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Xu L, Wang K, Yan T, Li L, Miao Y, Tian Z, Zhang R, Wang Y, Zhang C, Yan J, Cao N, Zhang N, Zhang X. Risk analysis of blood pressure changes on cardiovascular disease in Chinese population. J Clin Hypertens (Greenwich) 2024. [PMID: 39210580 DOI: 10.1111/jch.14888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 07/29/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024]
Abstract
The study aimed to assess the impact of changes in blood pressure on cardiovascular events in the Chinese population. It enrolled 33 179 Chinese participants aged ≥35 years (57.1% women) without CVD at baseline. BP status was defined according to the 2017 ACC/AHA hypertension guidelines. The type of BP change was defined as change in BP status from baseline to the end of follow-up, included stable BP <130/80, <130/80 to ≥130/80, ≥130/80 to <130/80 mm Hg, persistent BP ≥130/80 mm Hg. The hazard ratio (HR) of incident CVD by change in BP category was estimated using Cox proportional hazards and Fine-Gray models. During median follow-up of 3.17 years, 2023 CVD events occurred. Compared with BP <120/80, 120-129/<80 mm Hg at baseline (HR = 1.66, 95% CI: 1.09-2.53), 130-139/80-89 mm Hg (HR = 1.35, 95% CI: 0.94-1.95), and ≥140/90 mm Hg (HR = 2.46, 95% CI: 1.78-3.40) were risk factors for CVD. Compared with the group with stable BP <130/80 mm Hg, the risk of CVD was 1.88 (95% CI: 1.40-2.53) in the group with persistent BP ≥130/80 mm Hg and 1.40 (95% CI: 1.01-1.94) in the group of BP decreased to <130/80 mm Hg. These results showed that BP 120-129/<80, 130-139/80-89, and ≥140/90 mm Hg were associated with a high risk of CVD. Over time, persistent BP ≥130/80 mm Hg increased the risk of CVD, but a return to <130/80 mm Hg from hypertension decreased the risk of CVD.
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Affiliation(s)
- Lei Xu
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Kai Wang
- Department of Neurosurgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Tao Yan
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Lehui Li
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Yu Miao
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Zixuan Tian
- Department of Disease Control and Prevention, the First Hospital of Hohhot, Hohhot, China
| | - Ru Zhang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Ya Wang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Chunfa Zhang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Jinli Yan
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Ning Cao
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Nan Zhang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
| | - Xingguang Zhang
- School of Public Health, Inner Mongolia Medical University, Hohhot, China
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Zhang LN, Lu AX, Lin Y, Li J, Xu X, Yan CH, Zhang L. Association between systemic inflammation markers and blood pressure among children and adolescents: National Health and Nutrition Examination Survey. Pediatr Res 2024:10.1038/s41390-024-03472-1. [PMID: 39154142 DOI: 10.1038/s41390-024-03472-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 06/13/2024] [Accepted: 07/13/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Few studies have estimated the associations of systemic inflammation markers and high blood pressure (HBP) in the pediatric population. METHODS Basing on data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, we assessed the associations between four inflammation-related factors based on blood cell counts: systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and risk for pediatric HBP by estimating odds ratios (ORs) using multivariable logistic regression models. RESULTS A total of 17,936 children aged 8-19 years were included in the analysis, representing about 36.7 million American children. The prevalence rates of elevated blood pressure (EBP) and hypertension (HTN) were 15.79% and 6.77%, respectively. The results showed that the ORs for EBP per standard deviation (SD) increment in SII and NLR were estimated at 1.11 [95% confidence interval (95%CI): 1.04, 1.17] and 1.08 (95%CI: 1.02, 1.15), respectively; and the OR for EBP per SD increment in LMP were estimated at 0.90 (95%CI: 0.83, 0.96). These associations were stronger in boys and younger children. CONCLUSIONS The study suggested that inflammation-related factors could serve as easily accessible early biomarkers for HBP risk prediction and prevention in children and adolescents. IMPACT The study suggested that inflammation-related factors could serve as easily accessible early biomarkers for HBP risk prediction and prevention in children and adolescents. This is the first study that demonstrates the close association between systemic inflammation markers and HBP in children and adolescents using nationally representative population data. The findings have more public health implications and support that systemic inflammation markers based on blood cell counts could serve as easily accessible biomarkers of HBP risk and prevention in earlier identification of the diseases.
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Affiliation(s)
- Li-Na Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - An-Xin Lu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Yin Lin
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jing Li
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xi Xu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Chong-Huai Yan
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
| | - Lin Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
- Department of Labor Health and Environmental Hygiene, School of Public Health, Lanzhou University, Lanzhou, 730000, China.
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Leitão L, Campos Y, Louro H, Figueira ACC, Figueiredo T, Pereira A, Conceição A, Marinho DA, Neiva HP. Detraining and Retraining Effects from a Multicomponent Training Program on the Functional Capacity and Health Profile of Physically Active Prehypertensive Older Women. Healthcare (Basel) 2024; 12:271. [PMID: 38275551 PMCID: PMC10815818 DOI: 10.3390/healthcare12020271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Resuming a physical exercise program after a period of cessation is common in older women. Monitoring the responses during this detraining (DT) and retraining (RT) may allow us to analyze how the body reacts to an increase and a reduction in physical inactivity. Therefore, we conducted a follow-up training, DT, and RT in prehypertensive older women to analyze the response to these periods. METHODS Twenty-three prehypertensive older women (EG; 68.3 ± 2.8 years; 1.61 ± 0.44 m) performed 36 weeks of the multicomponent training program (MTP) followed by twelve weeks of DT plus eight weeks of RT. Fifteen prehypertensive older women (CG; 66.3 ± 3.2 years; 1.59 ± 0.37 m) maintained their normal routine. Functional capacity (FC), lipid, and hemodynamic profile were assessed before, during 24 and 36 weeks of the MTP, after 4 and 12 weeks of DT, and after 8 weeks of RT. RESULTS After 24 weeks of the MTP, only SBP did not improve. Four weeks of DT did not affect lower body strength (30-CS), TC, or GL. Eight weeks of RT improved BP (SBP: -2.52%; ES: 0.36; p < 0.00; DBP: -1.45%; ES: 0.44; p < 0.02), handgrip strength (3.77%; ES: 0.51; p < 0.00), and 30-CS (3.17%; ES: 0.38; p < 0.04) compared with 36 weeks of the MTP. CONCLUSIONS Eight weeks of RT allowed patients to recover the benefits lost with detraining, which after only four weeks affected them negatively, and the systematic practice of exercise contributed to greater regulation of BP since 24 weeks of the MTP proved not to be enough to promote positive effects of SBP.
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Affiliation(s)
- Luís Leitão
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (A.C.C.F.); (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (D.A.M.); (H.P.N.)
| | - Yuri Campos
- Post Graduate Program in Physical Education, Federal University of Juiz de Fora, Juiz de Fora 36036-900, Brazil;
- Study Group and Research in Neuromuscular Responses, Federal University of Lavras, Lavras 37200-900, Brazil
| | - Hugo Louro
- Department of Sport Sciences, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Santarém, Portugal; (H.L.); (A.C.)
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 6201-001 Covilhã, Portugal
| | - Ana Cristina Corrêa Figueira
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (A.C.C.F.); (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Teresa Figueiredo
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (A.C.C.F.); (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Ana Pereira
- Sciences and Technology Department, Superior School of Education of Polytechnic Institute of Setubal, 2910-761 Setúbal, Portugal; (A.C.C.F.); (T.F.); (A.P.)
- Life Quality Research Centre, 2040-413 Rio Maior, Portugal
| | - Ana Conceição
- Department of Sport Sciences, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Santarém, Portugal; (H.L.); (A.C.)
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 6201-001 Covilhã, Portugal
| | - Daniel A. Marinho
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (D.A.M.); (H.P.N.)
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 6201-001 Covilhã, Portugal
| | - Henrique P. Neiva
- Department of Sport Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal; (D.A.M.); (H.P.N.)
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), 6201-001 Covilhã, Portugal
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Endrias EE, Tesfaye Mamito T, Geta Hardido T, Ataro BA. Prevalence of Pre-Hypertension/Hypertension and Its Associated Factors Among Adults in the Wolaita Zone of Southern Ethiopia: A Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241246968. [PMID: 38641978 PMCID: PMC11032063 DOI: 10.1177/00469580241246968] [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: 11/09/2023] [Revised: 02/09/2024] [Accepted: 03/27/2024] [Indexed: 04/21/2024]
Abstract
Preventing the development of high blood pressure and resulting complication requires estimating the prevalence of prehypertension/hypertension and identifying associated risk factors. Information about pre-hypertension/hypertension in Ethiopia, especially in the southern region, is scarce, and limited knowledge exists regarding the prevalence and risk factors associated with pre-hypertension/hypertension. Objective of this study was to assess prevalence of pre-hypertension/hypertension and its associated factors among adults in Wolaita Zone of Southern Ethiopia, 2023. This cross-sectional study was conducted among adults attending outpatient departments in governmental hospitals in South Ethiopia in 2023. Face-to-face interviews were used to gather information on sociodemographic data, dietary and behavioral patterns, and medical history. Digital weighing scales, Stadiometers, and digital sphygmomanometers were used to measure height, blood pressure, and weight, respectively. Epi-Data version 3.1 was used to enter the data before exporting it to SPSS version 25 for analysis. To find factors associated with prehypertension/hypertension, binary logistic regressions were conducted and odds ratios with 95% confidence intervals were computed. The overall prevalence of prehypertension/hypertension was 42.8% (95% confidence interval: 39.56, 49.47). Factors associated with prehypertension/hypertension in this study were older age, male gender, obesity, diabetes mellitus comorbidity, alcohol drinking, and family history of hypertension. Lifestyle modification is demanded for pre-hypertensive/hypertensive patients to prevent progression to severe complications, including premature death and permanent disabilities.
