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Joshi A, Kaur S, Taneja SK, Mandal R. Review Article on Molecular Mechanism of Regulation of Hypertension by Macro-elements (Na, K, Ca and Mg), Micro-elements/Trace Metals (Zn and Cu) and Toxic Elements (Pb and As). Biol Trace Elem Res 2024; 202:1477-1502. [PMID: 37523058 DOI: 10.1007/s12011-023-03784-z] [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: 05/07/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023]
Abstract
Hypertension (HT) is a medical condition arising due to increase in blood pressure (BP) prevalent worldwide. The balanced dietary intakes of macro-elements and micro-elements including Na, K, Ca, Mg, Zn, and Cu have been described to maintain BP in humans by regulating the osmolarity of blood, cells/tissues, prevention of generation of oxidative and nitrosative stress (OANS), and endothelial damage through their functioning as important components of renin-angiotensin-aldosterone system (RAAS), antioxidant enzyme defense system, and maintenance of blood vascular-endothelial and vascular smooth muscle cell (VSMC) functions. However, inadequate/excess dietary intakes of Na/K, Ca/Mg, and Zn/Cu along with higher Pb and As exposures recognized to induce HT through common mechanisms including the followings: endothelial dysfunctions due to impairment of vasodilatation, increased vasoconstriction and arterial stiffness, blood clotting, inflammation, modification of sympathetic activity and higher catecholamine release, increased peripheral vascular resistance, and cardiac output; increased OANS due to reduced and elevated activities of extracellular superoxide dismutase and NAD(P)H oxidase, less nitric oxide bioavailability, decrease in cGMP and guanylate cyclase activity, increase in intracellular Ca2+ ions in VSMCs, and higher pro-inflammatory cytokines; higher parathyroid and calcitriol hormones; activation/suppression of RAAS resulting imbalance in blood Na+, K+, and water regulated by renin, angiotensin II, and aldosterone through affecting natriuresis/kaliuresis/diuresis; elevation in serum cholesterol and LDL cholesterol, decrease in HDL cholesterol due to defect in lipoprotein metabolism. The present study recommends the need to review simple dietary mineral intervention studies/supplementation trials before keeping their individual dietary excess intakes/exposures in consideration because their interactions lead to elevation and fall of their concentrations in body affecting onset of HT.
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Affiliation(s)
- Amit Joshi
- PG Department of Biotechnology and Microbial Biotechnology, Sri Guru Gobind Singh College, Sector-26, Chandigarh, UT, India
| | - Sukhbir Kaur
- Department of Zoology, Panjab University, Sector-14, Chandigarh, UT, India
| | | | - Reshu Mandal
- PG Department of Zoology, Sri Guru Gobind Singh College, Sector-26, Chandigarh, UT, India.
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Mekonen HH, Gebru TH, Kiros KG, Gebrehiwot TG, Tesfamichael YA. Undiagnosed hypertension and associated factors among adult population in central zone of Tigray, Northern Ethiopia 2020: A cross-sectional study. Health Sci Rep 2024; 7:e2052. [PMID: 38655424 PMCID: PMC11035904 DOI: 10.1002/hsr2.2052] [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: 08/02/2023] [Revised: 02/02/2024] [Accepted: 03/31/2024] [Indexed: 04/26/2024] Open
Abstract
Background and Aims Undiagnosed hypertension is a major risk factor for cardiovascular diseases and complications such as heart attack and stroke. Limited information is available on the prevalence of undiagnosed hypertension and its associated factors in Ethiopia, particularly in the study setting. This study aimed to assess the prevalence of undiagnosed hypertension and its associated factors in the central zone of Tigray, Northern Ethiopia. Methods A community-based cross-sectional study was conducted from April 1 to May 31, 2020. A pretested structured questionnaire was used and both face-to-face interview and physical measurement were used to collect the data. Blood pressure was measured on two different days for each study participant, and an average of the measurements were taken. In addition, 736 participants were included in this study, through a systematic random sampling technique. Data were analyzed using SPSS version 23. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with undiagnosed hypertension. Adjusted odds ratios and 95% confidence intervals were used to show the strength of the association and declare statistical significance at p < 0.05. Results In the study, the mean age of the participants was 51.9 (standard deviation: 17.9) years old. Prevalence of undiagnosed hypertension was found 15.4% (N = 113). The factors associated with undiagnosed hypertension were being divorced (adjusted odds ratio [AOR] = 15.2, 95% confidence interval [CI]: 8.2-28.3), alcohol consumption (AOR = 2.07, 95% CI: 1.22-3.51), not eating fruits (AOR = 4.1, 95% CI: 2.37-7.08), not eating vegetables (AOR = 3.47, 95% CI: 2.02-5.96) and poor knowledge (AOR = 3.05, 95% CI: 2.75-7.83). Conclusion Around one in six study participants had undiagnosed hypertension. Being divorced, drinking alcohol, not eating fruits, not consuming vegetables, and having poor knowledge of hypertension were significant factors. Public health interventions, like providing adequate hypertension health information, frequent screening, and implementation of an appropriate intervention for particular factors, are critical for reducing the burden of undiagnosed hypertension.
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Affiliation(s)
- Haftea Hagos Mekonen
- Department of Nursing, College of Medicine and Health ScienceAdigrat UniversityTigrayEthiopia
| | - Tsegu Hailu Gebru
- Department of Nursing, College of Medicine and Health ScienceAdigrat UniversityTigrayEthiopia
| | - Kbrom Gemechu Kiros
- Department of Nursing, College of Medicine and Health ScienceAdigrat UniversityTigrayEthiopia
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Adal AB, Kassa RN, Habte MH, Jebesa MG, Ademe S, Tiruneh CT, Andualem A, Aynalem ZB, Bewket B. Undiagnosed hypertension and associated factors among long-distance bus drivers in Addis Ababa terminals, Ethiopia, 2022: A cross-sectional study. PLoS One 2024; 19:e0292890. [PMID: 38359046 PMCID: PMC10868739 DOI: 10.1371/journal.pone.0292890] [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: 03/28/2023] [Accepted: 10/01/2023] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Hypertension is a major public health problem that is often unrecognized, and its detection and control should be prioritized. The level of undiagnosed hypertension and its associated factors among long-distance bus drivers in Ethiopia is unknown. OBJECTIVE This study aimed to assess the magnitude of undiagnosed hypertension and its associated factors among long-distance bus drivers in Addis Ababa bus terminals. METHODS A facility-based cross-sectional study was conducted on 391 long-distance bus drivers from December 15, 2021, to January 15 2022 at five cross-country bus terminals in Addis Ababa. A standardized and structured questionnaire was adapted based on the WHO stepwise approach to a non-communicable disease study and translated into Amharic. Data were coded, cleaned, and entered using Epi-data version 4.6 and exported to SPSS version 26. Logistic regression analysis was performed. Variables with a P-value < 0.25 in the bivariable analysis were selected for multivariable logistic regression analysis. Independent variables with a P-value < 0.05 were considered statistically significant. The magnitude of association between independent and dependent variables was measured by odds ratio with a 95% confidence interval. RESULTS In this study, 391 study participants were involved with a response rate of 97.1%. The prevalence of undiagnosed hypertension was 22.5% (CI: 18.7%, 26.6%). Poor level of knowledge (AOR: 2.00, CI: 1.08, 3.70), long duration of driving per day (AOR: 2.50, 95% CI: 1.37-4.56), habit of chewing of chat (AOR: 2.61, 95% CI: 1.44, 4.73), regular alcohol consumption (AOR = 3.46; 95% CI: 1.70, 7.05), overweight (AOR:3.14, 95%CI: 1.54,6.42) obesity (AOR: 3.21, 95% CI 1.35, 7.61) and regular physical exercise (AOR: 0.16, 95% CI: 0.09, 0.29) were statistically significantly associated with undiagnosed hypertension. CONCLUSION This study revealed that the prevalence of undiagnosed hypertension among long-distance bus drivers was 22.5%, which was associated with modifiable behavioral factors, lack of regular physical exercise, lack of adequate awareness and high body mass index. RECOMMENDATION Stakeholders must implement the necessary preventive measures. These include increasing the level of awareness of hypertension among long-distance drivers and developing prevention of hypertension strategies and policies focusing on lifestyle and behavioral modifications.
