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Hebbel RP, Milbauer L, Wei P. A novel promoter of endothelial dysfunction in African Americans: Relevance to sickle cell anaemia. Br J Haematol 2023; 203:e71-e73. [PMID: 37485546 DOI: 10.1111/bjh.18993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Robert P Hebbel
- Division of Hematology, Oncology and Transplantation, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Liming Milbauer
- Department of Pharmacology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Peng Wei
- Department of Biostatistics, University of Texas MD Anderson Center, Houston, Texas, USA
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Aldokhayyil M, Gomez DH, Cook MD, Kavazis AN, Roberts MD, Geetha T, Brown MD. Influence of Race and High Laminar Shear Stress on TNFR1 Signaling in Endothelial Cells. Int J Mol Sci 2023; 24:14723. [PMID: 37834170 PMCID: PMC10572906 DOI: 10.3390/ijms241914723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
Tumor necrosis factor (TNF) binding to endothelial TNF receptor-I (TNFR-I) facilitates monocyte recruitment and chronic inflammation, leading to the development of atherosclerosis. In vitro data show a heightened inflammatory response and atherogenic potential in endothelial cells (ECs) from African American (AA) donors. High laminar shear stress (HSS) can mitigate some aspects of racial differences in endothelial function at the cellular level. We examined possible racial differences in TNF-induced monocyte adhesion and TNFR1 signaling complex expression/activity, along with the effects of HSS. Tohoku Hospital Pediatrics-1 (THP-1) monocytes were used in a co-culture system with human umbilical vein ECs (HUVECs) from Caucasian American (CA) and AA donors to examine racial differences in monocyte adhesion. An in vitro exercise mimetic model was applied to investigate the potential modulatory effect of HSS. THP-1 adherence to ECs and TNF-induced nuclear factor kappa B (NF-κB) DNA binding were elevated in AA ECs compared to CA ECs, but not significantly. We report no significant racial differences in the expression of the TNFR-I signaling complex. Application of HSS significantly increased the expression and shedding of TNFR-I and the expression of TRAF3, and decreased the expression of TRAF5 in both groups. Our data does not support TNF-induced NF-κB activation as a potential mediator of racial disparity in this model. Other pathways and associated factors activated by the TNFR1 signaling complex are recommended targets for future research.
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Affiliation(s)
- Maitha Aldokhayyil
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Dulce H. Gomez
- School of Kinesiology, Auburn University, Auburn, AL 36849, USA
| | - Marc D. Cook
- Department of Kinesiology, North Carolina Agriculture and Technology State University, Greensboro, NC 27411, USA
| | | | | | - Thangiah Geetha
- Department of Nutritional Sciences, College of Human Sciences, Auburn University, Auburn, AL 36849, USA
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Waddle S, Garza M, Davis LT, Chitale R, Fusco M, Lee C, Patel NJ, Kang H, Jordan LC, Donahue MJ. Presurgical Magnetic Resonance Imaging Indicators of Revascularization Response in Adults With Moyamoya Vasculopathy. J Magn Reson Imaging 2022; 56:983-994. [PMID: 35289460 PMCID: PMC9481650 DOI: 10.1002/jmri.28156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 02/13/2022] [Accepted: 03/02/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Moyamoya is a progressive intracranial vasculopathy, primarily affecting distal segments of the internal carotid and middle cerebral arteries. Treatment may comprise angiogenesis-inducing surgical revascularization; however, lack of randomized trials often results in subjective treatment decisions. HYPOTHESIS Compensatory presurgical posterior vertebrobasilar artery (VBA) flow-territory reactivity, including greater cerebrovascular reactivity (CVR) and reduced vascular delay time, portends greater neoangiogenic response verified on digital subtraction angiography (DSA) at 1-year follow-up. STUDY TYPE Prospective intervention cohort. SUBJECTS Thirty-one patients with moyamoya (26 females; age = 45 ± 13 years; 41 revascularized hemispheres). METHODS Anatomical MRI, hypercapnic CVR MRI, and DSA acquired presurgically in adult moyamoya participants scheduled for clinically indicated surgical revascularization. One-year postsurgery, DSA was repeated to evaluate collateralization. FIELD STRENGTH 3 T. SEQUENCE Hypercapnic T 2 * -weighted gradient-echo blood-oxygenation-level-dependent, T2 -weighted