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Zhang J, Jia L, Zhu T, Zhu H, Shu L. The relationship and interaction between triglyceride glucose index and obesity in the risk of prehypertension population: a cross-sectional study from a survey in Anhui, Eastern China. BMC Cardiovasc Disord 2023; 23:336. [PMID: 37393221 PMCID: PMC10314550 DOI: 10.1186/s12872-023-03365-x] [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: 03/28/2023] [Accepted: 06/23/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND The triglyceride glucose (TyG) index has been regarded as an effective proxy of Insulin resistance (IR). Studies on the TyG index, obesity and the risk of prehypertension (PHT) in elderly people are not apparent currently. The study sought to investigate the predictive value of TyG index and the associations with PHT risk and obesity. METHODS A community-based cross-sectional study was conducted in Bengbu City, Anhui province, China. Participants older than 65 years accepted questionnaire surveys, physical examinations and blood biochemistry tests. Based on the testing results, indicators including BMI (body mass index), WC (waist circumference), WHtR (waist-to-height-ratio), LAP(Lipid accumulation products) and TyG were calculated. Residents were classified into quartiles by their TyG indexes. Receiver operating characteristic curve (ROC) analysis was carried out to predict obesity indices for PHT. The three additive interaction indicators, RERI (relative excess risk due to interaction), AP (attributable proportion due to interaction) and S (synergy index) were used to assess the interaction impacts. RESULTS Two thousand six hundred sixty-six eligible elderly people were included in study and the prevalence of PHT was 71.04% (n = 1894). With increasing TyG index quartile, PHT became more prevalent. After adjusting for confounding factors, the prevalence of PHT risk with TyG levels in the fourth quartile (Q4, male: 2.83, 95%CI: 1.77-4.54; female: 2.75, 95%CI:1.91-3.97) was greater than that in the first quartile (Q1:ref). TyG index (AUC: 0.626, 95%CI: 0.602 to 0.650) was superior than BMI (AUC: 0.609, 95%CI: 0.584 to 0.633) in predicting PHT among females. Eventually, there were significant interactions of TyG index with obesity in males (General obesity: AP = 0.87, 95%CI: 0.72 to 1.02, S = 10.48, 95%CI: 3.43 to 31.97; Abdominal obesity: AP = 0.60,95%CI: 0.38 to 0.83, S = 3.53, 95%CI: 1.99 to 6.26) and females (General obesity: AP = 0.89, 95%CI: 0.79 to 0.98, S = 12.46, 95%CI: 5.61 to 27.69; Abdominal obesity: AP = 0.66, 95%CI: 0.51 to 0.82, S = 3.89, 95%CI:2.54 to 5.98). CONCLUSION TyG index and PHT risk are tightly correlated. The risk of chronic disease in the elderly can be decreased by early detection of PHT utilizing the TyG index. In this research, the TyG index was more predictable than other indicators of obesity.
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Affiliation(s)
- Jiaye Zhang
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Linlin Jia
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Tongying Zhu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Hao Zhu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
| | - Li Shu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233030 Anhui Province China
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Mu TY, Zhu QY, Chen LS, Dong D, Xu JY, Xu RX, Shen CZ. Traditional Chinese Medicine constitution types of high-normal blood pressure: A meta-analysis. Heliyon 2023; 9:e13438. [PMID: 36825189 PMCID: PMC9941946 DOI: 10.1016/j.heliyon.2023.e13438] [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: 06/22/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/09/2023] Open
Abstract
Objective We determined the distribution of constitutional types of high-normal blood pressure in Traditional Chinese Medicine (TCM) and provided evidence for the prevention of high-normal blood pressure and hypertension. Methods Eight digital databases were searched from January 2011 to November 2022, including PubMed, EMBASE, Web of Science, EBSCOhost, CNKI, CBM, Wangfang, and CQVIP. We performed a meta-analysis with the random-effects model or fixed-effects model to describe the distribution of constitutional types of high-normal blood pressure in TCM. The studies were assessed based on heterogeneity testing and the potential for publication bias. The meta-analysis was performed on Stata software 15.0. Results A total of 17 studies with 8118 participants were included in this meta-analysis. The proportion of the biased constitution (82.3%; 95% CI: 75.6%-89.1%, p < 0.001) was higher than the balanced constitution (17.3%; 95% CI: 10.7-23.8%, p < 0.001). Phlegm-dampness constitution, Yin-deficiency constitution, and damp-heat constitution accounted for 16.0% (95%CI: 10.5-21.5%, p < 0.001), 14.8% (95% CI: 11.0-18.6%, p < 0.001), 11.3% (95% CI: 8.0-14.5%, p < 0.001) of the total high-normal blood pressure cases, respectively. The subgroup analyses performed that region, age and gender were positively associated with the distribution of constitution types of high-normal blood pressure in TCM. Compared with the general population, the risk of high-normal blood pressure in people with the phlegm-dampness constitution, Yin-deficiency constitution, and blood-stasis constitution was 2.665 (95%CI: 2.286-3.106, p < 0.001), 2.378 (95%CI: 1.197-4.724, p = 0.013), 1.965 (95%CI: 1.634-2.363, p < 0.001) times of the general population, respectively. Meanwhile, the risk of high-normal blood pressure was lower in people with a balanced constitution (0.248, 95%CI: 0.165-0.372, p < 0.001). Conclusions Phlegm-dampness constitution, Yin-deficiency constitution, and damp-heat constitution were the common constitution types of high-normal blood pressure. There might also be differences in the distribution characteristics of TCM constitution among people with high-normal blood pressure in different regions, ages, and genders. Finally, a balanced constitution might be a protective factor for hypertensive people.
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Affiliation(s)
- Ting-yu Mu
- School of Nursing, Zhejiang Chinese Medical University, Zhejiang, China
| | - Qian-yin Zhu
- School of Nursing, Zhejiang Chinese Medical University, Zhejiang, China
| | - Ling-shan Chen
- School of Nursing, Zhejiang Chinese Medical University, Zhejiang, China
| | - Die Dong
- School of Nursing, Zhejiang Chinese Medical University, Zhejiang, China
| | - Jia-yi Xu
- School of Nursing, Zhejiang Chinese Medical University, Zhejiang, China
| | - Ri-xiang Xu
- School of Humanities and Management, Zhejiang Chinese Medical University, Zhejiang, China,Corresponding author.
| | - Cui-zhen Shen
- School of Nursing, Zhejiang Chinese Medical University, Zhejiang, China,Corresponding author.
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Decompression Mechanism of Radish Seed in Prehypertension Rats through Integration of Transcriptomics and Metabolomics Methods. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2023; 2023:2139634. [PMID: 36760467 PMCID: PMC9904934 DOI: 10.1155/2023/2139634] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 10/10/2022] [Accepted: 11/24/2022] [Indexed: 02/04/2023]
Abstract
Radish seed (RS), the dried ripe seed of Raphanus sativus L., is widely used in traditional Chinese medicine (TCM) to reduce blood pressure. However, the molecular and pharmacological mechanisms underlying its therapeutic effects are still unclear. In this study, we analyzed the effects of RS in a rat model of prehypertension and assessed the mechanistic basis by integrating transcriptomics and metabolomics. RS administration significantly reduced blood pressure in prehypertensive male Wistar rats, negatively regulated endothelin-1, increased nitric oxide levels, and reduced the exfoliation of endothelium cells. In vitro vascular ring experiments further confirmed the effects of RS on vascular endothelial cells. Furthermore, we identified 65 differentially expressed genes (DEGs; P adj < 0.05 and fold change (FC) > 2) and 52 metabolites (VIP > 1, P < 0.05 and FC ≥ 2 or ≤0.5) in the RS intervention group using RNA-seq and UPLC-MS/MS, respectively. A network of the DEGs and the metabolites was constructed,q which indicated that RS regulates purine metabolism, linoleic acid metabolism, arachidonic acid metabolism, circadian rhythm, and phosphatidylinositol signaling pathway, and its target genes are Pik3c2a, Hspa8, Dnaja1, Arntl, Ugt1a1, Dbp, Rasd1, and Aldh1a3. Thus, the antihypertensive effects of RS can be attributed to its ability to improve vascular endothelial dysfunction by targeting multiple genes and pathways. Our findings provide new insights into the pathological mechanisms underlying prehypertension, along with novel targets for the prevention and treatment of hypertension.
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Mu T, Xu R, Zhu Q, Chen L, Dong D, Xu J, Shen C. Diet-related knowledge, attitudes, and behaviors among young and middle-aged individuals with high-normal blood pressure: A cross-sectional study in China. Front Public Health 2022; 10:898457. [PMID: 36117602 PMCID: PMC9479537 DOI: 10.3389/fpubh.2022.898457] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/16/2022] [Indexed: 01/22/2023] Open
Abstract
Background Dietary modifications play an important role in the prevention and management of high-normal blood pressure (BP). The aim of this study was to investigate diet-related knowledge, attitudes, and behaviors, and the socio-demographic determinants of these, among young and middle-aged Chinese individuals with high-normal BP. Methods Data from the 2015 China Health and Nutrition Survey (CHNS) were analyzed in this study. A total of 1,756 subjects with high-normal BP were included. A chi-square test and binary logistic regression analysis were conducted to identify the risk factors toward diet-related knowledge, attitudes, and behaviors. Results A total of 37.4% of the participants knew about the Chinese Food Pagoda (CFP) or the Dietary Guidelines for Chinese Residents (DGCR). Overall, 39.8% of the subjects were classified as having adequate diet-related knowledge literacy, 27.8% reported positive diet-related attitudes to healthy eating, and 35.3% reportedly looked for nutrition knowledge. Of note, 72.4% and 80.1% of the participants reported liking to eat fruits and vegetables, respectively. Individuals with a middle school education [odds ratio (OR) = 1.784, 95% CI = 1.236-2.576], high school/vocational education (OR = 1.944, 95% CI = 1.305-2.896), and college degree or above (OR = 2.089, 95% CI = 1.341-3.322), who were living in a rural area (OR = 1.311, 95% CI = 1.048-1.639), proactively looking for nutrition knowledge (OR = 1.529, 95% CI = 1.227-1.906), and reported liking to eat vegetables (OR = 1.939, 95% CI = 1.409-2.688), were more likely to have sufficient dietary knowledge literacy. Managers (OR = 1.655, 95% CI = 1.039-2.635) were more likely to have positive dietary attitudes. Female gender (OR = 1.396, 95% CI = 1.089-1.790), high school/vocational school education (OR = 2.071, 95% CI = 1.269-3.379), college degree and above (OR = 2.207, 95% CI = 1.262-3.862), knowledge about the CFP or DGCR (OR = 8.138, 95% CI = 6.326-10.468), and sufficient dietary knowledge literacy (OR = 1.338, 95% CI = 1.050-1.705) were associated with an increased likelihood of looking for nutrition knowledge. Conclusion Individuals with high-normal BP, predominantly males, living in rural area, with lower education, farmers, workers, service workers, and workers in the non-government employment unit may have poor diet-related knowledge, attitudes, and behaviors.
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Affiliation(s)
- Tingyu Mu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
- School of Nursing, Anhui University of Chinese Medicine, Hefei, China
| | - Rixiang Xu
- School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qianyin Zhu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lingshan Chen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Die Dong
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiayi Xu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
| | - Cuizhen Shen
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China
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Jayanthi R, Girijasivam SP, Gaur A. Association of blood pressure and BMI to corrected QT interval in young adults. Can J Physiol Pharmacol 2021; 99:894-899. [PMID: 33517855 DOI: 10.1139/cjpp-2020-0520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hypertension is often associated with obesity. Uncontrolled hypertension can lead to uncorrected cardiac dysautonomia that makes cardiac repolarization abnormally prolonged. Modern dietary habits, stress, and bad lifestyle habits make young adults vulnerable to hazards of health. We planned to study the association of body mass index (BMI) and blood pressure (BP) with corrected QT (QTc) intervals in young adults. After obtaining the written informed consent, 171 subjects were randomly selected in the age group of 18-35 years. A general history and physical examination were done before recording the BMI and BP. A 12-lead electrocardiogram was recorded and QTc calculated using Bazett's formula. The values obtained were compared and statistical analysis done. Of the 171 subjects 14.03% were hypertensive. The QTc interval was found to be prolonged in females and it is prolonged with age, BMI, and BP. QTc was significantly increased among the prehypertensive and hypertensive group and with the overweight and (or) obese BMI group compared with the normotensives and normal BMI group suggesting an altered autonomic homeostasis. This warrants lifestyle modification at a younger age to reduce the cardiovascular risk.