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Affiliation(s)
- Abebaw Bires Adal
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | - Rahel Nega Kassa
- Department of Nursing, St. Paul’s Millennium Medical College, Addis Ababa, Ethiopia
| | | | | | - Sewunet Ademe
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | | | - Atsedemariam Andualem
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | - Zewdu Bishaw Aynalem
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
| | - Bekalu Bewket
- College of Medicine and Health Science, Department of Nursing, Injibara University, Injibara, Ethiopia
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Ayalew TL. Case cancellations and associated factors on the day of surgery in hospitals of Wolaita Zone, South Ethiopia. BMC Surg 2024; 24:45. [PMID: 38311751 PMCID: PMC10840272 DOI: 10.1186/s12893-024-02330-5] [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: 08/19/2023] [Accepted: 01/22/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Cancellations of elective surgery cases are frequent and have significant negative consequences. It causes wasting of valuable resources, patient unhappiness, and psychological stress of patients. Despite this, little is known about the case cancellation and associated factors on the day of surgery in Ethiopia, particularly in the study area. OBJECTIVE This study aimed to assess the magnitude of case cancellation and associated factors on the day of surgery in hospitals in Wolaita zone, South Ethiopia, from May 17 to June 17, 2023. METHODS A hospital-based cross-sectional study involving 322 patients was conducted at Wolaita Sodo Zone, South Ethiopia. All elective surgical cases scheduled during the study period were included. The entire number of participants was selected using a systematic random sampling process. Epidata V.3 was used to enter data, and SPSS V.25 was used to analyze it. Binary logistic regression was used to check for a possible association. P-values < 0.05 and 95% CI were used on multi-variable analysis as the threshold for the significant statistical association. RESULT A total of 313 study participants were scheduled for elective surgical procedures during the study period and gave a response rate of 97.2%. The mean (± SD) age of the study participants was 39.18 (± 10.64) years. The two-third of patients, 53(64%) were rural residents, and more than half (178, or 55.3%) of the participants were female. This finding showed that the case cancellation was 22.4% (95% CI: 19.3 -25.9%). Among the total canceled cases, 49(58.3%) were males. Variables like rural residence (AOR = 3.48 95% CI: 1.22-9.95), Lack of lab result (AOR = 2.33, 95%CI:1.20-4.51), ophthalmology dept. (AOR = 2.53 95% CI:1.52-4.49), HTN (AOR = 2.53, 95% CI:1.52-4.49), patient refusal (AOR = 3.01 95% CI:1.22-5.05), and age b/n 31 and 43 (AOR = 1.50, 95% CI:1.02-2.01) were significantly associated factors with cancellation of elective surgical cases. CONCLUSION In this study schedule of case cancellation was high. The contributing factors of case cancellation were rural residence, Lack of lab results, ophthalmology dept, HTN, patient refusal, and age. To decrease unnecessary cancellations and increase cost efficiency, hospital administration and medical staff must plan ahead carefully, communicate effectively, and make efficient use of hospital resources.
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Affiliation(s)
- Tadele Lankrew Ayalew
- Department of Nursing, College of medicine and health science, Wolaita Sodo University, Wolaita, Ethiopia.
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Logan K, Nwokocha C, Asemota H, Gray W. Characterization of ACE inhibitory activity in Dioscorea alata cv and its implication as a natural antihypertensive extract. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117221. [PMID: 37742877 DOI: 10.1016/j.jep.2023.117221] [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: 07/23/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 09/26/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Yam (Dioscorea sp.) extracts have been shown to possess a vast array of medicinal properties such as antihypocholesterolemic, antiatherogenic and antihypertensive bioactivity. However, the compounds conferring its antihypertensive bioactivity have not been fully explored. AIM OF THE STUDY The objective of this study was to identify extractable bioactive fractions and associated compounds in Jamaican Renta Yam (Dioscorea alata) that contribute to its antihypertensive properties, using an activity driven chemoinformatic profiling method. MATERIALS AND METHODS A diethyl ether extract of Dioscorea alata was obtained by sequential Solid-Liquid extraction coupled to SPE-HPLC fractionation and its chemical composition was analyzed by GC-MS analysis. Its influence on hypertension was evaluated through a combination of in vitro ACE-Inhibitory activity assays and by molecular docking of the identified compounds to the ACE enzyme. RESULTS SLE revealed the presence of potent antihypertensive activity (ACE IC50 41.99 μg/mL) in the diethyl ether extract (DR2). GC-MS analysis of DR2 indicated the presence of small organic compounds (95.1 g/mol to 200 g/mol) with 2-Phenyl-1,3-oxazol-2-ine (2PO) being the most predominant small organic compound present in the bioactive extract. The binding affinity of 2PO was assessed using molecular docking of 2PO to the ACE enzyme and showed strong binding affinities forming two (2) hydrogen bonds with Tyr135 and Trp220 in the active site of the enzyme. The in vitro effect of DR2 using human umbilical vein endothelial cell lines (HUVECs) revealed; a significant dose-dependent ACE-Inhibitory activity, a stimulating of nitric oxide (NO) release and no toxicity towards these cells. CONCLUSION Overall, this study identified Jamaican Renta Yam (Dioscorea alata) as an alternative source of antihypertensive compounds which may address the toxicity seen with known synthetic antihypertensive agents.
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Affiliation(s)
- Keaton Logan
- Department of Basic Medical Sciences Biochemistry Section, Faculty of Medical Sciences, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Chukwuemeka Nwokocha
- Department of Basic Medical Sciences Physiology Section, Faculty of Medical Sciences, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Helen Asemota
- Department of Basic Medical Sciences Biochemistry Section, Faculty of Medical Sciences, The University of the West Indies, Mona Campus, Kingston, Jamaica; Biotechnology Centre University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Wesley Gray
- Biotechnology Centre University of the West Indies, Mona Campus, Kingston, Jamaica; Department of Environmental Toxicology, Southern University, Baton Rouge, LA, USA.
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Namkoong M, Baskar B, Singh L, Guo H, McMurray J, Branan K, Rahman MS, Hsiao CT, Kuriakose J, Hernandez J, Arikan AA, Garza-Rivera LE, Coté GL, Tian L. Add-on soft electronic interfaces for continuous cuffless blood pressure monitoring. ADVANCED MATERIALS TECHNOLOGIES 2023; 8:2300158. [PMID: 37701636 PMCID: PMC10495086 DOI: 10.1002/admt.202300158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Indexed: 09/14/2023]
Abstract
Continuous monitoring of arterial blood pressure is clinically important for the diagnosis and management of cardiovascular diseases. Soft electronic devices with skin-like properties show promise in a wide range of applications, including the human-machine interface, the Internet of things, and health monitoring. Here, we report the use of add-on soft electronic interfaces to address the connection challenges between soft electrodes and rigid data acquisition circuitry for bioimpedance monitoring of cardiac signals, including heart rate and cuffless blood pressure. Nanocomposite films in add-on electrodes provide robust electrical and mechanical contact with the skin and the rigid circuitry. We demonstrate bioimpedance sensors composed of add-on electrodes for continuous blood pressure monitoring with high accuracy. Specifically, the bioimpedance collected with add-on nanocomposite electrodes shows a signal-to-noise ratio of 37.0 dB, higher than the ratio of 25.9 dB obtained with standard silver/silver chloride (Ag/AgCl gel) electrodes. Although the sample set is low, the continuously measured systolic and diastolic blood pressure offer accuracy of -2.0 ± 6.3 mmHg and -4.3 ± 3.9 mmHg, respectively, confirming the grade A performance based on the IEEE standard. These results show promise in bioimpedance measurements with add-on soft electrodes for cuffless blood pressure monitoring.