turbo-spin-echo fluid-attenuated-inversion-recovery, T1 -weighted magnetization-prepared-rapid-gradient-echo, and T2 -weighted diffusion-weighted-imaging. ASSESSMENT Presurgical maximum CVR and response times were evaluated in VBA flow-territories. Revascularization success was determined using an ordinal scoring system of neoangiogenic collateralization from postsurgical DSA by two cerebrovascular neurosurgeons (R.V.C. with 8 years of experience; M.R.F. with 9 years of experience) and one neuroradiologist (L.T.D. with 8 years of experience). Stroke risk factors (age, sex, race, vasculopathy, and diabetes) were recorded. STATISTICAL TESTS Fisher's exact and Wilcoxon rank-sum tests were applied to compare presurgical variables between cohorts with angiographically confirmed good (>1/3 middle cerebral artery [MCA] territory revascularized) vs. poor (<1/3 MCA territory revascularized) outcomes. SIGNIFICANCE two-sided P < 0.05. Normalized odds ratios (ORs) were calculated. RESULTS Criteria for good collateralization were met in 25 of the 41 revascularized hemispheres. Presurgical normalized VBA flow-territory CVR was significantly higher in those with good (1.12 ± 0.13 unitless) vs. poor (1.04 ± 0.05 unitless) outcomes. Younger (OR = -0.60 ± 0.67) and White (OR = -1.81 ± 1.40) participants had highest revascularization success (good outcomes: age = 42 ± 14 years, race = 84% White; poor outcomes: age = 49 ± 11 years, race = 44% White). DATA CONCLUSION Presurgical MRI-measures of VBA flow-territory CVR are highest in moyamoya participants with better angiographic responses to surgical revascularization. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 4.
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Affiliation(s)
- Spencer Waddle
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maria Garza
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Larry T. Davis
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Rohan Chitale
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matthew Fusco
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Chelsea Lee
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Niral J. Patel
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lori C. Jordan
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Manus J. Donahue
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
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Kidney Function and Aortic Stiffness, Pulsatility, and Endothelial Function in African Americans: The Jackson Heart Study. Kidney Med 2021; 3:702-711.e1. [PMID: 34693252 PMCID: PMC8515070 DOI: 10.1016/j.xkme.2021.03.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Rationale & Objective The relation of vascular stiffness, endothelial function, and kidney function is incompletely elucidated in African Americans. Our hypothesis was that increased vascular stiffness and endothelial dysfunction are associated with low estimated glomerular filtration rate (eGFR) and albuminuria in African Americans. Study Design Cross-sectional cohort analysis of data from the Jackson Heart Study. Settings & Patients 2,244 Jackson Heart Study participants (2012-2017 after Exam 3) who had undergone noninvasive hemodynamic assessment using arterial tonometry. Predictors Baseline carotid-femoral pulse wave velocity, pulsatile hemodynamics forward wave amplitude, and hyperemic brachial artery flow were measured. Reduced eGFR was defined as eGFR between 15 and 60 mL/min/1.73 m2. Outcomes Prevalent albuminuria, urinary albumin-creatinine ratio. Analytical Approach 2-sample t test for continuous variables and χ2 test for categorical variables in addition to logistic and linear regression models to assess the risk for chronic kidney disease with each proposed hemodynamic variable. Results Among 2,244 participants, mean age was 66 ± 11 years and 64% were women. Reduced eGFR was present in 233 (10.4%), and elevated urinary albumin-creatinine ratio, in 232 (10.4%). In multivariable-adjusted analyses, higher carotid-femoral pulse wave velocity was associated with the presence of reduced eGFR (OR, 1.37 [95% CI, 1.08-1.75] per SD; P = 0.01) and with prevalent albuminuria (OR, 1.66 [95% CI, 1.32-2.11]; P < 0.001). Higher forward wave amplitude was significantly associated with prevalent albuminuria (OR, 1.37 [95% CI, 1.14-1.65]; P = 0.001). Limitations Cross-sectional analyses cannot inform causality. Conclusions Higher arterial stiffness and pulsatility are associated with higher odds of reduced eGFR in African Americans. Future studies should focus on whether improving arterial stiffness contributes to kidney protection in African Americans.
