1
|
Bousquet E, Chenevier-Gobeaux C, Jaworski T, Torres-Villaros H, Zola M, Mantel I, Kowalczuk L, Matet A, Daruich A, Zhao M, Yzer S, Behar-Cohen F. High Levels of C-Reactive Protein with Low Levels of Pentraxin 3 as Biomarkers for Central Serous Chorioretinopathy. OPHTHALMOLOGY SCIENCE 2023; 3:100278. [PMID: 36950301 PMCID: PMC10025279 DOI: 10.1016/j.xops.2023.100278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023]
Abstract
Purpose To investigate the association between the 2 acute phase proteins, C-reactive protein (CRP) and pentraxin 3 (PTX3) with central serous chorioretinopathy (CSCR), as PTX3 is a glucocorticoid-induced protein. Design Cross-sectional multicenter study. Participants Patients with CSCR compared with age- and sex-matched healthy participants. Methods Patients with CSCR from 3 centers in Europe were included in the study. The clinical form of CSCR was recorded. Blood samples from patients with CSCR and healthy participants were sampled, and high-sensitivity CRP and PTX3 levels were measured in the serum. Main Outcome Measures C-reactive protein and PTX3 serum level comparison between patients with CSCR with age- and sex-matched healthy participants. Results Although CRP levels were higher in patients with CSCR (n = 216) than in age- and sex-matched controls (n = 130) (2.2 ± 3.2 mg/l vs. 1.5 mg/l ± 1.4, respectively, P = 0.037), PTX3 levels were lower in patients with CSCR (10.5 ± 19.9 pg/ml vs. 87.4 ± 73.2 pg/ml, respectively, P < 0.001). There was no significant difference in CRP or PTX3 levels between patients with acute/recurrent and chronic CSCR. Conclusions In patients with CSCR, high CRP and low PTX3 levels suggest a form of low-grade systemic inflammation together with a lack of glucocorticoid pathway activation, raising new hypotheses on the pathophysiology of CSCR. Financial Disclosures The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
- Elodie Bousquet
- Department of Ophthalmology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Paris, France
- Centre de Recherche des Cordeliers, INSERM, University of Paris Cité, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
| | - Camille Chenevier-Gobeaux
- Service de diagnostic biologique automatisé, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Paris, France
| | - Thara Jaworski
- Centre de Recherche des Cordeliers, INSERM, University of Paris Cité, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
| | - Héloïse Torres-Villaros
- Department of Ophthalmology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Paris, France
| | - Marta Zola
- Department of Ophthalmology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Paris, France
- Centre de Recherche des Cordeliers, INSERM, University of Paris Cité, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
| | - Irmela Mantel
- Department of Ophthalmology, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, Switzerland
| | - Laura Kowalczuk
- Department of Ophthalmology, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, Switzerland
| | - Alexandre Matet
- Department of Ophthalmology, Institut Curie, University of Paris Cité, Paris, France
| | - Alejandra Daruich
- Centre de Recherche des Cordeliers, INSERM, University of Paris Cité, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
- Department of Ophthalmology, Necker Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Paris, France
| | - Min Zhao
- Centre de Recherche des Cordeliers, INSERM, University of Paris Cité, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
| | - Suzanne Yzer
- Department of Ophthalmology, Rotterdam Eye Hospital, Rotterdam, the Netherlands
| | - Francine Behar-Cohen
- Department of Ophthalmology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris Cité, Paris, France
- Centre de Recherche des Cordeliers, INSERM, University of Paris Cité, Physiopathology of ocular diseases: Therapeutic innovations, Paris, France
- Correspondence: Francine Behar-Cohen, MD, PhD, centre de recherche des cordeliers, 15 rue de l’école de médecine, 75006 Paris, France.
| |
Collapse
|
2
|
Yang L, Yue Q, Fang F, Zhang Y, Liu P, Zhang Z, Wang G, Chen S, Wu S, Yang X. Effect of dual residual risk of cholesterol and inflammation on all-cause mortality in patients with cardiovascular disease. Cardiovasc Diabetol 2023; 22:96. [PMID: 37095492 PMCID: PMC10127069 DOI: 10.1186/s12933-023-01826-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/03/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Randomized controlled trials confirm that risks of residual cholesterol and residual inflammation remains in patients with cardiovascular disease (CVD) even after lipid-lowering therapy. This study aims to investigate the association between dual residual risk of cholesterol and inflammation and all-cause mortality in a real-world population with CVD. METHODS Patients with a CVD history who first took statins between 1 January 2010 and 31 December 2017 in the Kailuan Study were selected as study participants. According to low-density lipoprotein cholesterol (LDL-C) and hypersensitive C-reactive protein levels, patients were divided into those with no residual risk, residual inflammatory risk (RIR), residual cholesterol risk (RCR), and residual cholesterol and inflammatory risk (RCIR). Cox proportional hazard model was conducted to determine hazard ratio (HR) of all-cause mortality for RIR, RCR, and RCIR. Stratified analysis was conducted according to good medication adherence and 75% of the percentage LDL-C decline, high SMART 2 risk score, and blood pressure and blood glucose at standard levels. RESULTS After 6.10 years of follow-up, 377 all-cause deaths occurred in 3509 participants (mean age 63.69 ± 8.41 years, 86.78% men). After adjusting for related risk factors, the HR and (95% confidence interval [CI]) of all-cause mortality in the RIR, RCR, and RCIR was 1.63 (1.05, 2.52), 1.37 (0.98, 1.90), and 1.75 (1.25, 2.46), compared with no residual risk. Similar associations were observed in participants with moderate or low statin compliance, a lower percentage of LDL-C decline, high SMART 2 risk score, uncontrolled blood pressure, and uncontrolled blood glucose, in the RCIR had a 1.66-fold, 2.08-fold, 1.69-fold, 2.04-fold, and 2.05-fold higher risk of all-cause mortality, respectively, than the reference. CONCLUSION Risks of residual cholesterol and residual inflammation remain in patients with CVD after receiving statins, and their combined effect significantly increases the risk of all-cause mortality. Here, this increased risk was dependent on statin compliance, LDL-C reduction, SMART 2 risk score, and blood pressure and blood glucose control.
Collapse
Affiliation(s)
- Ling Yang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China
| | - Qing Yue
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China
| | - Fang Fang
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research On Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China
| | - Yinggen Zhang
- Department of Nuclear Medicine, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, Hebei, China
| | - Peipei Liu
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China
| | - Zihao Zhang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, Hebei, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, Hebei, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, Hebei, China.
| | - Xiuhong Yang
- School of Public Health, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China.
- Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research On Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China.
- School of Public Health, Hebei Key Laboratory for Chronic Diseases, Tangshan Key Laboratory for Preclinical and Basic Research On Chronic Diseases, School of Basic Medical Sciences, North China University of Science and Technology, No. 21 Bohai Road, Caofeidian Eco-city, Tangshan, 063210, Hebei, China.
| |
Collapse
|
3
|
Mannarino MR, Bianconi V, Scalisi G, Franceschini L, Manni G, Cucci A, Bagaglia F, Mencarelli G, Giglioni F, Ricciuti D, Figorilli F, Pieroni B, Cosentini E, Padiglioni E, Colangelo C, Fuchs D, Puccetti P, Follenzi A, Pirro M, Gargaro M, Fallarino F. A tryptophan metabolite prevents depletion of circulating endothelial progenitor cells in systemic low-grade inflammation. Front Immunol 2023; 14:964660. [PMID: 37081894 PMCID: PMC10110845 DOI: 10.3389/fimmu.2023.964660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 03/20/2023] [Indexed: 04/07/2023] Open
Abstract
BackgroundChronic systemic inflammation reduces the bioavailability of circulating endothelial progenitor cells (EPCs). Indoleamine 2,3-dioxygenase 1 (IDO1), a key enzyme of immune tolerance catalyzing the initial step of tryptophan degradation along the so-called l-kynurenine (l-kyn) pathway, that is induced by inflammatory stimuli and exerts anti-inflammatory effects. A specific relationship between IDO1 activity and circulating EPC numbers has not yet been investigated.MethodsIn this study, circulating EPCs were examined in mice treated with low doses of lipopolysaccharide (LPS) to mimic low-grade inflammation. Moreover, the association between IDO1 activity and circulating EPCs was studied in a cohort of 277 patients with variable systemic low-grade inflammation.ResultsRepeated low doses of LPS caused a decrease in circulating EPCs and l-kyn supplementation, mimicking IDO1 activation, significantly increased EPC numbers under homeostatic conditions preventing EPC decline in low-grade endotoxemia. Accordingly, in patients with variable systemic low-grade inflammation, there was a significant interaction between IDO1 activity and high-sensitivity C-reactive protein (hs-CRP) in predicting circulating EPCs, with high hs-CRP associated with significantly lower EPCs at low IDO1 activity but not at high IDO1 activity.InterpretationOverall, these findings demonstrate that systemic low-grade inflammation reduces circulating EPCs. However, high IDO1 activity and l-kyn supplementation limit circulating EPC loss in low-grade inflammation.