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Affiliation(s)
- Myeong Namkoong
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | - Balaji Baskar
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | - Lakhvir Singh
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | - Heng Guo
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | - Justin McMurray
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | - Kimberly Branan
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | - Md. Saifur Rahman
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | - Chin-To Hsiao
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | - Josh Kuriakose
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | - Joanna Hernandez
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | | | | | - Gerard L. Coté
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
| | - Limei Tian
- Department of Biomedical Engineering, and Center for Remote Health Technologies and Systems, Texas A&M University, College Station, TX 77843, USA
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Correia RR, Veras ASC, Tebar WR, Rufino JC, Batista VRG, Teixeira GR. Strength training for arterial hypertension treatment: a systematic review and meta-analysis of randomized clinical trials. Sci Rep 2023; 13:201. [PMID: 36604479 PMCID: PMC9814600 DOI: 10.1038/s41598-022-26583-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
Cardiovascular diseases are the leading cause of death in the world and arterial hypertension (AH) accounts for 13.8% of deaths caused by cardiovascular diseases. Strength training interventions could be an important alternative tool for blood pressure control, however, consistent evidence and the most effective training protocol for this purpose are yet to be established. The current study used the Cochrane methodology to systematically review randomized controlled trials (RCTs) that investigated the effect of strength training on blood pressure in hypertensive patients. A systematic search was conducted in the PubMed, EMBASE, Scopus, Cochrane Library, and World Health Organization databases. This review included controlled trials that evaluated the effect of strength training for 8 weeks or more in adults with arterial hypertension, published up to December 2020. Data are described and reported as the weighted mean difference of systolic and diastolic pressure and a 95% confidence interval. Protocol registration: PROSPERO registration number CRD42020151269. A total of 14 studies were identified, including a combined total of 253 participants with hypertension. The meta-analysis showed that mean values of systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased significantly after strength training interventions. The strongest effect of strength training on decreasing blood pressure was observed in protocols with a moderate to vigorous load intensity (> 60% of one-repetition maximum-1RM), a frequency of at least 2 times per week, and a minimum duration of 8 weeks. We concluded that strength training interventions can be used as a non-drug treatment for arterial hypertension, as they promote significant decreases in blood pressure.
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Affiliation(s)
- Rafael Ribeiro Correia
- Department of Physical Education, School of Technology and Sciences, São Paulo State University-UNESP, Street Roberto Simonsen, 305, Presidente Prudente, SP, 19060-900, Brazil
- Multicenter Graduate Program in Physiological Sciences, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Allice Santos Cruz Veras
- Department of Physical Education, School of Technology and Sciences, São Paulo State University-UNESP, Street Roberto Simonsen, 305, Presidente Prudente, SP, 19060-900, Brazil
- Multicenter Graduate Program in Physiological Sciences, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - William Rodrigues Tebar
- Center of Clinical and Epidemiological Research, University Hospital, University of São Paulo-USP, Sao Paulo, Brazil
| | - Jéssica Costa Rufino
- Department of Physical Education, School of Technology and Sciences, São Paulo State University-UNESP, Street Roberto Simonsen, 305, Presidente Prudente, SP, 19060-900, Brazil
| | - Victor Rogério Garcia Batista
- Department of Physical Education, School of Technology and Sciences, São Paulo State University-UNESP, Street Roberto Simonsen, 305, Presidente Prudente, SP, 19060-900, Brazil
| | - Giovana Rampazzo Teixeira
- Department of Physical Education, School of Technology and Sciences, São Paulo State University-UNESP, Street Roberto Simonsen, 305, Presidente Prudente, SP, 19060-900, Brazil.
- Multicenter Graduate Program in Physiological Sciences, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil.
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High-Intensity Interval Training Minimizes the Deleterious Effects of Arterial Hypertension on the Urinary Bladder of Spontaneously Hypertensive Rats. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2023; 2023:9979397. [PMID: 36865350 PMCID: PMC9974255 DOI: 10.1155/2023/9979397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/13/2023] [Accepted: 01/25/2023] [Indexed: 02/23/2023]
Abstract
Arterial hypertension promotes urological complications by modifying the functional capacity of the urinary bladder. On the other hand, physical exercise has been suggested as a nonpharmacological tool to improve blood pressure regulation. High-intensity interval training (HIIT) can effectively increase peak oxygen consumption, body composition, physical fitness, and health-related characteristics of adults; however, its action on the urinary bladder is little discussed. In the present study, we verified the effect of HIIT on the modulation of the redox state, morphology, and inflammatory and apoptotic processes of the urinary bladder of hypertensive rats. Spontaneously hypertensive rats (SHR) were divided into two groups: SHR sedentary and SHR submitted to HIIT. Arterial hypertension promoted an increase in the plasma redox state, modified the volume of the urinary bladder, and increased collagen deposition in detrusor muscle. It was also possible to identify, in the sedentary SHR group, an increase in inflammatory markers such as IL-6 and TNF-α in the urinary bladder, as well as a reduction in BAX expression. However, in the HIIT group, reduced blood pressure levels were observed, together with an improvement in morphology, such as a decrease in collagen deposition. HIIT also regulated the proinflammatory response, promoting increases in IL-10 and BAX expressions and in the number of plasma antioxidant enzymes. The present work highlights the intracellular pathways involved with the oxidative and inflammatory capacity of the urinary bladder and the potential effect of HIIT on the regulation of the urothelium and detrusor muscle of hypertensive rats.
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Moloro AH, Seid AA, Jaleta FY. A systematic review and meta-analysis protocol on hypertension prevalence and associated factors among bank workers in Africa. SAGE Open Med 2023; 11:20503121231172001. [PMID: 37181276 PMCID: PMC10170600 DOI: 10.1177/20503121231172001] [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: 12/19/2022] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
Objective This systematic review and meta-analysis will investigate the pooled prevalence of hypertension and associated factors among bank workers in Africa. Methods Studies published with full texts in English will be searched in the PubMed/MEDLINE, Cumulative Index to Nursing and Allied Health Literature, African Journals Online, and Google Scholar databases. Checklists from the Joanna Briggs Institute will be used to assess the studies' methodology quality. Data extraction, critical appraisal, and screening of all retrieved articles will be conducted by two independent reviewers. Statistical analysis will be performed using STATA-14 software packages. A random effect will be employed to demonstrate pooled estimates of hypertension among bank workers. For determinants of hypertension, an effect size with a 95% confidence interval will be analyzed. Results Data extraction and statistical analyses will begin after identifying the most pertinent studies and evaluating their methodological quality. Data synthesis and the presentation of the results are scheduled for completion by the end of 2023. After the review is completed, the results will be presented at relevant conferences and published in a peer-reviewed journal. Conclusion Hypertension is a major public health concern in Africa. More than 2 out of 10 people aged older than 18 years suffer from hypertension. A number of factors contribute to hypertension in Africa. These factors include female gender, age, overweight or obesity, khat chewing, alcohol consumption, and family history of hypertension and diabetes mellitus. To address the alarming rise in hypertension in Africa, behavioral risk factors should be given primary attention. Protocol registration This systematic review and meta-analysis protocol is registered in PROSPERO with the registration ID and link as follows: CRD42022364354;CRD-register@york.ac.ukhttps://www.york.ac.uk/inst/crd.
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Affiliation(s)
- Abdulkerim Hassen Moloro
- Abdulkerim Hassen Moloro, Department of Nursing, College of Medicine and Health Science, Samara University, Samara, P.O. Box 132, Afar, Ethiopia.
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Relationship between blood pressure and BMI in young adult population: a national-level assessment in Bangladesh. Br J Nutr 2022; 128:2075-2082. [PMID: 34963504 DOI: 10.1017/s0007114521005134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Young adulthood is a crucial period for major physiological transitions. Environmental changes associated with these transitions can influence health behaviour and health (e.g. poor diet, high body weight and elevated blood pressure (EBP)). Excess body weight can lead to EBP; however, little is known about this relationship among young adults in developing countries. Focusing on Bangladesh, this study assessed the association between BMI and blood pressure (BP) metrics (systolic BP (SBP), diastolic BP (DBP) and BP class (optimal, normal/high normal and elevated)). Sex-specific analyses of these relationships were performed to assess any difference across sexes. Furthermore, associations of overweight/obesity with BP metrics were investigated. Young adults aged 18-24 years (n 2181) were included from nationally representative cross-sectional Bangladesh Demographic and Health Survey 2017-2018. Multivariable linear and multinomial logistic regression models examined the relationships between BMI, overweight/obesity and BP metrics. Findings reveal that higher BMI was associated with higher SBP (0·83; 95 % CI 0·67, 0·99), DBP (0·66; 95 % CI 0·54, 0·74) and higher odds of having EBP (adjusted OR 1·24; 95 % CI 1·17, 1·31). These relationships were stronger among males than females. Moreover, overweight/obese individuals had higher SBP, DBP and higher odds of having EBP than individuals with normal BMI. Strategies to reduce body weight and to improve healthy lifestyle, and awareness and monitoring of BP may help to address these serious health problems, particularly at an early age.