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Kim SR, Eirin A, Herrmann SMS, Saad A, Juncos LA, Lerman A, Textor SC, Lerman LO. Preserved endothelial progenitor cell angiogenic activity in African American essential hypertensive patients. Nephrol Dial Transplant 2019; 33:392-401. [PMID: 28402508 DOI: 10.1093/ndt/gfx032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/06/2017] [Indexed: 12/13/2022] Open
Abstract
Background African American (AA) subjects with essential hypertension (EH) have greater inflammation and cardiovascular complications than Caucasian EH. An impaired endogenous cellular repair system may exacerbate vascular injury in hypertension, yet whether these differ between AA EH and Caucasian EH remains unknown. Vascular repair by circulating endothelial progenitor cells (EPCs) is controlled by regulators of EPC mobilization, homing, adhesion and new vessel formation, but can be hindered by various cytokines. We hypothesized that EPC levels and function would be impaired in AA EH compared with Caucasian EH, in association with increased levels of inflammatory mediators and EPC regulators. Methods CD34+/KDR+ EPCs were isolated from inferior vena cava and renal vein blood samples of AA EH and Caucasian EH patients (n = 18 each) and from peripheral veins of 17 healthy volunteers (HVs) and enumerated using fluorescence-activated cell sorting. Angiogenic function of late-outgrowth endothelial cells expanded from these samples for 3 weeks was tested in vitro. Levels of inflammatory mediators, angiogenic factors and EPC regulators were measured by Luminex. Results EPC levels were decreased in both AA and Caucasian EH compared with HVs, whereas their late-outgrowth endothelial cell angiogenic function was comparable. Levels of several inflammatory mediators were elevated in AA EH compared with Caucasian EH and HVs. Contrarily, vascular endothelial growth factor and its receptor-2 were lower. EPC levels inversely correlated with blood pressure in all hypertensive patients and estimated glomerular filtration rate with inflammatory mediators only in AA EH. Conclusions Despite lower EPC numbers, decreased vascular endothelial growth factor signaling and inflammation, EPC function is preserved in AA EH compared with Caucasian EH and HVs, suggesting compensatory mechanisms for vascular repair.
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Affiliation(s)
- Seo Rin Kim
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Alfonso Eirin
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | | | - Ahmed Saad
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Luis A Juncos
- Division of Nephrology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Amir Lerman
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Stephen C Textor
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.,Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
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Circadian hemodynamics in men and women with high blood pressure: dipper vs. nondipper and racial differences. J Hypertens 2019; 36:250-258. [PMID: 28902662 DOI: 10.1097/hjh.0000000000001533] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The 'nondipping' pattern of circadian blood pressure (BP) variation is an established independent predictor of adverse cardiovascular outcomes. Although this phenomenon has been widely studied, its underlying circadian hemodynamics of cardiac output and systemic vascular resistance (SVR) have not been well characterized. We evaluated the hypothesis that BP nondipping would be associated with a blunted night-time reduction in SVR in a biracial sample of 140 (63 African-American and 77 white) men and women with elevated clinic BP (130-159/85-99 mmHg). METHODS AND RESULTS Twenty-four-hour ambulatory hemodynamics were assessed using standard ambulatory BP monitoring coupled with synchronized ambulatory impedance cardiography. Using the criterion of less than 10% dip in SBP, there were 51 nondippers (SBP dip = 7.3 ± 2.6%) and 89 dippers (SBP dip = 15.5 ± 3.4%). There was minimal change in cardiac output from daytime to night-time in both dippers and nondippers. However, SVR decreased from daytime to night-time, but nondippers compared with dippers exhibited a significantly attenuated decrease in SVR from daytime to night-time (7.8 vs. 16.1%, P < 0.001). Relative to their white counterparts, African-Americans also exhibited blunted SBP dipping (10.9 vs. 14.6%, P < 0.001) as well as an attenuated decrease in SVR (10.8 vs. 15.6%, P < 0.001). CONCLUSION Overall, these findings indicate that blunted night-time BP dipping is associated with impairment of the systemic vasodilation that is characteristic of the night-time sleep period and is especially prominent among African-Americans. In the context of high BP, these findings suggest that nondipping may be a manifestation, or marker, of more advanced vascular disease.
