lipid-lowering action but also from other effects. Recently, it has been suggested that statins can reduce blood pressure, especially in hypertensive patients. AIM The role of the hypotensive action of statins and other mechanisms which reduce cardiovascular risk in hypertensive patients are discussed in this review. METHODS Electronic databases searched were [MEDLINE (1966 - February 2009), EMBASE and SCOPUS (1965 - February 2009), DARE (1966 -- February 2009)]. Additionally, abstracts from national and international cardiovascular meetings were studied to identify unpublished studies. The main data search terms were: blood pressure, hypertension, hypercholesterolemia and statins. FINDINGS At present, it is difficult to unequivocally assess the impact of statins on blood pressure. However, according to most authors, the impact of statins on the decrease in BP is slight, but significant, especially among patients with hypertension.
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Affiliation(s)
- Mariusz Stepien
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland
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Santos DGB, Medeiros A, Brum PC, Mill JG, Mansur AJ, Krieger JE, Pereira AC. No evidence for an association between the -36A>C phospholamban gene polymorphism and a worse prognosis in heart failure. BMC Cardiovasc Disord 2009; 9:33. [PMID: 19638213 PMCID: PMC2734742 DOI: 10.1186/1471-2261-9-33] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Accepted: 07/28/2009] [Indexed: 12/03/2022] Open
Abstract
Background In Brazil, heart failure leads to approximately 25,000 deaths per year. Abnormal calcium handling is a hallmark of heart failure and changes in genes encoding for proteins involved in the re-uptake of calcium might harbor mutations leading to inherited cardiomyopathies. Phospholamban (PLN) plays a prime role in cardiac contractility and relaxation and mutations in the gene encoding PLN have been associated with dilated cardiomyopathy. In this study, our objective was to determine the presence of the -36A>C alteration in PLN gene in a Brazilian population of individuals with HF and to test whether this alteration is associated with heart failure or with a worse prognosis of patients with HF. Methods We genotyped a cohort of 881 patients with HF and 1259 individuals from a cohort of individuals from the general population for the alteration -36A>C in the PLN gene. Allele and genotype frequencies were compared between groups (patients and control). In addition, frequencies or mean values of different phenotypes associated with cardiovascular disease were compared between genotypic groups. Finally, patients were prospectively followed-up for death incidence and genotypes for the -36A>C were compared regarding mortality incidence in HF patients. Results No significant association was found between the study polymorphism and HF in our population. In addition, no association between PLN -36A>C polymorphism and demographic, clinical and functional characteristics and mortality incidence in this sample of HF patients was observed. Conclusion Our data do not support a role for the PLN -36A>C alteration in modulating the heart failure phenotype, including its clinical course, in humans.
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Affiliation(s)
- Diogo G B Santos
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), Sao Paulo University Medical School, Sao Paulo, Brazil.
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Tamanaha R, Camacho CP, Pereira AC, da Silva AMA, Maciel RMB, Cerutti JM. Evaluation of RET polymorphisms in a six-generation family with G533C RET mutation: specific RET variants may modulate age at onset and clinical presentation. Clin Endocrinol (Oxf) 2009; 71:56-64. [PMID: 19138318 DOI: 10.1111/j.1365-2265.2008.03491.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
CONTEXT We previously described a six-generation family with G533C RET mutation and medullary thyroid carcinoma, in the largest family reported do date. Of particular interest, phenotype variability regarding the age of onset and clinical presentation of the disease, was observed. OBJECTIVE We evaluate whether single SNPs within RET oncogene or haplotype comprising the RET variants (defined by Haploview) could predispose to early development of MTC in this family and influence the clinical manifestation. DESIGN Eight SNPs were selected based on their previous association with the clinical course of hereditary or sporadic MTC, in particular promoting an early onset of disease. The variants were initially tested in 77 G533C-carriers and 100 controls using either PCR-direct sequencing or PCR-RFLP. Association between a SNP or haplotype and age at diagnosis or presence of lymph node metastasis was tested in 34 G533C-carries with MTC. Different bioinformatic tools were used to evaluate the potential effects on RNA splicing. RESULTS An association was found between IVS1-126G > T and age at diagnosis. The variant [IVS8 +82A > G; 85-86 insC] was associated with the presence of lymph node metastases at diagnosis. In silico analysis suggested that this variant may induce abnormal splicing. This in silico analysis predicted that the [IVS8 +82A > G; 85-86 insC] could alter the splicing by disrupting and/or creating exonic splicing enhancer motifs. CONCLUSIONS We here identified two RET variants that were associated with phenotype variability in G533C-carriers, which highlights the fact that the modifier effect of a variant might depend on the type of mutation.