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High burden of hypertension amongst adult population in rural districts of Northwest Ethiopia: A call for community based intervention. PLoS One 2022; 17:e0275830. [PMID: 36227880 PMCID: PMC9560483 DOI: 10.1371/journal.pone.0275830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/24/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hypertension is a serious public health issue in Ethiopia, but there is a paucity of evidence in the country's rural areas. The aim of this study was to determine the prevalence of hypertension and its risk factors among adults in rural districts in northwest Ethiopia. METHODS A community-based cross-sectional study was conducted from June to October 2020. The 1177 study participants were chosen using a multistage sampling procedure. A face-to-face interview was conducted using an adapted version of the WHO STEPwise approach questionnaire. Blood pressure was measured three times using an aneroid sphygmomanometer, and the mean of the last two readings were used for the analysis. Data was entered using Epidata and analyzed using STATA-16. Multivariable logistic regression was used to identify risk factors associated with hypertension. RESULTS Of the total participants, 218 (18.5%) were found to be hypertensive. The prevalence of hypertension consistently increases with age. Hypertension was positively and significantly associated with female sex ((adjusted odd ratio (AOR) = 2.30, 95% CI: 1.53, 3.45)), age group 45-54 years (AOR = 4.63, 95% CI: 1.01, 21.37), 55-64 years (AOR = 14.40, 95% CI: 3.07, 67.63), ≥65 years (AOR = 19.37, 95% CI: 4.03, 93.09), having history of alcohol consumption (AOR = 3.25, 95% CI: 1.17, 9.02), used much amount of salt (AOR = 2.37, 95% CI: 1.53, 3.60) and too much amount of salt (AOR = 3.78, 95% CI: 1.85, 7.72), sleeping for a short duration (AOR = 2.05, 95%CI: 1.30, 3.24), and having family history of hypertension (AOR = 2.12, 95% CI; 1.32, 3.39). CONCLUSIONS Hypertension was significantly high among the rural population we studied and is emerging as a public health problem. Female sex, advanced age, ever used alcohol, excessive salt intake, insufficient sleep, and a family history of hypertension were factors that were positively and significantly associated with hypertension. We recommend local health authorities integrate promotion of hypertension health education, lifestyle modification intervention on salt and alcohol reduction, and hypertension detection, particularly for the female and elderly population, at the health post level to avert the problem.
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Malhotra K, Kalra A, Kumar A, Majmundar M, Wander GS, Bawa A. Understanding the digital impact of World Hypertension Day: key takeaways . EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2022; 3:489-492. [PMID: 36712162 PMCID: PMC9707911 DOI: 10.1093/ehjdh/ztac039] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/16/2022] [Accepted: 07/26/2022] [Indexed: 02/01/2023]
Abstract
Aim To understand the global digital impact of World Hypertension Day and identify areas for further improvement to steer future policy development. Methods and results We used three social media assessment tools (Sprout Social, SocioViz, and Symplur) and Google Trends to obtain data about the total tweets and global impressions from countries worldwide about World Hypertension Day. Social network analysis of top influencers, associated hashtags, and keywords was performed to understand the context of the posts. With over 60 000 tweets reaching more than 250 million impressions, World Hypertension Day was a highly impactful event. A large spike of over 800% yearly increase was seen in 2021 that has greatly facilitated wider dissemination. However, there was limited collaboration among the top influencers and negligible participation from several African and non-English-speaking European countries. Conclusion With support from several governmental bodies, organizations and media outlets, World Hypertension Day is a highly impactful healthcare awareness day and presents a global case study of effectively utilizing digital resources for creating awareness among the global audience. Prioritizing equitable involvement from underrepresented and underprivileged communities must be focused. Future policy development of other awareness events shall extract the constructive feedback from these findings to promote global and public health.
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Affiliation(s)
| | - Ankur Kalra
- Corresponding author. Tel: +91-11-45005600, Fax: +1 856-249-9096,
| | - Ashish Kumar
- Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA
| | - Monil Majmundar
- Department of Cardiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Gurpreet Singh Wander
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ashvind Bawa
- Department of General Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Hussain A, Virani SS, Zheng L, Gluckman TJ, Borden WB, Masoudi FA, Maddox TM. Potential Impact of 2017 American College of Cardiology/American Heart Association Hypertension Guideline on Contemporary Practice: A Cross-Sectional Analysis From NCDR PINNACLE Registry. J Am Heart Assoc 2022; 11:e024107. [PMID: 35656989 PMCID: PMC9238704 DOI: 10.1161/jaha.121.024107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Clinical implications of change in the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on the diagnosis and management of hypertension, compared with recommendations by 2014 expert panel and Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7), are not known. Methods and Results Using data from the NCDR (National Cardiovascular Data Registry) PINNACLE (Practice Innovation and Clinical Excellence) Registry (January 2013‐Decemver 2016), we compared the proportion and clinical characteristics of patients seen in cardiology practices diagnosed with hypertension, recommended antihypertensive treatment, and achieving blood pressure (BP) goals per each guideline document. In addition, we evaluated the proportion of patients at the level of practices meeting BP targets defined by each guideline. Of 6 042 630 patients evaluated, 5 027 961 (83.2%) were diagnosed with hypertension per the 2017 ACC/AHA guideline, compared with 4 521 272 (74.8%) per the 2014 panel and 4 545 976 (75.2%) per JNC7. The largest increase in hypertension prevalence was seen in younger ages, women, and those with lower cardiovascular risk. Antihypertensive medication was recommended to 70.6% of patients per the ACC/AHA guideline compared with 61.8% and 65.9% per the 2014 panel and JNC7, respectively. Among those on antihypertensive agents, 41.2% achieved BP targets per the ACC/AHA guideline, compared with 79.4% per the 2014 panel and 64.3% per JNC7. Lower proportions of women, non‐White (Black and "other") races, and those at higher cardiovascular risk achieved BP goals. Median practice‐level proportion of patients meeting BP targets per the 2014 panel but not the ACC/AHA guideline was 37.8% (interquartile range, 34.8%–40.7%) and per JNC7 but not the ACC/AHA guideline was 22.9% (interquartile range, 19.8%–25.9%). Conclusions Following publication of the 2017 guideline, significantly more people, particularly younger people and those with lower cardiovascular risk, will be diagnosed with hypertension and need antihypertensive treatment compared with previous recommendations. Significant practice‐level variation in BP control also exists. Efforts are needed to improve guideline‐concordant hypertension management in an effort to improve outcomes.
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Affiliation(s)
- Aliza Hussain
- Section of Cardiology Department of Medicine Baylor College of Medicine Houston TX
| | - Salim S Virani
- Section of Cardiology Department of Medicine Baylor College of Medicine Houston TX.,Section of Cardiology Michael E. DeBakey Veterans Affairs Hospital Houston TX
| | - Luke Zheng
- BAIM Institute for Clinical Research Boston MA
| | - Ty J Gluckman
- Center for Cardiovascular Analytics, Research and Data Science Providence Heart InstituteProvidence St Joseph Health Portland OR
| | - William B Borden
- Department of Medicine George Washington University Washington DC
| | - Frederick A Masoudi
- Division of Cardiology University of Colorado Anschutz Medical Campus Aurora CO
| | - Thomas M Maddox
- Division of Cardiology Washington University School of Medicine St. Louis MO
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Gender and rural-urban differences in hypertension among youth in India: Insights from a large scale survey, 2015-16. J Biosoc Sci 2022; 55:523-537. [PMID: 35343405 DOI: 10.1017/s0021932022000141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hypertension is considered one of the most persistent public health issues and the single largest contributor to avoidable morbidity and mortality in India. This study aims to investigate the prevalence and risk factors of hypertension in youths (15-29 years) by gender and rural-urban place of residence. Data from the fourth round of the National Family and Health Survey - 2015-16 (n = 395,207) was utilised for the study. After estimation of the stratified prevalence of hypertension by various characteristics, multivariable logistic regression analysis was conducted to assess the correlates of hypertension. The results revealed that the prevalence of hypertension in youths at the national level varied from 9.16% (Meghalaya) to 3.34% (Delhi). The stratified analysis suggests pronounced gender differences in the prevalence of hypertension among youth with insignificant rural-urban differences, although the prevalence was higher in urban areas. Overall, the prevalence of hypertension was found higher for male youths living in urban areas (7.82%) and females in rural areas (5.08%). Concurrently, results from regression analysis also suggest higher odds of hypertension for males residing in urban areas for a variety of demographic, socioeconomic, and health-risk factors. Advancing age, having no education, living in the northeast region, being overweight/obese and high blood glucose level was significantly associated with a greater likelihood of hypertension for both the gender and place of residence. Public health awareness regarding blood pressure needs to be tailored differently for both males and females considering the place of residence. The study suggests that more research should focus on blood pressure/hypertension among children, adolescents and youth since they point towards adult blood pressure patterns.