Collapse
Affiliation(s)
| | - Vanessa Bianconi
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- *Correspondence: Vanessa Bianconi, ; Marco Gargaro, ; Francesca Fallarino,
| | - Giulia Scalisi
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Luca Franceschini
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giorgia Manni
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Alessia Cucci
- Department of Health Sciences, School of Medicine, University of Piemonte Orientale, Novara, Italy
| | - Francesco Bagaglia
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Giulia Mencarelli
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Francesco Giglioni
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Doriana Ricciuti
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Filippo Figorilli
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Benedetta Pieroni
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Elena Cosentini
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | - Cecilia Colangelo
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Dietmar Fuchs
- Division of Biological Chemistry, Biocenter, Innsbruck Medical University, Innsbruck, Austria
| | - Paolo Puccetti
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Antonia Follenzi
- Department of Health Sciences, School of Medicine, University of Piemonte Orientale, Novara, Italy
| | - Matteo Pirro
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Marco Gargaro
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- *Correspondence: Vanessa Bianconi, ; Marco Gargaro, ; Francesca Fallarino,
| | - Francesca Fallarino
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- *Correspondence: Vanessa Bianconi, ; Marco Gargaro, ; Francesca Fallarino,
| |
Collapse
|
4
|
Zhao S, Dong S, Qin Y, Wang Y, Zhang B, Liu A. Inflammation index SIRI is associated with increased all-cause and cardiovascular mortality among patients with hypertension. Front Cardiovasc Med 2023; 9:1066219. [PMID: 36712259 PMCID: PMC9874155 DOI: 10.3389/fcvm.2022.1066219] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023] Open
Abstract
Background Inflammation plays an essential role in the pathogenesis of hypertension. A novel inflammatory biomarker systemic inflammatory response index (SIRI) is related with all-cause and cardiovascular (CVD) mortality, while the role of SIRI in hypertension patients is unclear. Methods A total of 21,506 participants with hypertension were recruited in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. SIRI was calculated as the neutrophil count * monocyte count/lymphocyte count. Hypertension was defined according to the examination of blood pressure, prescription, and self-reported physician diagnosis. Survival status was followed through 31 December 2019. The non-linear relationship was assessed using restricted cubic spline analysis. The association of all-cause mortality with SIRI was evaluated using the Kaplan-Meier curve and the weighted Cox regression analysis. The predictive abilities were assessed with Receiver operating curve. Results During 189,063 person-years of follow-up, 5,680 (26.41%) death events were documented, including 1,967 (9.15%) CVD related deaths. A J-shaped association was observed between SIRI and all-cause and CVD mortality. The Kaplan-Meier curve indicated the all-cause and CVD mortality risks were higher in high SIRI quartiles compared with lower SIRI quartiles. After adjusting for all covariates, the SIRI was positively associated with the all-mortality risk with HR = 1.19 (1.15, 1.22), and CVD mortality with HR = 1.19 (1.15, 1.24). The result was robust in subgroup analysis and sensitivity analysis. Conclusion Elevated SIRI level is associated with increased all-cause and CVD mortality among patients with hypertension. SIRI is considered as a potential inflammatory biomarker in the clinical practice. Further large-scale cohort studies are required to confirm our findings.
Collapse
Affiliation(s)
- Songfeng Zhao
- Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Siyuan Dong
- Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yongkai Qin
- Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yutong Wang
- Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Baorui Zhang
- Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China,*Correspondence: Baorui Zhang ✉
| | - Aihua Liu
- Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, China,Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,Aihua Liu ✉
| |
Collapse
|
5
|
He L, Fan C, Li G. The relationship between serum C-reactive protein and senile hypertension. BMC Cardiovasc Disord 2022; 22:500. [PMID: 36418968 PMCID: PMC9685935 DOI: 10.1186/s12872-022-02948-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Hypertension has become an important health risk factor in the twenty-first century, especially for the elderly. Studies have confirmed that inflammation is involved in the development of hypertension and that the inflammatory marker C-reactive protein(CRP) is significantly associated with hypertension. Therefore, in this study, we aimed to explore the CRP correlation with hypertension in the elderly. METHODS Serum CRP levels were measured in 196 hospitalized patients, and the CRP level was used as a criterion to divide them into the group with elevated CRP (> 10 mmol/L, n = 120) and the group with normal CRP (0 < CRP ≤ 10 mmol/L, n = 76). and the patient's baseline characteristics were collected and compared between the groups, and the correlation between CRP and other factors and hypertension in the elderly was analyzed by multi-factor logistic regression. RESULTS The prevalence of hypertension, coronary artery disease and joint reactive inflammation was significantly higher in the group with elevated CRP. There was also a significant association between the use of alcohol, low density lipoprotein cholesterol (LDL-C) and steroids and elevated CRP; logistic regression showed that elevated CRP (OR = 2.13, 95% CI: 1.14-3.99, p = 0.019), body mass index (BMI) (OR = 1.10, 95% CI:1.01-1.90, p = 0.030), diabetes (OR = 2.68, 95% CI:1.24-5.79, p = 0.012) were positively associated with hypertension, while statins use was negatively associated with hypertension (OR = 0.49, 95% CI: 0.25-0.94, p = 0.013). CONCLUSIONS Elevated CRP, BMI, and diabetes are positively associated with hypertension in the elderly, and early screening for CRP and initiation of treatment may help prevent further inflammatory responses in hypertension.
Collapse
Affiliation(s)
- Le He
- North China University of Science and Technology, Tangshan, Hebei, China
| | - Chenyang Fan
- Hebei North University, Zhangjiakou, Hebei, China
| | - Gang Li
- Division of Cardiology, Institute of Geriatric Diseases, Hebei General Hospital, Shijiazhuang, Hebei, China.
| |
Collapse
|
6
|
Rafaqat S, Afzal S, Rafaqat S, Khurshid H, Rafaqat S. Cardiac markers: Role in the pathogenesis of arterial hypertension. World J Hypertens 2022; 10:1-14. [DOI: 10.5494/wjh.v10.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/03/2022] [Accepted: 10/14/2022] [Indexed: 02/08/2023] Open
Abstract
Cardiac biomarkers may play unique roles in the prognostic evaluation of patients with hypertension, as many cardiac biomarker levels become abnormal long before the onset of obvious cardiovascular disease (CVD). There are numerous cardiac markers. However, this review article only reported the roles of creatinine kinase-MB, cardiac troponins, lipoprotein a, osteopontin, cardiac extracellular matrix, C-reactive protein, cardiac matrix metalloproteinases, cardiac natriuretic peptides, myoglobin, renin, and dynorphin in the pathogenesis of hypertension. This article explained recent major advances, as well as discoveries, significant gaps, and current debates and outlined possible directions for future research. Further studies are required to determine the association between myoglobin and other cardiac markers in hypertension. Moreover, therapeutic approaches are required to determine the early control of these cardiac markers, which ultimately reduce the prevalence of CVDs.
Collapse
Affiliation(s)
- Saira Rafaqat
- Department of Zoology, Lahore College for Women University, Lahore 5400, Pakistan
| | - Shaheed Afzal
- Emergency Department of Cardiology, Punjab Institute of Cardiology, Lahore 5400, Pakistan
| | - Sana Rafaqat
- Department of Biotechnology, Lahore College for Women University, Lahore 5400, Pakistan
| | - Huma Khurshid
- Department of Zoology, Lahore College for Women University, Lahore 5400, Pakistan
| | - Simon Rafaqat
- Department of Business, Forman Christian College, Lahore 5400, Pakistan
| |
Collapse
|
7
|
Tajbakhsh A, Gheibihayat SM, Askari H, Savardashtaki A, Pirro M, Johnston TP, Sahebkar A. Statin-regulated phagocytosis and efferocytosis in physiological and pathological conditions. Pharmacol Ther 2022; 238:108282. [DOI: 10.1016/j.pharmthera.2022.108282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 10/14/2022]
|
8
|
Su S, Chen R, Zhang S, Shu H, Luo J. Immune system changes in those with hypertension when infected with SARS-CoV-2. Cell Immunol 2022; 378:104562. [PMID: 35901625 PMCID: PMC9183242 DOI: 10.1016/j.cellimm.2022.104562] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 01/08/2023]
Abstract
The coronavirus disease 2019 (COVID-19) outbreak has become an evolving global health crisis. With an increasing incidence of primary hypertension, there is greater awareness of the relationship between primary hypertension and the immune system [including CD4+, CD8+ T cells, interleukin-17 (IL-17)/T regulatory cells (Treg) balance, macrophages, natural killer (NK) cells, neutrophils, B cells, and cytokines]. Hypertension is associated with an increased risk of various infections, post-infection complications, and increased mortality from severe infections. Despite ongoing reports on the epidemiological and clinical features of COVID-19, no articles have systematically addressed the role of primary hypertension in COVID-19 or how COVID-19 affects hypertension or specific treatment in these high-risk groups. Here, we synthesize recent advances in understanding the relationship between primary hypertension and COVID-19 and its underlying mechanisms and provide specific treatment guidelines for these high-risk groups.
Collapse
|
9
|
Sadeghi M, Kabiri S, Amerizadeh A, Heshmat-Ghahdarijani K, Masoumi G, Teimouri-Jervekani Z, Amirpour A. Anethum graveolens L. (Dill) effect on human lipid profile: An updated systematic Review. Curr Probl Cardiol 2021; 47:101072. [PMID: 34838903 DOI: 10.1016/j.cpcardiol.2021.101072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 12/11/2022]
Abstract
Dill is an aromatic edible herb, belongs to the genus Anethum in the celery family (Apiaceae or Umbelliferae) with a long history of cultivation from ancient times and two closely related cultivated species, European dill (Anethum graveolens) and Indian dill (Anethum Sowa). We wanted to do this systematic review on the effect of Anethum graveolens intake on lipid profile because the outcomes of multiple research and meta-analyses in this regard were inconsistent. A systematic search for English published randomized controlled trials (RCTs) covering PubMed, EMBASE, Scopus, and Coherence library. The pooled weighted mean difference (MD) and its 95% confidence interval (CI) were calculated and pooled using a random-effects model. Pooled data of six RCTs involving 171 intervention cases indicated that dill supplementation was associated with a significant reduction in mean serum total cholesterol (MD 95% CI= -3.71(-5.71,-1.70); p < 0.001), low-density lipoprotein cholesterol (LDL-C) (MD 95% CI= -1.51(-2.65,-0.47); p = 0.005), triglycerides (MD 95% CI= -2.48(-3.98,-0.98); p = 0.001) and interestingly high-density lipoprotein cholesterol level (HDL-C) (MD 95% CI= -2.19(-3.58,-0.81); p = 0.002). Subgroup analysis showed that dill use was more effective in lowering triglyceride in both hyperlipidemic patients, MD 95% CI= -3.54(-6.49,-0.60); p = 0.02) and type 2 diabetes (MD 95% CI= -3.64(-5.69,-1.58); p = 0.001). Dill use reduced the LDL levels more effectively in patients with type 2 diabetes (MD 95% CI= -3.54(-6.49,-0.60); p = 0.03). Dill supplementation significantly improved LDL-C, TG, and TC levels but not HDL-C. Further high quality controlled clinical trials on human is needed for more accurate and confirm conclusion.