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Affiliation(s)
- Rosana Tamanaha
- Division of Genetics, Federal University of São Paulo, São Paulo, Brazil
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Dias RG, Alves MJNN, Pereira AC, Rondon MUPB, dos Santos MR, Krieger JE, Krieger MH, Negrão CE. Glu298Asp eNOS gene polymorphism causes attenuation in nonexercising muscle vasodilatation. Physiol Genomics 2009; 37:99-107. [DOI: 10.1152/physiolgenomics.90368.2008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The influence of Glu298Asp endothelial nitric oxide synthase (eNOS) polymorphism in exercise-induced reflex muscle vasodilatation is unknown. We hypothesized that nonexercising forearm blood flow (FBF) responses during handgrip isometric exercise would be attenuated in individuals carrying the Asp298 allele. In addition, these responses would be mediated by reduced eNOS function and NO-mediated vasodilatation or sympathetic vasoconstriction. From 287 volunteers previously genotyped, we selected 33 healthy individuals to represent three genotypes: Glu/Glu [ n = 15, age 43 ± 3 yr, body mass index (BMI) 22.9 ± 0.3 kg/m2], Glu/Asp ( n = 9, age 41 ± 3 yr, BMI 23.7 ± 1.0 kg/m2), and Asp/Asp ( n = 9, age 40 ± 4 yr, BMI 23.5 ± 0.9 kg/m2). Heart rate (HR), mean blood pressure (MBP), and FBF (plethysmography) were recorded for 3 min at baseline and 3 min during isometric handgrip exercise. Baseline HR, MBP, FBF, and forearm vascular conductance (FVC) were similar among genotypes. FVC responses to exercise were significantly lower in Asp/Asp when compared with Glu/Asp and Glu/Glu (Δ = 0.07 ± 0.14 vs. 0.64 ± 0.20 and 0.57 ± 0.09 units, respectively; P = 0.002). Further studies showed that intra-arterial infusion of NG-monomethyl-l-arginine (l-NMMA) did not change FVC responses to exercise in Asp/Asp, but significantly reduced FVC in Glu/Glu (Δ = 0.79 ± 0.14 vs. 0.14 ± 0.09 units). Thus the differences between Glu/Glu and Asp/Asp were no longer observed ( P = 0.62). l-NMMA + phentolamine increased similarly FVC responses to exercise in Glu/Glu and Asp/Asp ( P = 0.43). MBP and muscle sympathetic nerve activity increased significant and similarly throughout experimental protocols in Glu/Glu and Asp/Asp. Individuals who are homozygous for the Asp298 allele of the eNOS enzyme have attenuated nonexercising muscle vasodilatation in response to exercise. This genotype difference is due to reduced eNOS function and NO-mediated vasodilatation, but not sympathetic vasoconstriction.
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Affiliation(s)
- Rodrigo G. Dias
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo
- LabCardio, University of Campinas, Campinas
| | | | | | | | | | - José E. Krieger
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo
| | | | - Carlos E. Negrão
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Maciel SS, Pereira ADC, Silva GJJ, Rodrigues MV, Mill JG, Krieger JE. Association between glutathione S-transferase polymorphisms and triglycerides and HDL-cholesterol. Atherosclerosis 2009; 206:204-8. [PMID: 19419718 DOI: 10.1016/j.atherosclerosis.2009.02.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Revised: 02/02/2009] [Accepted: 02/02/2009] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Null genotypes of glutathione S-transferase (GSTs) exhibit absence of enzymatic activity and are hypothesized to modulate an increased risk of developing cardiovascular disease. The aim of this study was to identify the potential association between GSTM1 and GSTT1 deleted polymorphisms with cardiovascular risk factors and coronary atherosclerosis in two independent urban populations. METHODS AND RESULTS Genotype distribution of GSTM1 and GSTT1 deleted polymorphism were examined in a sample of 1577 individuals from the general population and a replication sample of 871 individuals submitted to coronary angiography. Triglycerides, HDL-cholesterol and the triglycerides/HDL ratio were significantly associated with a double-deleted genotype in individuals from the general population. These findings were replicated in a second, independent, population of individuals submitted to coronary angiography. In addition, coronary artery disease severity was also associated with GSTs genotypes and the risk conferred from GSTs genotype was mainly due to triglycerides/HDL ratio information. CONCLUSIONS The data suggest that the presence of a double deletion genotypes of the GSTM1 and GSTT1 genes is associated with hypertriglyceridemia and low HDL-cholesterol levels in humans. These novel findings may provide a new unexplored link between lipid metabolism and GST homeostasis.