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Affiliation(s)
- Ramkumar Jayanthi
- Department of Physiology, Chengalpattu Medical College, Chengalpattu, India
| | | | - Archana Gaur
- Department of Physiology, AIIMS Jodhpur, Jodhpur, India
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High-normal blood pressure and related cardiovascular risk factors prevalence in the Romanian adult population: insights from the SEPHAR III study. J Hum Hypertens 2020; 35:884-895. [PMID: 32978496 DOI: 10.1038/s41371-020-00417-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/28/2020] [Accepted: 09/15/2020] [Indexed: 11/08/2022]
Abstract
High normal blood pressure (HNBP) is associated with an increased risk of incident high blood pressure (HBP) and of cardiovascular diseases (CVD). To estimate the prevalence of HNBP and related cardiovascular risk factors, a representative sample of 1970 Romanian adults was enrolled in SEPHAR III survey (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk in Romania). All were evaluated for blood pressure values and by a 71-item questionnaire, anthropometric measurements, together with extensive evaluation for target organ damage, blood, and urine sample collection. Prevalence of HNBP was 11% [45.1% had HBP, 43.9% normal BP (NBP)]. HNBP individuals were older (51.14 ± 17.13 years) than subjects with NBP (40.5 ± 15.96 years) but younger than those with HBP (55.79 ± 15.68 years), p < 0.0001 (95% CI 18-85, respectively 18-91). Values of weight, waist circumference, body mass index, total and LDL cholesterol, triglycerides, fasting blood glucose, glycosylated hemoglobin (HbA1c), uric acid, serum creatinine, glomerular filtration rate estimate by CKD-EPI equation, urinary albumin to creatinine ratio, intimae-media thickness, arterial stiffness measurements and diastolic dysfunction, indexed left ventricular mass, interventricular septum and posterior left ventricle wall thickness, left atrial volume, and LA dilatation were significantly higher in HNBP subjects than in NBP. Our study showed that individuals with HNBP represent ~11% and most of them had an elevated total cardiovascular risk. It is essential to educate the public and health care providers to be aware of these individuals and of steps that should be taken to treat modifiable cardiovascular risk factors.
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Fu J, Liu Y, Zhang L, Zhou L, Li D, Quan H, Zhu L, Hu F, Li X, Meng S, Yan R, Zhao S, Onwuka JU, Yang B, Sun D, Zhao Y. Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension. J Am Heart Assoc 2020; 9:e016804. [PMID: 32975166 PMCID: PMC7792371 DOI: 10.1161/jaha.120.016804] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and pairwise meta‐analyses. It is still unclear which intervention would be most efficacious. Methods and Results Bayesian network meta‐analyses were performed to estimate the comparative effectiveness of different interventions for lowering BP. From 60 166 potentially relevant articles, 120 eligible articles (14 923 participants) with a median follow‐up of 12 weeks, assessing 22 nonpharmacologic interventions, were included. According to the surface under the cumulative ranking probabilities and Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality of evidence, for adults with prehypertension to established hypertension, high‐quality evidence indicated that the Dietary Approach to Stop Hypertension (DASH) was superior to usual care and all other nonpharmacologic interventions in lowering systolic BP (weighted mean difference, 6.97 mm Hg; 95% credible interval, 4.50–9.47) and diastolic BP (weighted mean difference, 3.54 mm Hg; 95% credible interval, 1.80–5.28). Compared with usual care, moderate‐ to high‐quality evidence indicated that aerobic exercise, isometric training, low‐sodium and high‐potassium salt, comprehensive lifestyle modification, breathing‐control, and meditation could lower systolic BP and diastolic BP. For patients with hypertension, moderate‐ to high‐quality evidence suggested that the interventions listed (except comprehensive lifestyle modification) were associated with greater systolic BP and diastolic BP reduction than usual care; salt restriction was also effective in lowering both systolic BP and diastolic BP. Among overweight and obese participants, low‐calorie diet and low‐calorie diet plus exercise could lower more BP than exercise. Conclusions DASH might be the most effective intervention in lowering BP for adults with prehypertension to established hypertension. Aerobic exercise, isometric training, low‐sodium and high‐potassium salt, comprehensive lifestyle modification, salt restriction, breathing‐control, meditation and low‐calorie diet also have obvious effects on BP reduction.
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Affiliation(s)
- Jinming Fu
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Yupeng Liu
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Lei Zhang
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Lu Zhou
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Dapeng Li
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Hude Quan
- Department of Community Health Sciences University of Calgary Alberta Canada
| | - Lin Zhu
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Fulan Hu
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Xia Li
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Shuhan Meng
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Ran Yan
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Suhua Zhao
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Justina Ucheojor Onwuka
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Baofeng Yang
- Department of Pharmacology and the State-Province Key Laboratory of Biomedicine and Pharmaceutics Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Dianjun Sun
- Center for Endemic Disease Control Chinese Center for Disease Control and Prevention Harbin Medical University Harbin Heilongjiang Province P.R. China
| | - Yashuang Zhao
- Department of Epidemiology College of Public Health Harbin Medical University Harbin Heilongjiang Province P.R. China
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12
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Kobalava ZD, Konradi AO, Nedogoda SV, Shlyakhto EV, Arutyunov GP, Baranova EI, Barbarash OL, Boitsov SA, Vavilova TV, Villevalde SV, Galyavich AS, Glezer MG, Grineva EN, Grinstein YI, Drapkina OM, Zhernakova YV, Zvartau NE, Kislyak OA, Koziolova NA, Kosmacheva ED, Kotovskaya YV, Libis RA, Lopatin YM, Nebiridze DV, Nedoshivin AO, Ostroumova OD, Oschepkova EV, Ratova LG, Skibitsky VV, Tkacheva ON, Chazova IE, Chesnikova AI, Chumakova GA, Shalnova SA, Shestakova MV, Yakushin SS, Yanishevsky SN. Arterial hypertension in adults. Clinical guidelines 2020. ACTA ACUST UNITED AC 2020. [DOI: 10.15829/1560-4071-2020-3-3786] [Citation(s) in RCA: 164] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Arterial hypertension in adults. Clinical guidelines 2020
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13
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Ogbutor GU, Nwangwa EK, Uyagu DD. Isometric handgrip exercise training attenuates blood pressure in prehypertensive subjects at 30% maximum voluntary contraction. Niger J Clin Pract 2020; 22:1765-1771. [PMID: 31793486 DOI: 10.4103/njcp.njcp_240_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Prehypertension highlights a category of subjects who are at high risk of developing hypertension. Aim This study assessed the blood pressure attenuating effect of isometric handgrip exercise in the management of prehypertension. Materials and Methods A total of 400 prehypertensive subject with a mean age of 40 ± 10 years and recently diagnosed as prehypertension were recruited for the study. They were randomly distributed into exercise and control groups (n = 200). The control group was placed on lifestyle modification only, while the exercise group performed a 24 consecutive days isometric hand grip exercise training at 30% maximum voluntary contraction (MVC) for 2 min each day in combination with lifestyle modification protocol. Results The results show a statistically significant reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP). The exercise group had a mean reduction of 7.48 ± 0.06 and 6.41 ± 1.01 mmHg of the SBP and DBP, respectively. It was further observed that both the SBP and DBP and pulse rate significantly increased acutely within 5 min post exercise at 30% MVC with a mean value of 8.60 ± 0.20 mmHg, 7.33 ± 0.03 mmHg, and 8.24 ± 0.20 beats/min of the SBP and DBP and pulse rate, respectively. However, this increase returned to pre-exercise value within 10 min post exercises to a mean value of -0.68 + 1.64 mmHg, 1.48 ± 1.02 mmHg, and 3.00 ± 0.11 beats/min, respectively. Conclusion This study has shown that isometric handgrip exercise is effective in the attenuation of blood pressure in prehypertensive subjects especially when combined with the routinely recommended lifestyle modifications. However, caution should be taken when recommending it because of acute increase in blood pressure.
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Affiliation(s)
- G U Ogbutor
- Department of Physiotherapy, Federal Medical Centre, Asaba, Nigeria
| | - E K Nwangwa
- Department of Human Physiology and Family Medicine, College of Health Sciences, Delta State University, Abraka, Delta State, Nigeria
| | - D D Uyagu
- Department of Family Medicine, University of Benin Teaching Hospital, Benin City, Nigeria
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Zhang X, Ge Y, Bukhari AAS, Zhu Q, Shen Y, Li M, Sun H, Su D, Liang X. Estrogen negatively regulates the renal epithelial sodium channel (ENaC) by promoting Derlin-1 expression and AMPK activation. Exp Mol Med 2019; 51:1-12. [PMID: 31113930 PMCID: PMC6529463 DOI: 10.1038/s12276-019-0253-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/28/2019] [Accepted: 02/07/2019] [Indexed: 12/13/2022] Open
Abstract
The main functions of the epithelial sodium channel (ENaC) in the kidney distal nephron are mediation of sodium and water balance and stabilization of blood pressure. Estrogen has important effects on sodium and water balance and on premenopausal blood pressure, but its role in the regulation of ENaC function is not fully understood. Female Sprague–Dawley rats were treated with 17β-estradiol for 6 weeks following bilateral ovariectomy. Plasma estrogen, aldosterone, creatinine, and electrolytes were analyzed, and α-ENaC and derlin-1 protein expression in the kidney was determined by immunohistochemistry and western blotting. The expression levels of α-ENaC, derlin-1, AMPK, and related molecules were also examined by western blotting and real-time PCR in cultured mouse renal collecting duct (mpkCCDc14) epithelial cells following estrogen treatment. Immunofluorescence and coimmunoprecipitation were performed to detect α-ENaC binding with derlin-1 and α-ENaC ubiquitination. The results demonstrated that the loss of estrogen elevated systolic blood pressure in ovariectomized (OVX) rats. OVX rat kidneys showed increased α-ENaC expression but decreased derlin-1 expression. In contrast, estrogen treatment decreased α-ENaC expression but increased derlin-1 expression in mpkCCDc14 cells. Moreover, estrogen induced α-ENaC ubiquitination by promoting the interaction of α-ENaC with derlin-1 and evoked phosphorylation of AMPK in mpkCCDc14 cells. Our study indicates that estrogen reduces ENaC expression and blood pressure in OVX rats through derlin-1 upregulation and AMPK activation. Estrogen treatment could prove valuable in tackling high blood pressure (hypertension) in postmenopausal women. Long-term healthy blood pressure is linked to the correct regulation of sodium and water levels in the kidneys. The renal epithelial sodium channel (ENaC) is a cellular membrane channel responsible for mediating sodium reabsorption and fluid balance. Liang and co-workers at Nanjing Medical University in Nanjing, China, conducted experiments on postmenopausal rat models, and found that loss of estrogen elevates systolic blood pressure (the pressure during heart muscle contraction), and that the rats had high levels of ENaC expression. Further investigations showed that estrogen treatment restored blood pressure to normal levels by promoting two key proteins involved in cellular membrane health and energy metabolism. This in turn reinstated normal levels of ENaC breakdown in the kidneys, limiting hypertension.