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Abstract
PURPOSE OF THE REVIEW In the present paper, we overview emerging research examining the autonomic nervous system (ANS), especially the parasympathetic nervous system as indexed by heart rate variability (HRV), and the impact of psychosocial factors on hypertension-related disease in African Americans. RECENT FINDINGS A growing corpus of studies has shown that (1) usual patterns of compensatory sympathetic-parasympathetic regulation differ between African Americans and European Americans; (2) despite their enhanced cardiovascular disease risk profile, African Americans tend to exhibit higher HRV relative to European Americans; and (3) racial discrimination and other forms of psychosocial stress are associated with diminished HRV among African Americans. Significant disparities in hypertension-related disease exist such that African Americans have greater risk. The underlying factors associated with this increased risk are, to date, not fully understood. The present review provides evidence for a unique pattern of ANS regulation in African Americans and shows that psychosocial factors such as racial discrimination may contribute to this paradoxical situation.
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Affiliation(s)
- LaBarron K Hill
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Center for Biobehavioral Health Disparities Research, Duke University, Durham, NC, USA
| | - Julian F Thayer
- Department of Psychology, The Ohio State University, 175 Psychology Building, 1835 Neil Avenue, Columbus, OH, 43210, USA.
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Covassin N, Greene EL, Singh P, Somers VK. Disparities in Hypertension Among African-Americans: Implications of Insufficient Sleep. Curr Hypertens Rep 2018; 20:57. [PMID: 29884924 DOI: 10.1007/s11906-018-0855-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Sleep deficiency has been proposed as a potential contributor to racial disparities in cardiovascular health. We present contemporary evidence on the unequal burden of insufficient sleep in Blacks/African-Americans and the repercussions for disparate risk of hypertension. RECENT FINDINGS The prevalence of insufficient sleep is high and rising and has been recognized as an important cardiovascular risk factor. Presumably due to a constellation of environmental, psychosocial, and individual determinants, these risks appear exacerbated in Blacks/African-Americans, who are more likely to experience short sleep than other ethnic/racial groups. Population-based data suggest that the risk of hypertension associated with sleep deficiency is greater in those of African ancestry. However, there is a paucity of experimental evidence linking short sleep duration to blood pressure levels in African-Americans. Blacks/African-Americans may be more vulnerable to sleep deficiency and to its hypertensive effects. Future research is needed to unequivocally establish causality and determine the mechanism underlying the postulated racial inequalities in sleep adequacy and consequent cardiovascular risk.
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Affiliation(s)
- Naima Covassin
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Eddie L Greene
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Prachi Singh
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
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Dass N, Kilakkathi S, Obi B, Moosreiner A, Krishnaswami S, Widlansky ME, Kidambi S. Effect of gender and adiposity on in vivo vascular function in young African Americans. ACTA ACUST UNITED AC 2017; 11:246-257. [PMID: 28411075 DOI: 10.1016/j.jash.2017.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/15/2017] [Accepted: 03/02/2017] [Indexed: 01/29/2023]
Abstract
The relationship between obesity and high blood pressure is not as strong among African Americans (AA) as compared to Caucasians. We designed the current study to determine the effect of adiposity on vascular endothelial function (a harbinger of hypertension) among young healthy AA without additional cardiovascular disease risk factors. A total of 108 AA subjects (46 women) between the ages of 18 and 45 years were recruited. All the subjects were normotensive, nonsmokers, and normoglycemic. Anthropometric and cardiovascular disease risk factor measurements (lipid, insulin resistance, and inflammatory markers) were obtained. Vascular endothelial function was measured by brachial artery flow-mediated dilation (FMD). Adiposity distribution was measured by using magnetic resonance imaging scan. There were no gender differences in age and levels of blood pressure, lipids, insulin resistance, and inflammatory markers. Women had higher total body fat percentage and higher peripheral adiposity compared to men. We observed that total and central adiposity did not correlate significantly with brachial artery FMD in women (r = -0.12 and r = 0.23, respectively; P = NS). However, in men, waist circumference was positively associated with FMD (r = 0.3, P ≤ .05). Hyperemic flow was negatively correlated significantly with total and central adiposity in men (r = -0.34 and r = -0.48, respectively; P < .05), but not in women (r = -0.26 and r = 0.03, respectively; P = NS). Our study suggests that increased adiposity may pose greater risk to AA men compared to AA women by adversely affecting resistance vessel function (as measured by hyperemic flow). Larger studies are necessary to validate these findings.