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Affiliation(s)
- Simone S Maciel
- Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Eneas C. Aguiar 44, São Paulo, Brazil
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Sawada T, Kishimoto T, Osaki Y, Okamoto M, Tahara A, Kaetu A, Kurosawa Y, Kotani K. Relation of the Glu298Asp polymorphism of the nitric oxide synthase gene to hypertension and serum cholesterol in Japanese workers. Prev Med 2008; 47:167-71. [PMID: 18550157 DOI: 10.1016/j.ypmed.2008.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 04/03/2008] [Accepted: 04/13/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To assess whether the Glu298Asp polymorphism of the endothelial nitric oxide synthase (eNOS) gene possibly mediates the relation of blood pressure and serum cholesterol. METHOD Regular health examination in 2003 of 1,694 Japanese workers from the Shimane Prefecture, Japan. RESULTS The frequencies of the Glu/Glu, Glu/Asp, and Asp/Asp genotypes were 85.9%, 13.4%, and 0.7%, respectively. After adjustment for age, sex, BMI, and lifestyle (drinking, smoking, exercise and stress), the odds ratio (OR) of hypertension associated with high (> or = 220 mg/dl or under treatment) total cholesterol was 2.08 (95% Confidence Interval (CI) 1.02-4.24) among carriers of the eNOS 298Asp allele versus 1.18 (95% CI 0.89-1.55, p for interaction=0.50) among non-carriers. Similarly, the ORs of hypertension associated with counseling-need (120-139 mg/dl) and high (> or = 140 mg/dl) levels of LDL cholesterol among carriers of the eNOS 298Asp allele were significantly higher than those among non-carriers, at 2.65 (95% CI 1.16-6.01) versus 1.03 (95% CI 0.77-1.39, p for interaction=0.01), and 2.80 (95% CI 1.33-5.89) versus 0.95 (95% CI 0.71-1.26, p for interaction=0.04), respectively. CONCLUSION These results indicate that the eNOS 298Asp allele, which is weakly associated with hypertension, may increase the risk of hypertension when associated with high serum lipid levels.
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Affiliation(s)
- Tomoyo Sawada
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Tottori, Japan
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Relationship of endothelial nitric oxide synthase gene polymorphism with blood pressure, lipid profile and blood glucose level. ACTA ACUST UNITED AC 2008. [DOI: 10.1007/s11684-008-0033-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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de Oliveira CM, Pereira AC, de Andrade M, Soler JM, Krieger JE. Heritability of cardiovascular risk factors in a Brazilian population: Baependi Heart Study. BMC MEDICAL GENETICS 2008; 9:32. [PMID: 18430212 PMCID: PMC2386446 DOI: 10.1186/1471-2350-9-32] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2007] [Accepted: 04/22/2008] [Indexed: 12/22/2022]
Abstract
Background The heritability of cardiovascular risk factors is expected to differ between populations because of the different distribution of environmental risk factors, as well as the genetic make-up of different human populations. Methods The purpose of this analysis was to evaluate genetic and environmental influences on cardiovascular risk factor traits, using a variance component approach, by estimating the heritability of these traits in a sample of 1,666 individuals in 81 families ascertained randomly from a highly admixed population of a city in a rural area in Brazil. Results Before adjustment for sex, age, age2, and age × sex interaction, polygenic heritability of systolic (SBP) and diastolic (DBP) blood pressure were 15.0% and 16.4%, waist circumference 26.1%, triglycerides 25.7%, fasting glucose 32.8%, HDL-c 31.2%, total cholesterol 28.6%, LDL-c 26.3%, BMI 39.1%. Adjustment for covariates increased polygenic heritability estimates for all traits mainly systolic and diastolic blood pressure (25.9 and 26.2%, respectively), waist circumference (40.1%), and BMI (51.0%). Conclusion Heritability estimates for cardiovascular traits in the Brazilian population are high and not significantly different from other studied worldwide populations. Mapping efforts to identify genetic loci associated with variability of these traits are warranted.