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Affiliation(s)
- Xue Zhang
- Department of Pathophysiology, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Yamei Ge
- Department of Pathophysiology, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | | | - Qian Zhu
- Department of Pathophysiology, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Yachen Shen
- Department of Pathophysiology, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Min Li
- Department of Pathophysiology, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Hui Sun
- Department of Pathophysiology, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Dongming Su
- Center of Pathology and Clinical Laboratory, Sir Run Run Hospital, Department of Pathology, Nanjing Medical University, Nanjing, Jiangsu Province, China.,State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Xiubin Liang
- Department of Pathophysiology, Nanjing Medical University, Nanjing, Jiangsu Province, China. .,State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, Jiangsu Province, China.
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Owiredu EW, Dontoh E, Essuman SES, Bazanfara BB. Demographic and Lifestyle Predictors of Prehypertension: A Cross-Sectional Study among Apparently Healthy Adults in Kumasi, Ghana. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1764079. [PMID: 31179316 PMCID: PMC6507075 DOI: 10.1155/2019/1764079] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 03/26/2019] [Accepted: 04/16/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Prehypertension has been shown to increase future risk of hypertension. Some demographic and lifestyle characteristics have been implicated to increase the risk of development of prehypertension. Yet, there is paucity of data on the current prevalence of prehypertension and its associated risk factors in Ghana. This study evaluated the prevalence of prehypertension and examined the demographic and lifestyle characteristics associated with prehypertension among apparently healthy Ghanaian adults in Kumasi. METHODS This was a cross-sectional study conducted from March to April, 2018, in Kumasi, Ghana. A total of 204 participants (80 males, 124 females, 25 years and above) who reported not diagnosed of hypertension and not on any antihypertensive medication were included in the study. Validated questionnaire was used to obtain sociodemographic and lifestyle characteristics of study participants. Height and weight of each respondent were measured and their corresponding Body Mass Index (BMI) was calculated. Blood pressure (BP) was measured with an automated blood pressure apparatus from the right arm. Prehypertension was defined as systolic BP of 120-139 mmHg and/or diastolic BP of 80-89 mmHg. RESULTS Out of 204 participants, the prevalence of prehypertension was 49.0%. From multivariate logistic regression models, having lower level of education [aOR=2.74, 95% CI (1.15-6.55), p=0.02], not practicing at least 30 min daily walks [aOR=2.59, 95% CI (1.31-5.10), p=0.01], not exercising routinely [aOR=1.93, 95% CI (0.97-3.85), p=0.04], and alcohol consumption [aOR=3.58(1.52-8.46), p=0.004] were independently associated with higher odds of prehypertension. CONCLUSION The prevalence of prehypertension is high among apparently healthy Ghanaian adults (49.0%). Lower educational level, sedentary lifestyle, and alcohol consumption are the predominant risk factors for prehypertension in Kumasi.
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Affiliation(s)
- Eddie-Williams Owiredu
- Department of Medical Laboratory Technology, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ebenezer Dontoh
- Department of Medical Laboratory Technology, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Selma E. S. Essuman
- Department of Nursing, Faculty of Allied Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Heo BM, Ryu KH. Prediction of Prehypertenison and Hypertension Based on Anthropometry, Blood Parameters, and Spirometry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2571. [PMID: 30453592 PMCID: PMC6265931 DOI: 10.3390/ijerph15112571] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/08/2018] [Accepted: 11/14/2018] [Indexed: 01/01/2023]
Abstract
Hypertension and prehypertension are risk factors for cardiovascular diseases. However, the associations of both prehypertension and hypertension with anthropometry, blood parameters, and spirometry have not been investigated. The purpose of this study was to identify the risk factors for prehypertension and hypertension in middle-aged Korean adults and to study prediction models of prehypertension and hypertension combined with anthropometry, blood parameters, and spirometry. Binary logistic regression analysis was performed to assess the statistical significance of prehypertension and hypertension, and prediction models were developed using logistic regression, naïve Bayes, and decision trees. Among all risk factors for prehypertension, body mass index (BMI) was identified as the best indicator in both men [odds ratio (OR) = 1.429, 95% confidence interval (CI) = 1.304⁻1.462)] and women (OR = 1.428, 95% CI = 1.204⁻1.453). In contrast, among all risk factors for hypertension, BMI (OR = 1.993, 95% CI = 1.818⁻2.186) was found to be the best indicator in men, whereas the waist-to-height ratio (OR = 2.071, 95% CI = 1.884⁻2.276) was the best indicator in women. In the prehypertension prediction model, men exhibited an area under the receiver operating characteristic curve (AUC) of 0.635, and women exhibited a predictive power with an AUC of 0.777. In the hypertension prediction model, men exhibited an AUC of 0.700, and women exhibited an AUC of 0.845. This study proposes various risk factors for prehypertension and hypertension, and our findings can be used as a large-scale screening tool for controlling and managing hypertension.
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Affiliation(s)
- Byeong Mun Heo
- Database/Bioinformatics Laboratory, Chungbuk National University, Cheongju 28644, Korea.
| | - Keun Ho Ryu
- Faculty of Information Technology, Ton Duc Thang University, Hochiminh City 700000, Vietnam.
- Department of Computer Science, Chungbuk National University, Cheongju 28644, Korea.
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Ramirez LA, Sullivan JC. Sex Differences in Hypertension: Where We Have Been and Where We Are Going. Am J Hypertens 2018; 31:1247-1254. [PMID: 30299518 DOI: 10.1093/ajh/hpy148] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 10/04/2018] [Indexed: 12/25/2022] Open
Abstract
While it has been known since the 1940s that men have greater increases in blood pressure (BP) compared with women, there have been intense efforts more recently to increase awareness that women are also at risk for developing hypertension and that cardiovascular diseases (CVDs) are the leading causes of death among both men and women in the United States. With the release of the 2017 Hypertension Clinical Guidelines, 46% of adults in the United States are now classified as hypertensive, and hypertension is the primary modifiable risk factor for the development of CVD. This increase in the prevalence of hypertension is reflected in an increase in prevalence among both men and women across all demographics, although there were greater increases in the prevalence of hypertension among men compared with women. As a result, the well-established gender difference in the prevalence of hypertension is even more pronounced and now extends into the sixth decade of life. The goals of this review are to (i) review the historical clinical trial data and hypertension guidelines from the perspective of both genders and then (ii) review the role of the renin-angiotensin system and T-cell activation in contributing to sex differences in BP control.
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2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens 2018; 36:1953-2041. [PMID: 30234752 DOI: 10.1097/hjh.0000000000001940] [Citation(s) in RCA: 1809] [Impact Index Per Article: 301.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
: Document reviewers: Guy De Backer (ESC Review Co-ordinator) (Belgium), Anthony M. Heagerty (ESH Review Co-ordinator) (UK), Stefan Agewall (Norway), Murielle Bochud (Switzerland), Claudio Borghi (Italy), Pierre Boutouyrie (France), Jana Brguljan (Slovenia), Héctor Bueno (Spain), Enrico G. Caiani (Italy), Bo Carlberg (Sweden), Neil Chapman (UK), Renata Cifkova (Czech Republic), John G. F. Cleland (UK), Jean-Philippe Collet (France), Ioan Mircea Coman (Romania), Peter W. de Leeuw (The Netherlands), Victoria Delgado (The Netherlands), Paul Dendale (Belgium), Hans-Christoph Diener (Germany), Maria Dorobantu (Romania), Robert Fagard (Belgium), Csaba Farsang (Hungary), Marc Ferrini (France), Ian M. Graham (Ireland), Guido Grassi (Italy), Hermann Haller (Germany), F. D. Richard Hobbs (UK), Bojan Jelakovic (Croatia), Catriona Jennings (UK), Hugo A. Katus (Germany), Abraham A. Kroon (The Netherlands), Christophe Leclercq (France), Dragan Lovic (Serbia), Empar Lurbe (Spain), Athanasios J. Manolis (Greece), Theresa A. McDonagh (UK), Franz Messerli (Switzerland), Maria Lorenza Muiesan (Italy), Uwe Nixdorff (Germany), Michael Hecht Olsen (Denmark), Gianfranco Parati (Italy), Joep Perk (Sweden), Massimo Francesco Piepoli (Italy), Jorge Polonia (Portugal), Piotr Ponikowski (Poland), Dimitrios J. Richter (Greece), Stefano F. Rimoldi (Switzerland), Marco Roffi (Switzerland), Naveed Sattar (UK), Petar M. Seferovic (Serbia), Iain A. Simpson (UK), Miguel Sousa-Uva (Portugal), Alice V. Stanton (Ireland), Philippe van de Borne (Belgium), Panos Vardas (Greece), Massimo Volpe (Italy), Sven Wassmann (Germany), Stephan Windecker (Switzerland), Jose Luis Zamorano (Spain).The disclosure forms of all experts involved in the development of these Guidelines are available on the ESC website www.escardio.org/guidelines.
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Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; 39:3021-3104. [PMID: 30165516 DOI: 10.1093/eurheartj/ehy339] [Citation(s) in RCA: 5688] [Impact Index Per Article: 948.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Determination of the Best Anthropometric Index of Obesity for Prediction of Prehypertension and Hypertension in a Large Population - Based - Study; the Azar- Cohort. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.59911] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Effects of anti-hypertensive treatment on major cardiovascular events in populations within prehypertensive levels: a systematic review and meta-analysis. J Hum Hypertens 2018; 32:94-104. [PMID: 29317741 DOI: 10.1038/s41371-017-0026-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/07/2017] [Accepted: 11/16/2017] [Indexed: 02/06/2023]
Abstract
Uncertainties still remain in terms of the efficacy of anti-hypertensive treatment on the risk of major cardiovascular (CV) events within prehypertensive levels. This review aims to assess the efficacy and safety of anti-hypertensives on the CV risks in populations within prehypertensive levels. Randomized controlled trials (RCTs) concerning active treatment vs placebo in populations within prehypertensive levels were identified through electronic database and manual search. Outcomes included the first co-primary outcomes, stroke, heart failure (HF), myocardial infarction (MI), all-cause mortality, and cardiovascular mortality. The first co-primary outcomes were defined as composite cardiovascular disease (CVD) events in the included studies. A total of 29 RCTs involving 127,641 participants were identified. Pooled analysis showed active treatment was associated with a significant 7% reduction in risk of the first co-primary outcomes, 14% in stroke, and 10% in HF as compared to placebo (0.86, 0.77-0.96; 0.93, 0.89-0.98; and 0.90, 0.83-0.97). However, there were no significant reductions in risk of MI, all-cause mortality, and cardiovascular mortality. A significant reduction in risk of the first co-primary outcomes was observed in subpopulations with systolic blood pressure (SBP) 130-139 mmHg (0.94, 0.89-0.99) or prior CVDs (0.88, 0.82-0.94). Meta-regression analyses showed no significant relative risk reductions proportional to the magnitude of the mean baseline BP, mean on-treatment BP, the mean absolute change in BP, the proportion of patients with hypertension, and mean age. In summary, anti-hypertensive treatment has beneficial cardiovascular effects in populations within prehypertensive levels, especially in subpopulations with SBP 130-139 mmHg or prior CVDs.