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Current Knowledge about the New Drug Firibastat in Arterial Hypertension. Int J Mol Sci 2022; 23:ijms23031459. [PMID: 35163378 PMCID: PMC8836050 DOI: 10.3390/ijms23031459] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
Hypertension significantly increases the risk of cardiovascular disease. Currently, effective standard pharmacological treatment is available in the form of diuretics, ACE inhibitors, angiotensin II receptor blockers and calcium channel blockers. These all help to decrease blood pressure in hypertensive patients, each with their own mechanism. Recently, firibastat, a new first-in-class antihypertensive drug has been developed. Firibastat is a prodrug that when crossing the blood-brain barrier, is cleaved into two active EC33 molecules. EC33 is the active molecule that inhibits the enzyme aminopeptidase A. Aminopeptidase A converts angiotensin II to angiotensin III. Angiotensin III usually has three central mechanisms that increase blood pressure, so by inhibiting this enzyme activity, a decrease in blood pressure is seen. Firibastat is an antihypertensive drug that affects the brain renin angiotensin system by inhibiting aminopeptidase A. Clinical trials with firibastat have been performed in animals and humans. No severe adverse effects related to firibastat treatment have been reported. Results from studies show that firibastat is generally well tolerated and safe to use in hypertensive patients. The aim of this review is to investigate the current knowledge about firibastat in the treatment of hypertension.
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A UPLC-DAD-Based Bio-Screening Assay for the Evaluation of the Angiotensin Converting Enzyme Inhibitory Potential of Plant Extracts and Compounds: Pyrroquinazoline Alkaloids from Adhatoda vasica as a Case Study. Molecules 2021; 26:molecules26226971. [PMID: 34834066 PMCID: PMC8617709 DOI: 10.3390/molecules26226971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/21/2021] [Accepted: 10/23/2021] [Indexed: 12/03/2022] Open
Abstract
Angiotensin converting enzyme (ACE) plays a crucial role in regulating blood pressure in the human body. Identification of potential ACE inhibitors from medicinal plants supported the idea of repurposing these medicinal plants against hypertension. A method based on ultra-performance liquid chromatography (UPLC) coupled with a diode array detector (DAD) was used for the rapid screening of plant extracts and purified compounds to determine their ACE inhibitory activity. Hippuryl-histidiyl-leucine (HHL) was used as a substrate, which is converted into hippuric acid (HA) by the action of ACE. A calibration curve of the substrate HHL was developed with the linear regression 0.999. The limits of detection and quantification of this method were found to be 0.134 and 0.4061 mM, respectively. Different parameters of ACE inhibitory assay were optimized, including concentration, incubation time and temperature. The ACE inhibition potential of Adhatoda vasica (methanolic-aqueous extract) and its isolated pyrroquinazoline alkaloids, vasicinol (1), vasicine (2) and vasicinone (3) was evaluated. Compounds 1–3 were characterized by various spectroscopic techniques. The IC50 values of vasicinol (1), vasicine (2) and vasicinone (3) were found to be 6.45, 2.60 and 13.49 mM, respectively. Molecular docking studies of compounds 1–3 were also performed. Among these compounds, vasicinol (1) binds as effectively as captopril, a standard drug of ACE inhibition.
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Dejenie M, Kerie S, Reba K. Undiagnosed hypertension and associated factors among bank workers in Bahir Dar City, Northwest, Ethiopia, 2020. A cross-sectional study. PLoS One 2021; 16:e0252298. [PMID: 34043717 PMCID: PMC8158901 DOI: 10.1371/journal.pone.0252298] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 05/12/2021] [Indexed: 01/19/2023] Open
Abstract
Background Undiagnosed hypertension is defined as individuals who were hypertensive but did not report having been told by a health professional that they have hypertension. It is an important risk factor for development of chronic kidney disease, cardiovascular disease and all-cause mortality. Despite those problems and benefits of finding individuals with undiagnosed hypertension to prevent its outcomes, no enough investigations have been done regarding the prevalence and associated factors of undiagnosed hypertension. Therefore, the objective of this study was to assess the prevalence of undiagnosed hypertension and its associated factors among bank workers in Ethiopia. Methods An institutional based cross-sectional study was held at Bahir Dar city bank workers. The simple random sampling technique was used to select the study participants. Self-administered structured questionnaire and physical measurement were used to collect data. The data were entered into EPI data 3.1 versions and exported to SPSS version 23.0 statistical software for further analysis. In order to decide the association between independent and dependent variables; multivariate logistic regression analysis was implemented. A P-value of < 0.05 was used as the criterion for statistical significance and OR with 95% confidence interval was used to indicate the strength of association. Result In this study from a total of 524 participants 513 were completed the questionnaire correctly, which gives a response rate of 97.9%. The overall prevalence of undiagnosed hypertension among bank workers was 24.8% with (95% CI 21.1–28.5). Multivariate logistic regression revealed that age 35–44 [AOR = 2.56, 95% CI: (1.60–4.09)], being male [AOR = 3.61, 95% CI: (1.84–7.05)], having moderate knowledge [AOR = 3.81, 95% CI: (2.29–6.34)], having poor knowledge [AOR = 6.19, 95% CI: (3.07-)12.48], and being physically inactivity [AOR = 2.91, 95% CI: (1.26–6.76)] were variables significantly associated with undiagnosed hypertension. Conclusion The prevalence of undiagnosed hypertension among bank workers in Bahir Dar city was found to be high. An age group of 35–44 years, being male, having moderate and poor knowledge and being physically inactivity was the variables that were significantly associated with undiagnosed hypertension. Therefore, creating awareness, frequent screening and implementation of an appropriate intervention for this vulnerable group is important.
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Affiliation(s)
- Mekdes Dejenie
- Department of Nursing, Debre Tabor Health Science College, Debre Tabor, Ethiopia
| | - Sitotaw Kerie
- Department of Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
| | - Kidist Reba
- Department of Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Tebar WR, Rufino JC, Cruz Veras AS, Correia RR, Teixeira GR. Strength training for arterial hypertension treatment: a systematic review protocol. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.1894803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- William Rodrigues Tebar
- Post-Graduation Program in Movement Sciences, São Paulo State University - UNESP, Presidente Prudente, Sao Paulo, Brazil
| | - Jéssica Costa Rufino
- Department of Physical Education, School of Technology and Sciences, Sao Paulo State University - UNESP, Presidente Prudente, São Paulo, Brazil
| | - Allice Santos Cruz Veras
- Post-Graduation Program in Movement Sciences, São Paulo State University - UNESP, Presidente Prudente, Sao Paulo, Brazil
| | - Rafael Ribeiro Correia
- Department of Physical Education, School of Technology and Sciences, Sao Paulo State University - UNESP, Presidente Prudente, São Paulo, Brazil
| | - Giovana Rampazzo Teixeira
- Post-Graduation Program in Movement Sciences, São Paulo State University - UNESP, Presidente Prudente, Sao Paulo, Brazil
- Department of Physical Education, School of Technology and Sciences, Sao Paulo State University - UNESP, Presidente Prudente, São Paulo, Brazil
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Ketata N, Ben Ayed H, Ben Hmida M, Abdelhedi Z, Ben Jemaa M, Trigui M, Maamri H, Yaich S, Kassis M, Feki H, Damak J. Prevalence and predictors of hypertension self-care practice in primary health-care facilities in Southern Tunisia. JOURNAL DE MÉDECINE VASCULAIRE 2021; 46:72-79. [PMID: 33752849 DOI: 10.1016/j.jdmv.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Unmanaged hypertension (HTN) is usually accompanied with complications leading to disability in older adults. It has been demonstrated that self-care practice is essential for blood pressure control and reduction of HTN complications. OBJECTIVE OF THE STUDY This study aimed to estimate the level of implementation of HTN self-care practice and to identify their associated factors. STUDY DESIGN It was a cross-sectional study conducted in Sfax, Southern Tunisia in April 2020. MATERIALS AND METHODS A total of 6 primary health-care facilities were approached for the study participants according to a single-stage cluster sample, by selecting six grapes randomly. A total of 270 participants were recruited, among whom 250 cases (92.6%) completed the questionnaire. RESULTS A total of 250 hypertensive patients were included in the study, giving a male to female ratio of 0.77. There were 125 participants (50%) aged over 65years. Overall, 137 cases (54.8%) had a high total self-care practice score. The independent factors of good HTN self-care practice were≥65years [Adjusted odds ratio (AOR)=9.5; P<0.001], university educational level of the participants (AOR=21.2; P<0.001), as well as receiving a health education, by health-care providers (AOR=2.5; P=0.012) and family members (AOR=4.36; P=0.004). Advanced hypertension stage (II and III) (AOR=0.45; P=0.032) and chronic pulmonary diseases, including asthma (AOR=0.42; P=0.027) and chronic obstructive pulmonary diseases (AOR=0.27; P=0.016) were independently associated with poor HTN self-care practice. CONCLUSION Advanced hypertension stage, pulmonary co-morbidities, education level and lack of self-care education were predictive factors of poor self-care practice. These findings suggested that such factors should be considered when planning HTN self-care education.