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Chapman MJ, Sposito AC. Hypertension and dyslipidaemia in obesity and insulin resistance: Pathophysiology, impact on atherosclerotic disease and pharmacotherapy. Pharmacol Ther 2008; 117:354-73. [DOI: 10.1016/j.pharmthera.2007.10.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Accepted: 10/01/2007] [Indexed: 01/12/2023]
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Pereira TV, Rudnicki M, Cheung BMY, Baum L, Yamada Y, Oliveira PSL, Pereira AC, Krieger JE. Three endothelial nitric oxide (NOS3) gene polymorphisms in hypertensive and normotensive individuals: meta-analysis of 53 studies reveals evidence of publication bias. J Hypertens 2007; 25:1763-74. [PMID: 17762636 DOI: 10.1097/hjh.0b013e3281de740d] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Studies on the relationship between endothelial nitric oxide (NOS3) gene variants and hypertension have been conflicting. To explore this hypothesis further, we performed a meta-analysis and re-evaluated the relationship between the three most widely studied NOS3 polymorphisms and hypertension status and blood pressure levels. METHODS Data on 40,413 subjects from 53 studies were combined in five distinct meta-analyses, and heterogeneity and publication bias were explored. RESULTS Heterogeneity was observed in all meta-analyses. By a random-effects model, carriers of the four 27-basepair repeat variable number of tandem repeats in intron 4 were associated with a 28% increase in the risk of hypertension compared with those homozygous for the 5 repeat: odds ratio (OR) 1.28, 95% confidence interval (CI) 1.11-1.47, P=0.001. In Asian individuals, Asp allele carriers displayed a similar association: OR 1.28, 95% CI 1.06-1.54, P=0.01, as well as a 2 mmHg increase in both systolic (P=0.04) and diastolic (P=0.009) blood pressure levels. Furthermore, meta-regression analysis indicated that the effect of the Glu298Asp genotype on the risk of hypertension might be dependent on total cholesterol status. No effect of the T-786C variant on hypertension was detected. There was evidence that such findings might be a result of selectively reporting/publishing positive reports. CONCLUSION Our results suggest that current data on the relationship between NOS3 variants and hypertension are subject not only to important heterogeneity but also to publication bias. Future research should preferentially focus on gene-environment interactions as well as haplotype analyses.
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Affiliation(s)
- Tiago V Pereira
- Heart Institute (InCor), São Paulo University Medical School, University of São Paulo, Brazil
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Milionis HJ, Liberopoulos EN, Elisaf MS, Mikhailidis DP. Analysis of antihypertensive effects of statins. Curr Hypertens Rep 2007; 9:175-83. [PMID: 17519121 DOI: 10.1007/s11906-007-0032-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Hypertension and hyperlipidemia, two powerful risk factors of cardiovascular disease (CVD), often coexist. Therefore, treatment should consider the beneficial properties of drugs used to treat either condition. Statins, the mainstay of lipid-lowering therapy, result in a significant clinical benefit both in primary and secondary CVD prevention. In addition to their hypolipidemic capacity, other properties may contribute to statin-induced benefits. Clinical and experimental evidence indicates that statins may modulate blood pressure (BP). The mechanisms by which statins reduce BP seem to be largely independent of their lipid effects. Although small, reductions in BP are possibly clinically relevant. Large landmark studies confirm that statins can reduce CVD risk in hypertensive patients. These findings suggest that statins could be prescribed as an adjunct in treating hypertension with dyslipidemia or even in patients with "normal" cholesterol levels. Whether the effect of statins on BP is accompanied by an additional decrease in clinical outcomes needs to be investigated in long-term, large-scale trials.