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Efficacy of a mobile hypertension prevention delivery platform with human coaching. J Hum Hypertens 2017; 31:795-800. [PMID: 28972573 DOI: 10.1038/jhh.2017.69] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 07/03/2017] [Accepted: 07/25/2017] [Indexed: 01/06/2023]
Abstract
This pilot study evaluated the efficacy of a Hypertension Prevention Program (HPP) administered through a mobile application platform with human coaching (app) on reduction in blood pressure and weight in 50 adults with prehypertension or hypertension. Participants were recruited into a 24-week mobile application intervention to administer the HPP between January 2016 and July 2016. Dietary elements of the programme were based on the Dietary Approaches to Stop Hypertension. The programme included in-app human coaching with bi-weekly phone calls, meal logging, blood pressure tracking and educational material. Main outcome variables included change in systolic and diastolic blood pressure, hypertension category, and weight loss. Data were analysed between October 2016 and December 2016. The HPP yielded overall improvements in weight (-3.04±4.04 kg, P=<0.001), diastolic blood pressure (-5.06±11.89 mm Hg, P=0.004), and hypertension category (-0.48±0.74 mm Hg, P=<0.001). Sustained engagement of 80% resulted in significant reductions in systolic blood pressure (-7.75±12.56, P=<0.001) and weight (-3.73±4.01 kg, P<0.001) for programme completers, contributing to hypertension category change (-0.58±0.64 mm Hg, P<0.001). Mobile delivery of a lifestyle intervention for hypertension prevention showed short-term potential to reduce risk of hypertension, supporting the need for longer studies to investigate the use of mHealth lifestyle modification to reduce the risk of hypertension, a public health priority.
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The T > A (rs11646213) gene polymorphism of cadherin-13 ( CDH13 ) gene is associated with decreased risk of developing hypertension in Mexican population. Immunobiology 2017; 222:973-978. [DOI: 10.1016/j.imbio.2016.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 07/26/2016] [Accepted: 09/07/2016] [Indexed: 12/26/2022]
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Zhang R, Deng R, Shen P, Fan M, Leng B, Zhou Y, Cui Y, Li G. Prehypertension and socioeconomic status: A cross-sectional study in Chongqing, China. Clin Exp Hypertens 2017; 39:774-780. [PMID: 28692313 DOI: 10.1080/10641963.2017.1334794] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND A large amount of research is available on the relationship between socioeconomic status (SES) and hypertension. However, the relationship between SES and prehypertension remains complex and unclear. Prehypertension is defined as a systolic blood pressure (SBP) between 120 and 139 mmHg or diastolic blood pressure (DBP) 80 and 89 mmHg. This paper focuses on the impact of SES on the prevalence of prehypertension and provides suggestions for the prevention and control measures of prehypertension and health resource allocation. METHOD Using multistage random sampling, 11,773 subjects were selected. Subjects aged above 15 years old and subjects who had been living in the eight selected districts for more than 6 months were analyzed using a multivariable logistical model. RESULTS The prevalence of prehypertension at the present time reaches 55.17%, with it being higher among men than that among women (63.15% vs. 47.19%, p < 0.05). After adjustment for other factors such as age and gender, a logistic regression showed that a higher education level and a history of marital status were significantly associated with prehypertension. CONCLUSIONS People of different SES indicate different working and living conditions. They also face different risk factors for prehypertension. Lower education and a history of marital status were associated with a higher risk of prehypertension among residents in Chongqing, China.
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Affiliation(s)
- Rui Zhang
- a School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health , Chongqing Medical University , Chongqing , China
| | - Runze Deng
- a School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health , Chongqing Medical University , Chongqing , China
| | - Pengyu Shen
- a School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health , Chongqing Medical University , Chongqing , China
| | - Mingyue Fan
- a School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health , Chongqing Medical University , Chongqing , China
| | - Bing Leng
- b School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health , Chongqing Medical University , Chengdu , China
| | - Yujia Zhou
- a School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health , Chongqing Medical University , Chongqing , China
| | - Yadeng Cui
- a School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health , Chongqing Medical University , Chongqing , China
| | - Ge Li
- a School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health , Chongqing Medical University , Chongqing , China
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Booth JN, Li J, Zhang L, Chen L, Muntner P, Egan B. Trends in Prehypertension and Hypertension Risk Factors in US Adults: 1999-2012. Hypertension 2017; 70:275-284. [PMID: 28607131 DOI: 10.1161/hypertensionaha.116.09004] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 01/16/2017] [Accepted: 05/04/2017] [Indexed: 11/16/2022]
Abstract
Prehypertension is associated with increased risk for hypertension and cardiovascular disease. Data are limited on the temporal changes in the prevalence of prehypertension and risk factors for hypertension and cardiovascular disease among US adults with prehypertension. We analyzed data from 30 958 US adults ≥20 years of age who participated in the National Health and Nutrition Examination Surveys between 1999 and 2012. Using the mean of 3 blood pressure (BP) measurements from a study examination, prehypertension was defined as systolic BP of 120 to 139 mm Hg and diastolic BP <90 mm Hg or diastolic BP of 80 to 89 mm Hg and systolic BP <140 mm Hg among participants not taking antihypertensive medication. Between 1999-2000 and 2011-2012, the percentage of US adults with prehypertension decreased from 31.2% to 28.2% (P trend=0.007). During this time period, the prevalence of several risk factors for cardiovascular disease and incident hypertension increased among US adults with prehypertension, including prediabetes (9.6% to 21.6%), diabetes mellitus (6.0% to 8.5%), overweight (33.5% to 37.3%), and obesity (30.6% to 35.2%). There was a nonstatistically significant increase in no weekly leisure-time physical activity (40.0% to 43.9%). Also, the prevalence of adhering to the Dietary Approaches to Stop Hypertension eating pattern decreased (18.4% to 11.9%). In contrast, there was a nonstatistically significant decline in current smoking (25.9% to 23.2%). In conclusion, the prevalence of prehypertension has decreased modestly since 1999-2000. Population-level approaches directed at adults with prehypertension are needed to improve risk factors to prevent hypertension and cardiovascular disease.
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Affiliation(s)
- John N Booth
- From the Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Department of Mathematics, College of Charleston, SC (J.L.); Department of Public Health Sciences, Clemson University, SC (L.Z., L.C.); and Care Coordination Institute, University of South Carolina School of Medicine Greenville, Greenville Health System, SC (B.E.).
| | - Jiexiang Li
- From the Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Department of Mathematics, College of Charleston, SC (J.L.); Department of Public Health Sciences, Clemson University, SC (L.Z., L.C.); and Care Coordination Institute, University of South Carolina School of Medicine Greenville, Greenville Health System, SC (B.E.)
| | - Lu Zhang
- From the Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Department of Mathematics, College of Charleston, SC (J.L.); Department of Public Health Sciences, Clemson University, SC (L.Z., L.C.); and Care Coordination Institute, University of South Carolina School of Medicine Greenville, Greenville Health System, SC (B.E.)
| | - Liwei Chen
- From the Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Department of Mathematics, College of Charleston, SC (J.L.); Department of Public Health Sciences, Clemson University, SC (L.Z., L.C.); and Care Coordination Institute, University of South Carolina School of Medicine Greenville, Greenville Health System, SC (B.E.)
| | - Paul Muntner
- From the Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Department of Mathematics, College of Charleston, SC (J.L.); Department of Public Health Sciences, Clemson University, SC (L.Z., L.C.); and Care Coordination Institute, University of South Carolina School of Medicine Greenville, Greenville Health System, SC (B.E.)
| | - Brent Egan
- From the Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Department of Mathematics, College of Charleston, SC (J.L.); Department of Public Health Sciences, Clemson University, SC (L.Z., L.C.); and Care Coordination Institute, University of South Carolina School of Medicine Greenville, Greenville Health System, SC (B.E.)
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26
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Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017; 135:e146-e603. [PMID: 28122885 PMCID: PMC5408160 DOI: 10.1161/cir.0000000000000485] [Citation(s) in RCA: 6094] [Impact Index Per Article: 870.6] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Tabrizi JS, Sadeghi-Bazargani H, Farahbakhsh M, Nikniaz L, Nikniaz Z. Prevalence and Associated Factors of Prehypertension and Hypertension in Iranian Population: The Lifestyle Promotion Project (LPP). PLoS One 2016; 11:e0165264. [PMID: 27783691 PMCID: PMC5082665 DOI: 10.1371/journal.pone.0165264] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 10/07/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND This population-based study aimed at investigating the prevalence and associated factors of prehypertension/hypertension in Iran. METHODS AND FINDINGS The data (n = 2818) for this study were collected in 2015 as a part of the major Lifestyle Promotion Project (LPP) conducted in East Azerbaijan (urban and regional parts). The data for socio-demographic status, dietary information, and physical activity and anxiety levels were collected through validated questionnaires. Then, physical examination including systolic and diastolic blood pressure (SBP, DBP), body mass index (BMI) and conicity index was performed. First-morning spot urine (SU) sample was collected to assume salt intake. The One-way ANOVA, logistic regression, chi-square test and independent t-test were used for statistical analysis. The prevalence of prehypertension, stage I and stage II hypertension, and overall hypertension was 47.3%, 13.6%, 5.45% and 22.6% respectively. The mean systolic (p = 0.004) and diastolic (p<0.001) blood pressure in men were significantly higher than women. Results of logistic regression analysis showed that in both sexes, family history of hypertension, obesity, abdominal obesity, anxiety and having high levels of sodium intake were associated with high blood pressure (p< 0.05). Additionally, 45.8% of the hypertensive patients were aware of their disease, 10.0% of the aware patients, and 44.5% of everyone with high blood pressure were receiving antihypertensive medication. CONCLUSIONS Our data showed that prehypertension/hypertension is a major health problem in Iran. Focusing on identifying risk factors to hypertension, regular drug intake, good nutrition, physical activity, and changing lifestyles of patients with hypertension are essential.
