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da Silva RZ, de Assis Costa F, de Oliveira-Filho AD, Neves SJF. Translation, transcultural adaptation, and validation of the Brazilian Portuguese version of the general medication adherence scale (GMAS) in patients with high blood pressure. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 16:100502. [PMID: 39308553 PMCID: PMC11416553 DOI: 10.1016/j.rcsop.2024.100502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 08/22/2024] [Accepted: 09/04/2024] [Indexed: 09/25/2024] Open
Abstract
Objective To validate the General Medication Adherence Scale (GMAS) in Brazilian Portuguese for hypertensive patients. Methods The GMAS-English was translated into Brazilian Portuguese and adapted for cultural appropriateness by a translation process and expert panel. A cross-sectional study was conducted in northeast Brazilian cardiology divisions of public and private hospitals, interviewing hypertensive patients. Reliability was assessed using Cronbach's alpha, intraclass correlation, and Pearson's correlation. Convergent validity was tested against the BMQ using chi-square. Criterion validity was assessed by comparing GMAS with blood pressure control using chi-square. Results The GMAS was translated and adapted according to standard procedures. In a validation study with 167 hypertensive patients, Cronbach's alpha was 0.79, and Pearson's correlation showed significant test-retest reliability (p < 0.001). Convergent validity with BMQ was significant (p < 0.001), with 89.4 % sensitivity for behaviors considered adherent (High adherence and good adherence), but between the strata that measure low adherence (Partial adherence, low adherence and very low adherence), the specificity rate was 50 %. Criterion validity between GMAS and blood pressure control was not observed. Conclusion The Brazilian Portuguese version of the GMAS exhibited good consistency and reproducibility, modest agreement with BMQ scale and did not demonstrate acceptable criterion validity for hypertensive patients.
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Dong B, Zhao Y, Wang J, Lu C, Chen Z, Ma R, Bi H, Wang J, Wang Y, Ding X, Li Y. Epidemiological analysis of chronic kidney disease from 1990 to 2019 and predictions to 2030 by Bayesian age-period-cohort analysis. Ren Fail 2024; 46:2403645. [PMID: 39297199 DOI: 10.1080/0886022x.2024.2403645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 08/15/2024] [Accepted: 09/06/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Chronic Kidney Disease (CKD) has emerged as a significant global health issue. This study aimed to reveal and predict the epidemiological characteristics of CKD. METHODS Data from the Global Burden of Disease Study spanning the years 1990 to 2019 were employed to analyze the incidence, prevalence, death, and disability-adjusted life year (DALY) of CKD. Joinpoint analysis assessed epidemiological trends of CKD from 1990 to 2019. An age-period-cohort model evaluated risk variations. Risk factor analysis uncovered their influences on DALYs and deaths of CKD. Decomposition analysis explored the drivers to CKD. Frontier analysis evaluated the correlations between CKD burden and the sociodemographic index (SDI). A Bayesian Age-Period-Cohort model was employed to predict future incidence and death of CKD. RESULTS In 2019, there were 18,986,903 incident cases, 697,294,307 prevalent cases, 1,427,232 deaths, and 41,538,592 DALYs of CKD globally. Joinpoint analysis showed increasing age-standardized rates of CKD incidence, prevalence, mortality, and DALY from 1990 to 2019. High systolic blood pressure significantly contributed to CKD-related deaths and DALYs, particularly in the high SDI region. Decomposition analysis identified population growth as the primary driver of CKD incident cases and DALYs globally. Countries like Nicaragua showed the highest effective differences, indicating room for improvement in CKD management. By 2030, while incident cases of CKD were predicted to rise, the global deaths might decrease. CONCLUSIONS The study revealed a concerning upward trend in the global burden of CKD, emphasizing the need for targeted management strategies across different causes, regions, age groups, and genders.
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Affiliation(s)
- Boqing Dong
- Department of Renal Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yuting Zhao
- Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jiale Wang
- Department of Renal Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Cuinan Lu
- Department of Renal Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zuhan Chen
- Department of Renal Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ruiyang Ma
- Department of Renal Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Huanjing Bi
- Department of Renal Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jingwen Wang
- Department of Renal Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ying Wang
- Department of Renal Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoming Ding
- Department of Renal Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yang Li
- Department of Renal Transplantation, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Farih OA, Ali AO, Abokor AH, Ali MA, Egge AAA, Muse AH. Prevalance and determinants of hypertension among adults in Somalia using Somalia demographic health survey data, SDHS 2020. Curr Probl Cardiol 2024; 49:102783. [PMID: 39127429 DOI: 10.1016/j.cpcardiol.2024.102783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 08/07/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Hypertension, a major global health concern, continues to affect millions of adults worldwide, leading to significant morbidity and mortality. The burden of hypertension is particularly pronounced in low- and middle-income countries, where limited healthcare resources and infrastructure pose unique challenges for effective prevention and management. Despite the pressing need for accurate data on hypertension prevalence and determinants, there is a dearth of research focusing on the Somali population. In this study, we aim to fill this critical knowledge gap by analyzing the latest available data from the Somalia Demographic Health Survey (SDHS) conducted in 2020. METHOD The SDHS 2020 employed a three-stage stratified cluster sampling design to collect data from 48,796 individuals. Hypertension was measured through survey questions related to chronic diseases. Explanatory variables included age, sex, region, residence, tobacco use, wealth index, marital status, and body mass index (BMI). Statistical analysis involved univariate and multivariable logistic regression. RESULTS The prevalence of hypertension in Somalia was found to be 2.11%, lower than previous studies in Hargeisa and the SLHDS 2020 report. Females had a higher prevalence than males, and urban areas exhibited higher rates compared to rural areas. Age, BMI, region, and wealth index were identified as significant factors associated with hypertension. DISCUSSION The study's findings contribute to the understanding of hypertension in the Somali population and can inform public health interventions. The study benefits from its representative sample, multivariate analysis, and comparison with earlier studies. However, limitations include the cross-sectional design, limited information on lifestyle behaviors, and lack of data on treatment and control of hypertension. CONCLUSION Hypertension is a public health concern in Somalia, and targeted interventions are needed to reduce its burden. Addressing factors such as age, gender, urban residence, BMI, and wealth index can contribute to hypertension management and control strategies. Future research should consider longitudinal studies and incorporate additional factors for a comprehensive assessment of hypertension etiology and management.
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Affiliation(s)
- Omer Adam Farih
- Faculty of Science and Humanities, School of Postgraduate Studies and Research (SPGSR), Amoud University, Borama 25263, Somalia
| | - Abdirahman Omer Ali
- Faculty of Science and Humanities, School of Postgraduate Studies and Research (SPGSR), Amoud University, Borama 25263, Somalia; School of Medicine and Surgery, College of Health Sciences, Amoud University, Amoud Valley, Borama, 25263, Somalia.
| | - Abdirizak Hassan Abokor
- Faculty of Science and Humanities, School of Postgraduate Studies and Research (SPGSR), Amoud University, Borama 25263, Somalia
| | - Mustafe Abdillahi Ali
- Faculty of Science and Humanities, School of Postgraduate Studies and Research (SPGSR), Amoud University, Borama 25263, Somalia
| | - Ahmed Abdi Aw Egge
- School of Medicine and Surgery, College of Health Sciences, Amoud University, Amoud Valley, Borama, 25263, Somalia
| | - Abdisalam Hassan Muse
- Faculty of Science and Humanities, School of Postgraduate Studies and Research (SPGSR), Amoud University, Borama 25263, Somalia
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Zare P, Poustchi H, Mohammadi Z, Mesgarpour B, Akbari M, Kamalipour A, Abdipour-Mehrian SR, Hashemi ES, Ghamar-Shooshtari A, Hosseini SA, Malekzadeh R, Bazrafshan Drissi H, Malekzadeh F, Molavi Vardanjani H. Polypharmacy and medication usage patterns in hypertensive patients: Findings from the Pars Cohort Study. Res Social Adm Pharm 2024; 20:1038-1046. [PMID: 39098543 DOI: 10.1016/j.sapharm.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 05/19/2024] [Accepted: 07/31/2024] [Indexed: 08/06/2024]
Abstract
Polypharmacy, defined here as the concomitant use of five or more medications, is a significant health issue, particularly affecting individuals with chronic diseases like hypertension (HTN). To compare individuals with and without HTN in term of polypharmacy, and to investigate correlates of polypharmacy and medication use patterns in individuals with HTN in southwest Iran. This cross-sectional study used the baseline data of 9270 participants of the Pars Cohort Study (PCS) with a mean age of 52.6 ± 9.7 years. Poisson multivariable modeling was applied to identify correlates of polypharmacy, and Lexicomp® was used to assess drug-drug interactions. Anatomical Therapeutic Chemical classification was used to describe the pattern of medication use. The prevalence of polypharmacy in individuals without hypertension was 4.7 % (4.2%-5.2 %) vs. 23.7 % (22.1%-25.3 %) in individuals with hypertension (P < 0.001). Individuals with hypertension from middle-high socioeconomic status (SES) had a 1.51-fold higher prevalence of polypharmacy than vs. low SES. Those with more than three comorbidities had a 5.18 times higher prevalence of polypharmacy than those with isolated hypertension. Calcium channel blockers were the most common antihypertensives (20.9 %). In terms of drug-drug interactions, type C interactions were most prevalent among participants with hypertension and polypharmacy (76.0 %). Our findings imply a fairly high prevalence of polypharmacy and drug-drug interactions among individuals with hypertension; to tackle this issue, we recommend a national pharmacovigilance system, training programs for primary care physicians, public education and awareness campaigns, drug-checking campaigns, targeted screenings to alter modifiable risk factors, and the use of safe combination pills.
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Affiliation(s)
- Pooria Zare
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Mesgarpour
- Research and Technology, National Institute for Medical Research and Development (NIMAD), Tehran, Iran
| | - Mohammadreza Akbari
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Alireza Kamalipour
- Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, CA, USA
| | | | - Elham-Sadat Hashemi
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arash Ghamar-Shooshtari
- MPH Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Ophtalmology Resident of Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Hosseini
- Postdoctoral Researcher, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Malekzadeh
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Bazrafshan Drissi
- Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Malekzadeh
- Digestive Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Molavi Vardanjani
- MPH Department, School of Medicine, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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Carrillo-Larco RM. Cardiovascular predicted risk: A population-based comparison of the pooled cohorts equation and PREVENT. Int J Cardiol 2024; 414:132423. [PMID: 39102945 DOI: 10.1016/j.ijcard.2024.132423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/24/2024] [Accepted: 08/01/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND While the new cardiovascular risk score (PREVENT) has improvements, its implementation may lead to significant changes in the distribution of atherosclerotic cardiovascular diseases (ASCVD) in the United States. We aimed to quantify and characterize the distribution of the 10-year predicted absolute ASCVD risk using the Pooled Cohorts Equation (PCE) and PREVENT. METHODS We utilized the latest (2017-March 2020) round of the National Health and Nutrition Examination Survey (NHANES). Accounting for the complex survey design of the NHANES, we computed the mean predicted ASCVD risk overall and by sex, race, and education; similarly, we computed the prevalence of cardiovascular risk groups (<5%, 5%-7.4%, 7.5%-19.9%, and ≥ 20%). RESULTS The study included 3845 observations, representing 109,692,509 people. Using the PREVENT calculator resulted in a reduction of the mean 10-year ASCVD absolute risk by half compared to the PCE: 9.1% vs 4.7%. Under the PCE, the high-risk category accounted for 12.5% of the population, whereas under PREVENT it fell to 0.4%. Among those previously classified as high-risk under the PCE, 3.5% would remain in this category with PREVENT, while 93% would be reclassified as intermediate risk. CONCLUSIONS The adoption of the novel cardiovascular risk score, PREVENT, could lower the average predicted ASCVD risk and reduce the prevalence of high-risk individuals. While this shift might suggest improved cardiovascular health, it could also lead to complacency, potentially undermining ongoing public health efforts aimed at preventing cardiovascular disease.
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Gottlieb LA, Mahfoud F, Stavrakis S, Jespersen T, Linz D. Autonomic Nervous System: A Therapeutic Target for Cardiac End-Organ Damage in Hypertension. Hypertension 2024; 81:2027-2037. [PMID: 39136127 PMCID: PMC11404762 DOI: 10.1161/hypertensionaha.123.19460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Abstract
More than 1.5 billion people worldwide have arterial hypertension. Hypertension increases the risks of death and cardiovascular disease, such as atrial fibrillation and heart failure. The autonomic nervous system plays an essential role in hypertension development and disease progression. While lifestyle factors, such as obesity and obstructive sleep apnea, predispose to hypertension by increasing sympathetic activity, hypertension itself maintains the autonomic nervous imbalance, providing the substrate for atrial fibrillation and heart failure. Therefore, autonomic nervous system modulation either by direct targeting or indirect treatment of comorbidities has the potential to treat both hypertension and related atrial and ventricular end-organ damage. We discuss interventions for the modulation of the autonomic nervous system for hypertension and related cardiac end-organ damage, including pharmacological adrenergic beta-receptor blockade, renal denervation, carotid baroreceptor stimulation, low-level vagal stimulation, and ablation of ganglionated plexuses. In summary, the literature suggests that targeting the autonomic nervous system potentially represents a therapeutic approach to prevent atrial and ventricular end-organ damage in patients with hypertension. However, clinical trials specifically designed to test the effect of autonomic modulation on hypertension-mediated cardiac end-organ damage are scarce.
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Affiliation(s)
- Lisa A Gottlieb
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (L.A.G., T.J., D.L.)
| | - Felix Mahfoud
- Department of Internal Medicine III, Cardiology, Angiology, and Intensive Care Medicine, Saarland University Hospital, Homburg, Germany (F.M.)
| | - Stavros Stavrakis
- Department of Internal Medicine, Cardiovascular Section, University of Oklahoma Health Sciences Center, Oklahoma City (S.S.)
| | - Thomas Jespersen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (L.A.G., T.J., D.L.)
| | - Dominik Linz
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (L.A.G., T.J., D.L.)
- Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, the Netherlands (D.L.)
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Øvretveit K, Ingeström EML, Spitieris M, Tragante V, Thomas LF, Steinsland I, Brumpton BM, Gudbjartsson DF, Holm H, Stefansson K, Wisløff U, Hveem K. Polygenic Interactions With Environmental Exposures in Blood Pressure Regulation: The HUNT Study. J Am Heart Assoc 2024:e034612. [PMID: 39291479 DOI: 10.1161/jaha.123.034612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/10/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND The essential hypertension phenotype results from an interplay between genetic and environmental factors. The influence of lifestyle exposures such as excess adiposity, alcohol consumption, tobacco use, diet, and activity patterns on blood pressure (BP) is well established. Additionally, polygenic risk scores for BP traits are associated with clinically significant phenotypic variation. However, interactions between genetic and environmental risk factors in hypertension morbidity and mortality are poorly characterized. METHODS AND RESULTS We used genotype and phenotype data from up to 49 234 participants from the HUNT (Trøndelag Health Study) to model gene-environment interactions between genome-wide polygenic risk scores for systolic BP and diastolic BP and 125 environmental exposures. Among the 125 environmental exposures assessed, 108 and 100 were independently associated with SBP and DBP, respectively. Of these, 12 interactions were identified for genome-wide PRSs for systolic BP and 4 for genome-wide polygenic risk scores for diastolic BP, 2 of which were overlapping (P < 2 × 10-4). We found evidence for gene-dependent influence of lifestyle factors such as cardiorespiratory fitness, dietary patterns, and tobacco exposure, as well as biomarkers such as serum cholesterol, creatinine, and alkaline phosphatase on BP. CONCLUSIONS Individuals that are genetically susceptible to high BP may be more vulnerable to common acquired risk factors for hypertension, but these effects appear to be modifiable. The gene-dependent influence of several common acquired risk factors indicates the potential of genetic data combined with lifestyle assessments in risk stratification, and gene-environment-informed risk modeling in the prevention and management of hypertension.