Collapse
Affiliation(s)
- Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Shahrouz Kabiri
- Cardiac Department, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Atefeh Amerizadeh
- Cardiac Department, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Applied Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Kiyan Heshmat-Ghahdarijani
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Gholamreza Masoumi
- Anesthesiology Department, International Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Zahra Teimouri-Jervekani
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Afshin Amirpour
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
10
|
Bianconi V, Schiaroli E, Mannarino MR, Sahebkar A, Paciosi F, Benedetti S, Marini E, Pirro M, Francisci D. The association between neutrophil to lymphocyte ratio and endothelial dysfunction in people living with HIV on stable antiretroviral therapy. Expert Rev Anti Infect Ther 2021; 20:113-120. [PMID: 34030554 DOI: 10.1080/14787210.2021.1933438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Residual inflammation is thought to promote endothelial dysfunction and cardiovascular disease risk among people living with HIV (PLWH) receiving antiretroviral therapy (ART). Whether the neutrophil-to-lymphocyte ratio (NLR), a putative marker of systemic inflammation, may be associated with endothelial dysfunction has not been investigated in PLWH on stable ART. RESEARCH DESIGN AND METHODS In this cross-sectional study, 210 PLWH (mean age 49 years, 79% males, 88/7/5% Caucasians/Africans/Hispanics) on long-term ART (median ART duration 8 years) were enrolled among those who were afferent to an Infectious Diseases outpatient clinic. The association between NLR and brachial flow-mediated dilation (bFMD) was analysed. RESULTS A curvilinear association was observed between logarithmic-NLR and logarithmic-bFMD (R square = 0.034, p = 0.027), with logarithmic-bFMD decreasing significantly with increasing logarithmic-NLR only in PLWH with high NLR (≥1.47, median NLR) (r = -0.369, p < 0.001). However, NLR had a poor accuracy in the prediction of low bFMD (≤4.55, median bFMD) in PLWH with high NLR (55% sensitivity, 80% specificity, Youden index 0.35 for NLR 2.20). CONCLUSIONS Although there is an inverse association between NLR and bFMD among long-term ART-treated PLWH with high NLR, NLR has a low discriminatory ability toward endothelial dysfunction in this category of patients.
Collapse
Affiliation(s)
- Vanessa Bianconi
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Elisabetta Schiaroli
- Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Massimo R Mannarino
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Francesco Paciosi
- Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Sara Benedetti
- Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| | - Ettore Marini
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Matteo Pirro
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Daniela Francisci
- Unit of Infectious Diseases, Department of Medicine, University of Perugia, Perugia, Italy
| |
Collapse
|
11
|
Moradi M, Sohrabi G, Golbidi M, Yarmohammadi S, Hemati N, Campbell MS, Moradi S, Kermani MAH, Farzaei MH. Effects of artichoke on blood pressure: A systematic review and meta-analysis. Complement Ther Med 2021; 57:102668. [PMID: 33465383 DOI: 10.1016/j.ctim.2021.102668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/02/2020] [Accepted: 01/04/2021] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Clinical trials considering the effects of artichoke supplementation on blood pressure have yielded different and contradictory outcomes. Thus, a systematic review and meta-analysis were performed to assess effects of artichoke administration on blood pressure. METHODS Related studies were detected by searching the Cochrane Library, PubMed, Embase and Scopus databases up to 15 March 2020. Weighted Mean Differences (WMD) were pooled using a random-effects model. Heterogeneity, sensitivity analyses, and publication bias were evaluated using standard methods. RESULTS Pooled analysis of eight randomized controlled trials revealed that artichoke supplementation did not have an effect on systolic blood pressure (SBP), (WMD: -0.77 mmHg, 95 % CI: -2.76 to 1.22) or diastolic blood pressure (DBP) (WMD: -0.11 mmHg, 95 % CI: -1.72 to 1.50) when compared to the placebo group. However, subgroup analyses based on health status suggested that artichoke administration among hypertensive patients may significantly reduce SBP (WMD: -3.19 mmHg, 95 % CI: -3.32 to -3.06) and DBP (WMD: -2.33 mmHg, 95 % CI: -2.23 to -2.43), but no such reduction was found in NAFLD patients. Furthermore, our results indicated that artichoke supplementation for 12 weeks led to a significantly decreased DBP (WMD: -2.33 mmHg, 95 % CI: -2.43 to -2.23), but 8 weeks of intervention did not (WMD: 0.80 mmHg, 95 % CI: -1.06 to 2.66). CONCLUSION Artichoke supplementation may potentially lead to SBP and DBP reduction in hypertensive patients. In addition, artichoke supplementation for 12 weeks may significantly improve DBP.
Collapse
Affiliation(s)
- Mozhgan Moradi
- Internal Medicine Department, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ghazale Sohrabi
- General Practitioner, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Golbidi
- Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samira Yarmohammadi
- Internal Medicine Department, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Niloofar Hemati
- Internal Medicine Department, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Marilyn S Campbell
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky, USA
| | - Sajjad Moradi
- Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Ali Hojjati Kermani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Farzaei
- Pharmaceutical Sciences Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| |
Collapse
|
12
|
Fantin F, Disegna E, Manzato G, Comellato G, Zoico E, Rossi AP, Mazzali G, Rajkumar C, Zamboni M. Adipokines and Arterial Stiffness in the Elderly. Vasc Health Risk Manag 2020; 16:535-543. [PMID: 33324067 PMCID: PMC7733384 DOI: 10.2147/vhrm.s274861] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/18/2020] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION The aim of this study was to evaluate the relationship between adipokines and arterial stiffness in a group of 85 elderly subjects and the role of leptin and adiponectin on subclinical vascular damage, defined by a PWV>10 m/s. METHODS In each subject, we evaluated anthropometry, body composition by DXA (fat mass, fat mass%, lean mass), metabolic variables, leptin, adiponectin, systolic, diastolic, mean arterial pressure and pulse pressure (SBP, DBP, MAP, PP), carotid-femoral pulse wave velocity (cfPWV) and carotid-radial pulse wave velocity (crPWV). RESULTS In the study population, significant associations were observed between cfPWV and crPWV, age, SBP, MAP, waist circumference, fat body mass and leptin. The study population was subdivided in 2 subgroups according to adipokine patterns: group 1 included patients with high adiponectin and low leptin, and group 2 patients had high leptin and low adiponectin. SBP, PP, cfPWV were significantly higher in subjects with high leptin and low adiponectin (group 2). Even after adjustment for gender, fat mass%, MAP, HDL cholesterol and triglycerides, cfPWV was higher in group 2 than group 1. In a logistic binary regression on the entire population, considering subclinical vascular damage as a dependent variable and age, gender, MAP, fat mass%, triglycerides, HDL cholesterol and category of subjects with high leptin and low adiponectin as independent variables, MAP and category of subjects with high leptin and low adiponectin were significant predictors (OR, respectively, 1.09 and 3.61). CONCLUSION In conclusion, in the elderly, the presence at the same time of high leptin levels and low adiponectin levels seems to have synergic effects on arterial stiffness.
Collapse
Affiliation(s)
- Francesco Fantin
- Department of Medicine, Section of Geriatrics Medicine, University of Verona, Verona, Italy
| | - Eleonora Disegna
- Department of Medicine, Section of Geriatrics Medicine, University of Verona, Verona, Italy
| | - Gisella Manzato
- Department of Medicine, Section of Geriatrics Medicine, University of Verona, Verona, Italy
| | - Gabriele Comellato
- Department of Medicine, Section of Geriatrics Medicine, University of Verona, Verona, Italy
| | - Elena Zoico
- Department of Medicine, Section of Geriatrics Medicine, University of Verona, Verona, Italy
| | - Andrea P Rossi
- Department of Medicine, Section of Geriatrics Medicine, University of Verona, Verona, Italy
| | - Gloria Mazzali
- Department of Medicine, Section of Geriatrics Medicine, University of Verona, Verona, Italy
| | | | - Mauro Zamboni
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, Section of Geriatrics, University of Verona, Verona, Italy
| |
Collapse
|
13
|
Dose-response association between C-reactive protein and risk of all-cause and cause-specific mortality: a systematic review and meta-analysis of cohort studies. Ann Epidemiol 2020; 51:20-27.e11. [PMID: 32702432 DOI: 10.1016/j.annepidem.2020.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 12/13/2022]
|
14
|
Liu X, Wang B, Wang X, Tian M, Wang X, Zhang Y. Elevated plasma high-sensitivity C-reactive protein at admission predicts the occurrence of post-stroke fatigue at 6 months after ischaemic stroke. Eur J Neurol 2020; 27:2022-2030. [PMID: 32633437 DOI: 10.1111/ene.14430] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/30/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Post-stroke fatigue (PSF) is a common neuropsychiatric affective symptom occurring after stroke. Evidence indicates activated inflammatory pathways are involved in modulating the stroke and fatigue. High-sensitivity C-reactive protein (hs-CRP) is one of the most sensitive indicators of inflammation. Our aim was to estimate the association between plasma hs-CRP and PSF after acute ischaemic stroke. METHODS In all, 212 acute ischaemic stroke patients were consecutively recruited within the first 14 days after stroke onset and followed up for 6 months. Plasma hs-CRP levels were assayed by enzyme linked immunosorbent assay. Fatigue severity was assessed using the Fatigue Scale for Motor and Cognitive Functions. A score ≥ 43 is defined as PSF. RESULTS Sixty-eight stroke patients (32.1%) were diagnosed with PSF at 6 months' follow-up. In the patients with PSF, plasma hs-CRP levels were significantly higher compared with those in non-PSF patients (t = -8.524, P ≤ 0.001). In multivariate analyses, plasma levels of hs-CRP were independently associated with PSF at 6 months (odds ratio 3.435, 95% confidence interval 2.222-5.309; P ≤ 0.001) after adjusting other recorded variables. Based on the receiver operating characteristic curve, the optimal cut-off value of plasma hs-CRP levels as an indicator for the prediction of PSF was projected to be 0.52 mg/dl, which yielded a sensitivity of 77.9% and a specificity of 74.3%, with the area under the curve 0.794 (95% confidence interval 0.725-0.864; P ≤ 0.001). CONCLUSION Elevated plasma hs-CRP levels at admission were associated with PSF 6 months after stroke, suggesting that these alterations might predict the development of PSF in stroke patients.