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Affiliation(s)
- Jafar Sadegh Tabrizi
- Tabriz Health services management research center, Faculty of management and medical informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Homayoun Sadeghi-Bazargani
- Road and Traffic Injury Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mostafa Farahbakhsh
- Research center of psychiatry and behavioral sciences, Tabriz University of medical sciences, Tabriz, Iran
| | - Leila Nikniaz
- Tabriz Health services management research center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Nikniaz
- Liver and gastrointestinal disease research center, Tabriz University of Medical Sciences, Tabriz, Iran
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Derakhshan A, Bagherzadeh-Khiabani F, Arshi B, Ramezankhani A, Azizi F, Hadaegh F. Different Combinations of Glucose Tolerance and Blood Pressure Status and Incident Diabetes, Hypertension, and Chronic Kidney Disease. J Am Heart Assoc 2016; 5:JAHA.116.003917. [PMID: 27543801 PMCID: PMC5015306 DOI: 10.1161/jaha.116.003917] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background The impact of different combinations of glucose tolerance and blood pressure status on the development of type 2 diabetes mellitus (T2DM), hypertension (HTN), and chronic kidney disease (CKD) still needs to be investigated. Methods and Results A total of 12 808 Iranian adults aged ≥20 years were included in 3 separate analyses to investigate incidence of T2DM, HTN, and CKD. Multivariate Cox proportional hazard models were used to calculate hazard ratios (95% CI). During a median follow‐up of >10 years, the overall incidence rate for T2DM, HTN, and CKD was 12.2, 29.8, and 24.8 per 1000 person‐years. For incident T2DM, considering normal glucose tolerance/normal blood pressure as reference, prediabetes (PreDM)/HTN had the highest risk (hazard ratio: 7.22 [5.71–9.12]) while PreDM/normal blood pressure also showed a significant risk (5.58 [4.41–7.05]). Furthermore, risk of PreDM/HTN was higher than PreDM/normal blood pressure (P<0.05). For incident HTN, normal glucose tolerance/prehypertension was a strong predictor (3.28 [2.91–3.69]); however, addition of PreDM or T2DM did not increase the risk. For incident CKD, every category that included HTN and/or T2DM showed significant risk; this risk was marginally significant for the PreDM/HTN group (1.19 [0.98–1.43], P=0.06). In addition, PreDM/ normal blood pressure was a marginally significant risk factor for incident HTN while normal glucose tolerance/prehypertension was a significant predictor of T2DM. Conclusions Presence of HTN was associated with increased risk of T2DM among the PreDM population; however, dysglycemia did not increase the risk of HTN among individuals with prehypertension. For incident CKD, intensive management of HTN and T2DM, rather than their predisease states, should be considered.
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Affiliation(s)
- Arash Derakhshan
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Bagherzadeh-Khiabani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Banafsheh Arshi
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Pre-hypertension, pre-diabetes or both: which is best at predicting cardiovascular events in the long term? J Hum Hypertens 2016; 31:382-387. [PMID: 27334522 DOI: 10.1038/jhh.2016.42] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/16/2016] [Accepted: 05/17/2016] [Indexed: 12/30/2022]
Abstract
The present study aimed to assess the value of pre-diabetes and pre-hypertension in predicting cardiovascular events. A population-based, cross-sectional survey was conducted, representing a large sample of the general Iranian population aged 35 years and older from the Isfahan Province and determined using a random, multistage cluster-sampling 10-year cohort. The five end points considered as study outcome were unstable angina (UA), acute occurrence of myocardial infarction (MI), sudden cardiac death (SCD), brain stroke and cardiovascular disease (CVD). Of the 6323 subjects scheduled for assessment of diabetes state 617 were diabetics and 712 were pre-diabetic. In addition, of these subjects, 1754 had hypertension and 2500 had pre-hypertension. Analysing only pre-hypertension, pre-diabetes and its combination and adjusted for gender and age variables, pre-hypertension and pre-diabetes status together, could only effectively predict occurrence of MI (hazard ratio (HR)=3.21, 95% confidence interval (CI): 1.06-9.76, P=0.04). In the same COX regression models, pre-hypertension status could predict UA and CVD occurrence (HR=2.94, 95% CI: 1.68-5.14, P<0.001 and HR=1.74, 95% CI: 1.23-2.47, P=0.002, respectively). However, pre-diabetes status could not predict any of these events after adjustment for gender and age. Our data provide valuable evidence of the triggering role of pre-hypertension and pre-diabetes together, on appearance and progression of MI even in healthy individuals and the significant predicting value of pre-hypertension on the occurrence of UA and CVD. In this regard, the value of pre-hypertension and pre-diabetes together, and the pre-hypertension state alone, are clearly superior to pre-diabetes state alone in predicting cardiovascular events.
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Faramawi MF, Delongchamp R, Said Q, Balamurugan A, Hassan A, Abouelenien S, Ismaeil M. High-normal blood pressure is associated with visit-to-visit blood pressure variability in the US adults. Blood Press 2016; 26:18-23. [DOI: 10.1080/08037051.2016.1182855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Mohammed F. Faramawi
- Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Public Health, National Liver Institute, Menoufiya University, Menoufiya, Egypt
| | - Robert Delongchamp
- Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Qayyim Said
- Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Appathurai Balamurugan
- Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Arkansas Department of Health, Little Rock, AR, USA
| | - Alaa Hassan
- Department of Public Health, Beni Suif University, Beni Suif, Egypt
| | - Saly Abouelenien
- Clinical and Translational Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Mohamed Ismaeil
- Department of Anesthesiology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Santos ABS, Gupta DK, Bello NA, Gori M, Claggett B, Fuchs FD, Shah AM, Coresh J, Sharrett AR, Cheng S, Solomon SD. Prehypertension is Associated With Abnormalities of Cardiac Structure and Function in the Atherosclerosis Risk in Communities Study. Am J Hypertens 2016; 29:568-74. [PMID: 26350299 DOI: 10.1093/ajh/hpv156] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 08/13/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Prehypertension (blood pressure (BP) of 120-139 mm Hg systolic and/or 80-89 mm Hg diastolic) is highly prevalent and is associated with increased cardiovascular risk. Our goal was to investigate the extent to which prehypertension is associated with end-organ alterations in cardiac structure and function in a large biracial cohort of older men and women. METHODS We studied 4,871 participants of the Atherosclerosis Risk in Communities (ARIC) study who attended visit 5 (2011-2013) and underwent two-dimensional echocardiography while free of prevalent coronary heart disease or heart failure. We categorized participants into 3 groups: optimal BP (BP <120 mm Hg and <80 mm Hg) (n = 402), prehypertension (n = 537), and hypertension (n = 3,932). RESULTS Individuals with prehypertension (75±5 years) had higher left ventricular (LV) mass index and wall thickness, and higher prevalence of abnormal LV geometry than those with optimal BP (74±5 years), but lower than those with frank hypertension (76±5 years). In addition, participants with prehypertension had impairment of diastolic parameters (E/A, E' and E/E'), and had higher prevalence of mild and moderate-severe diastolic dysfunction compared to those with optimal BP, but no differences in systolic parameters. These differences in cardiac structure and function remained significant after adjusting for important clinical covariates. CONCLUSION In the ARIC cohort at visit 5, prehypertension was associated with increased LV remodeling and impaired diastolic function, but not systolic function, suggesting that even mildly elevated BP within the normal range is associated with cardiac end-organ damage.
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Affiliation(s)
- Angela B S Santos
- Brigham and Women's Hospital, Boston, Massachusetts, USA; Cardiology Division, Universidade Federal of Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Deepak K Gupta
- Brigham and Women's Hospital, Boston, Massachusetts, USA; Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Natalie A Bello
- Brigham and Women's Hospital, Boston, Massachusetts, USA; Columbia University Medical Center, Brooklyn, New York, USA
| | - Mauro Gori
- Brigham and Women's Hospital, Boston, Massachusetts, USA; Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (MG)
| | - Brian Claggett
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Flavio D Fuchs
- Cardiology Division, Universidade Federal of Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Amil M Shah
- Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Josef Coresh
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - A Richey Sharrett
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Susan Cheng
- Brigham and Women's Hospital, Boston, Massachusetts, USA
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Guo X, Zheng L, Zhang X, Zou L, Li J, Sun Z, Hu J, Sun Y. The prevalence and heterogeneity of prehypertension: a meta-analysis and meta-regression of published literature worldwide. Cardiovasc J Afr 2016; 23:44-50. [PMID: 22331252 PMCID: PMC3721861 DOI: 10.5830/cvja-2011-058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 09/15/2011] [Indexed: 01/15/2023] Open
Abstract
Objective Prehypertension appears to be a precursor of hypertension and has been recognised as a major risk factor for cardiovascular disease (CVD). Recognition of prehypertension provides important opportunities for preventing hypertension and CVD. We aimed to investigate the world-wide prevalence and heterogeneity of prehypertension. Methods We performed a meta-analysis of cross-sectional studies worldwide that reported the prevalence of prehypertension. We searched for publications between January 1966 and November 2010, using PubMed, Ovid and the Cochrane Library, with the keyword ‘prehypertension’, supplemented by a manual search of references from recent reviews and relevant published original studies. Pooled prevalence of prehypertension was calculated using random-effects models. Heterogeneity was investigated by subgroup analysis and meta-regression. Twenty-two articles met our inclusion criteria, with a total sample of 242 322 individuals. Results The overall pooled prevalence of prehypertension was 38%. Significant heterogeneity across estimates of prevalence was observed (p = 0.000, I2 = 99.9%). The prevalence rose as the sample size increased, and was higher among men than women (41 vs 34%). The non-Asian population was more likely to be prehypertensive than Asian individuals (42 vs 36%). A high prevalence of 47% was observed among the black African population in the non-Asian subgroup. The inception year of the surveys was the only source of heterogeneity we found by meta-regressional analysis (p = 0.06). Conclusion These results indicate that the prevalence of prehypertension was relatively high, particularly among males. Although more attention has been paid to this segment of the population since 2003, additional practical and reasonable steps should be taken to prevent and treat prehypertension.