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Affiliation(s)
- Namrata Dass
- Division of Endocrinology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sindhu Kilakkathi
- Division of Endocrinology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Brittaney Obi
- Division of Endocrinology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Andrea Moosreiner
- Division of Endocrinology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Shanthi Krishnaswami
- Division of Endocrinology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michael E Widlansky
- Division of Endocrinology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Srividya Kidambi
- Division of Endocrinology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
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Hill LK, Sherwood A, Blumenthal JA, Hinderliter AL. Hemodynamics and Vascular Hypertrophy in African Americans and Caucasians With High Blood Pressure. Am J Hypertens 2016; 29:1380-1385. [PMID: 27481880 DOI: 10.1093/ajh/hpw080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/06/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hypertension in African Americans is characterized by greater systemic vascular resistance (SVR) compared with Caucasian Americans, but the responsible mechanisms are not known. The present study sought to determine if peripheral vascular hypertrophy is a potential mechanism contributing to elevated SVR in African Americans with high blood pressure (BP). METHODS In a biracial sample of 80 men and women between the ages of 25 and 45 years, with clinic BP in the range 130/85-160/99mm Hg, we assessed cardiac output and SVR, in addition to BP. Minimum forearm vascular resistance (MFVR), a marker of vascular hypertrophy, also was assessed. RESULTS SVR was elevated in African Americans compared with Caucasians (P < 0.001). Regression models indicated that age, body mass index, 24-hour diastolic BP, and ethnicity were significant predictors of SVR. There was also a significant interaction between ethnicity and MFVR in explaining SVR in the study sample. In particular, there was a significant positive association between MFVR and SVR among African Americans (P = 0.002), whereas the association was inverse and not statistically significant among Caucasians (P = 0.601). CONCLUSION Hypertrophy of the systemic microvasculature may contribute to the elevated SVR that is characteristic of the early stages of hypertension in African American compared with Caucasians.
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Pilic L, Pedlar CR, Mavrommatis Y. Salt-sensitive hypertension: mechanisms and effects of dietary and other lifestyle factors. Nutr Rev 2016; 74:645-58. [PMID: 27566757 DOI: 10.1093/nutrit/nuw028] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Salt sensitivity, which is an increase in blood pressure in response to high dietary salt intake, is an independent risk factor for cardiovascular disease and mortality. It is associated with physiological, environmental, demographic, and genetic factors. This review focuses on the physiological mechanisms of salt sensitivity in populations at particular risk, along with the associated dietary factors. The interplay of mechanisms such as the renin-angiotensin aldosterone system, endothelial dysfunction, ion transport, and estrogen decrease in women contributes to development of salt sensitivity. Because of their effects on these mechanisms, higher dietary intakes of potassium, calcium, vitamin D, antioxidant vitamins, and proteins rich in L-arginine, as well as adherence to dietary patterns similar to the DASH (Dietary Approaches to Stop Hypertension) diet, can be beneficial to salt-sensitive populations. In contrast, diets similar to the typical Western diet, which is rich in saturated fats, sucrose, and fructose, together with excessive alcohol consumption, may exacerbate salt-sensitive changes in blood pressure. Identifying potential mechanisms of salt sensitivity in susceptible populations and linking them to protective or harmful dietary and lifestyle factors can lead to more specific guidelines for the prevention of hypertension and cardiovascular disease.