Collapse
Affiliation(s)
- X Liu
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - B Wang
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - X Wang
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - M Tian
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - X Wang
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Y Zhang
- Department of Emergency, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
15
|
Bianconi V, Bronzo P, Banach M, Sahebkar A, Mannarino MR, Pirro M. Particulate matter pollution and the COVID-19 outbreak: results from Italian regions and provinces. Arch Med Sci 2020; 16:985-992. [PMID: 32863986 PMCID: PMC7444704 DOI: 10.5114/aoms.2020.95336] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/12/2020] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Particulate matter exposure has been associated with the appearance and severity of several diseases, including viral infections. The aim of this study was to investigate whether coronavirus disease 2019 (COVID-19) cases and deaths across Italian regions and provinces in March 2020 were linked to past exposure to fine and coarse particulate matter (namely, PM2.5 and PM10, respectively). MATERIAL AND METHODS Geographical distributions of COVID-19 cases and deaths (105,792 and 12,428, respectively, up to 31st March 2020), PM2.5 and PM10 exposure, and demographic characteristics were extracted from publicly accessible databases. Adjusted regression models were performed to test the association between particulate matter exposure in different Italian regions and provinces and COVID-19 incidence proportions and death rates. RESULTS A heterogeneous distribution of COVID-19 cases/deaths and particulate matter exposure was observed in Italy, with the highest numbers in Northern Italy regions and provinces. Independent associations between regional PM2.5/PM10 exposure and COVID-19 incidence proportion and death rate were observed (COVID-19 incidence proportion: β = 0.71, p = 0.003, β = 0.61, p = 0.031, respectively; COVID-19 death rate: β = 0.68, p = 0.004 and β = 0.61, p = 0.029, respectively). Similarly, PM2.5/PM10 exposures were independently associated with COVID-19 incidence proportion (β = 0.26, p = 0.024 and β = 0.27, p = 0.006, respectively) at the provincial level. The number of days exceeding the provincial limit value of exposure to PM10 (50 µg/m3) was also independently associated with the COVID-19 incidence proportion (β = 0.30, p = 0.008). CONCLUSIONS Exposure to PM2.5 and PM10 is associated with COVID-19 cases and deaths, suggesting that particulate matter pollution may play a role in the COVID-19 outbreak and explain the heterogeneous distribution of COVID-19 in Italian regions and provinces.
Collapse
Affiliation(s)
- Vanessa Bianconi
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Paola Bronzo
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital, Medical University of Lodz, Lodz, Poland
- Polish Mothers Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
| | - Amirhossein Sahebkar
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Centre, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Massimo R. Mannarino
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| | - Matteo Pirro
- Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy
| |
Collapse
|
16
|
Shen Y, Zhang Y, Xiong S, Zhu X, Ke C. High-sensitivity C-reactive protein and cystatin C independently and jointly predict all-cause mortality among the middle-aged and elderly Chinese population. Clin Biochem 2019; 65:7-14. [DOI: 10.1016/j.clinbiochem.2018.12.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/22/2018] [Accepted: 12/24/2018] [Indexed: 02/05/2023]
|
17
|
Ferreira I, Hovind P, Schalkwijk CG, Parving HH, Stehouwer CDA, Rossing P. Biomarkers of inflammation and endothelial dysfunction as predictors of pulse pressure and incident hypertension in type 1 diabetes: a 20 year life-course study in an inception cohort. Diabetologia 2018; 61:231-241. [PMID: 29101422 PMCID: PMC6448953 DOI: 10.1007/s00125-017-4470-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 09/07/2017] [Indexed: 11/06/2022]
Abstract
AIMS/HYPOTHESIS Vascular inflammation and endothelial dysfunction are thought to contribute to arterial stiffening and hypertension. This study aims to test this hypothesis with longitudinal data in the context of type 1 diabetes. METHODS We investigated, in an inception cohort of 277 individuals with type 1 diabetes, the course, tracking and temporal inter-relationships of BP, specifically pulse pressure (a marker of arterial stiffening) and hypertension, and the following biomarkers of systemic and vascular inflammation/endothelial dysfunction: C-reactive protein (CRP), soluble intracellular adhesion molecule-1 (sICAM-1), soluble vascular cellular adhesion molecule-1 (sVCAM-1) and soluble E-selectin (sE-selectin). These biomarkers and other risk factors were measured at baseline and repeatedly up to 20 years after the onset of type 1 diabetes. Data were analysed with generalised estimating equations including adjustments for age, sex, smoking status, BMI, HbA1c, serum creatinine, total cholesterol, urinary AER, insulin treatment dose and mean arterial pressure. RESULTS Increases were noted in all biomarkers except sE-selectin, which decreased over time. Levels differed from baseline at 2-4 years and preceded the increase in pulse pressure, which occurred at 8-10 years after the onset of type 1 diabetes. Higher levels of sICAM-1 and sVCAM-1, but not CRP or sE-selectin, at baseline and throughout the 20 year follow-up, were significantly associated with higher (changes in) pulse pressure at subsequent time points. Higher levels of sVCAM-1 at baseline and during follow-up were also significantly associated with the prevalence (OR 3.60 [95% CI 1.36, 9.53] and OR 2.28 [1.03, 5.25], respectively) and incidence (OR 2.89 [1.08, 7.75] and OR 3.06 [1.01, 9.26], respectively) of hypertension. We also investigated the longitudinal associations between BP or hypertension as determinants of subsequent (changes in) levels of CRP, sICAM-1, sVCAM-1 and sE-selectin, but did not find evidence to support a reverse causality hypothesis. CONCLUSIONS/INTERPRETATION These findings support the involvement of vascular endothelial dysfunction and inflammation in the development of premature arterial stiffening and hypertension in type 1 diabetes.
Collapse
Affiliation(s)
- Isabel Ferreira
- Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Medicine, The University of Queensland, Herston Campus - Public Health Building, Herston Rd, Brisbane, 4006, Australia.
| | - Peter Hovind
- Steno Diabetes Centre, Gentofte, Denmark
- Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Glostrup, Denmark
| | - Casper G Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Peter Debyelaan 25, 6229HX, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, MUMC+, Maastricht, the Netherlands
| | - Hans-Henrik Parving
- Department of Medical Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Coen D A Stehouwer
- Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Peter Debyelaan 25, 6229HX, Maastricht, the Netherlands.
- CARIM School for Cardiovascular Diseases, MUMC+, Maastricht, the Netherlands.
| | - Peter Rossing
- Steno Diabetes Centre, Gentofte, Denmark
- Faculty of Health, University of Copenhagen, Copenhagen, Denmark
- HEALTH, Aarhus University, Aarhus, Denmark
| |
Collapse
|
18
|
Li Y, Zhong X, Cheng G, Zhao C, Zhang L, Hong Y, Wan Q, He R, Wang Z. Hs-CRP and all-cause, cardiovascular, and cancer mortality risk: A meta-analysis. Atherosclerosis 2017; 259:75-82. [PMID: 28327451 DOI: 10.1016/j.atherosclerosis.2017.02.003] [Citation(s) in RCA: 247] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/11/2017] [Accepted: 02/07/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND AIMS Inconsistent findings have been reported on the association between high-sensitivity C-reactive protein (hs-CRP) and mortality risk. The objective of this meta-analysis was to investigate the association of elevated baseline hs-CRP levels with all-cause, cardiovascular, and cancer mortality risk in the general population. METHODS PubMed and Embase were systematically searched for studies published from inception to October 2016. Prospective observational studies were eligible if they reported the effects of elevated baseline hs-CRP levels on cancer-related, cardiovascular or all-cause mortality in the general population. The pooled adjusted risk ratio (RR) with 95% confidence interval (CI) comparing the highest to the lowest category of hs-CRP levels was used as association measures. RESULTS A total of 83,995 participants from 14 studies were identified. When comparing the highest to the lowest category of hs-CRP levels, the pooled RR was 1.25 (95% CI 1.13-1.38) for cancer-related mortality, 2.03 (95% CI 1.65-2.50) for cardiovascular mortality, and 1.75 (1.55-1.98) for all-cause mortality, respectively. Subgroup analysis showed that the effect of elevated hs-CRP levels on cancer-related mortality was observed in men (RR 1.26; 95% CI 1.11-1.43) but not in women (RR 1.03; 95% CI 0.83-1.27). CONCLUSIONS Elevated hs-CRP levels can independently predict risk of all-cause, cardiovascular mortality in the general population. However, the gender differences in the predictive role of hs-CRP on cancer mortality should to be further investigated.
Collapse
Affiliation(s)
- Yunwei Li
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Xiaoming Zhong
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Guanchang Cheng
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China.
| | - Cuihua Zhao
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Lei Zhang
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Yan Hong
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Qilin Wan
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Ruili He
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| | - Zhizhong Wang
- Department of Cardiology, Huaihe Hospital of Henan University, Kaifeng, 475000, China
| |
Collapse
|
19
|
Hong X, Wongtongkam N, Ward PR, Xiao S, Wang S, Peng Q, Zuo Q, Zeng D, Wang J, Wang C, Chen J, Zhang N. An association of serum ALT with elevated blood pressure in senior adults: a case-control study. Clin Exp Hypertens 2016; 38:691-695. [PMID: 27936332 DOI: 10.1080/10641963.2016.1200608] [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] [Indexed: 10/20/2022]
Abstract
Hypertension is a major risk factor for cardiovascular diseases in China; hence, identifying good serum markers might provide cost benefits in terms of reducing morbidity rates. In this population-based case-control study, participants were recruited from five districts in Hunan province, and 416 cases were matched with an equal number of controls. Markers related to elevated blood pressure were assessed: Body Mass Index, total cholesterol, triglycerides, fasting blood glucose, and creatinine. Three potential serum markers homocysteine (HCY), C-reactive protein (CRP), and alanine aminotransferase (ALT) were dichotomized as normal or high level. Binary logistic regression was used to determine odds ratios (ORs) and 95% confidence intervals (CIs). The findings showed that ALT is a powerful serum marker for predicting high risk of high blood pressure with OR = 2.94, 95% CI (1.44-6.02), while there were no significant differences between cases and controls for HCY and CRP. Additionally, it seems likely that high concentrations of HCY conferred a protective effect against elevated blood pressure. When adjusted for sex, ORs for hypertensive females were nearly five times higher than for hypertensive males (OR = 4.34, 95% CI = 1.17-16.04). The study strongly supports findings showing ALT is a potential indicator for patients with hypertension.