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Affiliation(s)
- Karsten Øvretveit
- HUNT Center for Molecular and Clinical Epidemiology (MCE), Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Emma M L Ingeström
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Michail Spitieris
- HUNT Center for Molecular and Clinical Epidemiology (MCE), Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
- Department of Mathematical Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | | | - Laurent F Thomas
- HUNT Center for Molecular and Clinical Epidemiology (MCE), Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
- Department of Clinical and Molecular Medicine Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Ingelin Steinsland
- Department of Mathematical Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Ben M Brumpton
- HUNT Center for Molecular and Clinical Epidemiology (MCE), Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
- HUNT Research Centre, Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Levanger Norway
| | - Daniel F Gudbjartsson
- deCODE Genetics/Amgen Inc. Reykjavik Iceland
- School of Engineering and Natural Sciences University of Iceland Reykjavik Iceland
| | - Hilma Holm
- deCODE Genetics/Amgen Inc. Reykjavik Iceland
| | - Kari Stefansson
- deCODE Genetics/Amgen Inc. Reykjavik Iceland
- Faculty of Medicine University of Iceland Reykjavik Iceland
| | - Ulrik Wisløff
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Kristian Hveem
- HUNT Center for Molecular and Clinical Epidemiology (MCE), Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
- Department of Innovation and Research, St. Olav's Hospital Trondheim Norway
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Sun J, Chen Y, Zhao X, Niu Z, Gu Z, Yan Z, Wang W. Effect and interaction of PINK1 genetic polymorphisms and environmental factors on blood pressure in COEs-exposed workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-12. [PMID: 39295235 DOI: 10.1080/09603123.2024.2403685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 09/09/2024] [Indexed: 09/21/2024]
Abstract
Coke oven emissions (COEs) contain a variety of polycyclic aromatic hydrocarbons (PAHs), which can cause damage to the human cardiovascular system. In addition, myocardial mitochondria are susceptible to damage in hypertensive patients. However, it is not clear whether genetic variation, in single nucleotide polymorphisms (SNPs) in PINK1 affects COEs exposure-induced abnormal blood pressure. We surveyed and tested 518 workers exposed to COEs and statistically analyzed them with SPSS 21.0 software. SBP was greater in the high-exposure group than in the low-exposure group. Generalized linear model analysis showed that the interaction of PINK1 rs3738136 (GA+AA) and COEs had an effect on SBP [β(95%CI) = -6.537(-12.072, -1.002), p = 0.021] and DBP [β(95%CI) = -4.811(-8.567, -1.056), p = 0.012]. This study is the first to identify the role of PINK1 rs3738136 in COE- induced abnormal blood pressure, and to prove that the abnormal blood pressure of workers is the result of environmental and genetic factors.
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Affiliation(s)
- Jing Sun
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Yang Chen
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Xiangkai Zhao
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Zeming Niu
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Zhiguang Gu
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Zhaofan Yan
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Wei Wang
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
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Mugo JW, Day C, Choudhury A, Deetlefs M, Freercks R, Geraty S, Panieri A, Cotchbos C, Ribeiro M, Engelbrecht A, Micklesfield LK, Ramsay M, Pedretti S, Peter J. A GWAS of ACE Inhibitor-Induced Angioedema in a South African Population. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.09.13.24313664. [PMID: 39314982 PMCID: PMC11419215 DOI: 10.1101/2024.09.13.24313664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Background Angiotensin-converting enzyme inhibitor-induced angioedema (AE-ACEI) is a life-threatening adverse event and, globally, the commonest cause of emergency presentations with angioedema. Several large genome-wide association studies (GWAS) have found genomic associations with AE-ACEI. However, despite African Americans having a 5-fold increased risk of AE-ACEI, there are no published GWAS from Africa. The aim of this study was to conduct a case-control GWAS of AE-ACEI in a South African population and perform a meta-analysis with an African American and European American population. Methods The GWAS included 202 South African adults with a history of AE-ACEI and 513 controls without angioedema following angiotensin-converting enzyme inhibitor (ACEI) treatment for at least 2 years. A meta-analysis was conducted with GWAS summary statistics from an African American and European American cohort (from Vanderbilt/Marshfield with 174 cases and 489 controls). Results No SNPs attained genome-wide significance. However, 26 SNPs in the post-imputation standard GWAS of the South African cohort and 37 SNPs in the meta-analysis were associated to AE-ACEI with suggestive threshold(p-value<5.0×10 -06 ). Some of these SNPs were found to be located close to the genes PRKCQ and RIMS1, previously linked with drug-induced angioedema, and also close to the CSMD1 gene linked to ACEI cough, providing replication at the gene level, but with novel lead SNPs. Conclusions Our results highlight the importance of African populations to detect novel variants in replication studies. Further increased sampling across the continent and matched functional work are needed to confirm the importance of genetic variation in understanding the biology of AE-ACEI.
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Sukumaran R, Nair AS, Banerjee M. Ethnic and region-specific genetic risk variants of stroke and its comorbid conditions can define the variations in the burden of stroke and its phenotypic traits. eLife 2024; 13:RP94088. [PMID: 39268810 PMCID: PMC11398864 DOI: 10.7554/elife.94088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2024] Open
Abstract
Burden of stroke differs by region, which could be attributed to differences in comorbid conditions and ethnicity. Genomewide variation acts as a proxy marker for ethnicity, and comorbid conditions. We present an integrated approach to understand this variation by considering prevalence and mortality rates of stroke and its comorbid risk for 204 countries from 2009 to 2019, and Genome-wide association studies (GWAS) risk variant for all these conditions. Global and regional trend analysis of rates using linear regression, correlation, and proportion analysis, signifies ethnogeographic differences. Interestingly, the comorbid conditions that act as risk drivers for stroke differed by regions, with more of metabolic risk in America and Europe, in contrast to high systolic blood pressure in Asian and African regions. GWAS risk loci of stroke and its comorbid conditions indicate distinct population stratification for each of these conditions, signifying for population-specific risk. Unique and shared genetic risk variants for stroke, and its comorbid and followed up with ethnic-specific variation can help in determining regional risk drivers for stroke. Unique ethnic-specific risk variants and their distinct patterns of linkage disequilibrium further uncover the drivers for phenotypic variation. Therefore, identifying population- and comorbidity-specific risk variants might help in defining the threshold for risk, and aid in developing population-specific prevention strategies for stroke.
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Affiliation(s)
- Rashmi Sukumaran
- Human Molecular Genetics Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
- Department of Computational Biology and Bioinformatics, University of Kerala, Thiruvananthapuram, India
| | - Achuthsankar S Nair
- Department of Computational Biology and Bioinformatics, University of Kerala, Thiruvananthapuram, India
| | - Moinak Banerjee
- Human Molecular Genetics Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
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Swambulu TM, Mundedi YS, Nsimbi YL, Bompeka FL, Natuhoyila AN, Risasi JRM, Ilunga C, Kintoki Vita E, Kiese DK, Onembo NO, Minga RK, Madoda OT, M'buyamba-Kabangu JR, Phanzu BK. Masked uncontrolled hypertension among elderly black sub-saharan africans compared to younger adults: a cross-sectional in-hospital study. BMC Cardiovasc Disord 2024; 24:472. [PMID: 39232715 PMCID: PMC11373142 DOI: 10.1186/s12872-024-04150-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 08/29/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Although aging and being of African descent are well-known risk factors for masked uncontrolled hypertension (MUCH), data on MUCH among elderly black sub-Saharan Africans (BSSA) are limited. Furthermore, it is unclear whether the determinants of MUCH in younger individuals differ from those in the elderly. OBJECTIVE This study aimed to determine the prevalence and risk factors associated with MUCH in both elderly and younger BSSA individuals. METHODS In this study, 168 patients with treated hypertension were assessed for medical history, clinical examination, fundoscopy, echocardiography, and laboratory data. All patients underwent ambulatory blood pressure (BP) monitoring for 24 h. MUCH was diagnosed if the average 24-h mean BP ≥ 130/80 mmHg, the daytime mean BP ≥ 135/85 mmHg, and/or the nighttime mean BP ≥ 120/70 mmHg, despite controlled clinic BP (≤ 140/90 mmHg). Logistic regression analysis was performed to assess independent factors associated with MUCH, including elderly and younger adults separately. P-values < 0.05 were used to indicate statistical significance. RESULTS Of the 168 patients aged 53.6 ± 11.6 years, 92 (54.8%) were men, with a sex ratio of 1.2, and, 66 (39%) were aged ≥ 60 years. The proportion of patients with MUCH (27.4% for all patients) was significantly higher (p = 0.002) among elderly patients than among younger patients (45.5% vs. 15.7%). Diabetes mellitus (adjusted odds ratio [aOR], 2.44; 95% confidence interval [CI], 1.27-4.46; p = 0.043), anemia (aOR, 3.18; 95% CI, 1.07-5.81; p = 0.043), hypertensive retinopathy (aOR, 4.50; 95% CI, 1.57-5.4; p = 0.043), and left ventricular hypertrophy (aOR, 4.48; 95% CI, 2.26-8.35; p = 0.043) were independently associated with MUCH in the elderly. In younger individuals, male gender (aOR, 2.16; 95% CI, (1.33-4.80); p = 0.029), obesity (aOR, 3.02; 95% CI, (1.26-5.32); p = 0.001), and left ventricular hypertrophy (LVH) (aOR, 3.08; 95% CI, (2.14-6.24); p = 0.019) were independently associated with MUCH were independently associated with MUCH. CONCLUSION MUCH is more prevalent among elderly than among younger BSSA individuals. Determinants of MUCH vary by age. MUCH prevention and management strategies should be age-specific.
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Affiliation(s)
- Tresor Mvunzi Swambulu
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - Yannick Samafundu Mundedi
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - Yves Lubenga Nsimbi
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - François Lepira Bompeka
- Division of Nephrology, Department of Internal Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Aliocha Nkodila Natuhoyila
- Department of Family Medicine and Primary Health Care, Protestant University in the Congo, Kinshasa, Democratic Republic of Congo
| | - Jean-Robert Makulo Risasi
- Division of Nephrology, Department of Internal Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Cédric Ilunga
- Division of Nephrology, Department of Internal Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Eleuthère Kintoki Vita
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - Diane Kuntonda Kiese
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - Noel Otshudi Onembo
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo
| | - Roger Kongo Minga
- Unit of cardiology, Clinique Ngaliema, Kinshasa, Democratic Republic of Congo
| | | | | | - Bernard Kianu Phanzu
- Cardiology Unit, University of Kinshasa, Kinshasa 1, PO Box 1038, Kinshasa, Democratic Republic of Congo.
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12
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Ito S, Watanabe S, Komatsu H, Nagasaka K, Palai D, Maki N, Tai T, Sugai K, Kawamura T, Sato Y, Taguchi T. Development of a Janus tissue adhesive hemostatic patch based on hydrophobically-modified Alaska pollock gelatin. BIOMATERIALS ADVANCES 2024; 166:214028. [PMID: 39244829 DOI: 10.1016/j.bioadv.2024.214028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/24/2024] [Accepted: 09/02/2024] [Indexed: 09/10/2024]
Abstract
Uncontrollable hemorrhage from trauma and open surgery leads to a high percentage of death. Even though some patch-type hemostatic materials have been used in the clinic, sufficient tissue adhesion property and the management of tissue adhesion and anti-adhesion have been the challenges. In this report, we designed Janus tissue adhesive hemostatic patch, consisting of Alaska pollock gelatin (Org-ApGltn) as a support layer and decanoyl group-modified ApGltn (C10-ApGltn) with pentaerythritol poly(ethylene glycol) ether tetrasuccinimidyl glutarate (4S-PEG) as an adhesive layer, named as the C10-ApGltn patch. The C10-ApGltn patch adhered onto blood vessel surface by the activation 4S-PEG and hydrophobic groups in C10-ApGltn through the covalent bond formation and physical interaction. The burst strength of the C10-ApGltn patch was optimized in terms of the degree of substitution, the molecular weight of 4S-PEG, the concentration of C10-ApGltn, and the NHS/NH2 ratio. The optimized C10-ApGltn patch showed significantly higher burst strength with commercially available TachoSil®. The C10-ApGltn patch showed enzymatic degradability in a buffer solution with collagenase. In a rat liver hemorrhage model, the C10-ApGltn patch acted as a sealant on the hemorrhage site and exhibited competitive hemostatic property to TachoSil®.
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Affiliation(s)
- Shima Ito
- Biomaterials field, Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan; Graduate School of Science and Technology, Degree Programs in Pure and Applied Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
| | - Shiharu Watanabe
- Biomaterials field, Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan
| | - Hiyori Komatsu
- Biomaterials field, Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan; Graduate School of Science and Technology, Degree Programs in Pure and Applied Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
| | - Kazuhiro Nagasaka
- Biomaterials field, Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan; Graduate School of Science and Technology, Degree Programs in Pure and Applied Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
| | - Debabrata Palai
- Biomaterials field, Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan
| | - Naoki Maki
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
| | - Tetsuo Tai
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
| | - Kazuto Sugai
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
| | - Tomoyuki Kawamura
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
| | - Yukio Sato
- Department of Thoracic Surgery, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan
| | - Tetsushi Taguchi
- Biomaterials field, Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan; Graduate School of Science and Technology, Degree Programs in Pure and Applied Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8577, Japan.
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13
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Chesnaye NC, Ortiz A, Zoccali C, Stel VS, Jager KJ. The impact of population ageing on the burden of chronic kidney disease. Nat Rev Nephrol 2024; 20:569-585. [PMID: 39025992 DOI: 10.1038/s41581-024-00863-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2024] [Indexed: 07/20/2024]
Abstract
The burden of chronic kidney disease (CKD) and its risk factors are projected to rise in parallel with the rapidly ageing global population. By 2050, the prevalence of CKD category G3-G5 may exceed 10% in some regions, resulting in substantial health and economic burdens that will disproportionately affect lower-income countries. The extent to which the CKD epidemic can be mitigated depends largely on the uptake of prevention efforts to address modifiable risk factors, the implementation of cost-effective screening programmes for early detection of CKD in high-risk individuals and widespread access and affordability of new-generation kidney-protective drugs to prevent the development and delay the progression of CKD. Older patients require a multidisciplinary integrated approach to manage their multimorbidity, polypharmacy, high rates of adverse outcomes, mental health, fatigue and other age-related symptoms. In those who progress to kidney failure, comprehensive conservative management should be offered as a viable option during the shared decision-making process to collaboratively determine a treatment approach that respects the values and wishes of the patient. Interventions that maintain or improve quality of life, including pain management and palliative care services when appropriate, should also be made available.
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Affiliation(s)
- Nicholas C Chesnaye
- ERA Registry, Amsterdam UMC location University of Amsterdam, Medical Informatics, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Alberto Ortiz
- Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
- RICORS2040, Madrid, Spain
| | - Carmine Zoccali
- Associazione Ipertensione Nefrologia Trapianto Renale (IPNET), c/o Nefrologia, Grande Ospedale Metropolitano, Reggio Calabria, Italy
- Institute of Molecular Biology and Genetics (Biogem), Ariano Irpino, Italy
- Renal Research Institute, New York, NY, USA
| | - Vianda S Stel
- ERA Registry, Amsterdam UMC location University of Amsterdam, Medical Informatics, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Kitty J Jager
- ERA Registry, Amsterdam UMC location University of Amsterdam, Medical Informatics, Amsterdam, Netherlands.
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands.