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Affiliation(s)
- Leta Pilic
- L. Pilic, C.R. Pedlar, and Y. Mavrommatis are with the School of Sport, Health and Applied Science, St Mary's University, Twickenham, London, United Kingdom. CR Pedlar is with the Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
| | - Charles R Pedlar
- L. Pilic, C.R. Pedlar, and Y. Mavrommatis are with the School of Sport, Health and Applied Science, St Mary's University, Twickenham, London, United Kingdom. CR Pedlar is with the Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Yiannis Mavrommatis
- L. Pilic, C.R. Pedlar, and Y. Mavrommatis are with the School of Sport, Health and Applied Science, St Mary's University, Twickenham, London, United Kingdom. CR Pedlar is with the Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
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Yun L, Xu R, Zhang L, Li G, Huang S, Yao Y, Li J. The Role of Microalbuminuria in Arterial Endothelial Dysfunction in Hypertensive Patients With Carotid Plaques. Int Heart J 2014; 55:153-9. [DOI: 10.1536/ihj.13-232] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Lin Yun
- Department of Cardiology, Qianfoshan Hospital of Shandong Province, Shandong University
- Shandong Academy of Medical Sciences
| | - Rui Xu
- Department of Cardiology, Qianfoshan Hospital of Shandong Province, Shandong University
| | - Li Zhang
- Department of Ultrasound, Qianfoshan Hospital of Shandong Province, Shandong University
| | - Guohua Li
- Department of Cardiology, Qianfoshan Hospital of Shandong Province, Shandong University
| | - Shuai Huang
- Department of Cardiology, Qianfoshan Hospital of Shandong Province, Shandong University
| | - Yucai Yao
- Department of Cardiology, Qianfoshan Hospital of Shandong Province, Shandong University
| | - Jiamin Li
- Department of Cardiology, Qianfoshan Hospital of Shandong Province, Shandong University
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Emtiazy M, Choopani R, Khodadoost M, Tansaz M, Nazem E. Atheroprotector role of the spleen based on the teaching of Avicenna (Ibn Sina). Int J Cardiol 2013; 167:26-8. [PMID: 22726399 DOI: 10.1016/j.ijcard.2012.06.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 05/31/2012] [Accepted: 06/08/2012] [Indexed: 11/16/2022]
Affiliation(s)
- Majid Emtiazy
- The School of Iranian Traditional Medicine, Shahid Sadoughi University of Medical Sciences, Ardakan, Yazd, Iran.
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Caliskan M, Ciftci O, Gullu H, Caliskan Z, Güven A, Erdogan D, Muderrisoglu H. Effect of Masked, White-Coat, and Sustained Hypertension on Coronary Flow Reserve and Peripheral Endothelial Functions. Clin Exp Hypertens 2012; 35:183-91. [DOI: 10.3109/10641963.2012.712176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Choopani R, Mosaddegh M, Gir AADG, Emtiazy M. Avicenna (Ibn Sina) aspect of atherosclerosis. Int J Cardiol 2012; 156:330. [PMID: 22357428 DOI: 10.1016/j.ijcard.2012.01.094] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 01/28/2012] [Indexed: 11/30/2022]
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Tousoulis D, Antoniades C, Vlachopoulos C, Stefanadis C. Flow mediated dilation and carotid intima media thickness: clinical markers or just research tools? Int J Cardiol 2012; 163:226-228. [PMID: 22459376 DOI: 10.1016/j.ijcard.2012.03.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 03/03/2012] [Indexed: 10/28/2022]
Affiliation(s)
| | - Charalambos Antoniades
- 1st Cardiology Department, Athens University Medical School, Greece; Department of Cardiovascular Medicine, University of Oxford, UK
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Emtiazy M, Keshavarz M, Khodadoost M, Kamalinejad M, Gooshahgir SA, Shahrad Bajestani H, Hashem Dabbaghian F, Alizad M. Relation between Body Humors and Hypercholesterolemia: An Iranian Traditional Medicine Perspective Based on the Teaching of Avicenna. IRANIAN RED CRESCENT MEDICAL JOURNAL 2012; 14:133-8. [PMID: 22737569 PMCID: PMC3372029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 01/11/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiovascular diseases are among the most important causes of morbidity and mortality in the world. One of the important risk factors of cardiovascular disease is hyperlipidemia especially high levels of serum cholesterol. Due to the importance of hypercholesterolemia, being a serious condition, various treatments are used to control it, regardless of the cause, most of treatments, focused on reducing the level of serum lipids. This study aims to determine various view points for hypercholesterolemia in Iranian traditional medicine. METHODS We used several Iranian traditional medicine resources and literatures; then based on these texts; a pilot study was designed to assess their effects in 10 patients with high plasma cholesterol. The sign and symptoms in main digestive organs (Stomach and liver) were also evaluated. RESULTS Some patients showed hepatic temperament but all patients had gastric temperament. CONCLUSION With reference to Iranian traditional medical texts and literatures, the organs involved in the process of digestion, particularly the stomach and the liver play the most important role. Yet the proper function of stomach as the first step involved in the digestion chain should be emphasized.