Collapse
Affiliation(s)
- Xiuqin Hong
- a School of Public Health , Central South University , Changsha , China
| | - Nualnong Wongtongkam
- b School of Biomedical Sciences , Charles Sturt University , New South Wales , Australia
| | - Paul Russell Ward
- c School of Health Sciences, Faculty of Medicine , Nursing and Health Sciences, Flinders University , South Australia , Australia
| | - Shuiyuan Xiao
- d Center for Global Health , Central South University , Changsha , China
| | - Shuling Wang
- e Institute of Gerontology, Hunan Geriatric Hospital , Changsha , China
| | - Qian Peng
- e Institute of Gerontology, Hunan Geriatric Hospital , Changsha , China
| | - Qi Zuo
- e Institute of Gerontology, Hunan Geriatric Hospital , Changsha , China
| | - Dan Zeng
- e Institute of Gerontology, Hunan Geriatric Hospital , Changsha , China
| | - Jia Wang
- e Institute of Gerontology, Hunan Geriatric Hospital , Changsha , China
| | - Chenxu Wang
- e Institute of Gerontology, Hunan Geriatric Hospital , Changsha , China
| | - Jian Chen
- e Institute of Gerontology, Hunan Geriatric Hospital , Changsha , China
| | - Na Zhang
- e Institute of Gerontology, Hunan Geriatric Hospital , Changsha , China
| |
Collapse
|
20
|
Cortez AF, Muxfeldt ES, Cardoso CRL, Salles GF. Prognostic Value of C-Reactive Protein in Resistant Hypertension. Am J Hypertens 2016; 29:992-1000. [PMID: 26884133 DOI: 10.1093/ajh/hpw011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 01/19/2016] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND C-reactive protein (CRP) is a biomarker of systemic low-grade inflammation and a cardiovascular risk predictor in several clinical conditions. However, its prognostic value has never been examined in patients with resistant hypertension. METHODS In a prospective study, 476 patients with resistant hypertension had CRP levels measured at baseline, together with other clinical laboratory variables, including ambulatory blood pressures (BPs). Primary end points were a composite of major fatal or nonfatal cardiovascular events, all-cause mortality, and cardiovascular mortality. Multiple Cox regression assessed the associations between CRP levels and end points. RESULTS Median CRP was 3.8mg/l (interquartile range: 2.0-7.2mg/l). After a median follow-up of 9 years, 103 major cardiovascular events occurred, and 120 patients died, 62 from cardiovascular causes. Patients with CRP levels above the median value had a doubled excess risk of major cardiovascular events (95% confidence interval: 1.29-3.06; P = 0.002) and an 86% higher risk of cardiovascular death (95% confidence interval: 1.07-3.25; P = 0.029), after adjustments for potential confounders including traditional cardiovascular risk factors and ambulatory BP and dipping pattern. A high CRP equally predicted coronary (hazard ratio: 2.04; 95% confidence interval: 1.10-3.76; P = 0.023) and cerebrovascular events (hazard ratio: 2.72; 95% confidence interval: 1.30-5.67; P = 0.007). In interaction and sensitivity analyses, CRP levels were stronger predictors of worse cardiovascular outcomes in younger and obese patients, and in those with uncontrolled ambulatory BPs and with the nondipping pattern. CONCLUSIONS In patients with resistant hypertension, elevated serum CRP levels is predictive of worse cardiovascular prognosis above and beyond other cardiovascular risk factors, including ambulatory BP levels and dipping patterns.
Collapse
Affiliation(s)
- Arthur Fernandes Cortez
- Hypertension Program, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elizabeth Silaid Muxfeldt
- Hypertension Program, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Claudia Regina Lopes Cardoso
- Hypertension Program, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gil Fernando Salles
- Hypertension Program, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
21
|
Abstract
Adipokines are hormones produced by adipocytes and have been involved in multiple pathologic pathways, including inflammatory and cardiovascular complications in essential hypertension. Arterial stiffness is a frequent vascular complication that represents increased cardiovascular risk in hypertensive patients. Adipokines, such as adiponectin, leptin and resistin, might be implicated in hypertension, as well as in vascular alterations associated with this condition. Arterial stiffness has proven to be a predictor of cardiovascular events. Obesity and target-organ damage such as arterial stiffness are features associated with hypertension. This review aims to update the association between adipokines and arterial stiffness in essential and resistant hypertension (RHTN).
Collapse
|
22
|
Zhou Y, Han W, Gong D, Man C, Fan Y. Hs-CRP in stroke: A meta-analysis. Clin Chim Acta 2015; 453:21-7. [PMID: 26633855 DOI: 10.1016/j.cca.2015.11.027] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/18/2015] [Accepted: 11/25/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Studies on high-sensitivity C-reactive protein (hs-CRP) and stroke risk have yielded conflicting results. OBJECTIVE To determine whether elevated baseline hs-CRP presents an independent risk for different kinds of strokes by conducting a meta-analysis. METHODS The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases were systematically searched for prospective observational studies published until January 2015. Studies reporting hs-CRP levels and adjusted risk estimates of different stroke subtypes by hs-CRP were selected. Pooled results were expressed as adjusted risk ratios (RRs), with corresponding 95% confidence intervals (CI) for the highest versus the lowest hs-CRP category. RESULTS Twelve studies involving 2269 strokes, of which 2436 were ischemic and 655 were hemorrhagic, were identified from 66,560 participants. When comparing the highest with the lowest hs-CRP category, the pooled RR of ischemic strokes was 1.46 (95% CI 1.27-1.67) in a fixed-effect model. The pooled RRs of all strokes and hemorrhagic stroke were 1.23 (95% CI: 0.997-1.51) and 0.82 (95% CI 0.59-1.13), respectively. The risk of ischemic strokes seemed higher in men (RR 1.66; 95% CI 1.23-2.24). CONCLUSIONS Elevated baseline hs-CRP levels are independently associated with excessive ischemic stroke risk but exhibit no clear effect on hemorrhagic stroke.
Collapse
Affiliation(s)
- Yongjing Zhou
- Institute of Molecular Biology & Translational Medicine, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, PR China
| | - Wei Han
- Department of Pharmacy, Shenyang Children's Hospital, Shenyang 110032, PR China
| | - Dandan Gong
- Institute of Molecular Biology & Translational Medicine, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, PR China
| | - Changfeng Man
- Institute of Molecular Biology & Translational Medicine, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, PR China
| | - Yu Fan
- Institute of Molecular Biology & Translational Medicine, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, PR China.
| |
Collapse
|
23
|
Botha S, Fourie CMT, Schutte R, Eugen-Olsen J, Schutte AE. Soluble urokinase plasminogen activator receptor and hypertension among black South Africans after 5 years. Hypertens Res 2015; 38:439-44. [DOI: 10.1038/hr.2015.22] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/28/2015] [Accepted: 02/03/2015] [Indexed: 01/16/2023]
|
24
|
Muiesan ML, Salvetti M, Paini A, Agabiti Rosei C, Rubagotti G, Negrinelli A, Gregorini G, Cancarini G, Calabresi L, Franceschini G, Obici L, Perlini S, Merlini G, Agabiti Rosei E. Vascular alterations in apolipoprotein A-I amyloidosis (Leu75Pro). A case-control study. Amyloid 2015; 22:187-93. [PMID: 26193960 DOI: 10.3109/13506129.2015.1066771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Among hereditary amyloidoses, apolipoprotein A-I (APO A-I) amyloidosis (Leu75Pro) is a rare, autosomal dominant condition in which renal, hepatic, and testicular involvement has been demonstrated. OBJECTIVE To investigate vascular structural as well as functional alterations. METHODS In 131 carriers of the amyloidogenic Leu75Pro APO A-I mutation (mean age 52 + 16 years, 56 women) and in 131 subjects matched for age, sex, body mass index and clinic blood pressure (BP), arterial stiffness (pulse wave velocity, PWV) and carotid intima-media thickness (IMT) were measured. RESULTS By definition no differences for age, sex, body mass index, and BP were observed. Meanmax IMT (Mmax-IMT) in the common (CC), bifurcation (BIF) and internal (ICA) carotid artery were comparable in the two groups. After adjustment for high-density lipoprotein cholesterol and renal function differences between the two groups, a lower meanmax-IMT was observed in APO A-I Leu75Pro mutation carriers than in controls (CC Mmax-IMT 0.87 ± 0.21 versus 0.93 ± 0.2 mm, p = 0.07; BIF Mmax-IMT 1.19 ± 0.48 versus 1.36 ± 0.46 mm, p = 0.025; ICA Mmax-IMT 0.9 ± 0.37 versus 1.02 ± 0.35 mm, p = 0.028). On the other hand, aortic stiffness was significantly greater in patients with APO A-I amyloidosis than controls (PWV 11.5 ± 2.9 and 10.7 ± 2.3 m/s, p < 0.05), even after adjusting for confounders. CONCLUSIONS In carriers of the amyloidogenic Leu75Pro APO A-I mutation, a significant increase in arterial stiffness is observed; on the contrary, carotid artery IMT is comparable to that of control subjects. These results may add significant information to the clinical features of this rare genetic disorder.
Collapse
Affiliation(s)
- Maria Lorenza Muiesan
- a Internal Medicine, Department of Clinical and Experimental Sciences , University of Brescia and Spedali Civili , Brescia , Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
In prehypertension leukocytosis is associated with body mass index but not with blood pressure or incident hypertension. J Hypertens 2014; 32:251-9. [PMID: 24275841 DOI: 10.1097/hjh.0000000000000032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous studies reported increased white blood cell counts (WBCCs), an inflammatory marker, in hypertension, prehypertension and metabolic syndrome. Evidence suggests that inflammation precedes blood pressure (BP) elevation and may contribute to incident hypertension. Angiotensin receptor blockers (ARBs) may reduce inflammation. We analyzed WBCC trends in TRial Of Preventing HYpertension (TROPHY) to determine if this inflammatory marker predicted incident hypertension in prehypertensive individuals and whether randomized assignment to the ARB candesartan (391 individuals) for 2 years, lowered WBCC compared with placebo-treated controls (381 individuals). METHODS A new analysis of TROPHY trial data. RESULTS In the total population, baseline BMI correlated with WBCC (r = 0.185, P < 0.0001), neutrophils (r = 0.135, P < 0.001) and lymphocytes (r = 0.204, P < 0.0001). Baseline triglycerides also correlated significantly with inflammatory markers. Despite a wide range of home BP (HBP) values, HBP did not correlate with baseline WBCC counts. After 2 years, candesartan decreased placebo corrected HBP by -5.5/-2.5 mmHg, (P < 0.0001), but WBCC, neutrophil and lymphocyte counts were not different in placebo and in candesartan groups. Baseline WBCC, neutrophils and lymphocyte counts did not predict incident hypertension in the placebo group. CONCLUSION In TROPHY, candesartan lowered BP but did not alter WBCC. Baseline WBCC did not predict incident hypertension. Our findings do not support the hypothesis that inflammation contributes to incident hypertension or that ARB treatment suppresses inflammation. The significant independent association of WBCC with baseline BMI and triglycerides is consistent with the evidence that obesity and insulin resistance are associated with inflammation. The findings highlight the importance of effective lifestyle modification in prehypertension to reduce inflammatory cardio-metabolic risk and suppress transition to hypertension.