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14
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Lundblad LC, Eskelin JJ, Karlsson T, Elam M. Inhibition of muscle sympathetic nerve activity in premenopausal women: responses to sudden sensory stimuli predict responses to mental stress. J Appl Physiol (1985) 2024; 137:757-764. [PMID: 39052769 DOI: 10.1152/japplphysiol.00748.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 07/05/2024] [Accepted: 07/22/2024] [Indexed: 07/27/2024] Open
Abstract
Muscle sympathetic nerve responses to sudden sensory stimuli have been elucidated in several studies on young healthy men, showing reproducible interindividual differences ranging from varying degrees of inhibition to no significant change, with very few subjects showing significant excitation. These individual response patterns have been shown to predict the neural response to mental stress and coupled blood pressure responses. The aim of this study was to investigate whether premenopausal healthy women show similar neural and blood pressure responses. Muscle sympathetic nerve recordings from the peroneal nerve were performed in 34 healthy women (mean age 27 ± 8 yr) during sudden sensory stimuli (electrical stimuli to a finger) and 3 min of mental stress (forced arithmetics). After sensory stimuli, 18 women showed varying degrees of inhibition of muscle sympathetic nerve activity (burst amplitude mean reduction 60%, range 34-100%). The remaining 16 showed no inhibition (mean 5%, range -31 to 28%; one subject exhibiting excitation). During 3 min of mental stress, the normalized change in burst incidence for muscle sympathetic nerve activity correlated with the percentage change of muscle sympathetic nerve activity induced by the sensory stimulation protocol (r = 0.64, P = 0.0042). In contrast to men, the neural responses did not predict changes in blood pressure. Thus, premenopausal females show a similar range of individual differences in defense-related muscle sympathetic neural responses as men, but no associated differences in blood pressure responses. Whether these patterns are unchanged after menopause remains to be investigated.NEW & NOTEWORTHY Muscle sympathetic neural responses to sudden sensory stimuli in premenopausal women showed interindividual differences and the distribution of sympathetic responses was similar to that previously found in men. Despite this similarity, the associated differences in transient blood pressure responses seen in men were not found in women. The increased risk of developing hypertension in postmenopausal women warrants an investigation of whether these response patterns are altered after menopause.
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Affiliation(s)
- Linda C Lundblad
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Neurophysiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - John J Eskelin
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Tomas Karlsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Elam
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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15
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Amstutz C, Ilic M, Fontaine N, Siegenthaler L, Illi J, Haeberlin A, Zurbuchen A, Burger J. Development of a patient-specific model of the human coronary system for percutaneous transluminal coronary angioplasty balloon catheter training and testing. Biomed Eng Online 2024; 23:89. [PMID: 39215308 PMCID: PMC11363638 DOI: 10.1186/s12938-024-01271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/22/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND To treat stenosed coronary arteries, percutaneous transluminal coronary angioplasty (PTCA) balloon catheters must combine pushability, trackability, crossability, and rewrap behavior. The existing anatomic track model (ASTM F2394) for catheter testing lacks 3D morphology, vessel tortuosity, and compliance, making evaluating performance characteristics difficult. This study aimed to develop a three-dimensional patient-specific phantom (3DPSP) for device testing and safe training for interventional cardiologists. METHODS A range of silicone materials with different shore hardnesses (00-30-45 A) and wall thicknesses (0.5 mm, 1 mm, 2 mm) were tested to determine compliance for creating coronary vessel phantoms. Compliance was assessed using optical coherence tomography (OCT) and compared to values in the literature. Stenosis was induced using multilayer casting and brushing methods, with gypsum added for calcification. The radial tensile properties of the samples were investigated, and the relationship between Young's modulus and compliance was determined. Various methods have been introduced to approximate the friction between silicone and real coronary vessel walls. Computerized tomography (CT) scans were used to obtain patient-specific anatomy from the femoral artery to the coronary arteries. Artery lumens were segmented from the CT scans to create dissolvable 3D-printed core models. RESULTS A 15A shore hardness silicone yielded an experimental compliance of 12.3-22.4m m 2 mmHg · 10 3 for stenosed tubes and 14.7-57.9m m 2 mmHg · 10 3 for uniform tubes, aligning closely with the literature data (6.28-40.88m m 2 mmHg · 10 3 ). The Young's modulus ranged from 43.2 to 75.5 kPa and 56.6-67.9 kPa for the uniform and calcified materials, respectively. The dependency of the compliance on the wall thickness, Young's modulus, and inner diameter could be shown. Introducing a lubricant reduced the silicone friction coefficient from 0.52 to 0.13. The 3DPSP was successfully fabricated, and comparative analyses were conducted among eight commercially available catheters. CONCLUSION This study presents a novel method for crafting 3DPSPs with realistic mechanical and frictional properties. The proposed approach enables the creation of comprehensive and anatomically precise setups spanning the right femoral artery to the coronary arteries, highlighting the importance of such realistic environments for advancing medical device development and fostering safe training conditions.
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Affiliation(s)
- C Amstutz
- School of Biomedical and Precision Engineering, Faculty of Medicine, University of Bern, Güterstrasse 24/26, CH-3010, Bern, Switzerland.
| | - M Ilic
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - N Fontaine
- School of Biomedical and Precision Engineering, Faculty of Medicine, University of Bern, Güterstrasse 24/26, CH-3010, Bern, Switzerland
| | - L Siegenthaler
- School of Biomedical and Precision Engineering, Faculty of Medicine, University of Bern, Güterstrasse 24/26, CH-3010, Bern, Switzerland
| | - J Illi
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - A Haeberlin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - A Zurbuchen
- School of Biomedical and Precision Engineering, Faculty of Medicine, University of Bern, Güterstrasse 24/26, CH-3010, Bern, Switzerland
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - J Burger
- School of Biomedical and Precision Engineering, Faculty of Medicine, University of Bern, Güterstrasse 24/26, CH-3010, Bern, Switzerland
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16
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Liu AB, Lin YX, Meng TT, Tian P, Chen JL, Zhang XH, Xu WH, Zhang Y, Zhang D, Zheng Y, Su GH. Global prevalence and disability-adjusted life years of hypertensive heart disease: A trend analysis from the Global Burden of Disease Study 2019. J Glob Health 2024; 14:04172. [PMID: 39212657 PMCID: PMC11364089 DOI: 10.7189/jogh.14.04172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Background As hypertensive heart disease (HHD) presents a significant public health challenge globally, we analysed its global, regional, and national burdens and trends from 1990 to 2019. Methods We used data from the Global Burden of Disease (GBD) 2019 study, focussing on the age-standardised prevalence rates (ASPRs) of HHD prevalence, age-standardised disability-adjusted life year (DALY) rates, average annual percentage change (AAPC), and risk factor attributions. We compared the HHD burden across sociodemographic index (SDI) strata, gender, age groups, and 204 countries and territories. Results In 2019, the global prevalence of HHD was estimated at 18 598 thousand cases, with DALYs reaching 21 508 thousand. From 1990 to 2019, the ASPRs increased (AAPC = 0.21; 95% confidence interval (CI) = 0.17, 0.24), while the age-standardised DALY rates decreased (AAPC = -0.45; 95% CI = -1.23, -0.93). We observed the highest increase in ASPRs in high-middle SDI quantile countries, and an overall negative correlation between age-standardised DALY rates and SDI. Individuals above 70 years of age were the most affected, particularly elderly women. There has been a significant increase in HHD burden attributed to high body mass index (BMI) since 1990. The burden of HHD is concentrated in the middle SDI quintile, with population ageing and growth being major drivers for the increase in DALYs. We identified opportunities for reducing age-standardised DALY rates in the middle SDI quintile or lower. Conclusion Despite a declining trend in the age-standardised DALY rates, the ASPRs of HHD continue to rise, especially in high-middle SDI regions. Meanwhile, countries in middle and lower SDI quintiles face a higher burden of age-standardised DALY rates. Targeted attention towards elderly women and controlling high BMI, alongside enhancing hypertension and HHD management awareness, is crucial for reducing the global burden of HHD.
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Affiliation(s)
- An-Bang Liu
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yan-Xia Lin
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Ting-Ting Meng
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Peng Tian
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Jinan Central Hospital, Shandong University, Jinan, Shandong, China
| | - Jian-Lin Chen
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Xin-He Zhang
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Wei-Hong Xu
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yu Zhang
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Jinan Central Hospital, Shandong University, Jinan, Shandong, China
| | - Dan Zhang
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Jinan Central Hospital, Shandong University, Jinan, Shandong, China
| | - Yan Zheng
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Research Center of Translational Medicine, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Guo-Hai Su
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China
- Department of Cardiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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17
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Wang X, Shaw JE, Yu J, Jennings G, Stavreski B, Magliano D, Gill TK, Adams R, Rodgers A, Woodward M, Schlaich MP, Singleton R, Zhou B, Schutte AE. Prevalence, awareness, treatment, and control rates of hypertension in the general population of Australia: a systematic review and meta-analysis. J Hypertens 2024:00004872-990000000-00528. [PMID: 39248145 DOI: 10.1097/hjh.0000000000003854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
BACKGROUND A recent call-to-action highlighted that Australia is lagging behind high-income countries regarding hypertension control rates. METHODS We performed a systematic literature search of reports on prevalence, awareness, treatment and control rates since 2010. We also undertook an individual participant data meta-analysis of six population-based studies in the general population from 1980 to 2018 to understand the size of the problem and trajectories over time. RESULTS The aggregated data showed that after 2010, hypertension prevalence was 31% ]95% confidence interval (CI) 27-34%], and awareness, treatment, and control rates among people with hypertension were 56% (41-71%), 54% (46-62%) and 34% (22-47%), respectively. Since 1980, these figures have shown slight improvement. However, we noted a low availability of quality nationwide randomized databases for Australia. CONCLUSIONS We require critical action to improve the prevention, detection and treatment of hypertension, and highlight the need for large-scale investment in tracking population health in order to produce vital health statistics for the nation.
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Affiliation(s)
- Xia Wang
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, NSW
| | - J E Shaw
- Baker Heart and Diabetes Institute, Melbourne
| | - J Yu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, NSW
| | - G Jennings
- Baker Heart and Diabetes Institute, Melbourne
- Faculty of Medicine & Health, University of Sydney, Camperdown, NSW
| | - B Stavreski
- Faculty of Medicine & Health, University of Sydney, Camperdown, NSW
| | - D Magliano
- Baker Heart and Diabetes Institute, Melbourne
| | - T K Gill
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide
| | - R Adams
- Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - A Rodgers
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, NSW
| | - M Woodward
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, NSW
- George Institute for Global Health, Imperial College London, London, UK
| | - M P Schlaich
- Dobney Hypertension Centre, Medical School - Royal Perth Hopsital Unit, The University of Western Australia, Perth, Australia
| | - R Singleton
- Department of Epidemiology and Biostatistics, School of Public Health
- MRC Centre for Environment and Health, School of Public Health
- The Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College London, London, UK
- School of Population Health, University of New South Wales, Sydney, Australia
| | - B Zhou
- Department of Epidemiology and Biostatistics, School of Public Health
- MRC Centre for Environment and Health, School of Public Health
- The Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College London, London, UK
| | - A E Schutte
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, NSW
- School of Population Health, University of New South Wales, Sydney, Australia
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18
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Diallo BA, Hassan S, Kagwanja N, Oyando R, Badjie J, Mumba N, Prentice AM, Perel P, Etyang A, Nolte E, Tsofa B. Managing hypertension in rural Gambia and Kenya: Protocol for a qualitative study exploring the experiences of patients, health care workers, and decision-makers. NIHR OPEN RESEARCH 2024; 4:5. [PMID: 39238902 PMCID: PMC11375402 DOI: 10.3310/nihropenres.13523.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/07/2024]
Abstract
Background Hypertension is the single leading risk factor for premature death in Sub-Saharan Africa (SSA). Prevalence is high, but awareness, treatment, and control are low. Community-centred interventions show promise for effective hypertension management, but embedding such interventions sustainably requires a good understanding of the wider context within which they are being introduced. This study aims to conduct a systematic health system assessment exploring the micro (patients/carers), meso (health care workers and facilities), and macro (broader system) contexts in rural Gambia and Kenya. Methods This study will utilise various qualitative approaches. We will conduct (i) focus group discussions with people living with hypertensive to map a 'typical' patient journey through health systems, and (ii) in-depth interviews with patients and family carers, health care workers, decision-makers, and NCD partners to explore their experiences of managing hypertension and assess the capacity and readiness of the health systems to strengthen hypertension management. We will also review national guidelines and policy documents to map the organisation of services and guidance on hypertension management. We will use thematic analysis to analyse data, guided by the cumulative complexity model, and theories of organisational readiness and dissemination of innovations. Expected findings This study will describe the current context for the management of hypertension from the perspective of those involved in seeking (patients), delivering (health care workers) and overseeing (decision-makers) health services in rural Gambia and Kenya. It will juxtapose what should be happening according to health system guidance and what is happening in practice, drawing on the experiences of study participants. It will outline the various barriers to and facilitators of hypertension management, as perceived by patients, providers, and decision-makers, and the conditions that would need to be in place for effective and sustainable implementation of a community-centred intervention to improve the management of hypertension in rural settings.
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Affiliation(s)
- Brahima A Diallo
- Nutrition and Planetary Health, MRC Unit The Gambia at LSHTM, Banjul, Other / None, 273, The Gambia
| | - Syreen Hassan
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Jainaba Badjie
- Nutrition and Planetary Health, MRC Unit The Gambia at LSHTM, Banjul, Other / None, 273, The Gambia
| | - Noni Mumba
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Andrew M Prentice
- Nutrition and Planetary Health, MRC Unit The Gambia at LSHTM, Banjul, Other / None, 273, The Gambia
| | - Pablo Perel
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Ellen Nolte
- London School of Hygiene and Tropical Medicine, London, UK
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19
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McClintock HF, Peacock V, Nkiri Asong R. Social determinants of health and hypertension screening among women in The Gambia: an evaluation of 2019-2020 demographic and health survey data. J Hum Hypertens 2024:10.1038/s41371-024-00945-y. [PMID: 39154114 DOI: 10.1038/s41371-024-00945-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 08/03/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Abstract
Hypertension is a leading modifiable risk factor for morbidity and mortality among women in Sub-Saharan Africa. Social determinants of health (SDH) are associated with sex-based differences in access to preventative screenings globally. Little research has assessed the influence of SDH on screening for hypertension among women in The Gambia. The aim of this study was to identify SDH associated with the utilization of hypertension screening among women in The Gambia. Data was examined from the 2019-2020 Gambia Demographic and Health Survey. Weighted multivariate logistic was used to identify whether SDH were associated with hypertension screening. Among 4116 women, over one-fifth (21.1%) had not been screened for hypertension in their lifetime. In fully adjusted models, older age, rural residence, higher than secondary educational attainment, employment, identification with specific ethnic groups, richer wealth status, parity (1 or more), and antenatal care visits increased the likelihood of lifetime hypertension screening. Women who indicated that others made their healthcare decisions for them (partners or someone else) were significantly less likely to have been screened for hypertension in their lifetime than women who made their healthcare decisions alone (adjusted odds ratio = 0.552, 95% confidence interval = (0.384-0.794)). SDH influence access to screening for hypertension among women in The Gambia. Initiatives may need to address the role of SDH to improve access and uptake of hypertension screening.
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Affiliation(s)
- Heather F McClintock
- Department of Public Health, College of Health Sciences, Arcadia University, Glenside, PA, USA.
| | - Victoria Peacock
- Department of Health and Human Performance, The Leahy College of Health Science, University of Scranton, Scranton, PA, USA
| | - Rose Nkiri Asong
- Department of Public Health, College of Health Sciences, Arcadia University, Glenside, PA, USA
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20
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de Albuquerque PVC, Tomasi E. Assessing hypertension care quality in Brazil: gender, race, and socioeconomic intersection in public and private services, 2013 and 2019 national health surveys. BMC Health Serv Res 2024; 24:939. [PMID: 39152425 PMCID: PMC11330122 DOI: 10.1186/s12913-024-11358-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/25/2024] [Indexed: 08/19/2024] Open
Abstract
We conducted a cross-sectional study of hypertension care in public and private services, analyzing gender, color, and socioeconomic status. Using data from the 2013 (n = 60,202) and 2019 (n = 90,846) national health surveys, hypertension prevalence increased from 21.4 to 23.9%. Quality of care declined from 41.7 to 35.4%, particularly in public services, disproportionately affecting low-income Black women. Poisson regression estimated prevalence ratios (PRs), with the lowest adjusted PR for high-quality care among low-income Black women. These findings highlight persistent health inequalities and the urgent need for intersectoral policies to promote health equity.