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Affiliation(s)
- N Ketata
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia.
| | - H Ben Ayed
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - M Ben Hmida
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Z Abdelhedi
- High Institute of Nursing, University of Sfax, Sfax, Tunisia
| | - M Ben Jemaa
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - M Trigui
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - H Maamri
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - S Yaich
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - M Kassis
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - H Feki
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - J Damak
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
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Naqvi S, Asar TO, Kumar V, Al-Abbasi FA, Alhayyani S, Kamal MA, Anwar F. A cross-talk between gut microbiome, salt and hypertension. Biomed Pharmacother 2021; 134:111156. [PMID: 33401080 DOI: 10.1016/j.biopha.2020.111156] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/21/2022] Open
Abstract
Cardiac disorders contribute to one of the major causes of fatality across the world. Hypertensive patients, even well maintained on drugs, possess a high risk to cardiovascular diseases. It is, therefore, highly important to identify different factors and pathways that lead to risk and progression of cardiovascular disorders. Several animals and human studies suggest that taxonomical alterations in the gut are involved in the cardiovascular physiology. In this article, with the help of various experimental evidences, we suggest that the host gut-microbiota plays an important in this pathway. Short chain fatty acids (SCFAs) and Trimethyl Amine -n-Oxide (TMAO) are the two major products of gut microbiome. SCFAs present a crucial role in regulating the blood pressure, while TMAO is involved in pathogenesis of atherosclerosis and other coronary artery diseases, including hypertension. We prove that there exists a triangular bridge connecting the gap between dietary salt, hypertension and gut microbiome. We also present some of the dietary interventions which can regulate and control microbiota that can prevent cardiovascular complications.We strongly believe that this article would improve the understanding the role of gut microbiota in hypertension, and will be helpful in the development of novel therapeutic strategies for prevention of hypertension through restoring gut microbiome homeostasis in the near future.
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Affiliation(s)
- Salma Naqvi
- Department of Biomedical Sciences, College of Medicine, Gulf Medical University, Ajman, United Arab Emirates
| | - Turky Omar Asar
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Biology, College of Science and Arts at Alkamil, University of Jeddah, Jeddah, Saudi Arabia
| | - Vikas Kumar
- Natural Product Discovery Laboratory, Department of Pharmaceutical Sciences, Shalom Institute of Health and Allied Sciences. Sam Higginbottom University of Agriculture, Technology and Sciences, Naini, Prayagraj, 211007, India.
| | - Fahad A Al-Abbasi
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sultan Alhayyani
- Department of Chemistry. College of Sciences & Arts, Rabigh King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Amjad Kamal
- Novel Global Community Educational Foundation, Australia; King Fahd Medical Research Center, King Abdulaziz University, P. O. Box 80216, Jeddah, 21589, Saudi Arabia; Enzymoics, 7 Peterlee Place, Hebersham, NSW, 27707, Australia
| | - Firoz Anwar
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
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Franco RJDS. Physical Activity in the Present Can Be the Recipe to Avoid the Ills of Obesity and Hypertension in the Future. Arq Bras Cardiol 2020; 115:50-51. [PMID: 32785493 PMCID: PMC8384312 DOI: 10.36660/abc.20200483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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22
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Investigation on the effect of Womersley number, ECG and PPG features for cuff less blood pressure estimation using machine learning. Biomed Signal Process Control 2020. [DOI: 10.1016/j.bspc.2020.101942] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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PANAHI MH, MAHDAVI HEZAVEH AR, SAMAVAT T, HODJATZADEH A, YOUSEFI E. Hypertension Surveillance in Rural Regions of Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:2313-2314. [PMID: 31993407 PMCID: PMC6974851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mohammad Hossein PANAHI
- Ministry of Health and Medical Education, Tehran, Iran,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author:
| | | | | | | | - Elham YOUSEFI
- Ministry of Health and Medical Education, Tehran, Iran
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Kharazmi-Khorassani J, Asoodeh A, Tanzadehpanah H. Antioxidant and angiotensin-converting enzyme (ACE) inhibitory activity of thymosin alpha-1 (Thα1) peptide. Bioorg Chem 2019; 87:743-752. [PMID: 30974297 DOI: 10.1016/j.bioorg.2019.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/11/2019] [Accepted: 04/02/2019] [Indexed: 01/25/2023]
Abstract
In this research, the antioxidant property of thymosin alpha-1 (Thα1) peptide was investigated through various antioxidant methods. Thα1 showed 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity (IC50 = 20 µM) and its 2,2-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) scavenging reached 45.33% at 80 µM (IC50 = 85 µM). In addition, hydroxyl and superoxide radical scavenging of Thα1 peptide exhibited a concentration-depended manner. The IC50 values of hydroxyl and superoxide radical scavenging were estimated to be 82 µM and 20 µM, respectively. The effect of Thα1 on eliminating superoxide radicals was higher (62.23%) than other antioxidant assays. Moreover, the antioxidant activity of Thα1 peptide was evaluated by measuring cellular reactive oxygen species (ROS). Results indicated that Thα1 decreased the generation of ROS level in 1321 N1 human neural asterocytoma cells. The inhibitory effect of Thα1 on angiotensin-converting enzyme (ACE) was determined. The kinetic parameters (Km and Vmax) and the inhibition pattern were examined. Based on the Lineweaver-Burk plot, Thα1 displayed a mixed inhibition pattern. The IC50 and Ki values of Thα1 were 0.8 µM and 3.33 µM, respectively. Molecular modeling suggested that Thα1 binds to ACE-domains with higher affinity binding to N-domain with the binding energy of -22.87 kcal/mol. Molecular docking indicated that Thα1 interacted with ACE enzyme (N- and C-domains) due to electrostatic, hydrophobic, and hydrogen forces. Our findings suggested that Thα1 possess a multifunctional peptide with dual antioxidant and ACE-inhibitory properties. Further researches are needed to investigate the antioxidant and anti-hypertensive effect of Thα1 both in vitro and in vivo.
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Affiliation(s)
| | - Ahmad Asoodeh
- Department of Chemistry, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran.
| | - Hamid Tanzadehpanah
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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25
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Sun CQ. Aqueous charge injection: solvation bonding dynamics, molecular nonbond interactions, and extraordinary solute capabilities. INT REV PHYS CHEM 2018. [DOI: 10.1080/0144235x.2018.1544446] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Chang Q. Sun
- EBEAM, Yangtze Normal University, Chongqing, People's Republic of China
- NOVITAS, EEE, Nanyang Technological University, Singapore, Singapore
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Wardak H, Tutakhel OAZ, Van Der Wijst J. Role of the alternative splice variant of NCC in blood pressure control. Channels (Austin) 2018; 12:346-355. [PMID: 30264650 PMCID: PMC6207291 DOI: 10.1080/19336950.2018.1528820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The renal thiazide-sensitive sodium-chloride cotransporter (NCC), located in the distal convoluted tubule (DCT) of the kidney, plays an important role in blood pressure regulation by fine-tuning sodium excretion. The human SLC12A3 gene, encoding NCC, gives rise to three isoforms, of which only the third isoform (NCC3) has been extensively investigated so far. However, recent studies unraveled the importance of the isoforms 1 and 2, collectively referred to as NCC splice variant (NCCSV), in several (patho)physiological conditions. In the human kidney, NCCSV localizes to the apical membrane of the DCT and could constitute a functional route for renal sodium-chloride reabsorption. Analysis of urinary extracellular vesicles (uEVs), a non-invasive method for measuring renal responses, demonstrated that NCCSV abundance changes in response to acute water loading and correlates with patients’ thiazide responsiveness. Furthermore, a novel phosphorylation site at serine 811 (S811), exclusively present in NCCSV, was shown to play an instrumental role in NCCSV as well as NCC3 function. This review aims to summarize these new insights of NCCSV function in humans that broadens the understanding on NCC regulation in blood pressure control.