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Affiliation(s)
- M Emtiazy
- School of Iranian Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran,Research Institute for Islamic and Complementary Medicine, Tehran University of Medical Sciences, Tehran, Iran,Correspondence: Majid Emtiazy, MD, PhD Student of Iranian Traditional Medicine, School of Iranian Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran. Tel.: +98-21-55601274, E-mail:
| | - M Keshavarz
- School of Iranian Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - M Khodadoost
- Department of Traditional Medicine, School of Medicine, Shahed University, Tehran, Iran
| | - M Kamalinejad
- Department of Pharmacognosy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S A Gooshahgir
- Research Institute for Islamic and Complementary Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - H Shahrad Bajestani
- Department of Endocrine and Metabolism, Rasoole Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - F Hashem Dabbaghian
- Research Institute for Islamic and Complementary Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - M Alizad
- School of Iranian Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
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18
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Hoffman RP. Effect of adolescent obesity on cardiometabolic risk in african-americans and Caucasians. ISRN OBESITY 2012; 2012:603205. [PMID: 24533206 PMCID: PMC3914275 DOI: 10.5402/2012/603205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 11/29/2012] [Indexed: 01/04/2023]
Abstract
African-Americans have more hypertension, stroke, and type 2 diabetes than do Caucasians. Endothelial dysfunction and insulin resistance are precursors for each. Since these diseases have origins in pediatrics and are associated with obesity, this study was designed to determine if obesity has different effects on endothelial function, insulin sensitivity, and secretion in African-American and Caucasian adolescents. Thirty-three Caucasian and 25 African-Americans (10–18 years old) were subdivided by BMI into lean, overweight, and obesity groups. Endothelial function was measured as forearm vascular resistance (FVR) over 1 min following 5 min of upper arm vascular occlusion. Insulin sensitivity and secretion were measured using intravenous glucose tolerance test and minimal model. Postocclusive FVR was significantly increased in obese African-Americans. Insulin sensitivity was reduced in obese subjects but did not differ by race. Insulin secretion was increased in African-Americans but did not differ by obesity. Subjects were subdivided into risk groups based on 20th percentile for postocclusion FVR response in lean. Seven of nine obese African-Americans were in the high risk group compared to 0 of 5 obese Caucasians. These results demonstrate that obesity significantly impairs endothelial function in African-Americans. Endothelial dysfunction likely predisposes to future cardiometabolic disease in obese African-American adolescents.