Collapse
|
26
|
Pirro M, Vaudo G, Lupattelli G, Pasqualini L, Mannarino MR, Schillaci G, Alaeddin A, Paciullo F, Fallarino F, Bagaglia F, Mannarino E. On-treatment C-reactive protein and HDL cholesterol levels in patients at intermediate cardiovascular risk: Impact on carotid intima-media thickness. Life Sci 2013; 93:338-43. [DOI: 10.1016/j.lfs.2013.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 06/24/2013] [Accepted: 07/06/2013] [Indexed: 12/17/2022]
|
27
|
Inflammatory biomarkers CRP, MCP-1, serum amyloid alpha and interleukin-18 in patients with HTN and dyslipidemia: impact of diabetes mellitus on metabolic syndrome and the effect of statin therapy. Hypertens Res 2013; 36:550-8. [DOI: 10.1038/hr.2012.214] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
28
|
Ratto E, Leoncini G, Viazzi F, Falqui V, Parodi A, Conti N, Tomolillo C, Deferrari G, Pontremoli R. C-reactive protein and target organ damage in untreated patients with primary hypertension. ACTA ACUST UNITED AC 2012; 1:407-13. [PMID: 20409873 DOI: 10.1016/j.jash.2007.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Revised: 08/30/2007] [Accepted: 09/08/2007] [Indexed: 11/30/2022]
Abstract
High sensitivity C-reactive protein (hs-CRP) has been recognized as a risk factor for cardiovascular disease. Asymptomatic organ damage is known to precede cardiovascular events in hypertension. The aim of the present study was to investigate the relationship between hs-CRP and signs of organ damage, namely left ventricular mass index (LVMI), albuminuria, and carotid atherosclerosis in a group of hypertensive patients. One hundred and eighty-two untreated patients with primary hypertension were studied. HS-CRP was measured by immunonephelometry. LVMI was assessed by echocardiography, albuminuria was measured as albumin to creatinine ratio, and carotid atherosclerosis by ultrasonography. Patient stratification according to quartiles of hs-CRP showed a significant trend toward higher age, prevalence of left ventricular hypertrophy, and carotid plaques. Moreover, there was a significant correlation among hs-CRP quartiles and left ventricular mass index, carotid cross-sectional area, carotid plaques, and albuminuria. Multiple regression analysis showed that, after adjusting for established cardiovascular risk factors (ie, age, duration of hypertension, smoking habit, body mass index (BMI), 24-hour systolic and diastolic blood pressures, glucose, creatinine, uric acid, triglycerides, total and low-density lipoprotein cholesterol), hs-CRP remained a strong correlate of target organ damage. These results support the importance of chronic microinflammation in the development of atherosclerotic disease in hypertension.
Collapse
Affiliation(s)
- Elena Ratto
- Department of Cardio-Nephrology, Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Leiva E, Mujica V, Brito K, Palomo I, Orrego R, Moore-Carrasco R, Vásquez M, Guzmán L, Nuñez S, Díaz N, Icaza G, Arredondo M. High levels of hsCRP are associated with carbohydrate metabolism disorder. J Clin Lab Anal 2012; 25:375-81. [PMID: 22086789 DOI: 10.1002/jcla.20455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM To determine risk parameters associated with high values of high sensitive C-reactive protein (hsCRP) in subjects with different glucose fasting levels. METHODS Anthropometric parameters, arterial pressure, glycemia, lipid profile, uric acid, and hsCRP were studied in a population of 513 individuals between 40 and 65 years. RESULTS In total, 349 (68.0%) were normoglycemic (NG); 113 (22.0%) had impaired fasting glucose (IFG); and 51 (9.9%) were diabetic subjects. A multivariate linear regression analysis showed that the natural logarithm of hsCRP was associated significantly with glycemia levels (P = 0.009), uric acid (P = 0.001), diastolic blood pressure (P = 0.011), smoking habit (P = 0.021), BMI (P<0.001), and sex (P<0.001). One-third of the NG subjects had high hsCRP levels. A multiple logistic regression analysis showed that sex and BMI were variables related to high levels of hsCRP in subjects with IFG and NG. In NG subjects, uric acid levels were associated with risk of presenting high hsCRP levels and were higher in women than men. In NG women, ROC curves analysis identified a uric acid level of 3.9 mg/dl as a cut-off point to predict a high value of hsCRP. Those individuals with uric acid values higher than 3.9 mg/dl and normal glycemia had 3.5-fold more risk of having hsCRP levels over 3.0 mg/l. CONCLUSIONS We sustain that high levels of hsCRP are associated with disturbance in carbohydrate metabolism. In addition, we believe that in low cardiovascular risk population, such as NG women, uric acid levels above 3.9 mg/dl might represent a signal of possible pro-inflammatory state and cardiovascular risk.
Collapse
Affiliation(s)
- Elba Leiva
- Programa de Investigación de Factores de Riesgo de Enfermedades, Cardiovasculares, Universidad de Talca, Talca, Chile
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Dogru T, Genc H, Bagci S. C reactive protein levels in non-alcoholic fatty liver disease. J Hepatol 2012; 56:507-8; author reply 508-10. [PMID: 21888877 DOI: 10.1016/j.jhep.2011.06.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 06/11/2011] [Indexed: 12/04/2022]
|
31
|
Lu Z, Gao Y, Tan A, Yang X, Zhang H, Mo L, Wu C, Hu Y, Mo Z. Increased high-sensitivity C-reactive protein predicts a high risk of lower urinary tract symptoms in Chinese male: Results from the Fangchenggang Area Male Health and Examination Survey. Prostate 2012; 72:193-200. [PMID: 21594882 DOI: 10.1002/pros.21421] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Accepted: 04/14/2011] [Indexed: 01/08/2023]
Abstract
BACKGROUND Reports have shown that increased serum C-reactive protein (CRP) suggests a risk of lower urinary tract symptoms (LUTS) in the West population. However, few studies have investigated the role of CRP as regards LUTS in a Chinese male population. METHODS Data were collected from 1,452 men who participated in the population-based Fangchenggang Area Male Health and Examination Survey (FAMHES), which was carried out in Guangxi, China, from September 2009 to December 2009. In the current study, serum CRP was measured with a high-sensitivity method (hsCRP) and LUTS was assessed by International Prostate Symptom Score (IPSS). Meanwhile, information about potential confounding variables (smoking, hypertension, diabetes, etc.) were included. RESULTS We observed that statistically significant distinction presented in the distribution of hsCRP levels and age between LUTS group and non-LUTS group (P < 0.001). Comparing with the lowest hsCRP tertile, men with the highest hsCRP tertile were 1.72 times more likely to have overall LUTS and 1.93 times more likely to have irritative symptoms. As for individual symptoms of LUTS, statistically significant correlations were noted between serum hsCRP levels and urgency (OR = 1.74, 95% CI = 1.09-2.78) and nocturia (OR = 1.64, 95% CI = 1.18-2.27), when comparing them from the 1st to 3rd hsCRP tertiles. After multivariate adjusted, the results changed slightly and were still significant. CONCLUSIONS In a Chinese male population, we firstly confirmed a positive correlation of serum hsCRP with LUTS. It can be inferred that inflammation may be involved in the processes of LUTS.
Collapse
Affiliation(s)
- Zheng Lu
- Institute of Urology and Nephrology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Crane TE, Kubota C, West JL, Kroggel MA, Wertheim BC, Thomson CA. Increasing the vegetable intake dose is associated with a rise in plasma carotenoids without modifying oxidative stress or inflammation in overweight or obese postmenopausal women. J Nutr 2011; 141:1827-33. [PMID: 21865569 PMCID: PMC3174856 DOI: 10.3945/jn.111.139659] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The optimal amount of vegetable consumption required to reduce chronic disease risk is widely debated. Intervention trials evaluating biological activity of vegetables at various doses are limited. We conducted a 3-dose, crossover feeding trial to test the hypothesis that vegetable intake is associated in a dose-dependent manner with increased plasma carotenoids and subsequently reduced oxidative stress and inflammation in 49 overweight, postmenopausal women. Participants were assigned in random order to 2 (130 g), 5 (287 g), and 10 (614 g) daily servings of fresh, greenhouse-grown vegetables for 3-wk intervals with a 4-wk washout period between treatments. Plasma total carotenoids significantly increased from 1.63 to 2.07 μmol/L with a dose of 2 vegetable servings, from 1.49 to 2.84 μmol/L with a dose of 5 vegetable servings, and from 1.40 to 4.42 μmol/L with a dose of 10 vegetable servings (pre-post paired ttests, all P < 0.001). The change during each feeding period increased with each dose level (P < 0.001). Urine concentrations of 8-isoprostane F2α, hexanoyl lysine, and serum high sensitivity C-reactive protein were not affected by any administered vegetable dose. In this variable-dose vegetable study, a dose-response for plasma carotenoids was demonstrated without significant change in oxidative stress and inflammation in overweight, postmenopausal women.
Collapse
Affiliation(s)
| | | | | | | | | | - Cynthia A. Thomson
- Department of Nutritional Sciences,Arizona Cancer Center, University of Arizona, Tucson, AZ,To whom correspondence should be addressed. E-mail:
| |
Collapse
|
33
|
Krupinski J, Turu MM, Slevin M, Martínez-González J. Carotid plaque, stroke pathogenesis, and CRP: treatment of ischemic stroke. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2010; 9:229-35. [PMID: 17601387 DOI: 10.1007/s11936-007-0017-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Inflammation is receiving increased attention as a cause of atherosclerosis and stroke. Several inflammatory biomarkers, and particularly high-sensitivity C-reactive protein (hsCRP), have been identified as likely predictors of the risk of a future stroke. In clinical settings, it has been consistently observed that higher concentrations of CRP are associated with larger brain infarcts, stroke severity, neurologic disability, and future vascular events. However, there is still controversy over the degree of risk conferred by elevated CRP concentrations. Some studies reported that the predictive value of CRP is moderate compared with classical risk factors and is only weakly related to cardiovascular damage after adjustment for traditional cardiovascular risk factors. CRP like many other hemostatic factors is an acute-phase protein and, therefore, it is not always clear whether its association with cerebrovascular disease reflects its contribution to atherothrombosis, its acute-phase condition, or both. Furthermore, the value of single measurements of CRP in patients with concurrent infection or other inflammatory conditions has not been established and reported data should be interpreted cautiously. Several drugs, especially hydroxymethylglutaryl coenzyme A reductase inhibitors (statins), have been demonstrated to reduce hsCRP levels independently of their effects on plasma cholesterol. Recently, emerging therapies have been aimed at the control of blood pressure and inflammation in stroke patients. Whether a reduction of hsCRP levels could be beneficial to stroke patients remains to be clarified, and it is also unclear whether other drugs may be useful to lower hsCRP levels. More studies are needed before hsCRP becomes a routine part of the evaluation of stroke patients. This should also prompt the search for new agents directly blocking CRP actions.