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Affiliation(s)
| | - Elaine Tomasi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, City of Pelotas, State of Rio Grande do Sul, Brazil
- Department of Social Medicine, Faculty of Medicine, Federal University of Pelotas, City of Pelotas, State of Rio Grande do Sul, Brazil
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21
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Sekome K, Gómez-Olivé FX, Sherar LB, Esliger DW, Myezwa H. Sociocultural perceptions of physical activity and dietary habits for hypertension control: voices from adults in a rural sub-district of South Africa. BMC Public Health 2024; 24:2194. [PMID: 39138450 PMCID: PMC11320885 DOI: 10.1186/s12889-024-19320-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 07/01/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Over half of adults from rural South Africa are hypertensive. Apart from pharmaceutical treatment, lifestyle changes such as increasing physical activity and reducing dietary salt have been strongly advocated for the control of hypertension. However, the control rates of hypertension for adults in rural South Africa are low. In this paper we explore whether this is due to the recommended lifestyle intervention not aligning with the individual's socio-cultural determinants of behaviour change. AIM To explore the social and cultural beliefs, perceptions and practices regarding physical activity and diet as a hypertension control intervention on hypertensive adults living in a rural sub-district in South Africa. METHODS Nine focus group discussions were conducted with hypertensive adults aged 40 years and above from Bushbuckridge sub-district in Mpumalanga Province of South Africa using a semi-structured interview guide. Each session began with introductions of the discussion theme followed by a short discussion on what the participants know about hypertension and the normal blood pressure readings. Physical activity and dietary habits were then introduced as the main subject of discussion. Probing questions were used to get more insight on a specific topic. A thematic analysis approach was used to generate codes, categories, and themes. A manual approach to data analysis was chosen and data obtained through transcripts were analysed inductively. FINDINGS Participants had a lack of knowledge about blood pressure normal values. Perceived causes of hypertension were alluded to psychosocial factors such as family and emotional-related issues. Physical activity practices were influenced by family and community members' attitudes and gender roles. Factors which influenced dietary practices mainly involved affordability and availability of food. To control their hypertension, participants recommend eating certain foods, emotional control, taking medication, exercising, praying, correct food preparation, and performing house chores. CONCLUSION Lifestyle interventions to control hypertension for adults in a rural South African setting using physical activity promotion and dietary control must consider the beliefs related to hypertension control of this population.
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Affiliation(s)
- Kganetso Sekome
- Department of physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg, 2193, South Africa.
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, South Africa.
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, South Africa
| | - Dale W Esliger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, South Africa
| | - Hellen Myezwa
- School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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22
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Chavan TA, Kaviprawin M, Sakthivel M, Kishore N, Jogewar P, Gill SS, Kunwar A, Durgad K, Wankhede AB, Bharadwaj V, Khedkar SN, Sarode L, Das B, Bangar SD, Venkatasamy V, Gupta A, Kriina M, Krishna A, Pathni AK, Sahoo SK, Parasuraman G, Shivashankar R, Pragya P, Sharma M, Kaur P. India Hypertension Control Initiative: decentralization of hypertension care to health wellness centres in Punjab and Maharashtra, India, 2018-2022. BMC Health Serv Res 2024; 24:884. [PMID: 39095821 PMCID: PMC11297667 DOI: 10.1186/s12913-024-11354-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
INTRODUCTION The India Hypertension Control Initiative (IHCI) emphasizes decentralized patient-centric care to boost hypertension control in public healthcare facilities. We documented the decentralization process, enrolment pattern by facility type, and treatment outcomes in nine districts of Punjab and Maharashtra states, India, from 2018-2022. METHODS We detailed the shift in hypertension care from higher facilities to Health and Wellness Centres (HWCs) using the World Health Organization (WHO) health system pillar framework. We reviewed hypertension treatment records in 4,045 public facilities from nine districts in the two states, focusing on indicators including registration numbers, the proportion of controlled, uncontrolled blood pressure (BP), and missed visits among those under care. RESULTS The decentralization process involved training, treatment protocol provision, supervision, and monitoring. Among 394,038 individuals registered with hypertension from 2018-2021, 69% were under care in 2022. Nearly half of those under care (129,720/273,355) received treatment from HWCs in 2022. Care of hypertensive individuals from district hospitals (14%), community health centres (20%), and primary health centres (24%) were decentralized to HWCs. Overall BP control rose from 20% (4,004/20,347) in 2019 to 58% (157,595/273,355) in 2022, while missed visits decreased from 61% (12,394/20,347) in 2019 to 26% (70,894/273,355) in 2022. This trend was consistent in both states. HWCs exhibited the highest BP control and the lowest missed visits throughout the study period compared to other facility types. CONCLUSION We documented an increase in decentralized access to hypertension treatment and improved treatment outcomes over four years. We recommend operationalizing hypertension care at HWCs to other districts in India to improve BP control.
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Affiliation(s)
- Tejpalsinh A Chavan
- Division of Noncommunicable Diseases (NCD), Indian Council of Medical Research (ICMR) - National Institute of Epidemiology (NIE), Chennai, India.
- India Hypertension Control Initiative (IHCI) Project, District NCD Cell, World Health Organization (WHO), Pune, India.
| | - Mogan Kaviprawin
- Division of Noncommunicable Diseases (NCD), Indian Council of Medical Research (ICMR) - National Institute of Epidemiology (NIE), Chennai, India
| | - Manikandanesan Sakthivel
- Division of Noncommunicable Diseases (NCD), Indian Council of Medical Research (ICMR) - National Institute of Epidemiology (NIE), Chennai, India
| | - Navneet Kishore
- Division of Noncommunicable Diseases (NCD), Indian Council of Medical Research (ICMR) - National Institute of Epidemiology (NIE), Chennai, India
- IHCI Project, State NCD Cell, WHO, Chandigarh, Punjab, India
| | - Padmaja Jogewar
- State NCD Cell, Directorate of Health Services, Government of Maharashtra, Mumbai, India
| | - Sandeep Singh Gill
- State NCD Cell, Department of Health and Family Welfare, Government of Punjab, Chandigarh, India
| | - Abhishek Kunwar
- Department of Noncommunicable Diseases, WHO Country Office, New Delhi, India
| | - Kiran Durgad
- Department of Noncommunicable Diseases, WHO Country Office, New Delhi, India
| | - Amol B Wankhede
- IHCI Project, State NCD Cell, WHO, Mumbai, Maharashtra, India
| | | | - Suhas N Khedkar
- IHCI Project, District NCD Cell, WHO, Satara, Maharashtra, India
| | - Lalit Sarode
- IHCI Project, District NCD Cell, WHO, Wardha, Maharashtra, India
| | - Bidisha Das
- IHCI Project, District NCD Cell, WHO, Bhatinda, Punjab, India
| | | | - Vettrichelvan Venkatasamy
- Division of Noncommunicable Diseases (NCD), Indian Council of Medical Research (ICMR) - National Institute of Epidemiology (NIE), Chennai, India
| | - Ashu Gupta
- State NCD Cell, Department of Health and Family Welfare, Government of Punjab, Chandigarh, India
| | - Mosoniro Kriina
- Division of Noncommunicable Diseases (NCD), Indian Council of Medical Research (ICMR) - National Institute of Epidemiology (NIE), Chennai, India
| | | | | | | | - Ganeshkumar Parasuraman
- Division of Noncommunicable Diseases (NCD), Indian Council of Medical Research (ICMR) - National Institute of Epidemiology (NIE), Chennai, India
| | | | | | | | - Prabhdeep Kaur
- Division of Noncommunicable Diseases (NCD), Indian Council of Medical Research (ICMR) - National Institute of Epidemiology (NIE), Chennai, India
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23
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Palermiti A, Pappaccogli M, Rabbia F, D'Avolio A, Veglio F. Multiple drug intolerance in antihypertensive patients: what is known and what is missing. J Hypertens 2024; 42:1289-1297. [PMID: 38690922 DOI: 10.1097/hjh.0000000000003737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Drug allergy and intolerance are increasingly recognized as significant public health concerns, leading to adverse reactions in patients undergoing pharmacological treatments. Multiple drug intolerance syndrome (MDIS), characterized by adverse reactions to at least three different drug classes without a clear immunological mechanism, poses a substantial challenge, particularly in hypertensive patients. Despite its link to suboptimal adherence and uncontrolled blood pressure, MDIS in the context of hypertension remains insufficiently explored. This review synthesizes existing literature on MDIS, emphasizing clinical characteristics, pathogenesis, and psychiatric comorbidity. Furthermore, it delves into MDIS in the context of hypertension, highlighting the importance of a multidisciplinary approach in diagnosis and management, including innovative therapeutic strategies such as novel therapeutic algorithms or renal denervation. The review concludes by emphasizing the necessity for further research and clinical trials to enhance our understanding and address MDIS, especially in hypertensive patients.
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Affiliation(s)
| | - Marco Pappaccogli
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Franco Rabbia
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Franco Veglio
- Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Turin, Italy
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24
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Li J, Wang S, Yan K, Wang P, Jiao J, Wang Y, Chen M, Dong Y, Zhong J. Intestinal microbiota by angiotensin receptor blocker therapy exerts protective effects against hypertensive damages. IMETA 2024; 3:e222. [PMID: 39135690 PMCID: PMC11316932 DOI: 10.1002/imt2.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 08/15/2024]
Abstract
Dysbiosis of the gut microbiota has been implicated in hypertension, and drug-host-microbiome interactions have drawn considerable attention. However, the influence of angiotensin receptor blocker (ARB)-shaped gut microbiota on the host is not fully understood. In this work, we assessed the alterations of blood pressure (BP), vasculatures, and intestines following ARB-modified gut microbiome treatment and evaluated the changes in the intestinal transcriptome and serum metabolome in hypertensive rats. Hypertensive patients with well-controlled BP under ARB therapy were recruited as human donors, spontaneously hypertensive rats (SHRs) receiving normal saline or valsartan were considered animal donors, and SHRs were regarded as recipients. Histological and immunofluorescence staining was used to assess the aorta and small intestine, and 16S rRNA amplicon sequencing was performed to examine gut bacteria. Transcriptome and metabonomic analyses were conducted to determine the intestinal transcriptome and serum metabolome, respectively. Notably, ARB-modified fecal microbiota transplantation (FMT), results in marked decreases in systolic BP levels, collagen deposition and reactive oxygen species accumulation in the vasculature, and alleviated intestinal structure impairments in SHRs. These changes were linked with the reconstruction of the gut microbiota in SHR recipients post-FMT, especially with a decreased abundance of Lactobacillus, Aggregatibacter, and Desulfovibrio. Moreover, ARB-treated microbes contributed to increased intestinal Ciart, Per1, Per2, Per3, and Cipc gene levels and decreased Nfil3 and Arntl expression were detected in response to ARB-treated microbes. More importantly, circulating metabolites were dramatically reduced in ARB-FMT rats, including 6beta-Hydroxytestosterone and Thromboxane B2. In conclusion, ARB-modified gut microbiota exerts protective roles in vascular remodeling and injury, metabolic abnormality and intestinal dysfunctions, suggesting a pivotal role in mitigating hypertension and providing insights into the cross-talk between antihypertensive medicines and the gut microbiome.
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Affiliation(s)
- Jing Li
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
- Department of Cardiology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
| | - Si‐Yuan Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
- Department of Cardiology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
| | - Kai‐Xin Yan
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
- Department of Cardiology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
| | - Pan Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
- Department of Cardiology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
| | - Jie Jiao
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
- Department of Cardiology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
| | - Yi‐Dan Wang
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
- Department of Cardiology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
| | - Mu‐Lei Chen
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
- Department of Cardiology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
| | - Ying Dong
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
- Department of Cardiology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
| | - Jiu‐Chang Zhong
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
- Department of Cardiology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina
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25
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Li XY, Lv JJ, Zhao Y, Zhang YJ, Yang XT, Zhang RH, Guo ZL, Wang ZW, Cheng ZH. Global Burden of Stroke Attributable to Low Physical Activity/High Body Mass Index Among People Aged 55 Years and Older. Stroke 2024; 55:2075-2085. [PMID: 38920043 DOI: 10.1161/strokeaha.123.046180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/06/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND This study aimed to quantify the global stroke burden attributable to low physical activity and high body mass index in adults aged ≥55 years using data from the Global Burden of Disease 2019 study. METHODS We extracted data on stroke mortality, disability-adjusted life years, and risk factor exposure from the Global Burden of Disease 2019 study for people aged ≥55 years. We calculated the population-attributable fraction and absolute number of stroke cases and disability-adjusted life years attributable to low physical activity and high body mass index by location, age group, sex, and year. RESULTS Globally, body mass index and physical inactivity-attributable stroke burden have declined modestly since 1990, but with diverging escalatory regional trajectories. Population growth and aging drive this rising burden. CONCLUSIONS Multidimensional, context-specific strategies focused on modifiable lifestyle risks are imperative to address the modest declines and escalatory regional trajectories in body mass index and physical inactivity-attributable stroke burden.
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Affiliation(s)
- Xin-Yu Li
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
- Department of Plastic and Reconstructive Surgery (X.-Y.L., R.-H.Z.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Jia-Jie Lv
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Yan Zhao
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
- Department of Nursing (Y.Z.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Yuan-Jie Zhang
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Xi-Tao Yang
- Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies (X.-T.Y.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Ru-Hong Zhang
- Department of Plastic and Reconstructive Surgery (X.-Y.L., R.-H.Z.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Zhi-Lin Guo
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
| | - Zhao-Wei Wang
- Department of Neurology, Qianjiang Central Hospital of Hubei Province, PR China (Z.-W.W.)
| | - Zhi-Hua Cheng
- Department of Neurosurgery (X.-Y.L., J.-J.L., Y.Z., Y.-J.Z., Z.-L.G., Z.-H.C.), Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, PR China
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Rao P, Keyes MJ, Mi MY, Barber JL, Tahir UA, Deng S, Clish CB, Shen D, Farrell LA, Wilson JG, Gao Y, Yimer WK, Ekunwe L, Hall ME, Muntner PM, Guo X, Taylor KD, Tracy RP, Rich SS, Rotter JI, Xanthakis V, Vasan RS, Bouchard C, Sarzynski MA, Gerszten RE, Robbins JM. Plasma Proteomics of Exercise Blood Pressure and Incident Hypertension. JAMA Cardiol 2024; 9:713-722. [PMID: 38865108 PMCID: PMC11170454 DOI: 10.1001/jamacardio.2024.1397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/10/2024] [Indexed: 06/13/2024]
Abstract
Importance Blood pressure response during acute exercise (exercise blood pressure [EBP]) is associated with the future risk of hypertension and cardiovascular disease (CVD). Biochemical characterization of EBP could inform disease biology and identify novel biomarkers of future hypertension. Objective To identify protein markers associated with EBP and test their association with incident hypertension. Design, Setting, and Participants This study assayed 4977 plasma proteins in 681 healthy participants (from 763 assessed) of the Health, Risk Factors, Exercise Training and Genetics (HERITAGE; data collection from January 1993 to December 1997 and plasma proteomics from January 2019 to January 2020) Family Study at rest who underwent 2 cardiopulmonary exercise tests. Individuals were free of CVD at the time of recruitment. Individuals with resting SBP ≥160 mm Hg or DBP ≥100 mm Hg or taking antihypertensive drug therapy were excluded from the study. The association between resting plasma protein levels to both resting BP and EBP was evaluated. Proteins associated with EBP were analyzed for their association with incident hypertension in the Framingham Heart Study (FHS; n = 1177) and validated in the Jackson Heart Study (JHS; n = 772) and Multi-Ethnic Study of Atherosclerosis (MESA; n = 1367). Proteins associated with incident hypertension were tested for putative causal links in approximately 700 000 individuals using cis-protein quantitative loci mendelian randomization (cis-MR). Data were analyzed from January 2023 to January 2024. Exposures Plasma proteins. Main Outcomes and Measures EBP was defined as the BP response during a fixed workload (50 W) on a cycle ergometer. Hypertension was defined as BP ≥140/90 mm Hg or taking antihypertensive medication. Results Among the 681 participants in the HERITAGE Family Study, the mean (SD) age was 34 (13) years; 366 participants (54%) were female; 238 (35%) were self-reported Black and 443 (65%) were self-reported White. Proteomic profiling of EBP revealed 34 proteins that would not have otherwise been identified through profiling of resting BP alone. Transforming growth factor β receptor 3 (TGFBR3) and prostaglandin D2 synthase (PTGDS) had the strongest association with exercise systolic BP (SBP) and diastolic BP (DBP), respectively (TGFBR3: exercise SBP, β estimate, -3.39; 95% CI, -4.79 to -2.00; P = 2.33 × 10-6; PTGDS: exercise DBP β estimate, -2.50; 95% CI, -3.29 to -1.70; P = 1.18 × 10-9). In fully adjusted models, TGFBR3 was inversely associated with incident hypertension in FHS, JHS, and MESA (hazard ratio [HR]: FHS, 0.86; 95% CI, 0.75-0.97; P = .01; JHS, 0.87; 95% CI, 0.77-0.97; P = .02; MESA, 0.84; 95% CI, 0.71-0.98; P = .03; pooled cohort, 0.86; 95% CI, 0.79-0.92; P = 6 × 10-5). Using cis-MR, genetically predicted levels of TGFBR3 were associated with SBP, hypertension, and CVD events (SBP: β, -0.38; 95% CI, -0.64 to -0.11; P = .006; hypertension: odds ratio [OR], 0.99; 95% CI, 0.98-0.99; P < .001; heart failure with hypertension: OR, 0.86; 95% CI, 0.77-0.97; P = .01; CVD: OR, 0.84; 95% CI, 0.77-0.92; P = 8 × 10-5; cerebrovascular events: OR, 0.77; 95% CI, 0.70-0.85; P = 5 × 10-7). Conclusions and Relevance Plasma proteomic profiling of EBP identified a novel protein, TGFBR3, which may protect against elevated BP and long-term CVD outcomes.