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Affiliation(s)
- Robert P Hoffman
- Division of Pediatric Endocrinology, Metabolism, and Diabetes, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA
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19
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Veerabhadrappa P, Diaz KM, Feairheller DL, Sturgeon KM, Williamson ST, Crabbe DL, Kashem AM, Brown MD. Endothelial-dependent flow-mediated dilation in African Americans with masked-hypertension. Am J Hypertens 2011; 24:1102-7. [PMID: 21677701 DOI: 10.1038/ajh.2011.103] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Office-blood pressure (BP) measurements alone overlook a significant number of individuals with masked-hypertension (office-BP: 120/80-139/89 mm Hg and 24-h ambulatory BP monitoring (ABPM) daytime ≥135/85 mm Hg or night-time ≥120/70 mm Hg). Diminished endothelial function contributes to the pathogenesis of hypertension. To better understand the pathophysiology involved in the increased cardiovascular (CV) disease risk associated with masked-hypertension, we estimated the occurrence, assessed the endothelial function, compared plasma levels of inflammatory markers, white blood cell count (WBC count), tumor necrosis factor-α (TNF-α), and high sensitivity C-reactive protein (hsCRP) and examined the possible relationship between endothelial function and inflammatory markers in apparently healthy prehypertensive (office-BP: 120/80-139/89 mm Hg) African Americans. METHODS Fifty African Americans who were sedentary, nondiabetic, nonsmoking, devoid of CV disease were recruited. Office-BP was measured according to JNC-7 guidelines to identify prehypertensives in whom ABPM was then assessed. Fasting plasma samples were assayed for inflammatory markers. Brachial artery flow-mediated dilation (FMD) at rest and during reactive hyperemia was measured in a subset of prehypertensives. RESULTS Subjects in the masked-hypertension sub-group had a higher hsCRP (P = 0.04) and diminished endothelial function (P = 0.03) compared to the true-prehypertensive sub-group (office-BP: 120/80-139/89 mm Hg and ABPM: daytime <135/85 mm Hg or night-time <120/70 mm Hg). Regression analysis showed that endothelial function was inversely related to hsCRP amongst the masked-hypertensive sub-group (R(2) = 0.160; P = 0.04). CONCLUSIONS Masked-hypertension was identified in 58% of African Americans which suggests that a masking phenomenon may exist in a sub-group of prehypertensives who also seem to have a diminished endothelial function that could be mediated by an elevated subclinical inflammation leading to the increased CV disease.
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Wei P, Milbauer LC, Enenstein J, Nguyen J, Pan W, Hebbel RP. Differential endothelial cell gene expression by African Americans versus Caucasian Americans: a possible contribution to health disparity in vascular disease and cancer. BMC Med 2011; 9:2. [PMID: 21223544 PMCID: PMC3029215 DOI: 10.1186/1741-7015-9-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 01/11/2011] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Health disparities and the high prevalence of cardiovascular disease continue to be perplexing worldwide health challenges. This study addresses the possibility that genetic differences affecting the biology of the vascular endothelium could be a factor contributing to the increased burden of cardiovascular disease and cancer among African Americans (AA) compared to Caucasian Americans (CA). METHODS From self-identified, healthy, 20 to 29-year-old AA (n = 21) and CA (n = 17), we established cultures of blood outgrowth endothelial cells (BOEC) and applied microarray profiling. BOEC have never been exposed to in vivo influences, and their gene expression reflects culture conditions (meticulously controlled) and donor genetics. Significance Analysis of Microarray identified differential expression of single genes. Gene Set Enrichment Analysis examined expression of pre-determined gene sets that survey nine biological systems relevant to endothelial biology. RESULTS At the highly stringent threshold of False Discovery Rate (FDR) = 0, 31 single genes were differentially expressed in AA. PSPH exhibited the greatest fold-change (AA > CA), but this was entirely accounted for by a homolog (PSPHL) hidden within the PSPH probe set. Among other significantly different genes were: for AA > CA, SOS1, AMFR, FGFR3; and for AA < CA, ARVCF, BIN3, EIF4B. Many more (221 transcripts for 204 genes) were differentially expressed at the less stringent threshold of FDR <.05. Using the biological systems approach, we identified shear response biology as being significantly different for AA versus CA, showing an apparent tonic increase of expression (AA > CA) for 46/157 genes within that system. CONCLUSIONS Many of the genes implicated here have substantial roles in endothelial biology. Shear stress response, a critical regulator of endothelial function and vascular homeostasis, may be different between AA and CA. These results potentially have direct implications for the role of endothelial cells in vascular disease (hypertension, stroke) and cancer (via angiogenesis). Also, they are consistent with our over-arching hypothesis that genetic influences stemming from ancestral continent-of-origin could impact upon endothelial cell biology and thereby contribute to disparity of vascular-related disease burden among AA. The method used here could be productively employed to bridge the gap between information from structural genomics (for example, disease association) and cell function and pathophysiology.
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Affiliation(s)
- P Wei
- Vascular Biology Center, Department of Medicine, Medical School, University of Minnesota, Minneapolis, MN 55455, USA
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