Collapse
Affiliation(s)
- Jerzy Krupinski
- Department of Neurology, Stroke Unit, Hospital Universitari de Bellvitge, Feixa Llarga s/n 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | | | | | | |
Collapse
|
34
|
Angiotensin-II receptor antagonist combined with calcium channel blocker or diuretic for essential hypertension. Hypertens Res 2009; 32:962-8. [PMID: 19696778 DOI: 10.1038/hr.2009.133] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
To achieve the target blood pressure recommended by the latest guidelines, multiple antihypertensive drugs are needed in most patients. In this study, the efficacy of treatment using an angiotensin II receptor antagonist (ARB) combined with a calcium channel blocker (CCB) or a diuretic was compared from multiple perspectives in patients with hypertension. Twenty-nine patients with essential hypertension, who had failed to achieve their target blood pressure (<130/85 mm Hg for patients <65 years old and <140/90 mm Hg for those >/=65 years) when treated with the ARB olmesartan at 20 mg day(-1), were additionally given 8-16 mg day(-1) of the CCB azelnidipine or 1-2 mg day(-1) of trichlormethiazide (a thiazide diuretic) in a randomized crossover manner for 4 months each. At the end of each combination therapy period, blood and urine samples were collected and arterial stiffness was evaluated by measuring the cardio-ankle pulse wave velocity. Compared with monotherapy, the blood pressure was reduced similarly by adding azelnidipine (-12/-10 mm Hg) or trichlormethiazide (-14/-9 mm Hg). The heart rate was decreased with the CCB by 4 b.p.m. (P<0.05), whereas it was unchanged with the thiazide. Serum K, lipids and blood glucose were not significantly changed with either combination, whereas serum uric acid was increased with the thiazide (P<0.01) but was unchanged with azelnidipine. Plasma levels of renin, angiotensin II and aldosterone were also increased with the thiazide period, whereas high-sensitivity C-reactive protein and oxidized low-density lipoprotein were decreased with azelnidipine. In addition, the cardio-ankle vascular index, a parameter of arterial stiffness, was decreased with the azelnidipine period but was unchanged with the thiazide period (P<0.01). It is suggested that the combination of olmesartan and azelnidipine has advantages over the combination of olmesartan and a thiazide with respect to avoiding hyperuricemia, sympathetic activation, renin-angiotensin-aldosterone system stimulation, inflammation, oxidative stress, and increased arterial stiffness in patients with moderate hypertension. These properties may provide cardiovascular protection in addition to the hypotensive effect.
Collapse
|
35
|
St Sauver JL, Sarma AV, Jacobson DJ, McGree ME, Lieber MM, Girman CJ, Nehra A, Jacobsen SJ. Associations between C-reactive protein and benign prostatic hyperplasia/lower urinary tract symptom outcomes in a population-based cohort. Am J Epidemiol 2009; 169:1281-90. [PMID: 19395697 DOI: 10.1093/aje/kwp085] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Inflammation may play a role in the development of benign prostatic hyperplasia and/or lower urinary tract symptoms (LUTS). Higher levels of C-reactive protein (CRP) may therefore be associated with the development of these outcomes. The authors examined the association of CRP levels measured in 1996 with rapid increases in prostate volume, prostate-specific antigen levels, and LUTS as well as rapid decreases in peak flow rates (through 2005) in a population-based cohort of men residing in Olmsted County, Minnesota. Men with CRP levels of > or =3.0 mg/L were more likely to have rapid increases in irritative LUTS (odds ratio (OR) = 2.14, 95% confidence interval (CI): 1.18, 3.85) and rapid decreases in peak flow rates (OR = 2.54, 95% CI: 1.09, 5.92) compared with men with CRP levels of <3.0 mg/L. CRP levels were not significantly associated with rapid increases in prostate volume, obstructive LUTS, or prostate-specific antigen levels. Associations were attenuated after adjusting for age, body mass index, hypertension, and smoking history (irritative LUTS: OR = 2.00, 95% CI: 1.04, 3.82; peak flow rate: OR = 2.45, 95% CI: 0.73, 8.25). These results suggest that rapid increases in irritative LUTS and rapid decreases in peak flow rates may be due to inflammatory processes.
Collapse
Affiliation(s)
- Jennifer L St Sauver
- Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
| | | | | | | | | | | | | | | |
Collapse
|
36
|
Friedewald VE, Cather JC, Gelfand JM, Gordon KB, Gibbons GH, Grundy SM, Jarratt MT, Krueger JG, Ridker PM, Stone N, Roberts WC. AJC editor's consensus: psoriasis and coronary artery disease. Am J Cardiol 2008; 102:1631-43. [PMID: 19064017 DOI: 10.1016/j.amjcard.2008.10.004] [Citation(s) in RCA: 203] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Accepted: 10/29/2008] [Indexed: 11/30/2022]
Affiliation(s)
- Vincent E Friedewald
- Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, Texas, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
El-Gendi SS, Bakeet MY, El-Hamed EA, Ibrahim FK, Ahmed R. The value of lipoprotein (a), homocysteine, and Doppler of carotid and femoral arteries in assessment of atherosclerosis in asymptomatic cardiovascular risk patients. J Cardiol 2008; 52:202-11. [DOI: 10.1016/j.jjcc.2008.08.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2008] [Revised: 06/26/2008] [Accepted: 06/30/2008] [Indexed: 01/07/2023]
|
38
|
Krupinski J, Turu MM, Slevin M, Martínez-González J. Carotid plaque, stroke pathogenesis, and CRP: treatment of ischemic stroke. Curr Cardiol Rep 2008; 10:25-30. [PMID: 18416997 DOI: 10.1007/s11886-008-0006-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
C-reactive protein (CRP), an inflammatory marker, has been identified as a likely predictor of the risk of a future stroke. In clinical settings, it has been consistently observed that higher concentrations of CRP are associated with larger brain infarcts and worst neurologic outcome. However, there is still controversy over the degree of risk conferred by elevated CRP concentrations. CRP, like many other hemostatic factors, is an acute-phase protein and, therefore, it is not always clear whether its association with cerebrovascular disease reflects its contribution to atherothrombosis, its acute-phase condition, or both. Whether a reduction of CRP levels could be beneficial to stroke patients remains to be clarified. More studies are needed before CRP becomes a routine part of the evaluation of stroke patients.
Collapse
Affiliation(s)
- Jerzy Krupinski
- Department of Neurology, Stroke Unit, Hospital Universitari de Bellvitge, Feixa Llarga s/n 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | | | | | | |
Collapse
|
39
|
Uchida H, Nakamura Y, Kaihara M, Norii H, Hanayama Y, Makino H. The MUSCAT study: a Multicenter PROBE Study Comparing the Effects of Angiotensin II Type-1 Receptor Blockers on Self-Monitored Home Blood Pressure in Patients with Morning Hypertension: study design and background characteristics. Hypertens Res 2008; 31:51-8. [PMID: 18360018 DOI: 10.1291/hypres.31.51] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Elevated morning home blood pressure (MHBP) has been reported to have a close relationship to cerebro-cardiovascular events and hypertensive target organ damages, and hence is regarded as a predictor of cardiovascular events. However, there is no evidence that lowering of MHBP can improve morbidity, mortality or target organ damage. In recent guidelines, angiotensin II type-1 receptor blockers (ARBs) are recommended as the first-choice drugs for antihypertensive therapy. Pharmacological characteristics differ among ARBs, and some are suggested to have greater efficacy in lowering MHBP than others. In preparation for the MUSCAT study, we surveyed both self-monitored MHBP and office blood pressure (OBP) in 1,234 patients with essential hypertension. Among them, 367 patients had diabetes mellitus (DM) and 229 suffered from chronic kidney disease (CKD). More than 64% (n=790) of patients had morning hypertension. In MUSCAT, we will investigate the different effects of four ARBs (losartan, candesartan, valsartan, and telmisartan) in patients with morning hypertension, with a focus on the drugs' MHBP-lowering efficiency. Secondly, we will evaluate the different actions of the four ARBs on cardiovascular surrogate markers, such as the brachial-ankle pulse wave velocity, high-sensitive C-reactive protein level, and urinary albumin excretion/creatinine ratio. Patients will be randomized into four arms, and given one of the four "sartans" once daily for 12 months. MHBPs and surrogate markers will be examined at baseline and after 1 year of follow-up. In the stratified analysis, we will determine the significance of MHBP reduction on cardiovascular risk management.
Collapse
Affiliation(s)
- Haruhito Uchida
- Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | | | | | | | | | | |
Collapse
|
40
|
Arcari A, Zito F, Di Castelnuovo A, De Curtis A, Dirckx C, Arnout J, Cappuccio FP, van Dongen MCJM, De Lorgeril M, Krogh V, Siani A, Donati MB, De Gaetano G, Iacoviello L. C reactive protein and its determinants in healthy men and women from European regions at different risk of coronary disease: the IMMIDIET Project. J Thromb Haemost 2008; 6:436-43. [PMID: 18036188 DOI: 10.1111/j.1538-7836.2007.02851.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Differences in C-reactive protein (CRP) levels and its determinants in three European populations at different risk of coronary artery disease (CAD) were studied. METHODS Subjects were recruited randomly in Limburg (Belgium), Abruzzo (Italy) and south-west (SW) London (England). RESULTS Ten-year risk of fatal coronary events (estimated using risk equations provided by the SCORE Project) was lower both in men and women from Abruzzo, intermediate in people from Limburg and higher in subjects from SW London. Within each country, high sensitivity (hs)-CRP levels were higher in the high-risk class in men but not in women. Men from Abruzzo had higher hs-CRP levels than those from Limburg and SW London. Women always had higher hs-CRP levels than men. The strongest hs-CRP determinant was body mass index (BMI, R(2) = 0.14) in women and waist circumference (WC, R(2) = 0.046) in men. The highest hs-CRP levels were observed in subjects with both high BMI and high WC. Metabolic syndrome was associated with high levels of CRP both in men and women, even after adjustment for confounders. DISCUSSION Difference in CRP levels cannot explain the European gradient of CVD risk, although CRP levels are associated with the calculated SCORE risk of fatal coronary events within each country.