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Affiliation(s)
- Prashant Rao
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Michelle. J. Keyes
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Michael Y. Mi
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Jacob L. Barber
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Usman A. Tahir
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Shuliang Deng
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Clary B. Clish
- Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge
| | - Dongxiao Shen
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Laurie. A. Farrell
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - James G. Wilson
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Yan Gao
- Department of Data Sciences, University of Mississippi Medical Center, Jackson
| | - Wondwosen K. Yimer
- Department of Data Sciences, University of Mississippi Medical Center, Jackson
| | - Lynette Ekunwe
- Jackson Heart Study Field Center, University of Mississippi Medical Center, Jackson
| | - Michael E. Hall
- Department of Medicine, Division of Cardiology, University of Mississippi Medical Center, Jackson
| | - Paul M. Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, the Lundquist Institute for Biomedical Innovation at Harbor–University of California, Los Angeles Medical Center, Torrance
| | - Kent D. Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, the Lundquist Institute for Biomedical Innovation at Harbor–University of California, Los Angeles Medical Center, Torrance
| | - Russell P. Tracy
- Department of Pathology Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville
| | - Jerome I. Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, the Lundquist Institute for Biomedical Innovation at Harbor–University of California, Los Angeles Medical Center, Torrance
| | - Vanessa Xanthakis
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Ramachandran S. Vasan
- Boston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Claude Bouchard
- Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Mark A. Sarzynski
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Robert E. Gerszten
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Broad Institute of the Massachusetts Institute of Technology and Harvard, Cambridge
| | - Jeremy M. Robbins
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Xiang X, Palasuberniam P, Pare R. The Role of Estrogen across Multiple Disease Mechanisms. Curr Issues Mol Biol 2024; 46:8170-8196. [PMID: 39194700 DOI: 10.3390/cimb46080483] [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: 06/13/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 08/29/2024] Open
Abstract
Estrogen is a significant hormone that is involved in a multitude of physiological and pathological processes. In addition to its pivotal role in the reproductive system, estrogen is also implicated in the pathogenesis of a multitude of diseases. Nevertheless, previous research on the role of estrogen in a multitude of diseases, including Alzheimer's disease, depression, cardiovascular disease, diabetes, osteoporosis, gastrointestinal diseases, and estrogen-dependent cancers, has concentrated on a single disease area, resulting in a lack of comprehensive understanding of cross-disease mechanisms. This has brought some challenges to the current treatment methods for these diseases, because estrogen as a potential therapeutic tool has not yet fully developed its potential. Therefore, this review aims to comprehensively explore the mechanism of estrogen in these seven types of diseases. The objective of this study is to describe the relationship between each disease and estrogen, including the ways in which estrogen participates in regulating disease mechanisms, and to outline the efficacy of estrogen in treating these diseases in clinical practice. By studying the role of estrogen in a variety of disease mechanisms, it is hoped that a more accurate theoretical basis and clinical guidance for future treatment strategies will be provided, thus promoting the effective management and treatment of these diseases.
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Affiliation(s)
- Xiuting Xiang
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Praneetha Palasuberniam
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Rahmawati Pare
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
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Park J, Shin S, Kim Y, Bu Y, Choi HY, Lee K. Effect of Torilis japonica Fruit Extract for Endothelium-Independent Vasorelaxation and Blood Pressure Lowering in Rats. Int J Mol Sci 2024; 25:8101. [PMID: 39125672 PMCID: PMC11311312 DOI: 10.3390/ijms25158101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 07/12/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024] Open
Abstract
Torilis japonica (TJ) fruit, is a herb that is traditionally used for erectile dysfunction (ED). Given the shared mechanisms of ED and hypertension through vascular smooth muscle, we hypothesized that TJ would be effective in vasodilation and blood pressure reduction. This study confirmed the authenticity of TJ samples via DNA barcoding and quantified the main active compound, torilin, using HPLC. TJ was extracted with distilled water (TJW) and 50% ethanol (TJE), yielding torilin contents of 0.35 ± 0.01% and 2.84 ± 0.02%, respectively. Ex vivo tests on thoracic aortic rings from Sprague-Dawley rats showed that TJE (3-300 µg/mL) induced endothelium-independent, concentration-dependent vasodilation, unlike TJW. Torilin caused concentration-dependent relaxation with an EC50 of 210 ± 1.07 µM. TJE's effects were blocked by a voltage-dependent K+ channel blocker and alleviated contractions induced by CaCl2 and angiotensin II. TJE inhibited vascular contraction induced by phenylephrine or KCl via extracellular CaCl2 and enhanced inhibition with nifedipine, indicating involvement of voltage-dependent and receptor-operated Ca2+ channels. Oral administration of TJE (1000 mg/kg) significantly reduced blood pressure in spontaneously hypertensive rats. These findings suggest TJ extract's potential for hypertension treatment through vasorelaxant mechanisms, though further research is needed to confirm its efficacy and safety.
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MESH Headings
- Animals
- Rats
- Vasodilation/drug effects
- Plant Extracts/pharmacology
- Blood Pressure/drug effects
- Male
- Fruit/chemistry
- Rats, Sprague-Dawley
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/metabolism
- Antihypertensive Agents/pharmacology
- Vasodilator Agents/pharmacology
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/metabolism
- Rats, Inbred SHR
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Hypertension/drug therapy
- Hypertension/metabolism
- Hypertension/physiopathology
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Affiliation(s)
- Junkyu Park
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Sujin Shin
- Department of Korean Medicine, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea;
| | - Youngmin Kim
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (Y.K.); (Y.B.); (H.-Y.C.)
| | - Youngmin Bu
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (Y.K.); (Y.B.); (H.-Y.C.)
| | - Ho-Young Choi
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (Y.K.); (Y.B.); (H.-Y.C.)
| | - Kyungjin Lee
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea; (Y.K.); (Y.B.); (H.-Y.C.)
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Kibria GMA, Rahman Shawon MS, Hashan MR, Khan MH, Gibson DG. Disparities and factors affecting hypertension diagnosis from qualified doctors in Bangladesh and its impact on receiving hypertension control advice: Analysis of demographic & health survey 2017-18. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003496. [PMID: 39042619 PMCID: PMC11265666 DOI: 10.1371/journal.pgph.0003496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 06/25/2024] [Indexed: 07/25/2024]
Abstract
The burden of hypertension is increasing in many low- and middle-income countries, including Bangladesh, and a large proportion of Bangladeshi people seek healthcare from unqualified medical practitioners, such as paramedics, village doctors, and drug store salesmen; however, there has been limited investigation regarding diagnosis and care provided by qualified doctors. This study investigated the factors associated with hypertension diagnosis by qualified doctors (i.e., registered medically trained doctors or medical doctors with at least an MBBS degree) and how this diagnosis is related to hypertension-controlling advice and treatment among Bangladeshi adults. This cross-sectional study used data from Bangladesh Demographic and Health Survey 2017-18. After describing sample characteristics, we conducted simple and multivariable logistic regression analyses to investigate the associated factors and associations. Among 1710 participants (68.3% females, mean age: 50.1 (standard error: 0.43) years) with self-reported hypertension diagnosis, about 54.9% (95% confidence interval (CI): 51.8-58.0) had a diagnosis by qualified doctors. The following variables had significant associations with hypertension diagnoses from qualified doctors: 40-54- or 55-year-olds/above (ref: 18-29-year-olds), overweight/obesity (ref: not overweight/obese), college/above education (ref: no formal education), richest wealth quintile (ref: poorest), urban residence (ref: rural), and residence in Chittagong, Barisal, and Sylhet divisions (ref: Dhaka division). Lastly, compared to people who had not been diagnosed by qualified doctors, those with the diagnosis from qualified doctors had higher odds of receiving any hypertension-controlling advice and treatment, including drugs (1.73 (95% CI: 1.27-2.36), salt intake reduction (AOR: 2.36, 95% CI: 1.80-3.10), weight reduction (AOR: 2.58, 95% CI: 1.97-3.37), smoking cessation (AOR: 2.22, 95% CI: 1.66-2.96),), and exercise promotion (AOR: 2.34, 95% CI: 1.77-3.09). This study showed significant socioeconomic and rural-urban disparities regarding hypertension diagnosis from qualified doctors. Diagnosis by qualified doctors was also positively associated with receiving hypertension-controlling advice and treatment. Reducing these inequalities would be crucial to reducing the country's hypertension burden.
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Affiliation(s)
- Gulam Muhammed Al Kibria
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | | | - Mohammad Rashidul Hashan
- Bangladesh Civil Service, Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka, Bangladesh
| | - Maryam Hameed Khan
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Dustin G. Gibson
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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30
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Gualan M, Ster IC, Veloz T, Granadillo E, Llangari-Arizo LM, Rodriguez A, Critchley JA, Whincup P, Martin M, Romero-Sandoval N, Cooper PJ. Cardiometabolic diseases and associated risk factors in transitional rural communities in tropical coastal Ecuador. PLoS One 2024; 19:e0307403. [PMID: 39024320 PMCID: PMC11257341 DOI: 10.1371/journal.pone.0307403] [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: 02/08/2024] [Accepted: 07/03/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND There is a growing epidemic of chronic non-communicable diseases in low and middle-income countries, often attributed to urbanization, although there are limited data from marginalized rural populations. This study aimed to estimate prevalence of cardiometabolic diseases and associated risk factors in transitional rural communities. METHODS A cross-sectional study of Montubio adults aged 18-94 years living in agricultural communities in a tropical coastal region of Ecuador. Data were collected by questionnaires and anthropometry, and fasting blood was analyzed for glucose, glycosylated hemoglobin, insulin, and lipid profiles. Population-weighted prevalences of diabetes, hypertension, and metabolic syndrome were estimated. Associations between potential risk factors and outcomes were estimated using multilevel regression techniques adjusted for age and sex. RESULTS Out of 1,010 adults recruited, 931 were included in the analysis. Weighted prevalences were estimated for diabetes (20.4%, 95% CI 18.3-22.5%), hypertension (35.6%, 95% CI 29.0-42.1%), and metabolic syndrome (54.2%. 95% CI 47.0-61.5%) with higher prevalence observed in women. Hypertension prevalence increased with age while diabetes and metabolic syndrome peaked in the 6th and 7th decades of life, declining thereafter. Adiposity indicators were associated with diabetes, hypertension, and metabolic syndrome. CONCLUSION We observed an unexpectedly high prevalence of diabetes, hypertension, and metabolic syndrome in these marginalized agricultural communities. Transitional rural communities are increasingly vulnerable to the development of cardiometabolic risk factors and diseases. There is a need for targeted primary health strategies to reduce the burden of premature disability and death in these communities.
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Affiliation(s)
- Monsermin Gualan
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- Grup’s de Recerca d’ Amèrica i Àfrica Llatines-GRAAL, Barcelona, Spain
| | - Irina Chis Ster
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
| | - Tatiana Veloz
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Emily Granadillo
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- Grup’s de Recerca d’ Amèrica i Àfrica Llatines-GRAAL, Barcelona, Spain
| | - Luz M. Llangari-Arizo
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- Grup’s de Recerca d’ Amèrica i Àfrica Llatines-GRAAL, Barcelona, Spain
| | | | - Julia A. Critchley
- Population Health Research Institute, St George’s University of London, London, United Kingdom
| | - Peter Whincup
- Population Health Research Institute, St George’s University of London, London, United Kingdom
| | - Miguel Martin
- Grup’s de Recerca d’ Amèrica i Àfrica Llatines-GRAAL, Barcelona, Spain
- Unidad de Bioestadística, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Natalia Romero-Sandoval
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- Grup’s de Recerca d’ Amèrica i Àfrica Llatines-GRAAL, Barcelona, Spain
| | - Philip J. Cooper
- School of Medicine, Universidad Internacional del Ecuador, Quito, Ecuador
- Institute of Infection and Immunity, St George’s University of London, London, United Kingdom
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Hu X, Liao G, Wang J, Ye Y, Chen X, Bai L, Shi F, Liu K, Peng Y. Patient-Specific Factors Predicting Renal Denervation Response in Patients With Hypertension: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2024; 13:e034915. [PMID: 38979821 PMCID: PMC11292764 DOI: 10.1161/jaha.124.034915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 06/05/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND The accurate selection of patients likely to respond to renal denervation (RDN) is crucial for optimizing treatment outcomes in patients with hypertension. This systematic review was designed to evaluate patient-specific factors predicting the RDN response. METHODS AND RESULTS We focused on individuals with hypertension who underwent RDN. Patients were categorized based on their baseline characteristics. The primary outcome was blood pressure (BP) reduction after RDN. Both randomized controlled trials and nonrandomized studies were included. We assessed the risk of bias using corresponding tools and further employed the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the overall quality of evidence. A total of 50 studies were ultimately included in this systematic review, among which 17 studies were for meta-analysis. Higher baseline heart rate and lower pulse wave velocity were shown to be associated with significant antihypertensive efficacy of RDN on 24-hour systolic BP reduction (weighted mean difference, -4.05 [95% CI, -7.33 to -0.77]; weighted mean difference, -7.20 [95% CI, -9.79 to -4.62], respectively). In addition, based on qualitative analysis, higher baseline BP, orthostatic hypertension, impaired baroreflex sensitivity, and several biomarkers are also reported to be associated with significant BP reduction after RDN. CONCLUSIONS In patients with hypertension treated with the RDN, higher heart rate, and lower pulse wave velocity were associated with significant BP reduction after RDN. Other factors, including higher baseline BP, hypertensive patients with orthostatic hypertension, BP variability, impaired cardiac baroreflex sensitivity, and some biomarkers are also reported to be associated with a better BP response to RDN.