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Affiliation(s)
- Hila Wardak
- a Department of Physiology , Radboud Institute for Molecular Life Sciences, Radboud university medical center , Nijmegen , The Netherland
| | - Omar A Z Tutakhel
- a Department of Physiology , Radboud Institute for Molecular Life Sciences, Radboud university medical center , Nijmegen , The Netherland.,b Department of Translational Metabolic Laboratory , Radboud university medical center , Nijmegen , The Netherlands
| | - Jenny Van Der Wijst
- a Department of Physiology , Radboud Institute for Molecular Life Sciences, Radboud university medical center , Nijmegen , The Netherland
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Le Goff CM, Gonzalez-Antuña A, Peeters SD, Fabregat-Cabello N, Van Der Gugten JG, Vroonen L, Pottel H, Holmes DT, Cavalier E. Migration from RIA to LC-MS/MS for aldosterone determination: Implications for clinical practice and determination of plasma and urine reference range intervals in a cohort of healthy Belgian subjects. CLINICAL MASS SPECTROMETRY 2018. [DOI: 10.1016/j.clinms.2018.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kucan M, Mrsic-Pelcic J, Vitezic D. Antihypertensive Drugs in Croatia: What Changes the Drug Usage Patterns? Clin Ther 2018; 40:1159-1169. [PMID: 30017168 DOI: 10.1016/j.clinthera.2018.05.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 05/10/2018] [Accepted: 05/30/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Possible factors that could influence changes in patterns of prescribing antihypertensives could be identified by monitoring national trends in hypertension treatment. The choice of pharmacologic treatment in people with hypertension has important therapeutic and financial implications, due to the fact that the financial costs associated with hypertension continue to increase. The aims of our study were to identify and analyze changes in the usage of antihypertensive drugs in Croatia from 2000 to 2016 and to identify the changes in prescribing patterns as well as mean prices per defined daily dose (DDD). METHODS Data on consumption in Croatia were obtained from the International Medical Statistics database. According to the World Health Organization's Collaborating Center for Drugs Statistics Methodology, per-annum volumes of drugs are presented in DDD per 1000 population per day (DDD/1000), while data on financial expenditure are presented in euros. FINDINGS The consumption of drugs for cardiovascular disease in Croatia during the period from 2000 to 2016 increased 150.81%, while financial expenditure in the same period increased 47.32%. The most frequently prescribed subgroup was agents acting on the renin-angiotensin system (RAS). Their share among antihypertensives increased from 39.13% (2000) to 53.39% (2016). The share of diuretics in the same period decreased from 20.16% in 2000 to 12.73% in 2016. IMPLICATIONS The prescribing patterns of antihypertensive drugs in Croatia have changed, which could be a result of a combination of different factors, such as changes in laws, pharmaceutical marketing, and guidelines on hypertension therapy. The most prescribed subgroup in all of the investigated years was agents acting on the RAS, mainly because of the increased prescribing of combinations of RAS agents plus diuretics. The financial implications of legal changes and the introduction of new generic drugs led to decreased cost per DDD of antihypertensives during the investigated period, but the total expenditure on antihypertensives in Croatia increased due to increased consumption.
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Affiliation(s)
- Marta Kucan
- University Hospital Center Rijeka, Rijeka, Croatia.
| | | | - Dinko Vitezic
- University Hospital Center Rijeka, Rijeka, Croatia; University of Rijeka Medical School, Rijeka, Croatia
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Ni C, Sun C, Zhou Z, Huang Y, Liu X. Surface tension mediation by Na-based ionic polarization and acidic fragmentation: Inference of hypertension. J Mol Liq 2018. [DOI: 10.1016/j.molliq.2018.02.113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Ghods R, Gharouni M, Amanlou M, Sharifi N, Ghobadi A, Amin G. Effect of Onopordon acanthium L. as Add on Antihypertensive Therapy in Patients with Primary Hypertension Taking Losartan: a Pilot Study. Adv Pharm Bull 2018; 8:69-75. [PMID: 29670841 PMCID: PMC5896397 DOI: 10.15171/apb.2018.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 12/25/2022] Open
Abstract
Purpose: Onopordon acanthium L. is known for its medicinal properties. Our recent study showed that its seed extract is a novel natura angiotensin-converting-enzyme inhibitor (ACEI). This study was carried out to investigate its possible antihypertensive effects in patients receiving losartan. Methods: This uncontrolled clinical trial was carried out among 20 patients (30-60y) with uncontrolled hypertension despite receiving 50 mg losartan (stage I & II) in two hospitals in Iran. After completing informed consent, patients were treated by 2 capsules [each 1g of Onopordon acanthium seed extract (OSE)] as add-on therapy, two times per day. Results: 18 patients completed the study (50.94 ±8.37y). Mean systolic blood pressure (SBP) at the baseline was 151.9 ± 13.74mmHg and at the end of the study, it was 134.6 ± 18.25 mmHg and mean diastolic blood pressure (DBP) was 97.41 ± 10.36 at the baseline and was 85.71 ± 7.481 after 8 weeks. OSE significantly reduced SBP and DBP at the end of 8 weeks (P=0.003, 95% CI: -19.7, -15.1; P=0.0006, 95% CI: -10.23, -13.15; respectively). No evidence of hepatic or renal toxicity was detected. Conclusion: Based on the results of this study OSE has antihypertensive property with no significant adverse effects. However, because of the low number of samples, this medication may be not safely administered. The results of this study could be the basis for further studies with larger sample size. IRCT registration number: IRCT2013020712391N.
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Affiliation(s)
- Roshanak Ghods
- Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran
- School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Massoud Amanlou
- Department of Medicinal Chemistry, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Niusha Sharifi
- Department of Medicinal Chemistry, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghobadi
- Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran
- School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Amin
- Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
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Haspula D, Clark MA. Neuroinflammation and sympathetic overactivity: Mechanisms and implications in hypertension. Auton Neurosci 2018; 210:10-17. [DOI: 10.1016/j.autneu.2018.01.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/02/2018] [Accepted: 01/08/2018] [Indexed: 02/07/2023]
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Yan KK, Zhao H, Pang H. A comparison of graph- and kernel-based -omics data integration algorithms for classifying complex traits. BMC Bioinformatics 2017; 18:539. [PMID: 29212468 PMCID: PMC6389230 DOI: 10.1186/s12859-017-1982-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 11/26/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND High-throughput sequencing data are widely collected and analyzed in the study of complex diseases in quest of improving human health. Well-studied algorithms mostly deal with single data source, and cannot fully utilize the potential of these multi-omics data sources. In order to provide a holistic understanding of human health and diseases, it is necessary to integrate multiple data sources. Several algorithms have been proposed so far, however, a comprehensive comparison of data integration algorithms for classification of binary traits is currently lacking. RESULTS In this paper, we focus on two common classes of integration algorithms, graph-based that depict relationships with subjects denoted by nodes and relationships denoted by edges, and kernel-based that can generate a classifier in feature space. Our paper provides a comprehensive comparison of their performance in terms of various measurements of classification accuracy and computation time. Seven different integration algorithms, including graph-based semi-supervised learning, graph sharpening integration, composite association network, Bayesian network, semi-definite programming-support vector machine (SDP-SVM), relevance vector machine (RVM) and Ada-boost relevance vector machine are compared and evaluated with hypertension and two cancer data sets in our study. In general, kernel-based algorithms create more complex models and require longer computation time, but they tend to perform better than graph-based algorithms. The performance of graph-based algorithms has the advantage of being faster computationally. CONCLUSIONS The empirical results demonstrate that composite association network, relevance vector machine, and Ada-boost RVM are the better performers. We provide recommendations on how to choose an appropriate algorithm for integrating data from multiple sources.