Collapse
Affiliation(s)
- A Arcari
- Research Laboratories, John Paul II Centre for High Technology Research and Education in Biomedical Sciences, Catholic University, Campobasso, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Peatman E, Terhune J, Baoprasertkul P, Xu P, Nandi S, Wang S, Somridhivej B, Kucuktas H, Li P, Dunham R, Liu Z. Microarray analysis of gene expression in the blue catfish liver reveals early activation of the MHC class I pathway after infection with Edwardsiella ictaluri. Mol Immunol 2008; 45:553-66. [PMID: 17599411 DOI: 10.1016/j.molimm.2007.05.012] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Accepted: 05/13/2007] [Indexed: 01/03/2023]
Abstract
The acute nature of disease outbreaks in aquaculture settings has served to emphasize the importance of the innate immune response of fish for survival and led to the recent identification and characterization of many of its components. Catfish, the predominant aquaculture species in the United States, is an important model for the study of the teleost immune system. However, transcriptomic-level studies of disease-related gene expression in catfish have only recently been initiated, and understanding of immune responses to pathogen infections is limited. Here, we have developed and utilized a 28K in situ oligonucleotide microarray composed of blue catfish (Ictalurus furcatus) and channel catfish (Ictalurus punctatus) transcripts. While channel catfish accounts for the majority of commercial production, the closely related blue catfish possesses several economically important phenotypic traits. Microarray analysis of gene expression changes in blue catfish liver after infection with Gram-negative bacterium Edwardsiella ictaluri indicated the strong upregulation of several pathways involved in the inflammatory immune response and potentially in innate disease resistance. A multifaceted response to infection could be observed, encompassing the complement cascade, iron regulation, inflammatory cell signaling, and antigen processing and presentation. The induction of several components of the MHC class I-related pathway following infection with an intracellular bacterium is reported here for the first time in fish. A comparison with previously published expression profiles in the channel catfish liver was also made and the microarray results extended by use of quantitative RT-PCR. Our results add to the understanding of the teleost immune responses and provide a solid foundation for future functional characterization, genetic mapping, and QTL analysis of immunity-related genes from catfish.
Collapse
Affiliation(s)
- Eric Peatman
- The Fish Molecular Genetics and Biotechnology Laboratory, Department of Fisheries and Allied Aquacultures, Program of Cell and Molecular Biosciences, Aquatic Genomics Unit, Auburn University, Auburn, AL 36849, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
King DE, Mainous AG, Egan BM, Player M, Geesey ME. Use of statins and blood pressure. Am J Hypertens 2007; 20:937-41. [PMID: 17765132 PMCID: PMC2042140 DOI: 10.1016/j.amjhyper.2007.03.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2006] [Revised: 01/08/2007] [Accepted: 03/31/2007] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Markers of inflammation such as high-sensitivity C-reactive protein (CRP) were shown to be elevated in patients with hypertension. Small trials using statin therapy showed blood-pressure (BP) reductions, but it is unknown whether this association extends to larger populations. The objective of this study was to determine whether statin use was associated with better blood-pressure control in adults with hypertension and whether inflammation levels mediated this relationship. METHODS This was a cross-sectional study of 2584 hypertensive adults aged >or=40 years with no known cardiovascular disease from the National Health and Nutrition Examination Survey 1999-2002. Logistic regression models were calculated to determine whether there was an association between statin use and blood-pressure control. C-reactive protein was added to the full model to determine its impact on the association. RESULTS Compared with people not using statin medication, significantly more statin users had their blood pressure under control (52.2% v 38.0%). After adjustment for demographic factors, statin users were two times (95% confidence interval [CI], 1.46 to 2.72) more likely to have their blood pressure under control (<140/90 mm Hg) than nonusers. After further adjustment for body mass index, diabetes, smoking, exercise, low-salt diet, and antihypertensive medications, the likelihood of having blood pressure under control remained more likely among statin users (odds ratio, 1.46; 95% CI, 1.05 to 2.05). The association between statin use and lower BP was most evident among participants who used antihypertensive medication as well as statins and was unchanged with the addition of CRP to the model. CONCLUSIONS Statin use was associated with a BP level <140/90 mm Hg in a representative sample of US adults with hypertension. Levels of CRP did not attenuate the association. Further studies are needed to explore the effects of statin use on blood pressure and to determine how best to apply this knowledge in clinical care.
Collapse
Affiliation(s)
- Dana E King
- Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
| | | | | | | | | |
Collapse
|
43
|
Chow WS, Cheung BMY, Tso AWK, Xu A, Wat NMS, Fong CHY, Ong LHY, Tam S, Tan KCB, Janus ED, Lam TH, Lam KSL. Hypoadiponectinemia as a predictor for the development of hypertension: a 5-year prospective study. Hypertension 2007; 49:1455-61. [PMID: 17452504 DOI: 10.1161/hypertensionaha.107.086835] [Citation(s) in RCA: 203] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Low circulating levels of adiponectin, an adipokine with insulin-sensitizing, antiatherogenic, and anti-inflammatory properties, are found in hypertensive patients. Adiponectin replenishment ameliorated hypertension in adiponectin-deficient mice or obese, hypertensive mice with hypoadiponectinemia, suggesting an etiologic role of adiponectin in hypertension. We aimed to determine, in this 5-year prospective study, whether hypoadiponectinemia could predict the development of hypertension in a nondiabetic Chinese cohort. A total of 577 subjects (249 men and 328 women) were recruited from the population-based Hong Kong Cardiovascular Risk Factor Prevalence Study and prospectively followed up for 5 years. The relationship of serum adiponectin with the development of hypertension (sitting blood pressure >or=140/90 mm Hg) was investigated in a nested case-control study consisting of 70 subjects who had developed hypertension on follow-up and 140 age- and sex-matched control subjects who were normotensive both at baseline and at year 5. At baseline, serum adiponectin level in the lowest sex-specific tertile was more likely to be associated with hypertension (P=0.003 versus the highest tertile, after adjusting for age, body mass index, fasting insulin, and high-sensitivity C-reactive protein). At year 5, baseline serum adiponectin was a significant independent predictor of incident hypertension in the nested case-control study (P=0.015; age adjusted), together with mean arterial pressure (P<0.001), high-sensitivity C-reactive protein (P=0.018), and body mass index (P=0.004). Normotensive subjects with baseline serum adiponectin levels in the lowest sex-specific tertile had an increased risk of becoming hypertensive (adjusted odds ratio: 2.76; 95% CIs: 1.06 to 7.16; P=0.037 versus highest tertile). Our data suggest that hypoadiponectinaemia may be involved in the pathogenesis of hypertension in humans.
Collapse
Affiliation(s)
- Wing-Sun Chow
- Department of Medicine, University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Rd, Hong Kong, People's Republic of China
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
PURPOSE OF REVIEW To summarize the recommended work-up in a child who presents with elevated blood pressure as well as innovative evaluation techniques under development. RECENT FINDINGS 'The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents' contains several updates on the diagnosis, evaluation and treatment of childhood hypertension. New risk factors for hypertension have been identified and include obesity, sleep apnea, and low birth weight. The roles of uric acid, leptin and C-reactive protein in the pathophysiology of hypertension have been examined. The presence of hypertensive end-organ damage has been demonstrated in hypertensive children. SUMMARY Current knowledge emphasizes the need to diagnose and treat hypertension when it develops in childhood to decrease the risk of cardiovascular morbidity in adulthood. End-organ injury is evident, illustrated by the presence of left ventricular hypertrophy, even in young children. Assessment for the presence of comorbidities and end-organ damage should be emphasized. Further study is needed to isolate the etiologic factors for childhood hypertension, improve evaluation techniques, and determine if end-organ damage is reversible with proper therapy.
Collapse
Affiliation(s)
- Mai Nguyen
- Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA
| | | |
Collapse
|
45
|
Peatman E, Baoprasertkul P, Terhune J, Xu P, Nandi S, Kucuktas H, Li P, Wang S, Somridhivej B, Dunham R, Liu Z. Expression analysis of the acute phase response in channel catfish (Ictalurus punctatus) after infection with a Gram-negative bacterium. DEVELOPMENTAL AND COMPARATIVE IMMUNOLOGY 2007; 31:1183-96. [PMID: 17449095 DOI: 10.1016/j.dci.2007.03.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Revised: 02/01/2007] [Accepted: 03/04/2007] [Indexed: 05/15/2023]
Abstract
The acute phase response (APR) is a set of metabolic and physiological reactions occurring in the host in response to tissue infection or injury and is a crucial component of the larger innate immune response. The APR is best characterized by dramatic changes in the concentration of a group of plasma proteins known as acute phase proteins (APPs) which are synthesized in the liver and function in a wide range of immunity-related activities. Utilizing a new high-density in situ oligonucleotide microarray, we have evaluated the APR in channel catfish liver following infection with Edwardsiella ictaluri, a bacterial pathogen that causes enteric septicemia of catfish. Our catfish microarray design (28K) builds upon a previous 19K channel catfish array by adding recently sequenced immune transcripts from channel catfish along with 7159 unique sequences from closely related blue catfish. The analysis of microarray results using a traditional 2-fold change in gene expression cutoff and a 10% false-discovery rate revealed a well-developed APR in catfish, with particularly high upregulation (>50-fold) of genes involved in iron homeostasis (i.e. intelectin, hemopexin, haptoglobin, ferritin, and transferrin). Other classical APP genes upregulated greater than 2-fold included coagulation factors, proteinase inhibitors, transport proteins, and complement components. Upregulation of the majority of the complement cascade was observed including the membrane attack complex components and complement inhibitors. A number of pathogen recognition receptors (PRRs) and chemokines were also differentially expressed in the liver following infection. Independent testing of a selection of differentially expressed genes with real-time RT-PCR confirmed microarray results.
Collapse
Affiliation(s)
- Eric Peatman
- The Fish Molecular Genetics and Biotechnology Laboratory, Department of Fisheries and Allied Aquacultures and Program of Cell and Molecular Biosciences, Aquatic Genomics Unit, Auburn University, 203 Swingle Hall, Auburn, AL 36849, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|