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Affiliation(s)
- Xin‐Ru Hu
- Department of CardiologyWest China Hospital, Sichuan UniversityChengduSichuanPeople’s Republic of China
| | - Guang‐Zhi Liao
- Department of CardiologyWest China Hospital, Sichuan UniversityChengduSichuanPeople’s Republic of China
| | - Jun‐Wen Wang
- Department of CardiologyWest China Hospital, Sichuan UniversityChengduSichuanPeople’s Republic of China
| | - Yu‐Yang Ye
- Department of CardiologyWest China Hospital, Sichuan UniversityChengduSichuanPeople’s Republic of China
| | - Xue‐Feng Chen
- Department of CardiologyWest China Hospital, Sichuan UniversityChengduSichuanPeople’s Republic of China
| | - Lin Bai
- Department of CardiologyWest China Hospital, Sichuan UniversityChengduSichuanPeople’s Republic of China
| | - Fan‐Fan Shi
- Department of Clinical Research and Management, Center of Biostatistics, Design, Measurement and Evaluation (CBDME)West China Hospital, Sichuan UniversityChengduSichuanPeople’s Republic of China
| | - Kai Liu
- Department of CardiologyWest China Hospital, Sichuan UniversityChengduSichuanPeople’s Republic of China
| | - Yong Peng
- Department of CardiologyWest China Hospital, Sichuan UniversityChengduSichuanPeople’s Republic of China
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32
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Zhao Z, Jia J, Lyu X, Zhang L, Wang Y, He Y, Peng Z, Zhang Y, Zhang H, Wang Q, Shen H, Zhang Y, Yan D, Ma X, Yang Y. Association of psychological stress with wives' hypertension across over 10 million Chinese married female population aged 20-49 years. Chin Med J (Engl) 2024; 137:1583-1591. [PMID: 38932742 PMCID: PMC11230796 DOI: 10.1097/cm9.0000000000003065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Psychological stress has been reported to be a potential risk factor for hypertension among females, but it remains unclear whether spousal chronic stress levels alter the risk of hypertension among women. We examined the associations between stress within the family and hypertension among married women. METHODS Reproductive-aged women who were planning for pregnancy and their husbands were recruited from the National Free Pre-pregnancy Checkup Projects (NFPCP) across 31 provinces in China in 2016 and 2017. Perceived stress of wives or husbands was measured with a 5-point Likert-type scale, and assessed from three domains: work/life-related stress, economic stress, and overall stress. Multivariable-adjusted logistic regression models were used to assess the associations between stress status and the prevalence of hypertension. RESULTS Of 10,027,644 couples, 261,098 (2.60%) women had hypertension. The results showed that higher stress levels among themselves or their husbands were associated with a higher prevalence of hypertension in women ( Pfor trend <0.001). Compared with non-stressed participants, female participants with the highest stress themselves were at a greater risk of hypertension, with adjusted odds ratio (OR) of 1.31 (95% confidence interval [CI]: 1.25-1.37); and compared with participants whose husbands had no stress, those whose husbands had the highest stress level were at a higher risk of hypertension with adjusted OR of 1.24 (95% CI: 1.20-1.29). Moreover, compared with non-stressed status for both couples, only-wife-stressed, only-husband-stressed, and both-stressed couples were found to be significantly associated with increased risks of wives' hypertension, with adjusted ORs of 1.28 (95% CI: 1.25-1.31), 1.19 (95% CI: 1.17-1.21), and 1.28 (95% CI: 1.26-1.31), respectively. CONCLUSION Moderate to severe stress in both spouses might be associated with female hypertension prevalence, which highlights the importance of paying attention to the psychological stresses of couples within the family.
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Affiliation(s)
- Zhenyan Zhao
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Jiajing Jia
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
| | - Xinyi Lyu
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Lihua Zhang
- State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100037, China
| | - Yuanyuan Wang
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
| | - Ya Zhang
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing 100044, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing 100044, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing 100044, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing 100044, China
| | - Xu Ma
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing 100081, China
- National Human Genetic Resources Center, Beijing 102206, China
- Graduate School of Peking Union Medical College, Beijing 100730, China
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Dong S, Yu B, Yin C, Li Y, Zhong W, Feng C, Lin X, Qiao X, Yin Y, Wang Z, Chen T, Liu H, Jia P, Li X, Yang S. Associations between PM2.5 and its chemical constituents and blood pressure: a cross-sectional study. J Hypertens 2024:00004872-990000000-00500. [PMID: 39248113 DOI: 10.1097/hjh.0000000000003795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
OBJECTIVES To investigate the associations between PM2.5 and its chemical constituents with blood pressure (BP), assess effects across BP quantiles, and identify the key constituent elevating BP. METHODS A total of 36 792 adults were included in the cross-sectional study, representing 25 districts/counties of southeast China. Quantile regression models were applied to estimate the associations of PM2.5 and its chemical constituents (ammonium [NH4+], nitrate [NO3-], sulfate [SO42-], black carbon [BC], organic matter [OM]) with systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean artery pressure (MAP). A weighted quantile sum (WQS) index was used to estimate the relative importance of each PM2.5 chemical constituent to the joint effect on BP. RESULTS The adverse effects of each interquartile range (IQR) increase in PM2.5, NH4+, NO3-, SO42-, and BC on BP were found to be greater with elevated BP, especially when SBP exceeded 133 mmHg and DBP exceeded 82 mmHg. Each IQR increase in all five PM2.5 chemical constituents was associated with elevated SBP (β [95% CI]: 0.90 [0.75, 1.05]), DBP (β: 0.44 [0.34, 0.53]), and MAP (β: 0.57 [0.45, 0.69]), NH4+ (for SBP: weight = 99.43%; for DBP: 12.78%; for MAP: 60.73%) and BC (for DBP: 87.06%; for MAP: 39.07%) predominantly influencing these effects. The joint effect of PM2.5 chemical constituents on risks for elevated SBP and DBP exhibited an upward trend from the 70th quantile (SBP exceeded 133 mmHg, DBP exceeded 82 mmHg). CONCLUSION Long-term exposure to PM2.5 and its chemical constituents was associated with increased risk for elevated BP, with NH4+ and BC being the main contributors, and such associations were significantly stronger at 70th to 90th quantiles (SBP exceeded 133 mmHg, DBP exceeded 82 mmHg).
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Affiliation(s)
- Shu Dong
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Bin Yu
- West China School of Public Health and West China Fourth Hospital, Sichuan University
- Institute for Disaster Management and Reconstruction, Sichuan University - The Hong Kong Polytechnic University, Chengdu
| | - Chun Yin
- School of Resource and Environmental Sciences
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
| | - Yuchen Li
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Wenling Zhong
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou
| | - Chuanteng Feng
- West China School of Public Health and West China Fourth Hospital, Sichuan University
- Institute for Disaster Management and Reconstruction, Sichuan University - The Hong Kong Polytechnic University, Chengdu
| | - Xi Lin
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou
| | - Xu Qiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University
- Institute for Disaster Management and Reconstruction, Sichuan University - The Hong Kong Polytechnic University, Chengdu
| | - Yanrong Yin
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou
| | - Zihang Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Tiehui Chen
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou
| | - Hongyun Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University
| | - Peng Jia
- School of Resource and Environmental Sciences
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
- Hubei Luojia Laboratory
- School of Public Health, Wuhan University, Wuhan, China
| | - Xiaoqing Li
- Fujian Provincial Center for Disease Control and Prevention, Fuzhou
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University
- International Institute of Spatial Lifecourse Health (ISLE), Wuhan University, Wuhan, China
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Yu T, Zhang S, Wakayama R, Horimoto T, Tange C, Nishita Y, Otsuka R. The relationship between the dietary index based Meiji nutritional profiling system for adults and lifestyle-related diseases: a predictive validity study from the National Institute for Longevity Sciences-Longitudinal Study of Aging. Front Nutr 2024; 11:1413980. [PMID: 39021596 PMCID: PMC11252029 DOI: 10.3389/fnut.2024.1413980] [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: 04/08/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024] Open
Abstract
Background Nutritional profiling system (NPS) holds promise as a public health tool for companies to measure product healthiness and for individuals in making healthier food choices. The Meiji NPS for adults specifically targets lifestyle-related diseases prevalent among Japan's adult population, including overweight/obesity, hypertension, diabetes, and dyslipidemia. This study examined the cross-sectional association between the Meiji NPS for adults Dietary Index (MNfA-DI) and indicators of lifestyle-related diseases in a population. Methods The study comprised 1,272 middle-aged individuals (40-64 years, 50.1% male) who participated in the seventh wave (2010-2012) of the National Institute for Longevity Sciences-Longitudinal Study of Aging project, with no missing data on three-day dietary records. The MNfA-DI was computed at the individual diet level (accounting for the whole diet) using arithmetic energy-weighted means. A higher MNfA-DI indicated a greater nutritional quality of an individual's overall diet. Lifestyle-related disease indicators included body mass index (BMI, kg/m2), body fat (%), systolic and diastolic blood pressure (mmHg), fasting plasma glucose (mg/dL), HbA1c (%), triglyceride levels (mg/dL), LDL, and HDL cholesterol levels (mg/dL). A multiple regression model was used to assess the association between the MNfA-DI and lifestyle-related disease indicators, adjusting for demographics, socioeconomic status, lifestyle factors, disease history, and energy intake as covariates, depending on the outcome. Results The median (interquartile range) age and MNfA-DI were 53.0 (46.0, 59.0) years and 10.1 (6.0, 14.0) points, respectively. MNfA-DI was negatively associated with body fat [partial regression coefficient (95% confidence interval) -0.04 (-0.07, -0.01)], diastolic blood pressure [-0.08 (-0.17, -0.002)], fasting plasma glucose [-0.18 (-0.33, -0.01)], and triglyceride [-1.36 (-2.16, -0.55)]. Additionally, MNfA-DI was also associated with almost indicators (except for LDL and HDL cholesterol) among participants with a BMI between 18.5 and 24.9 kg/m2. Conclusion These findings suggest that the Meiji NPS for adults could be associated with a lower risk of lifestyle-related diseases. In addition, from a public health nutrition perspective, the Meiji NPS for adults may be useful to assess the food healthiness of the adult population.
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Affiliation(s)
- Tao Yu
- R&D Division Meiji Co., Ltd., Tokyo, Japan
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Shu Zhang
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | | | | | - Chikako Tange
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Yukiko Nishita
- National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Rei Otsuka
- National Center for Geriatrics and Gerontology, Aichi, Japan
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Zheng G, Zhou B, Fang Z, Chen X, Liu M, He F, Zhang H, Zhu H, Dong Y, Hao G. Long-Term Visit-to-Visit Blood Pressure Variability and Cognitive Decline Among Patients With Hypertension: A Pooled Analysis of 3 National Prospective Cohorts. J Am Heart Assoc 2024; 13:e035504. [PMID: 38934858 PMCID: PMC11255695 DOI: 10.1161/jaha.124.035504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND A limited number of studies investigated the association between blood pressure variability (BPV) and cognitive impairment in patients with hypertension. This study aimed to identify the longitudinal association between BPV and cognitive decline and the role of blood pressure (BP) control in this association. METHODS AND RESULTS Participants with hypertension from the HRS (Health and Retirement Study), the ELSA (English Longitudinal Study of Ageing), and the CHARLS (China Health and Retirement Longitudinal Study) were included. Variation independent of the mean (VIM) was adopted to measure BPV. Cognitive function was measured by standard questionnaires, and a standardized Z score was calculated. Linear mixed-model and restricted cubic splines were adopted to explore the association between BPV and cognitive decline. The study included 4853, 1616, and 1432 eligible patients with hypertension from the HRS, ELSA, and CHARLS, respectively. After adjusting for covariates, per-SD increment of VIM of BP was significantly associated with global cognitive function decline in Z scores in both systolic BP (pooled β, -0.045 [95% CI, -0.065 to -0.029]) and diastolic BP (pooled β, -0.022 [95% CI, -0.040 to -0.004]) among hypertensive patients. Similar inverse associations were observed in patients with hypertension taking antihypertensive drugs and in patients with hypertension with well-controlled BP. CONCLUSIONS High BPV was independently associated with a faster cognitive decline among patients with hypertension, even those with antihypertensive medications or well-controlled BP. Further studies are needed to confirm our results and determine whether reducing BPV can prevent or delay cognitive decline.
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Affiliation(s)
- Guangjun Zheng
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouChina
| | - Biying Zhou
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouChina
| | - Zhenger Fang
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouChina
| | - Xia Chen
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouChina
| | - Mingliang Liu
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouChina
| | - Fudong He
- School of Public HealthGuangdong Pharmaceutical UniversityGuangzhouChina
| | - Haofeng Zhang
- School of Public HealthGuangdong Pharmaceutical UniversityGuangzhouChina
| | - Haidong Zhu
- Georgia Prevention Institute, Department of Medicine, Medical College of GeorgiaAugusta UniversityAugustaGAUSA
| | - Yanbin Dong
- Georgia Prevention Institute, Department of Medicine, Medical College of GeorgiaAugusta UniversityAugustaGAUSA
| | - Guang Hao
- School of Public HealthGuangdong Pharmaceutical UniversityGuangzhouChina
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Gao H, Chen F, Wang S. Hesperidin reduces systolic blood pressure in diabetic patients and has no effect on blood pressure in healthy individuals: A systematic review and meta-analysis. Phytother Res 2024; 38:3706-3719. [PMID: 38772688 DOI: 10.1002/ptr.8231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/23/2024]
Abstract
In recent years, there have been a number of studies where hesperidin was administered to modify arterial blood pressure, but the conclusions of each study are contradictory. In order to investigate the effect of hesperidin on blood pressure, we searched the CNKI, Wanfang Database, the VIP database, Sinomed database, Pubmed, Embase and The Cochrane Library databases, and searched the literature on hesperidin and blood pressure published in Chinese and English journals, mainly focusing on patients' systolic blood pressure and diastolic blood pressure. The search time frame was from the inception of the databases until December 2023. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the overall quality and used Cohen's kappa coefficient (κ) to measure agreement. We did preliminary screening of the retrieved literature through Notexpress, 14 articles with a total of 656 patients were included. Cochrance data conversion tool was used for data conversion, and RevMan 5.3 was used for meta-analysis, and finally Stata was used to make the Egger's test for the included study. The results of total population blood pressure showed that hesperidin had no antihypertensive effect on the population, but the conclusions changed when the population was divided into groups. The results of different populations showed that hesperidin had no effect on systolic blood pressure (weighted mean difference [WMD] = -0.50, 95% CI: -3.25 ~ 2.26, Z = 0.35, p = 0.72) and diastolic blood pressure (WMD = -0.51, 95% CI: -2.53 ~ 1.51, Z = 0.50, p = 0.62) in healthy individuals. However, hesperidin reduced systolic blood pressure in patients with type 2 diabetes (WMD = -4.32, 95% CI: - 7.77 ~ - 0.87, Z = 2.45, p = 0.01), and had a tendency to reduce diastolic blood pressure in diabetic patients (WMD = -3.72, 95% CI: -7.63 ~ 0.18, Z = 1.87, p = 0.06). The results in patients with type 2 diabetes needed to be further supported by future research focusing on individuals with diabetes.
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Affiliation(s)
- Haifeng Gao
- School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, Shandong, China
| | - Fang Chen
- School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, Shandong, China
| | - Shuo Wang
- School of Pharmaceutical Sciences, Liaocheng University, Liaocheng, Shandong, China
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Gaur A, Varatharajan S, Taranikanti M, John NA, Kalpana M, Ganji V, Umesh M, Katta R. Inter-trial Variation in the Sensitivity of Thermal Threshold Testing for the Diagnosis of Neuropathy in Type 2 Diabetes Mellitus. Int J Appl Basic Med Res 2024; 14:182-186. [PMID: 39310082 PMCID: PMC11412566 DOI: 10.4103/ijabmr.ijabmr_207_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/18/2024] [Accepted: 07/26/2024] [Indexed: 09/25/2024] Open
Abstract
Background Thermal threshold testing (TTT) is a simple non-invasive approach for diagnosing diabetic neuropathy earlier. Conventionally the TTT is done in all four limbs and at least 6 trials are done to obtain the mean threshold, which is time consuming. Aim We propose to assess the validity and reliability of reduced number of trials of TTT in the lower limbs. Materials and Methods After obtaining ethics approval from the Institute Ethics Committee, 100 patients with type 2 Diabetes Mellitus of both gender between the ages of 35 to 65 years attending medicine OPD were recruited. Neuropathy assessment was done using Temperature threshold testing. At least 6 trials were performed for each site and the mean threshold obtained. The mean of 5 trials, 4 trials and 3 trials were noted for the comparison. Results On comparing hot tests of 3 trials with 6 trials had a sensitivity and specificity of 88.7% and 96.6 %. In cold threshold testing, 4 trials and 3 trials showed similar results of sensitivity of 77.8%, specificity of 98.8%. The measures of agreement between the hot trials 6 vs 5 had Kappa value of 0.953, 6vs 4 showed a Kappa value of 0.862 and 6 vs 3 showed Kappa value of 0.819. Conclusion Hot threshold tests of lower limb are more sensitive than cold thresholds. The 4 trial test is a reliable test and can be performed over 6 trial tests. When time is a factor, three trials are sufficient to diagnose small fibre neuropathy.