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Affiliation(s)
- X Guo
- Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
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Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Isasi CR, Jiménez MC, Judd SE, Kissela BM, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Magid DJ, McGuire DK, Mohler ER, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Rosamond W, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Woo D, Yeh RW, Turner MB. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2015; 133:e38-360. [PMID: 26673558 DOI: 10.1161/cir.0000000000000350] [Citation(s) in RCA: 3739] [Impact Index Per Article: 415.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Jiménez MC, Rexrode KM, Glynn RJ, Ridker PM, Gaziano JM, Sesso HD. Association Between High-Sensitivity C-Reactive Protein and Total Stroke by Hypertensive Status Among Men. J Am Heart Assoc 2015; 4:e002073. [PMID: 26391131 PMCID: PMC4599494 DOI: 10.1161/jaha.115.002073] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND High-sensitivity C-reactive protein (hsCRP), a marker of systemic inflammation, may promote atherosclerosis, particularly among adults with elevated blood pressure; however, data are sparse. We examined the association between hsCRP concentrations and risk of total stroke by hypertension status (normotension, prehypertension, and hypertension) among men in the Physicians' Health Study (PHS). METHODS AND RESULTS Blood samples were collected (1996-1997) and assayed for hsCRP among 10 456 initially healthy men from PHS I and PHS II and followed from 1997 to 2012. Self-reported hypertension status, cardiovascular risk factors, lifestyle, and alcohol consumption were obtained from the baseline questionnaire prior to randomization in PHS II. Strokes were updated approximately annually and confirmed by medical records according to the National Survey of Stroke criteria. Multivariable Cox models were used. We observed 395 incident total strokes over 115 791 person-years. In analyses adjusted for potential confounders and stroke risk factors, clinically elevated hsCRP (>3 mg/L) was associated with a 40% significantly greater hazard of total stroke compared with hsCRP <1 mg/L (hazard ratio 1.40, 95% CI 1.06 to 1.87; Ptrend=0.01). Additional adjustment for blood pressure and biomarkers associated with cardiovascular risk marginally attenuated the estimates. Results were similar by hypertension status, although not statistically significant among normotensive and prehypertensive participants due to limited events. CONCLUSIONS Elevated hsCRP levels were associated with a greater risk of total stroke, even after adjustment for potential confounders and cardiovascular risk factors. Risk of total stroke was significantly higher among hypertensive men with elevated hsCRP compared with normotensive men with low hsCRP.
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Affiliation(s)
- Monik C Jiménez
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.C.J., K.M.R., R.J.G., P.R., M.G., H.D.S.)
| | - Kathryn M Rexrode
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.C.J., K.M.R., R.J.G., P.R., M.G., H.D.S.)
| | - Robert J Glynn
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.C.J., K.M.R., R.J.G., P.R., M.G., H.D.S.) Department of Biostatistics, Harvard School of Public Health, Boston, MA (R.J.G.)
| | - Paul M Ridker
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.C.J., K.M.R., R.J.G., P.R., M.G., H.D.S.)
| | - J Michael Gaziano
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.C.J., K.M.R., R.J.G., P.R., M.G., H.D.S.) Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA (M.G., H.D.S.)
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.C.J., K.M.R., R.J.G., P.R., M.G., H.D.S.) Department of Epidemiology, Harvard School of Public Health, Boston, MA (H.D.S.) Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA (M.G., H.D.S.)
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Kwaśniewska M, Kozińska J, Dziankowska-Zaborszczyk E, Kostka T, Jegier A, Rębowska E, Orczykowska M, Leszczyńska J, Drygas W. The impact of long-term changes in metabolic status on cardiovascular biomarkers and microvascular endothelial function in middle-aged men: a 25-year prospective study. Diabetol Metab Syndr 2015; 7:81. [PMID: 26388952 PMCID: PMC4573488 DOI: 10.1186/s13098-015-0074-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 09/07/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The aim of this analysis was to examine long-term effects of changes in metabolic status on microvascular endothelial function and cardiovascular diseases (CVD) biomarkers among physically active middle-aged men. METHODS Metabolically healthy men (n = 101, mean age 59.7 years), free of symptoms and treatment, have been prospectively observed for their lifestyle and CVD risk factors (observation period 24.7 years). At the latest follow-up (2011/2012) a set of CVD biomarkers was measured using enzyme-linked immunosorbent assay. Microvascular endothelial function was evaluated by means of the reactive hyperemia index (RHI) using Endo-PAT2000 system. At follow-up the participants were divided into metabolically healthy (0-1 metabolic parameters) and metabolically unhealthy (≥2 metabolic parameters) groups. Metabolic syndrome was defined according to the NCEP ATP III definition. RESULTS Traditional metabolic risk factors were significantly associated with hsCRP, ox-LDL, Il-6, leptin and adiponectin/leptin ratio. Reactive hyperemia index was negatively related to body mass (p < 0.01), waist circumference (p < 0.05), triglycerides (p < 0.01), TG/HDL ratio (p < 0.01), uric acid (p < 0.05), sICAM-1 (p < 0.05) and Il-6 (p < 0.05), and positively to HDL-C (p < 0.01) and leisure-time physical activity (p < 0.01). Men who maintained metabolically healthy status (n = 47) through the observation had significantly lower hsCRP and uric acid (p < 0.05), higher adiponectin/leptin ratio (p < 0.05), higher mean RHI and lower prevalence of endothelial dysfunction (p < 0.05) as compared to the metabolically unhealthy group (n = 54). Regular physical activity level was significantly higher among metabolically healthy individuals during the whole observation. CONCLUSIONS Even subtle changes in metabolic profile influence inflammatory biomarkers and microvascular endothelial function. Leptin, adiponectin/leptin ratio and hsCRP are significant predictors of metabolic profile. Interleukine-6 and sICAM-1 may be used as indicators of early endothelial dysfunction in asymptomatic men. High leisure-time physical activity level is an important contributor of metabolically healthy profile through middle adulthood.
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Affiliation(s)
- Magdalena Kwaśniewska
- />Department of Preventive Medicine, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland
| | - Joanna Kozińska
- />Department of Preventive Medicine, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland
| | | | - Tomasz Kostka
- />Department of Geriatrics, Medical University of Lodz, Zeromskiego 113, Lodz, Poland
| | - Anna Jegier
- />Department of Sports Medicine, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
| | - Ewa Rębowska
- />Department of Preventive Medicine, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland
| | - Milena Orczykowska
- />Central Clinical Hospital, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
| | - Joanna Leszczyńska
- />Department of Sports Medicine, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland
| | - Wojciech Drygas
- />Department of Preventive Medicine, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland
- />Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Institute of Cardiology, Niemodlinska 33, 04-635 Warsaw, Poland
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Prehypertension prior to or during early pregnancy is associated with increased risk for hypertensive disorders in pregnancy and gestational diabetes. J Hypertens 2015; 33:1860-7; discussion 1867. [DOI: 10.1097/hjh.0000000000000646] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Ribeiro EF, de Fátima Reis C, de Carvalho FS, Abreu JPS, Arruda AF, Garrote CFD, Rocha ML. Diuretic effects and urinary electrolyte excretion induced by Aspidosperma subincanum Mart. and the involvement of prostaglandins in such effects. JOURNAL OF ETHNOPHARMACOLOGY 2015; 163:142-148. [PMID: 25625354 DOI: 10.1016/j.jep.2015.01.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/14/2015] [Accepted: 01/19/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Aspidosperma subincanum Mart. is a medicinal herb known for its diuretic properties and used for the treatment of cardiovascular-related illnesses. Although our earlier study has shown that the ethanol extract of Aspidosperma subincanum (EEAS) induces hypotension and vasodilation, no scientific data have been recorded to evaluate the diuretic effects of this Brazilian medicinal plant. The aim of this study was to evaluate the diuretic activity of EEAS, and possible mechanism of action, using Wistar rats. MATERIAL AND METHODS EEAS (60 and 120mg/kg), furosemide (20mg/kg) or saline (control) were orally administered to rats individually held in metabolic cages for urine collection 1, 2, 4, 6, 8, 12 and 24h after treatment. In order to evaluate the involvement of prostaglandins in the diuretic action of EEAS, the animals received piroxicam (5mg/kgi.p.), a nonselective inhibitor of cyclooxygenase, before treatment with EEAS at 120mg/kg. The control groups received only saline (NaCl, 0.9%), or saline and piroxicam. Urinary volume, electrolyte excretion and pH were measured. RESULTS Oral administration of EEAS 60 and 120mg/kg significantly increased diuresis and electrolyte excretion of Na(+) and K(+) on a continuous basis throughout the study period. Both EEAS 60 and 120mg/kg caused a relative increase of around 77% and 142%, respectively, in cumulative diuresis compared with the control group. From 4th hour until the end of the experiment, the group treated with EEAS 120mg/kg provided a greater excretion of Na(+) than the furosemide group. The diuretic effects of EEAS were neutralized by piroxicam between 4 and 8h after treatment. CONCLUSION The results suggest that EEAS could present compound(s) responsible for diuretic activities, and the mechanism could involve the prostaglandin system.
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Affiliation(s)
- Emmeline Flor Ribeiro
- Faculty of Pharmacy, Federal University of Goias, Avenida Universitária s/n, 74605-220 Goiânia, GO, Brazil
| | - Carolina de Fátima Reis
- Faculty of Pharmacy, Federal University of Goias, Avenida Universitária s/n, 74605-220 Goiânia, GO, Brazil
| | - Flávio Silva de Carvalho
- Institute of Chemistry, Federal University of Goias, Campus Samambaia, Caixa Postal 131, 74001-970 Goiânia, GO, Brazil
| | - João Pedro Silva Abreu
- Institute of Chemistry, Federal University of Goias, Campus Samambaia, Caixa Postal 131, 74001-970 Goiânia, GO, Brazil
| | - Andréa Fernandes Arruda
- Institute of Chemistry, Federal University of Goias, Campus Samambaia, Caixa Postal 131, 74001-970 Goiânia, GO, Brazil
| | | | - Matheus Lavorenti Rocha
- Faculty of Pharmacy, Federal University of Goias, Avenida Universitária s/n, 74605-220 Goiânia, GO, Brazil.
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Liang X, Xing W, He J, Fu F, Zhang W, Su F, Liu F, Ji L, Gao F, Su H, Sun X, Zhang H. Magnolol administration in normotensive young spontaneously hypertensive rats postpones the development of hypertension: role of increased PPAR gamma, reduced TRB3 and resultant alleviative vascular insulin resistance. PLoS One 2015; 10:e0120366. [PMID: 25793876 PMCID: PMC4367990 DOI: 10.1371/journal.pone.0120366] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 01/20/2015] [Indexed: 01/04/2023] Open
Abstract
Patients with prehypertension are more likely to progress to manifest hypertension than those with optimal or normal blood pressure. However, the mechanisms underlying the development from prehypertension to hypertension still remain largely elusive and the drugs for antihypertensive treatment in prehypertension are absent. Here we determined the effects of magnolol (MAG) on blood pressure and aortic vasodilatation to insulin, and investigated the underlying mechanisms. Four-week-old male spontaneous hypertensive rats (SHR) and age-matched normotensive Wistar-Kyoto (WKY) control rats were used. Our results shown that treatment of young SHRs with MAG (100 mg/kg/day, o.g.) for 3 weeks decreased blood pressure, improved insulin-induced aorta vasodilation, restored Akt and eNOS activation stimulated by insulin, and increased PPARγ and decreased TRB3 expressions. In cultured human umbilical vein endothelial cells (HUVECs), MAG incubation increased PPARγ, decreased TRB3 expressions, and restored insulin-induced phosphorylated Akt and eNOS levels and NO production, which was blocked by both PPARγ antagonist and siRNA targeting PPARγ. Improved insulin signaling in HUVECs by MAG was abolished by upregulating TRB3 expression. In conclusion, treatment of young SHRs with MAG beginning at the prehypertensive stage decreases blood pressure via improving vascular insulin resistance that is at least partly attributable to upregulated PPARγ, downregulated TRB3 and consequently increased Akt and eNOS activations in blood vessels in SHRs.