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Affiliation(s)
- Haralampos J Milionis
- Department of Clinical Biochemistry, Vascular Disease Prevention Clinics, Royal Free Hospital, Pond Street, London NW3 2QG, UK
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Marra CA, Nella J, Manti D, de Alaniz MJT. Lipid Metabolism in Rats is Modified by Nitric Oxide Availability Through a Ca++-Dependent Mechanism. Lipids 2007; 42:211-28. [PMID: 17393227 DOI: 10.1007/s11745-006-3004-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Accepted: 11/23/2006] [Indexed: 10/23/2022]
Abstract
We studied lipid metabolism and the antioxidant defense system in plasma and liver of rats fed diets supplemented with L(omega)-nitro-L-arginine methyl ester (L-NAME), isosorbide dinitrate (DIS), L-arginine (Arg), or the associations of these drugs. Liver hydroperoxide and thiobarbituric-acid-reactive substance (TBARS) levels were decreased by Arg and increased by L-NAME or DIS treatments. Oxidized glutathione and conjugated dienes were increased by DIS. Nitrate + nitrite levels and serum calcium ([Ca(++)]) were incremented by Arg or DIS and reduced by L-NAME. Superoxide dismutase and catalase activities decreased under Arg treatment, while L-NAME or DIS caused stimulation. Liver high-density lipoprotein (HDL) cholesterol was increased by DIS or NAME (alone or associated with Arg). Free fatty acids and neutral and polar lipids were increased by Arg, L: -NAME, and DIS. However, predominating phospholipid synthesis increased the neutral/polar ratio. Decreased levels of nitric oxide (NO) (low [Ca(++)]) was directly associated with increased fatty acid synthetase, decreased phospholipase A(2), carnitine-palmitoyl transferase, and fatty acid desaturase activities. Raised NO (high [Ca(++)]) inversely correlated with increased phospholipase-A(2) and acyl-coenzyme A (CoA) synthetase and decreased fatty acid synthetase and beta-oxidation rate. Arg or DIS produced changes that were partially reverted by association with L-NAME. Based on these observations, prolonged therapeutical approaches using drugs that modify NO availability should be carefully considered.
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Affiliation(s)
- Carlos A Marra
- INIBIOLP Instituto de Investigaciones Bioquímicas de La Plata, CONICET-UNLP, Cátedra de Bioquímica, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina.
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Milionis HJ, Liberopoulos EN, Achimastos A, Elisaf MS, Mikhailidis DP. Statins: another class of antihypertensive agents? J Hum Hypertens 2006; 20:320-35. [PMID: 16511505 DOI: 10.1038/sj.jhh.1002001] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The assessment of global cardiovascular risk is an essential step in the management of atherosclerotic disease prevention. Among the risk factors to be addressed are hypertension and hyperlipidaemia; these commonly coexist. A neutral or lipid-friendly antihypertensive agent is probably useful in the presence of lipid abnormalities. Similarly, statins have been shown to decrease cardiovascular risk in hypertensive patients. There is also experimental and clinical evidence that statins have blood pressure (BP)-lowering effects. In this review, we discuss the beneficial effects of statins on BP, and provide an overview of the underlying pathophysiology. We also consider the evidence justifying the use of statins in the management of hypertensive patients.
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Affiliation(s)
- H J Milionis
- Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece
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Zintzaras E, Kitsios G, Stefanidis I. Endothelial NO synthase gene polymorphisms and hypertension: a meta-analysis. Hypertension 2006; 48:700-10. [PMID: 16940230 DOI: 10.1161/01.hyp.0000238124.91161.02] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Studies investigated the association between endothelial NO synthase gene polymorphisms and hypertension-reported contradicted or nonconclusive results. A meta-analysis of 35 genetic association studies that examined the relation between hypertension and the G894T, 4a/b, T786C, and G23T polymorphisms of the endothelial nitric oxide synthase gene was carried out. Subgroup analysis by ethnicity and potential sources of heterogeneity and bias were explored. The meta-analysis included genotype data on 7779/10 498, 2216/3222, 2491/3913, and 833/587 cases/controls for G894T, 4b/a, T786C, and G23T, respectively. For the 4b/a polymorphism, overall, the heterogeneity between studies was not significant (P=0.82), and the allele b was associated with a 15% decreased risk of hypertension relative to allele a (odds ratio: 0.85; 95% CI: 0.74 to 0.98). Overall and in whites, the recessive model for allele b produced significant results (odds ratios: 0.78; 95% CI: 0.68 to 0.90 and OR: 0.76 95% CI: 0.62 to 0.92, respectively), whereas the dominant model produced nonsignificant results. In studies involved East Asians and blacks, an association was not demonstrated. Regarding the G894T, T768C, and G23T polymorphisms, in no case (ie, overall, in whites, or in East Asians) was a statistically significant association and heterogeneity found. There was no substantial source of bias in the selected studies. In conclusion, there is evidence of association only between 4b/a polymorphism and hypertension; however, studies exploring combinations of the polymorphisms may help us better understand the genetics of hypertension.
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Affiliation(s)
- Elias Zintzaras
- Department of Biomathematics, University of Thessaly School of Medicine, Papakyriazi 22, 41222 Larissa, Greece.
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