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Affiliation(s)
- Archana Gaur
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | | | - Madhuri Taranikanti
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Nitin Ashok John
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Medala Kalpana
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Vidya Ganji
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Madhusudhan Umesh
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Roja Katta
- Department of Physiology, ESIC Medical College and Hospital, Hyderabad, Telangana, India
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Carlin de Ramos do Espírito Santo B, Amante Cardoso L, Sudatti Delevatti R, de la Rocha Freitas C. +Acute blood pressure response after Mat Pilates alone and combined with aerobic exercise. J Bodyw Mov Ther 2024; 39:579-582. [PMID: 38876689 DOI: 10.1016/j.jbmt.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/17/2023] [Accepted: 03/03/2024] [Indexed: 06/16/2024]
Abstract
The objective of this study was to evaluate the response of systolic blood pressure (SBP) and diastolic blood pressure (DBP) after one session of the Mat Pilates Method alone (traditional) - (MPA) and a second session of the Mat Pilates Method combined with an aerobic exercise (MP + STEP). The sample consisted of 10 adults, of both sexes, Pilates practitioners. Two MP sessions were performed, using 21 original exercises of the method. Blood pressure (BP) was measured before the beginning of the sessions, after 10 min of rest, immediately after the sessions, and 5 min after the end of the sessions. Statistical analyses were performed using generalized estimating equations, α: 5%. In both sessions, SBP (mmHg) increased immediately after (p < 0.001) and returned to baseline values 5 min post-session (p = 0.181) (MPA-rest: 113.90 ± 3.22, immediately after: 120.70 ± 3.57.5; 5 min after: 117.20 ± 2.12; MP + STEP: rest: 112.80 ± 3.03, immediately after: 119.00 ± 3.00, 5 min after: 114.90 ± 2.09). DBP (mmHg) showed a reduction in both sessions immediately (p = 0.001) and 5 min after the sessions (p = 0.008) (MPA - rest: 71.00 ± 2.98; immediately after: 67.00 ± 3 0.03; 5 min after: 67.70 ± 2.31; MP + STEP - rest: 74.90 ± 2.10, immediately after: 67.10 ± 2.63; 5 min after: 70.00 ± 2.23). It is concluded that, regardless of the association with aerobic exercise, the Mat Pilates method can be performed without significant increases in SBP and with a reduction in DBP.
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Affiliation(s)
| | - Licelli Amante Cardoso
- Physical Education Department, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Pandey KN. Genetic and Epigenetic Mechanisms Regulating Blood Pressure and Kidney Dysfunction. Hypertension 2024; 81:1424-1437. [PMID: 38545780 PMCID: PMC11168895 DOI: 10.1161/hypertensionaha.124.22072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
The pioneering work of Dr Lewis K. Dahl established a relationship between kidney, salt, and high blood pressure (BP), which led to the major genetic-based experimental model of hypertension. BP, a heritable quantitative trait affected by numerous biological and environmental stimuli, is a major cause of morbidity and mortality worldwide and is considered to be a primary modifiable factor in renal, cardiovascular, and cerebrovascular diseases. Genome-wide association studies have identified monogenic and polygenic variants affecting BP in humans. Single nucleotide polymorphisms identified in genome-wide association studies have quantified the heritability of BP and the effect of genetics on hypertensive phenotype. Changes in the transcriptional program of genes may represent consequential determinants of BP, so understanding the mechanisms of the disease process has become a priority in the field. At the molecular level, the onset of hypertension is associated with reprogramming of gene expression influenced by epigenomics. This review highlights the specific genetic variants, mutations, and epigenetic factors associated with high BP and how these mechanisms affect the regulation of hypertension and kidney dysfunction.
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Affiliation(s)
- Kailash N. Pandey
- Department of Physiology, Tulane University Health Sciences Center, School of Medicine, New Orleans, LA
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40
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Wei W, Ma D, Li L, Zhang L. Cognitive impairment in cerebral small vessel disease induced by hypertension. Neural Regen Res 2024; 19:1454-1462. [PMID: 38051887 PMCID: PMC10883517 DOI: 10.4103/1673-5374.385841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/22/2023] [Indexed: 12/07/2023] Open
Abstract
ABSTRACT Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease, the most common cerebrovascular disease. However, the causal relationship between hypertension and cerebral small vessel disease remains unclear. Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease. Chronic hypertension and lifestyle factors are associated with risks for stroke and dementia, and cerebral small vessel disease can cause dementia and stroke. Hypertension is the main driver of cerebral small vessel disease, which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction, leukoaraiosis, white matter lesions, and intracerebral hemorrhage, ultimately resulting in cognitive decline and demonstrating that the brain is the target organ of hypertension. This review updates our understanding of the pathogenesis of hypertension-induced cerebral small vessel disease and the resulting changes in brain structure and function and declines in cognitive ability. We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.
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Affiliation(s)
- Weipeng Wei
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Denglei Ma
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Lin Li
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Lan Zhang
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
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41
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Reindl M, Lechner I, Reinstadler SJ, Metzler B. Cardiac remodelling patterns in hypertension: does ethnicity matter? Eur Heart J Cardiovasc Imaging 2024; 25:912-913. [PMID: 38700002 DOI: 10.1093/ehjci/jeae116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 04/23/2024] [Indexed: 05/05/2024] Open
Affiliation(s)
- Martin Reindl
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Ivan Lechner
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Sebastian J Reinstadler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Bernhard Metzler
- University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria
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Santos JSD, Mulinari-Santos G, DE Souza Batista FR, Gomes-Ferreira PHS, Palin LP, Antoniali C, Okamoto R. Analysis of peri-implant bone tissue between hydrophilic and rough implant surfaces in spontaneously hypertensive rats treated with losartan. J Appl Oral Sci 2024; 32:e20230374. [PMID: 38922240 PMCID: PMC11182640 DOI: 10.1590/1678-7757-2023-0374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVES to evaluate the morphological and functional characteristics of the peri-implant bone tissue that was formed during the healing process by the placement implants using two different surface treatments: hydrophilic Acqua™ (ACQ) and rough NeoPoros™ (NEO), in spontaneously hypertensive (SHR) and normotensive rats (Wistar) whether or not treated with losartan. METHODOLOGY In total, 96 male rats (48 Wistar and 48 SHR) were divided into eight subgroups: absolute control rough (COA NEO), absolute control hydrophilic (COA ACQ), losartan control rough (COL NEO), losartan control hydrophilic (COL ACQ), SHR absolute rough (SHR NEO), SHR absolute hydrophilic (SHR ACQ), SHR losartan rough (SHRL NEO), and SHR losartan hydrophilic (SHRL ACQ). The rats medicated with losartan received daily doses of the medication. NeoPoros™ and Acqua™ implants were installed in the tibiae of the rats. After 14 and 42 days of the surgery, the fluorochromes calcein and alizarin were injected in the rats. The animals were euthanized 67 days after treatment. The collected samples were analyzed by immunohistochemistry, biomechanics, microcomputerized tomography, and laser confocal scanning microscopy analysis. RESULTS The osteocalcin (OC) and vascular endothelium growth factor (VEGF) proteins had moderate expression in the SHRL ACQ subgroup. The same subgroup also had the highest implant removal torque. Regarding microarchitectural characteristics, a greater number of trabeculae was noted in the control animals that were treated with losartan. In the bone mineralization activity, it was observed that the Acqua™ surface triggered higher values of MAR (mineral apposition rate) in the COA, COL, and SHRL groups (p<0.05). CONCLUSION the two implant surface types showed similar responses regarding the characteristics of the peri-implant bone tissue, even though the ACQ surface seems to improve the early stages of osseointegration.
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Affiliation(s)
- Jaqueline Silva Dos Santos
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Odontologia de Araçatuba, Departamento de Ciências Básicas, Araçatuba, Brasil
| | - Gabriel Mulinari-Santos
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Odontologia de Araçatuba, Departamento de Diagnóstico e Cirurgia, Araçatuba, Brasil
| | - Fábio Roberto DE Souza Batista
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Odontologia de Araçatuba, Departamento de Diagnóstico e Cirurgia, Araçatuba, Brasil
| | - Pedro Henrique Silva Gomes-Ferreira
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Odontologia de Araçatuba, Departamento de Diagnóstico e Cirurgia, Araçatuba, Brasil
| | - Letícia Pitol Palin
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Odontologia de Araçatuba, Departamento de Diagnóstico e Cirurgia, Araçatuba, Brasil
| | - Cristina Antoniali
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Odontologia de Araçatuba, Departamento de Ciências Básicas, Araçatuba, Brasil
| | - Roberta Okamoto
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Faculdade de Odontologia de Araçatuba, Departamento de Ciências Básicas, Araçatuba, Brasil
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Yao Y, Shen J, Luo J, Li N, Liao X, Zhang Y. Disagreements in risk of bias assessment for randomized controlled trials in hypertension-related Cochrane reviews. Trials 2024; 25:405. [PMID: 38907276 PMCID: PMC11191165 DOI: 10.1186/s13063-024-08145-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/29/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND The inter-reviewer reliability of the risk of bias (RoB) assessment lacked agreement in previous studies. It is important to analyse these disagreements to improve the repeatability of RoB assessment. The objective of the study was to evaluate the frequency and reasons for disagreements in RoB assessments for randomised controlled trials (RCTs) that were included in multiple Cochrane reviews in the field of hypertension. METHODS A cross-sectional study was employed. We retrieved any RCTs that had been included in multiple Cochrane reviews in the field of hypertension from ARCHIE. The results of the RoB assessments were extracted, and the distributions of agreements and possible reasons for disagreement were analyzed. RESULTS Twenty-six Cochrane reviews were included in this study. A total of 78 RCTs appeared in more than one Cochrane review. The level of agreement ranged from domain to domain. "Blinding of outcome assessment" showed a reasonably high level of agreement (94.9%), while "incomplete outcome data", "selective outcome reporting" and "other sources of bias" showed moderate levels of agreement (74.6%, 79.2% and 75.6%, respectively). However, the domains of "allocation concealment", "random sequence generation" and "blinding of participants and personnel" showed low levels of agreement (24.4%, 23.5%, and 47.4%, respectively). In the domains of "allocation concealment" and "blinding of participants and personnel", the agreement group had higher proportion of publication year ≤ 1996 than the disagreement group (P = 0.008 and P < 0.001, respectively). In the "blinding of participants and personnel", the impact factor was higher in the agreement group (P < 0.001). By analyzing the support text, we found that the most likely reason for disagreement was extracting different information from the same RCT. CONCLUSION For Cochrane reviews in the field of hypertension using the 2011 version of the RoB tool, there was a large disagreement in the RoB assessment. It is suggested that the results of RoB assessments in systematic reviews that used the 2011 version of the RoB tool need to be interpreted with caution. More accurate information from RCTs needs to be collected when we synthesize clinical evidence.
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Affiliation(s)
- Yi Yao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Jing Shen
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jianzhao Luo
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Nian Li
- Department of Medical Administration, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaoyang Liao
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Yonggang Zhang
- Department of Periodical Press and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Arshed M, Mahmud A, Minhat HS, Lim PY, Zakar R. Effectiveness of a Multifaceted Mobile Health Intervention (Multi-Aid-Package) in Medication Adherence and Treatment Outcomes Among Patients With Hypertension in a Low- to Middle-Income Country: Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e50248. [PMID: 38896837 PMCID: PMC11222770 DOI: 10.2196/50248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 01/31/2024] [Accepted: 04/30/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The high prevalence of uncontrolled hypertension in Pakistan is predominantly attributed to poor medication adherence. As more than 137 million people in Pakistan use cell phones, a suitable mobile health (mHealth) intervention can be an effective tool to overcome poor medication adherence. OBJECTIVE We sought to determine whether a novel mHealth intervention is useful in enhancing antihypertensive therapy adherence and treatment outcomes among patients with hypertension in a low- to middle-income country. METHODS A 6-month parallel, single-blinded, superiority randomized controlled trial recruited 439 patients with hypertension with poor adherence to antihypertensive therapy and access to smartphones. An innovative, multifaceted mHealth intervention (Multi-Aid-Package), based on the Health Belief Model and containing reminders (written, audio, visual), infographics, video clips, educational content, and 24/7 individual support, was developed for the intervention group; the control group received standard care. The primary outcome was self-reported medication adherence measured using the Self-Efficacy for Appropriate Medication Adherence Scale (SEAMS) and pill counting; the secondary outcome was systolic blood pressure (SBP) change. Both outcomes were evaluated at baseline and 6 months. Technology acceptance feedback was also assessed at the end of the study. A generalized estimating equation was used to control the covariates associated with the probability of affecting adherence to antihypertensive medication. RESULTS Of 439 participants, 423 (96.4%) completed the study. At 6 months post intervention, the median SEAMS score was statistically significantly higher in the intervention group compared to the controls (median 32, IQR 11 vs median 21, IQR 6; U=10,490, P<.001). Within the intervention group, there was an increase in the median SEAMS score by 12.5 points between baseline and 6 months (median 19.5, IQR 5 vs median 32, IQR 11; P<.001). Results of the pill-counting method showed an increase in adherent patients in the intervention group compared to the controls (83/220, 37.2% vs 2/219, 0.9%; P<.001), as well as within the intervention group (difference of n=83, 37.2% of patients, baseline vs 6 months; P<.001). There was a statistically significant difference in the SBP of 7 mmHg between the intervention and control groups (P<.001) at 6 months, a 4 mmHg reduction (P<.001) within the intervention group, and a 3 mmHg increase (P=.314) within the controls. Overall, the number of patients with uncontrolled hypertension decreased by 46 in the intervention group (baseline vs 6 months), but the control group remained unchanged. The variables groups (adjusted odds ratio [AOR] 1.714, 95% CI 2.387-3.825), time (AOR 1.837, 95% CI 1.625-2.754), and age (AOR 1.618, 95% CI 0.225-1.699) significantly contributed (P<.001) to medication adherence. Multi-Aid-Package received a 94.8% acceptability score. CONCLUSIONS The novel Multi-Aid-Package is an effective mHealth intervention for enhancing medication adherence and treatment outcomes among patients with hypertension in a low- to middle-income country. TRIAL REGISTRATION ClinicalTrials.gov NCT04577157; https://clinicaltrials.gov/study/NCT04577157.
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Affiliation(s)
- Muhammad Arshed
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
- University Institute of Public Health, Faculty of Allied Health Sciences, University of Lahore, Punjab, Lahore, Pakistan
| | - Aidalina Mahmud
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Halimatus Sakdiah Minhat
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Poh Ying Lim
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Rubeena Zakar
- Department of Public Health, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
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Huang M, Wang T, Wang Y, Deng Q, Chen J, Li L, Luo H, Lu Y. Marine sourced tripeptide SRP and its sustained-release formulation SRP-PLGA-MS exhibiting antihypertensive effect in spontaneously hypertensive rats and HUVECs. Front Nutr 2024; 11:1423098. [PMID: 38933890 PMCID: PMC11199895 DOI: 10.3389/fnut.2024.1423098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Biopeptides from Sipunculus nudus were reported with good ACE inhibitory activity, and the tripeptide SRP was one with the highest ACE inhibition rate. However, the disadvantage of short half-life limited the development of peptide drugs. Moreover, the distinct mechanism of the peptide inhibiting ACE remained unknown. Thus, in this study, a sustained release formulation of SRP-PLGA-MS was designed and prepared. Its long-lasting antihypertensive effect as well as improvement of vascular pathomorphology was verified in spontaneously hypertensive rat (SHR). In addition, the anti-oxidant activity of SRP in human umbilical vein endothelial cells (HUVECs) was evaluated. The results showed that SRP inhibited the production of ROS and NO, which involve the NADPH oxidase, and Keap1/Nrf2 signaling pathway. This study demonstrated that SRP-PLGA-MS had the potential to develop sustained-release drugs for hypertension treatment.