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Affiliation(s)
- Xiangyan Liang
- Experiment Teaching Center, Fourth Military Medical University, Xi'an, China
| | - Wenjuan Xing
- Department of Physiology, Fourth Military Medical University, Xi'an, China
| | - Jinxiao He
- Department of Pediatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Feng Fu
- Department of Physiology, Fourth Military Medical University, Xi'an, China
| | - Wei Zhang
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Feifei Su
- Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Fange Liu
- Experiment Teaching Center, Fourth Military Medical University, Xi'an, China
| | - Lele Ji
- Experiment Teaching Center, Fourth Military Medical University, Xi'an, China
| | - Feng Gao
- Department of Physiology, Fourth Military Medical University, Xi'an, China
| | - Hui Su
- Department of Geratology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- * E-mail: (HZ); (XS); (HS)
| | - Xin Sun
- Department of Pediatrics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- * E-mail: (HZ); (XS); (HS)
| | - Haifeng Zhang
- Experiment Teaching Center, Fourth Military Medical University, Xi'an, China
- * E-mail: (HZ); (XS); (HS)
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Sodium Intake and Blood Pressure: New Controversies, New Labels . . . New Guidelines? J Acad Nutr Diet 2015; 115:200-204. [DOI: 10.1016/j.jand.2014.10.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/19/2014] [Indexed: 11/19/2022]
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Fernandes RA, Zanesco A. Early sport practice is related to lower prevalence of cardiovascular and metabolic outcomes in adults independently of overweight and current physical activity. Medicina (B Aires) 2015; 51:336-42. [DOI: 10.1016/j.medici.2015.10.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 10/22/2015] [Indexed: 01/21/2023] Open
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Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Judd SE, Kissela BM, Lackland DT, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Matchar DB, McGuire DK, Mohler ER, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Willey JZ, Woo D, Yeh RW, Turner MB. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation 2014; 131:e29-322. [PMID: 25520374 DOI: 10.1161/cir.0000000000000152] [Citation(s) in RCA: 4464] [Impact Index Per Article: 446.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2014; 31:1281-357. [PMID: 23817082 DOI: 10.1097/01.hjh.0000431740.32696.cc] [Citation(s) in RCA: 3284] [Impact Index Per Article: 328.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Judd SE, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Mackey RH, Magid DJ, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, Neumar RW, Nichol G, Pandey DK, Paynter NP, Reeves MJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Wong ND, Woo D, Turner MB. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation 2014; 129:e28-e292. [PMID: 24352519 PMCID: PMC5408159 DOI: 10.1161/01.cir.0000441139.02102.80] [Citation(s) in RCA: 3534] [Impact Index Per Article: 353.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Differential effects of antihypertensive treatments on apoptosis, oxidative stress, and expression of angiotensin receptors in the cerebral cortex from the onset of prehypertension and hypertension in stroke-prone spontaneous hypertensive rats. Neuroreport 2013; 24:911-7. [DOI: 10.1097/wnr.0000000000000019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bhagatwala J, Harris RA, Parikh SJ, Zhu H, Huang Y, Kotak I, Seigler N, Pierce GL, Egan BM, Dong Y. Epithelial Sodium Channel Inhibition by Amiloride on Blood Pressure and Cardiovascular Disease Risk in Young Prehypertensives. J Clin Hypertens (Greenwich) 2013; 16:47-53. [DOI: 10.1111/jch.12218] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 09/06/2013] [Accepted: 09/15/2013] [Indexed: 02/05/2023]
Affiliation(s)
- Jigar Bhagatwala
- Georgia Prevention Center; Medical College of Georgia; Georgia Regents University; Augusta GA
- Department of Internal Medicine; Medical College of Georgia; Georgia Regents University; Augusta GA
| | - Ryan A. Harris
- Georgia Prevention Center; Medical College of Georgia; Georgia Regents University; Augusta GA
| | - Samip J. Parikh
- Georgia Prevention Center; Medical College of Georgia; Georgia Regents University; Augusta GA
- Department of Internal Medicine; Medical College of Georgia; Georgia Regents University; Augusta GA
| | - Haidong Zhu
- Georgia Prevention Center; Medical College of Georgia; Georgia Regents University; Augusta GA
| | - Ying Huang
- Georgia Prevention Center; Medical College of Georgia; Georgia Regents University; Augusta GA
| | - Ishita Kotak
- Georgia Prevention Center; Medical College of Georgia; Georgia Regents University; Augusta GA
| | - Nichole Seigler
- Georgia Prevention Center; Medical College of Georgia; Georgia Regents University; Augusta GA
| | - Gary L. Pierce
- Georgia Prevention Center; Medical College of Georgia; Georgia Regents University; Augusta GA
| | - Brent M. Egan
- General Medicine Division; Department of Medicine; Medical University of South Carolina; Charleston SC
| | - Yanbin Dong
- Georgia Prevention Center; Medical College of Georgia; Georgia Regents University; Augusta GA
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Chiang PPC, Lamoureux EL, Shankar A, Tai ES, Wong TY, Sabanayagam C. Cardio-metabolic risk factors and prehypertension in persons without diabetes, hypertension, and cardiovascular disease. BMC Public Health 2013; 13:730. [PMID: 23919264 PMCID: PMC3751051 DOI: 10.1186/1471-2458-13-730] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 07/26/2013] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND Prehypertension has been shown to be an early risk factor of cardiovascular disease (CVD). We investigated the prevalence and pattern of cardiometabolic risk factors in prehypertension in three ethnic Asian populations in Singapore. METHODS We examined data from Chinese (n=1177), Malay (n=774), and Indian (n=985) adults aged 40-80 years who participated in three independent population based studies conducted from 2004-2011 in Singapore who were free of diabetes, hypertension and previous CVD. Prehypertension was defined as systolic blood pressure (BP) 120-139 mm Hg or diastolic BP 80-89 mm Hg. Random blood glucose, glycated haemoglobin (HbA1c), body mass index (BMI), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol were examined as indicators of adverse cardiometabolic profile. The association between metabolic variables and prehypertension was examined using logistic regression models adjusting for potential confounders. RESULTS The prevalence of prehypertension was 59.8% (Chinese), 68.9% (Malays) and 57.7% Indians. Higher levels of blood glucose, HbA1c and BMI were significantly associated with prehypertension in all three ethnic groups, odds ratio (95% confidence interval) of prehypertension in Chinese, Malays and Indians were: 1.42 (1.10, 1.83), 1.53 (1.05, 2.24), 1.49 (1.13, 1.98) for high-glucose; 3.50 (1.01, 12.18), 3.72 (1.29, 10.75), 2.79 (1.31, 5.94) for high-HbA1c; 1.86 (1.34, 2.56), 2.96 (2.10, 4.18), 1.68 (1.28, 2.20) for high-BMI. In addition, higher levels of LDL cholesterol in Chinese and higher levels of triglycerides were significantly associated with prehypertension. These associations persisted when metabolic variables were analysed as continuous variables. CONCLUSIONS Higher levels of blood glucose, HbA1c and BMI were associated with prehypertension in all three ethnic groups in Singapore. Screening for prehypertension and lifestyle modifications could potentially reduce the burden of CVD in otherwise healthy Asian adults living in Singapore.
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Affiliation(s)
| | | | | | | | | | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Level 6, 11 Third Hospital Avenue, Singapore 168751, Singapore.
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Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F, Redon J, Dominiczak A, Narkiewicz K, Nilsson PM, Burnier M, Viigimaa M, Ambrosioni E, Caufield M, Coca A, Olsen MH, Schmieder RE, Tsioufis C, van de Borne P, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, Clement DL, Coca A, Gillebert TC, Tendera M, Rosei EA, Ambrosioni E, Anker SD, Bauersachs J, Hitij JB, Caulfield M, De Buyzere M, De Geest S, Derumeaux GA, Erdine S, Farsang C, Funck-Brentano C, Gerc V, Germano G, Gielen S, Haller H, Hoes AW, Jordan J, Kahan T, Komajda M, Lovic D, Mahrholdt H, Olsen MH, Ostergren J, Parati G, Perk J, Polonia J, Popescu BA, Reiner Z, Rydén L, Sirenko Y, Stanton A, Struijker-Boudier H, Tsioufis C, van de Borne P, Vlachopoulos C, Volpe M, Wood DA. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34:2159-219. [PMID: 23771844 DOI: 10.1093/eurheartj/eht151] [Citation(s) in RCA: 3168] [Impact Index Per Article: 288.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Giuseppe Mancia
- Centro di Fisiologia Clinica e Ipertensione, Università Milano-Bicocca, Milano, Italy.
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Prehypertension is not associated with all-cause mortality: a systematic review and meta-analysis of prospective studies. PLoS One 2013; 8:e61796. [PMID: 23634212 PMCID: PMC3636247 DOI: 10.1371/journal.pone.0061796] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Accepted: 03/13/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Quantitative associations between prehypertension or its two separate blood pressure (BP) ranges and cardiovascular disease (CVD) or all-cause mortality have not been reliably documented. In this study, we performed a comprehensive systematic review and meta-analysis to assess these relationships from prospective cohort studies. METHODS We conducted a comprehensive search of PubMed (1966-June 2012) and the Cochrane Library (1988-June 2012) without language restrictions. This was supplemented by review of the references in the included studies and relevant reviews identified in the search. Prospective studies were included if they reported multivariate-adjusted relative risks (RRs) and corresponding 95% confidence intervals (CIs) of CVD or all-cause mortality with respect to prehypertension or its two BP ranges (low range: 120-129/80-84 mmHg; high range: 130-139/85-89 mmHg) at baseline. Pooled RRs were estimated using a random-effects model or a fixed-effects model depending on the between-study heterogeneity. RESULTS Thirteen studies met our inclusion criteria, with 870,678 participants. Prehypertension was not associated with an increased risk of all-cause mortality either in the whole prehypertension group (RR: 1.03; 95% CI: 0.91 to 1.15, P = 0.667) or in its two separate BP ranges (low-range: RR: 0.91; 95% CI: 0.81 to 1.02, P = 0.107; high range: RR: 1.00; 95% CI: 0.95 to 1.06, P = 0.951). Prehypertension was significantly associated with a greater risk of CVD mortality (RR: 1.32; 95% CI: 1.16 to 1.50, P<0.001). When analyzed separately by two BP ranges, only high range prehypertension was related to an increased risk of CVD mortality (low-range: RR: 1.10; 95% CI: 0.92 to 1.30, P = 0.287; high range: RR: 1.26; 95% CI: 1.13 to 1.41, P<0.001). CONCLUSIONS From the best available prospective data, prehypertension was not associated with all-cause mortality. More high quality cohort studies stratified by BP range are needed.
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Cardiovascular events increased at normal and high-normal blood pressure in young and middle-aged Japanese male smokers but not in nonsmokers. J Hypertens 2013; 31:263-70. [DOI: 10.1097/hjh.0b013e32835b8d22] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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