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Affiliation(s)
- Kang K Yan
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Hongyu Zhao
- Department of Biostatistics, Yale University, New Haven, CT, USA
| | - Herbert Pang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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Simpson JK. Appeal to fear in health care: appropriate or inappropriate? Chiropr Man Therap 2017; 25:27. [PMID: 28932388 PMCID: PMC5605990 DOI: 10.1186/s12998-017-0157-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/25/2017] [Indexed: 11/24/2022] Open
Abstract
AIM This paper examines appeal to fear in general: its perceived positive aspects, its negative characteristics, its appropriate as well as its fallacious use. BACKGROUND Appeal to fear is a commonly used marketing method that attempts to change behaviour by creating anxiety in those receiving a fearful message. It is regularly used in public health initiatives such as anti-smoking, anti-drunk driving campaigns as well as in hypertension awareness campaigns. Some chiropractors appear to use appeal to fear to promote subluxation awareness and thereby encourage the use of chiropractic treatment. Research supporting its use is equivocal; nevertheless, when used judiciously, appeal to fear probably has sufficient strengths to warrant its continued conditional use. When used to promote care for which there is no supporting evidence, its use is fallacious. DISCUSSION Appeal to fear has been used in health promotion campaigns for sixty years or more with the intent of modifying behaviours. While there is evidence to suggest that appeal to fear may motivate some individuals to modify offending behaviour or adopt recommended behaviour there is growing resistance to the use of appeal to fear on ethical and psychological grounds. Using appeal to fear as a tool of persuasion can be valid or fallacious depending on the truth of the premises within the argument. When used to raise awareness about genuine health concerns such as smoking, drunk driving and hypertension appeal to fear is considered to be a valid approach with certain caveats. However, when appeal to fear, not based on evidence or reason, is used as motivator to get others to accept unnecessary interventions for unproven disorders, the use of appeal to fear is fallacious. CONCLUSION In spite of the evidence against its use, it seems likely that appeal to fear will continue to be used in conjunction with other public awareness initiatives to modify recognized detrimental behaviours such as smoking and drunk driving as well as silent killers such as hypertension. However, when used to promote a treatment that has no evidentiary basis such as subluxation based practice in chiropractic the appeal to fear is a fallacy and must be stopped.
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Affiliation(s)
- J. Keith Simpson
- Discipline of Chiropractic, Murdoch University, South Street, Murdoch, WA 6150 Australia
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Eghbali-Babadi M, Khosravi A, Feizi A, Sarrafzadegan N. Design and implementation of a combined observational and interventional study: Trends of prevalence, awareness, treatment and control hypertension and the effect of expanded chronic care model on control, treatment and self-care. ARYA ATHEROSCLEROSIS 2017; 13:211-220. [PMID: 29371867 PMCID: PMC5774793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Lack of information about hypertension leads to failure in detection, treatment and reduced estimation of this disease effects. So, a comprehensive study, named trends of prevalence, awareness, treatment and control hypertension among the adults in Isfahan, Iran (2001-2016) and evaluation of the effect of expanded chronic care model (ECCM) on control, treatment and self-care, has been designed. This study explains the aspects of design and methods of its implementation. METHODS This study was conducted in four stages in 2014-2016. In the 1st stage, valid questionnaires were made to assess knowledge, attitude and practice, and self-care. In the 2nd stage, the status of prevalence, awareness, treatment and control and hypertension risk factors was assessed. In the 3rd stage, a two-group clinical trial was conducted to evaluate the effectiveness of ECCM on hypertensive patients and their families. In the 4th stage, the results of hypertension prevalence and its risk factors in adults in 2016 were compared with two other studies undertaken in 2001 and 2007. RESULTS To develop the questionnaire, face and content validity, internal and external reliability, and construct validity were examined. Prevalence, awareness, treatment and control of hypertension and risk factors among 2107 adult individuals were determined in Isfahan. In a clinical trial, 216 hypertensive patients were randomly assigned into intervention and control groups. Finally, a sample size of 8073 people was used to determine and compare the 15-year-old trend of hypertension and its affecting factors. CONCLUSION It is obvious that the final findings of this study will play a key role in health and research policy and provide a suitable model for implementing appropriate interventional measures at the provincial and national levels.
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Affiliation(s)
- Maryam Eghbali-Babadi
- PhD Candidate, Hypertension Research Center, Cardiovascular Research Institute AND School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Associate Professor, Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Correspondence to: Alireza Khosravi,
| | - Awat Feizi
- Associate Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute AND Department of Biostatistics and Epidemiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Huang D, Zhou J, Su D, Yu W, Chen J. Variations of perioperative baroreflex sensitivity in hypertensive and normotensive patients. Clin Exp Hypertens 2017; 39:74-79. [PMID: 28060537 DOI: 10.1080/10641963.2016.1210624] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Impaired baroreflex sensitivity (BRS) is a marker of autonomous dysfunction, which may play an important role in the long-term development of hypertension. Perioperative patients with hypertension are rapidly increasing in all populations worldwide. OBJECTIVE To estimate the value of BRS for hypertension in a surgery cohort. METHODS An observational and cross-sectional study was performed, involving 96 patients who underwent video-assisted thoracoscopic pulmonary lobectomy or segmentectomy. Invasive blood pressure and heart rate before and after giving nitroglycerin were measured in 48 normotensive patients and 48 hypertensive patients (25 and 23 undergoing regular treatment hypertensive [HR] and irregular treatment hypertensive [HI], respectively) while entering the operation room, 30 minutes after skin incision, and 10 minutes after skin suture. RESULTS BRSpreoperative of hypertensive group (Group H) was lower than normotensive group (Group N) (3.49 ± 1.55 vs. 5.75 ± 4.15 ms/mmHg; P < 0.05). BRSintraoperative of Group H was lower than Group N (1.70 ± 1.18 vs. 2.84 ± 1.11 ms/mmHg; P < 0.05). BRSpreoperative of patients in irregular-treated group (Group HI) was lower than regular-treated group (Group HR) (2.92 ± 1.36 vs. 4.31 ± 1.87 ms/mmHg; P < 0.05). BRSintraoperative of Group HI was lower than Group HR (1.45 ± 0.90 vs. 2.08 ± 1.82 ms/mmHg; P < 0.05). BRSintraoperative and BRSpostoperative were lower than BRSpreoperative in each group (P < 0.01). CONCLUSION The perioperative autonomic nerve function was significantly impaired in hypertensive patients. This effect was less pronounced for those who were on regular antihypertensive treatment. Attention should be paid to maintain the stability of cardiovascular function, to ensure patients can go through perioperative period safely.
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Affiliation(s)
- Dan Huang
- a Department of Anesthesiology, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , China
| | - Jie Zhou
- a Department of Anesthesiology, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , China
| | - Diansan Su
- a Department of Anesthesiology, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , China
| | - Weifeng Yu
- a Department of Anesthesiology, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , China
| | - Jie Chen
- a Department of Anesthesiology, Renji Hospital, School of Medicine , Shanghai Jiaotong University , Shanghai , China
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Abstract
The World Health Organization attributes hypertension, or high blood pressure, as the leading cause of cardiovascular mortality. The World Hypertension League (WHL), an umbrella organization of 85 national hypertension societies and leagues, recognized that more than 50% of the hypertensive population worldwide are unaware of their condition. To address this problem, the WHL initiated a global awareness campaign on hypertension in 2005 and dedicated May 17 of each year as World Hypertension Day (WHD). Over the past three years, more national societies have been engaging in WHD and have been innovative in their activities to get the message to the public. In 2007, there was record participation from 47 member countries of the WHL. During the week of WHD, all these countries -- in partnership with their local governments, professional societies, nongovernmental organizations and private industries -- promoted hypertension awareness among the public through several media and public rallies. Using mass media such as Internet and television, the message reached more than 250 million people. As the momentum picks up year after year, the WHL is confident that almost all the estimated 1.5 billion people affected by elevated blood pressure can be reached. The success of WHD is due to the enthusiasm and voluntary action of multiple stakeholders from every member country.
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