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Affiliation(s)
- Miaoen Huang
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang, China
- College of Pharmacy, Guangdong Medical University, Zhanjiang, China
| | - Tianji Wang
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang, China
- College of Pharmacy, Guangdong Medical University, Zhanjiang, China
| | - Yinghao Wang
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang, China
- Zhanjiang Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, China
| | - Qingyan Deng
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang, China
- College of Pharmacy, Guangdong Medical University, Zhanjiang, China
| | - Jinjun Chen
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang, China
- Zhanjiang Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, China
| | - Li Li
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang, China
- College of Pharmacy, Guangdong Medical University, Zhanjiang, China
| | - Hui Luo
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang, China
- College of Pharmacy, Guangdong Medical University, Zhanjiang, China
- Zhanjiang Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, China
| | - Yingnian Lu
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang, China
- College of Pharmacy, Guangdong Medical University, Zhanjiang, China
- Zhanjiang Marine Biomedical Research Institute, Guangdong Medical University, Zhanjiang, China
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Zhu G, Wen Y, Liang J, Wang T. Effect modification of diet and vitamins on the association between air pollution particles of different diameters and hypertension: A 12-year longitudinal cohort study in densely populated areas of China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 928:172222. [PMID: 38588735 DOI: 10.1016/j.scitotenv.2024.172222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/12/2024] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Particulate matter (PM) is identified as one of the exacerbating and triggering factors for hypertension. Diet intake and the consumption of vitamins may potentially moderate the impact of PM on hypertension. METHODS A 12-year longitudinal cohort study was conducted on a population in densely populated areas of China. Residual balancing with weighted methods was employed to control for time-varying and no time-varying confounding factors. Stratified Cox proportional hazards models were conducted to examine the moderating effects of diet and vitamins on the risk of hypertension with PM. RESULTS There was a significant positive association between long-term exposure to different diameter PM and the risk of developing hypertension. The hazard ratios (HRs) for hypertension were 1.0200 (95 % CIs: 1.0147, 1.0253) for PM1, 1.0120 (95 % CIs: 1.0085, 1.0155) for PM2.5, and 1.0074 (95 % CIs, 1.0056, 1.0092) for PM10. The diet and vitamins moderated these associations, the intake of healthy foods and vitamins exhibited a significant positive moderating effect on the relationship between PM exposure and hypertension risk. Among all participants, the high intake of fruit (PM1 (HRs: 1.0102, 95 % CIs: 1.0024, 1.0179), PM2.5 (HRs: 1.0060, 95 % CIs: 1.0011, 1.0109), and PM10 (HRs: 1.0044, 95 % CIs: 1.0018, 1.0070)) and vitamin E (PM1 (HRs: 1.0143, 95 % CIs: 1.0063, 1.0223), PM2.5 (HRs:1.0179, 95 % CIs: 1.0003, 1.0166), and PM10 (HRs: 1.0042, 95 % CIs: 1.0008, 1.0075)) with lower risk of hypertension than the overall level and low intake of related foods and vitamins, exhibited a strong positive moderating effect on the relationship between PM and hypertension. Similar trends were observed for the intake of fish, root food, whole grains, eggs, fungus food, vitamin B2, B3. However, Na, meat, sugary and alcoholic exhibited opposite trends. The moderating effect of vitamin E intake was stronger than vitamin B and C. CONCLUSIONS Diet and vitamins intake may moderate the association between PM exposure and the risk of hypertension in adults.
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Affiliation(s)
- Guiming Zhu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, China
| | - Yanchao Wen
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, China
| | - Jie Liang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, China
| | - Tong Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, China.
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Li G, Liu L, Liu DL, Yu ZZ, Golden AR, Yin XY, Cai L. Tobacco exposure and alcohol drinking prevalence and associations with hypertension in rural southwest China: A cross-sectional study. Tob Induc Dis 2024; 22:TID-22-101. [PMID: 38860152 PMCID: PMC11163415 DOI: 10.18332/tid/189222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/19/2024] [Accepted: 05/23/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION This study examined the prevalence of tobacco exposure and drinking and ascertained the relationships between tobacco exposure, alcohol drinking, concurrent smoking and drinking, and hypertension in rural southwestern China. METHODS Data were collected from a cross-sectional health interview and examination survey, which included 7572 adults aged ≥35 years, in rural China. Participant demographic characteristics, smoking habits, exposure to secondhand smoke (SHS), and alcohol drinking habits were obtained using a standard questionnaire. Blood pressure (BP), height, weight, and waist circumference were measured for each participant. RESULTS The overall prevalence of smoking, SHS exposure, drinking, concurrent smoking and drinking, concurrent exposure to SHS and drinking, and hypertension was 37.7%, 27.4%, 16.2%, 12.6%, 1.6%, and 41.3%, respectively. Males had a significantly higher prevalence of smoking (74.1% vs 2.2%, p<0.01), drinking (31.1% vs 1.7%, p<0.01), and concurrent smoking and drinking than females (25.3% vs 0.3%, p<0.01). However, females had a higher prevalence of SHS exposure than males (30.2% vs 20.6%, p<0.01). Ethnic minorities had a higher prevalence of SHS exposure, drinking, and concurrent smoking and drinking, than Han participants (p<0.01). Participants with a higher education level had a higher prevalence of smoking, drinking, and concurrent smoking and drinking than their counterparts (p<0.01). In contrast, participants with a lower education level had a higher prevalence of SHS exposure than their counterparts (p<0.01). Multivariate logistic regression analysis found that smokers (AOR=1.31; 95% CI: 1.13-1.51), individuals exposed to SHS (AOR=1.24; 95% CI: 1.11-1.43), drinkers (AOR=1.31; 95%: CI: 1.15-1.50), and concurrent smokers and drinkers (AOR=1.45; 95% CI: 1.25-1.67) all had a higher probability of having hypertension (p<0.01). Additionally, concurrent smoking and drinking had the strongest association with the prevalence of hypertension (AOR=1.45; 95% CI: 1.25-1.67; p<0.01). CONCLUSIONS Socioeconomic factors play an important role in influencing the prevalence of smoking, exposure to SHS, and drinking in rural southwest China. Interventions to prevent and reduce hypertension should, in particular, focus on smokers, individuals exposed to SHS, drinkers, and, in particular, concurrent smokers and drinkers.
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Affiliation(s)
- Guohui Li
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Lan Liu
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Du-li Liu
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Zi-zi Yu
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Allison R. Golden
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Xiang-yang Yin
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
| | - Le Cai
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Key Laboratory of Public Health and Biosafety, School of Public Health, Kunming Medical University
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Camara A, Koné A, Millimono TM, Sow A, Kaké A, Preux PM, Balde MD, Jesus P. Prevalence, risks factors, and control of hypertension in Guinean older adults in 2021: a cross-sectional survey. BMC Public Health 2024; 24:1530. [PMID: 38844883 PMCID: PMC11157834 DOI: 10.1186/s12889-024-18936-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 05/23/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND The incidence of arterial hypertension increases with the aging of the population, but its magnitude remains insufficiently assessed. The aim of this study was to investigate the prevalence of hypertension and associated factors in elderly people in Guinea. METHODS Data were obtained from a cross-sectional general population survey, conducted among people aged ≥ 60 years. A stratified enumeration area random sample survey was conducted in the four natural regions of Guinea from February to April 2021. This study included an interview on sociodemographic data, and a clinical examination. Hypertension was defined as systolic blood pressure ≥ 140mmHg and/or diastolic blood pressure ≥ 90mmHg or previous diagnosis of hypertension (with or without antihypertensive medication). Hypertension control was defined as blood pressure below 140/90 mmHg during treatment. Age-standardized prevalence was calculated, and logistic regression was used to examine factors associated with hypertension. RESULTS A total of 1698 adults (1079 men, mean age: 71.6 ± 9.4 years) had at least two blood pressure measurements. The standardized prevalence of hypertension was 61.4% [95% CI: 61.3-61.6], ranging from 52% in Middle Guinea to 67% in Upper Guinea, and was higher in women (65.2%: 65.0-65.4) than in men (59.1%:58.9-59.3). Among those with hypertension, 46.7% were unaware of their condition before the survey and 49.6% were on treatment and only 18.5% had controlled hypertension. Whatever the residence (rural or urban), increasing age, being unmarried, working as a trader or functionary, jobless, living in upper Guinea, low monthly income, intake of extra salt, known diabetic, overweight, and obesity increased the risk of hypertension. In urban area, female sex (AOR: 1.14: 1.12-1.17), living in lower Guinea (AOR: 3.08: 2.97-3.20), being Maninka (AOR: 1.26: 1.21-1.31), being Nguerze (AOR: 1.71: 1.63-1.81) increased the risk of hypertension, but living in forest Guinea (AOR: 0.88: 0.83-0.93), being Soussou (AOR: 0.88: 0.85-0.92) decreased the risk. In rural area, living in forest Guinea (AOR: 2.14: 2.03-2.26), being Soussou (AOR: 1.14: 1.12-1.17) increased the risk of hypertension, but female sex (AOR: 0.96: 0.94-0.98), living in lower Guinea (AOR: 0.87: 0.85-0.89), being Maninka (AOR: 0.94: 0.92-0.97), being Nguerze (AOR: 0.50: 0.47-0.52) decreased the risk. CONCLUSION Hypertension is a major problem in the elderly population in Guinea, and the level of treatment and control in elderly with known hypertension is inadequate. The place of hypertension among cardiovascular diseases and the identification of associated factors underlines the need to develop innovative approaches to control this major risk factor.
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Affiliation(s)
- Alioune Camara
- Department of Public Health, Faculty of Sciences and Health Technics, Gamal Abdel Nasser University of Conakry, Conakry, BP: 1017, CP:030, Guinea.
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea.
| | - Alpha Koné
- Department of Cardiology, Faculty of Sciences and Health Technics, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Thierno Mamadou Millimono
- Department of Public Health, Faculty of Sciences and Health Technics, Gamal Abdel Nasser University of Conakry, Conakry, BP: 1017, CP:030, Guinea
- EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Inserm U1094, IRD U270, CHU Limoges, Univ. Limoges, Limoges, France
| | - Abdoulaye Sow
- Department of Public Health, Faculty of Sciences and Health Technics, Gamal Abdel Nasser University of Conakry, Conakry, BP: 1017, CP:030, Guinea
- African Center of Excellence for the Prevention and Control of Communicable Diseases, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Amadou Kaké
- National Program of Prevention and Control of Non-Communicable Diseases, Ministry of Health Public Hygiene, Conakry, Guinea
| | - Pierre-Marie Preux
- EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Inserm U1094, IRD U270, CHU Limoges, Univ. Limoges, Limoges, France
| | - Mamadou Dadhi Balde
- Department of Cardiology, Faculty of Sciences and Health Technics, Gamal Abdel Nasser University of Conakry, Conakry, Guinea
| | - Pierre Jesus
- EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, Inserm U1094, IRD U270, CHU Limoges, Univ. Limoges, Limoges, France
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Gupta R, Gaur K, Ahuja S, Anjana RM. Recent studies on hypertension prevalence and control in India 2023. Hypertens Res 2024; 47:1445-1456. [PMID: 38379011 DOI: 10.1038/s41440-024-01585-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/27/2023] [Accepted: 12/30/2023] [Indexed: 02/22/2024]
Abstract
Hypertension is the most important chronic disease risk factor in India. Recent epidemiological studies have reported that hypertension is increasing in India with a more rapid increase in rural and young populations. Fifth National Family Health Survey (NFHS-5) and Indian Council of Medical Research-INDIAB surveys have reported that there are substantial geographic variations in hypertension prevalence with greater prevalence in more developed states and districts of the country. There is a high prevalence of young-age hypertension, especially in the less developed states. The incidence of adverse events from hypertension-related cardiovascular disease is significantly greater in India than in more developed countries. A low level of hypertension awareness, treatment, and control, especially in rural and underserved urban populations is an important finding. In this narrative review, we highlight recent nationwide studies and unique features of hypertension in India and suggest strategies for better hypertension management and control.
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Affiliation(s)
- Rajeev Gupta
- Department of Preventive Cardiology & Medicine, Eternal Heart Care Centre & Research Institute, Jaipur, India.
- Research Board, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India.
| | - Kiran Gaur
- Department of Statistics, Mathematics and Computer Science, Government SKN Agriculture University, Jobner, Jaipur, India
| | - Shiva Ahuja
- Department of Orthodontics, Jaipur Dental College, Jaipur, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr Mohan's Diabetes Research Centre, Chennai, India
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50
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Ding C, Li J, Wei Y, Fan W, Cao T, Chen Z, Shi Y, Yu C, Yuan T, Zhao P, Zhou W, Yu C, Wang T, Zhu L, Huang X, Bao H, Cheng X. Associations of total homocysteine and kidney function with all-cause and cause-specific mortality in hypertensive patients: a mediation and joint analysis. Hypertens Res 2024; 47:1500-1511. [PMID: 38438721 DOI: 10.1038/s41440-024-01613-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/19/2024] [Accepted: 01/27/2024] [Indexed: 03/06/2024]
Abstract
Plasma total homocysteine (tHcy) and kidney function are both associated with mortality risk, but the degree to which kidney function modifies the impact of tHcy on mortality remains unknown. This prospective cohort study included a total of 14,225 hypertensive adults. Cox proportional hazard regression was used to analyze the separate and combined association of tHcy and estimated glomerular filtration rate (eGFR) with all-cause and cause-specific mortality. Mediation analysis was conducted to explore the mediating effect of eGFR. During a median follow-up of 4.0 years, 805 deaths were identified, including 397 deaths from cardiovascular disease (CVD). There were significant, positive relationships of tHcy with all-cause mortality (per 5 μmol/L; HR: 1.09; 95% CI: 1.07, 1.11), CVD mortality (HR: 1.11; 95% CI: 1.08, 1.13), and non-CVD mortality (HR: 1.07; 95% CI: 1.04, 1.10). The proportions of eGFR mediating these relationships were 39.1%, 35.7%, and 49.7%, respectively. There were additive interactions between tHcy and eGFR. Compared with those with low tHcy (<15 μmol/L) and high eGFR (≥90 mL·min-1·1.73 m-2), participants with high tHcy (≥20 μmol/L) and low eGFR (<60 mL·min-1·1.73 m-2) had the highest risk of all-cause mortality (HR: 4.89; 95% CI: 3.81, 6.28), CVD mortality (HR: 5.80; 95% CI: 4.01, 8.40), and non-CVD mortality (HR: 4.25; 95% CI: 3.02, 5.97). In conclusion, among Chinese hypertensive adults, high tHcy and impaired kidney function were independently and jointly associated with higher risks of all-cause and cause-specific mortality. Importantly, kidney function explained most (nearly 40%) of the increased risk of mortality conferred by high tHcy.
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Affiliation(s)
- Congcong Ding
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Junpei Li
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Yaping Wei
- College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Weiguo Fan
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Tianyu Cao
- Biological anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Zihan Chen
- Queen Mary School, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Yumeng Shi
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Chuanli Yu
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Ting Yuan
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Peixu Zhao
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Chao Yu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Tao Wang
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Lingjuan Zhu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Xiao Huang
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China.
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China.
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
| | - Huihui Bao
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China.
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China.
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China.
- Jiangxi Sub-center of National Clinical Research Center for Cardiovascular Diseases, Nanchang, Jiangxi, China.
- Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
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